Drug prices are on the rise, especially those set at launch by pharmaceutical companies, according to a recent report by the Institute for Clinical and Economic Review (ICER). The organization is gearing up to release a new report in October to delve deeper into these pricing increases and their impact on efficacy and patient access.
ICER has highlighted a study from April which revealed that cancer drugs with higher launch prices between 2008 and 2022 did not necessarily show greater effectiveness, despite the prices doubling from $100,000 to $200,000 during that period. The complexity of patient access in the U.S., including payer coverage dynamics, further complicates the true cost of these drugs.
The upcoming report by ICER will analyze drugs approved by the FDA between 2022 and 2024 to examine trends in list and net prices, their correlation with advancements in efficacy, and the out-of-pocket costs for patients. This extensive analysis will cover 160 new drug approvals over three years, excluding generics, biosimilars, and vaccines.
Among the drugs to be scrutinized in the report are Eli Lilly’s GLP-1 diabetes and weight loss drug Mounjaro, gene therapies like Sarepta Therapeutics’ Elevidys and CRISPR-based Casgevy, as well as cell therapies such as Carvykti from Johnson & Johnson and Legend Biotech. The aim of these reports is to contribute to ongoing policy discussions and potentially offer solutions to make drugs more affordable and accessible.
ICER has been a driving force in promoting transparency in the complex realm of drug pricing since its inception in 2005. The organization applies a value assessment framework to establish benchmarks for drug costs and monitor price hikes over time. Recent reports have shown that many drugs have seen price increases well above the rate of inflation, with half lacking evidence to justify these hikes.
The upcoming report will also examine the impact of government regulations, such as Medicare price negotiations, on initial list prices for drugs. ICER acknowledges the challenges of comparing different types of drugs but relies on benchmarking models to assess the cost-effectiveness and quality of life improvements offered by various treatments.
In addition to list prices, ICER is considering other factors that affect patient access to drugs, such as coverage restrictions and cost-sharing measures. By analyzing data on coverage restrictions and out-of-pocket expenses, ICER aims to provide a comprehensive view of the challenges patients face in accessing necessary medications.
Overall, ICER’s upcoming report promises to shed light on the complexities of drug pricing, efficacy, and patient access, with the ultimate goal of driving discussions and proposing solutions to make essential medications more affordable and accessible to all.
