Hello, everyone, and welcome to this edition of Excelsior Solutions’ ICER Update. Here is this week’s ICER recap:
ICER published its revised Evidence Report assessing the comparative clinical effectiveness and value of esketamine (Spravato), Janssen’s nasal spray approved by the FDA in March as a therapy for treatment-resistant depression (TRD). Esketamine is one of the two mirror-image molecules (enantiomers) that make up ketamine, an anesthetic that is commonly used off-label to treat TRD. The Midwest CEPAC will deliberate on the overall value of esketamine during a May 23 public meeting.
EXCELSIOR ACTION POINT: In an unfortunate and all-too-often repeat of its findings, ICER found that although Spravato provides clinical benefits to patients suffering with TRD, its current pricing exceeds a reasonable cost-benefit threshold.
Specifically, ICER found that, “…In the absence of long-term safety data, the evidence provides moderate certainty that esketamine, when taken with a background antidepressant, achieves a comparable, small, or substantial net health benefit, but the evidence is inadequate to completely exclude the possibility that harms may exceed benefits. Given the lack of head-to-head trials and differences in study design, the evidence was insufficient to judge the net health benefit of esketamine versus ketamine, electroconvulsive therapy, transcranial magnetic stimulation, oral antidepressants, or augmentation with antipsychotics.”
Plans should consider and weigh both the clinical and economic findings as they contemplate coverage rules for Spravato.
If you would like to discuss these ICER initiatives, 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 time!
Bob Kordella, RPh, MBA