States struggle with escalating prescription drug costs; payers increasingly demand pharmacoeconomic analysis and many refer to the Institute for Clinical and Economic Review (ICER) for cost effectiveness analysis. Free Market Pioneer Institute commissioned a recent study, titled “Key Questions for Legislators on the Institute of the Clinical and Economic Review (ICER)” to outline ethical, methodological and disease-specific questions pricing decision makers should consider prior to signing up with ICER. The Pioneer Institute’s recent study results convey that ICER’s review methodology could adversely impact the elderly, those that are disabled as well as cancer patients, and others with rare diseases. According to the Pioneer Institute report, ICER bases analysis on the Quality Adjusted Life Years (QALYs), a debated evaluation method that assigns economic value to the longevity and quality of human life. Author William Smith notes “U.S. politicians may want to proceed cautiously in adopting QALYs.” The UK’s National Heath Service (NHS) utilizes QALYs but in the U.S. the Affordable Care Act (ACA) banned the use for Medicare programs due to concerns about impact on the elderly, the disabled and the terminally ill.
TrialSite News is an independent digital media platform. We often believe that the world cannot be “black or white” but that there are many shades of grey. Pioneer Institute has been called by some a “right wing” think tank, but on the other hand, many of their works seek an objective non-partisan perspective. Who doesn’t want more efficient government? More efficient markets where resources are allocated in an efficient and effective manner?
We believe that Mr. Smith’s research needs to be considered by any legislature for any truthful elements. Drug pricing is a contentious issue and there are considerable number of material factors and forces to consider. Ultimately it will include political, economic and social influences. After all, a market is a combination of all—people, societal mores and norms, psychology, laws and institutions and cultural forces. The Pioneer perspective will be of a pure market-based outlook. When we look at prices, we factor in markets (and the elements and factors we include above). Our point is that if drug prices get too high, too few will benefit and ultimately the optimal combination of economic return and social good via healthier communities won’t be achieved.