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BOSTON, September 8, 2025 – The Institute for Clinical and Economic Review (ICER) today posted its revised Evidence Report assessing the comparative clinical effectiveness and value of brensocatib (Brinsupri™, Insmed Incorporated) for the treatment of non-cystic fibrosis bronchiectasis (NCFB).
“NCFB is an incredibly burdensome condition with impacts that go well beyond its respiratory effects and include social, emotional, and productivity challenges,” said ICER’s Chief Scientific Officer and Director of Health Technology Assessment Methods and Engagement, Dan Ollendorf, PhD, MPH. “ICER’s analyses found that brensocatib, the first medication to be specifically indicated for NCFB, reduces the rate of pulmonary exacerbations and may also somewhat slow the rate of deterioration in lung function. Despite these benefits, however, we found that brensocatib’s expected discounted price was far out of alignment with the modest clinical improvements demonstrated in clinical studies. Pricing policy that balances innovation signals while addressing affordability and value will be an important topic at the public meeting.”
This Evidence Report will be reviewed at a virtual public meeting of the CTAF on September 25, 2025. The CTAF is one of ICER’s three independent evidence appraisal committees comprising medical evidence experts, practicing clinicians, methodologists, and leaders in patient engagement and advocacy.
Register here to watch the live webcast of the virtual meeting.
A draft version of this report was previously open for a four-week public comment period. The updated Evidence Report and voting questions reflect changes made based on comments received from patient groups, clinicians, drug manufacturers, and other stakeholders. Detailed responses to public comments can be found here.
Key Clinical Findings
When compared with usual care, ICER assigned a rating of B+ for brensocatib plus usual care (“moderate certainty of a small or substantial net health benefit, with high certainty of at least a comparable net health benefit”). According to current evidence, brensocatib improves overall health outcomes within the trial population, however some important uncertainties remain.
Within the trial population, there was no therapeutic benefit in subgroups of individuals with more severe symptoms and worse lung function. And, although patients have said that they would welcome the reduction in exacerbations observed in the overall population, they have concerns about daily symptoms outside of exacerbations, including fatigue, as well as burdens and side effects of current therapies.
Key Cost-Effectiveness Findings
Brensocatib has been approved by the FDA for NCFB and the manufacturers announced a price of $88,000 per year, as well as an expectation that they will offer discounts of 25-35% from the list price. ICER has integrated both the list price and expected discount levels in its analysis, and calculated a health benefit price benchmark (HBPB) of between $3,100 and $3,700 per year.
ICER’s HBPB is a price range suggesting the highest US price a manufacturer should charge for a treatment, net of all rebates and discounts, based on the amount of improvement in overall health patients receive from that treatment, when a higher price would cause disproportionately greater losses in health among other patients in the health system due to rising overall costs of health care and health insurance. In short, it is the top price range at which a health system can reward innovation and better health for patients without doing more harm than good.
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