Value-based price benchmarks can help payers determine whether a drug’s price aligns with its ability to help patients, which can then facilitate the innovation and uptake of new therapies, said Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review (ICER).
Value-based price benchmarks can help payers determine whether a drug’s price aligns with its ability to help patients, which can then facilitate the innovation and uptake of new therapies, said Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review (ICER).
Transcript (slightly modified)
What role does the value-based price benchmark play when judging the affordability and value of a therapy?
In our system, where we do have sometimes insurers saying that they’re not going to cover something, but that’s on the basis of the clinical information they have, most of the time. Sometimes, they do feel that 2 treatment options would be similarly effective and one is much more expensive, and they might only cover the one that’s less expensive.
On the other hand, our system could be based more on linking the added benefit to patients to the price that we are willing to pay. So, the issue is not whether we will or won’t cover it as part of insurance; it is, we will cover it but at what price? What is the price that would align best with the ability to help patients, which is really what I think we ought to anchor pricing to in our healthcare system.
That’s what the ICER value-based price benchmark does. It begins the discussion, it creates a way to think transparently and consistently across different treatment areas about how we would line up that price with the benefit to patients, because ultimately the goal is to say that if we can get the pricing aligned appropriately, we should be able to have a system that is much more accommodating to innovation, to new treatments, because at a value-aligned price, we want to facilitate uptake. We want to facilitate use, and get the benefits for as many patients as should be appropriately treated.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More