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From ICER’s President and CEO, Sarah K. Emond, MPP:
Let’s take a moment to reflect on the tremendous innovation coming from the pharmaceutical industry. Last week, a treatment for spinal muscular atrophy (SMA), Isembyld, was approved. Just a few weeks ago, we saw another milestone in the treatment of pancreatic cancer with the approval of Rasonque. The pharmaceutical scientists diligently working to alleviate suffering for patients are not slowing down, despite the critical conversations we are having about drug prices. For that, we should be grateful.
Unfortunately, pricing overreach by drug makers isn’t slowing down, either. When ICER reviewed Isembyld, we gave it a “promising, but inconclusive” rating. According to the evidence, short-term benefits were small, long-term benefits were unknown, and the rate of serious adverse events was high. ICER’s recommended price for the drug, incorporating all that uncertainty about patient-centered benefit, went up to about $30,000 per year. This week the manufacturer picked an annual net price of around $310,000, over ten times higher than ICER’s recommended price.
Every time a company prices a drug above its value, we are harming unseen patients in our health care system as insurers then raise premiums, patients ration or skip medications, and employers reduce health care coverage. The evidence on affordability is stark.
Every stakeholder has a role to play in creating a more affordable and equitable health care system. Payers, PBMs, hospitals, and employers all have opportunities to do better. But the pharmaceutical industry has more opportunities than most. They have the power to pick the price that the rest of the system must take. Until the pharmaceutical industry starts making different pricing decisions, we can expect to see more access and affordability problems for patients, and more employers dropping coverage. The time for urgent action is now. Pharmaceuticals must be priced in line with value to ensure affordability for everyone.
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