Weekly View

August 11, 2023

Good morning, everyone.

Recently, we hosted a public meeting on gene therapies for sickle cell disease. Some of you may be wondering – why does ICER even hold public meetings?

ICER’s goal is to create a public process of determining what a “fair” price would be for a new drug – with the patient perspective serving as the guiding structure. Throughout our process, we share an ongoing dialogue about what matters to patients and what evidence is available. At the public meeting, patients help the appraisal committee hear first-hand about the true burden of their disease, what health outcomes matter most to them, if a treatment has any benefits and disadvantages that may not have been adequately captured in a clinical trial, and the broader context policymakers should consider when evaluating the fairness of a price.

All of the tensions inherent to the U.S. health system -- unaffordable pricing, fears about insurers limiting patient access, clinical trials that don't measure the outcomes that matter most to patients, and the need to incentivize R&D for truly transformative therapies are discussed in this public forum.

While often uncomfortable and never easy, this public process sure beats the alternative of having manufacturers and insurers make consequential decisions about drug pricing and access behind closed doors -- without an independent view of the evidence, and without patients in the room.        

If you missed our July 27th sickle cell disease public meeting, watch the recordings here:

Let's see what happened this week...

ICER in the News

Wegovy cardiovascular study has doctors seeing new possibilities in weight loss drug


Novo Nordisk announced that its semaglutide drug, Wegovy, cut the risk of cardiovascular disease by 20% in its large SELECT trial. STAT spoke with ICER’s Chief Medical Officer, David Rind about our obesity management report, which included Wegovy:

“[David Rind] said that he had already been prescribing semaglutide drugs for weight loss under the assumption there were also cardiovascular benefits. To see Novo’s results is ‘really exciting,’ he said. 'People really want these drugs,’ Rind said. ‘They work. We haven’t really had something before that worked.’


Once Novo releases detailed results from its trial, ICER may increase its fair price, given the larger cardiovascular event reduction. ICER suggests a cost-effective range for a drug, but Rind encourages manufacturers to come in below that. They’ll still make a ton of money, and they’ll be able to treat many more people, he said. Drugs like Wegovy are going to have a huge impact on the budgets of the employers and insurers that cover them, Rind said.

‘The costs are enormous,’ he said. ‘Anybody who decides they’re covering these drugs is going to have to figure out where the money is coming from. That means shifting it away from other things they’re doing or raising premiums, and that’s a big deal.’”

ICER’s 2022 obesity management Final Evidence Report included subcutaneous semaglutide (Wegovy, Novo Nordisk), liraglutide (Saxenda, Novo Nordisk), phentermine/topiramate (Qsymia, Vivus Pharmaceuticals), and bupropion/naltrexone (Contrave, Currax Pharma). We found that semaglutide used for weight loss would achieve common thresholds for cost-effectiveness if priced between $7,500 – $9,800 per year. The current annual estimated net price is over $13,000.

New data from the SELECT trial are likely to be presented soon at a conference, with a peer-reviewed article appearing concurrently or soon thereafter. We will be updating our cost-effectiveness results and health benefit price benchmarks when the data are available in more detail.

Pharmaceutical News


Drug price increases layered over decades: AARP analysis shows how list prices can rise by more than 700%

Endpoints News

A new AARP analysis released Thursday shows how list prices for the 25 top Medicare Part D drugs increased by an average of 226% since they first entered the market, making the need clear for the upcoming government drug price negotiations and ongoing inflation-related rebates, the retirees’ group said.

The findings from the report, which author and AARP drug policy principal Leigh Purvis said “serves as a wake-up call,” shows how all but one of the top 25 drugs’ lifetime price increases greatly exceeded the rate of inflation.

Major US health systems expect to offer Alzheimer's drug Leqembi in a few months


Five major U.S. health systems said they would offer Eisai and Biogen's new Alzheimer's drug Leqembi after working out payment and administrative policies, and how to assess and monitor patients, most likely in the next month or two.

Earlier this year, we released our Final Evidence Report assessing the comparative clinical effectiveness and value of Leqembi. ICER analyses suggested the treatment would achieve common thresholds for cost-effectiveness if priced between $8,900 – $21,500 per year. Leqembi's list price is $26,500 per year.

A Revolution Is Coming to Medicine. Who Will It Leave Out?

The New York Times

Dr. James Tabery, a professor at the University of Utah, penned an op-ed for the New York Times on personalized medicine. He stated:

“There is thus an inherent tension at the heart of personalized medicine. It purports to both tailor health care and drive down costs, but the more it succeeds at individualization, the higher go the prices. Patients, as a result, can now face an agonizing decision: forgo treatment or suffer financial ruin.” 

More drugmakers are filing continuation patents that sideline generic competition


Amid concerns that the pharmaceutical industry unfairly wins monopolies on medicines, a new analysis finds there has been a whopping 200% increase in patents filed by companies that made few substantive changes to their drugs during a 15-year period.

Pharmaceutical companies often file what are known as continuation patents to extend their window to block lower-cost generic competitors from reaching the market. But critics argue such patents can amount to inconsequential tweaks, which bolster bottom lines, but force the U.S. health care system to pay higher prices for medicines for extended periods.

Majority of Medicare Advantage enrollees don't fully understand their plan

Fierce Healthcare

Most Medicare Advantage (MA) beneficiaries are satisfied with their health plan, but many enrollees feel they are overbilled, have struggled navigating the prior authorization process or are confused by the features of their plan, a new survey from Retirement Living recently revealed.


Join ICER!

Want to work for a fast-paced, mission-driven organization? Look no further! ICER is looking to expand our team, which includes a diverse set of clinicians, researchers, and policy experts.

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ICER Analytics

ICER Analytics revolutionizes your ability to plan drug development, establish drug pricing, negotiate drug reimbursement, and explore new ways to apply evidence in a drive toward a health system that can achieve fair prices and fair access for all. ICER Analytics is comprised of two tools:


  • The ICER Evidence Compendium™: leverage a rapidly searchable and sortable summary of results from ICER’s library of evidence reports.

  • The ICER Interactive Modeler™: analyze key aspects of over 35 economic models produced for ICER evidence reports, and update parameter inputs based on your own prices, your own data on patient characteristics, or your own assumptions about drug performance and uptake.


Email [email protected] for more information or to get started on a free 30-day trial of ICER Analytics. 

Key Upcoming Dates
  • 8/21: Sickle Cell Disease -- Final Evidence Report

  • 9/14: Metachromatic Leukodystrophy -- Revised Evidence Report

  • 9/25: Pulmonary Arterial Hypertension -- Draft Evidence Report

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