ICER Update 04.15.2019

Hello, everyone, and welcome to this edition of Excelsior Solutions’ ICER Update.

Here is this week’s ICER recap:

  1. This week ICER released a draft evidence report assessing the clinical effectiveness and value of Viaskin Peanut and AR101, two new technologies for inducing immune tolerance to peanuts. ICER is now accepting public comment through May 8, and the feedback ICER receives may be reflected in their revised Evidence Report.

    EXCELSIOR ACTION POINT: While this category may seem to be one not worthy of attention in light of everything else that is on our plates, the sheer prevalence of peanut allergy in the population, estimated by ICER at between 130,000 to 250,000 children per year (see Section 7.2 of Draft Evidence Report for methods), argues for paying attention to both the clinical and economic features of these two pipeline products.

  2. ICER published the draft scope of its assessment of treatments for rheumatoid arthritis. In addition to incorporating data that has emerged since their 2017 assessment of this therapy class, ICER will be evaluating upadacitinib, which is currently under FDA review, as well as the approved biosimilar Inflectra. ICER is accepting public comment on this draft scope through May 1.

    EXCELSIOR ACTION POINT: As many of the new treatments for RA that have been approved by the FDA since 2017 have the potential to deliver better clinical outcomes at lower costs than some of the older biologic products that have been available for nearly 20 years, this re-assessment is particularly timely, especially since two products in particular – Humira and Enbrel – combine to be at or very near the top of most Plans’ most expensive pharmacy benefit drugs. As always, we encourage you to avail yourselves of the opportunity to share your insight and experiences with ICER through their public commenting procedure.

  3. ICER initiated a new assessment on therapies to treat Type 2 diabetes. They will be comparing oral semaglutide to Victoza, Jardiance, Januvia, and potentially the sulfonylurea class of drugs. ICER is accepting public input through April 29.

    EXCELSIOR ACTION POINT: Much of the focus being given to diabetes these days specifically concerns insulin, but the non-insulin treatments for Type 2 diabetes are equally worthy of some focused attention from ICER, particularly in the absence, in most instances, of generic versions of these drugs. This assessment is as equally timely and relevant as is the RA assessment described above. To reiterate, we encourage you to avail yourselves of the opportunity to share your insight and experiences with ICER through their public commenting procedure.

If you would like to discuss these ICER activities, or any other aspects of your Pharmacy Benefit Plan, simply reach out to your Excelsior Solutions account team and we will be happy to quickly set up a call.

Until next week!

Bob has more than 30 years of diverse experience in the pharmacy industry. Over the course of his career, Bob has led clinical and PBM operations teams in successfully managing more than $4 billion in annual drug spend. This was also while limiting per-member-per-year spending growth to levels that have simultaneously drawn industry acclaim and consistently high levels of member and payer satisfaction.

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