Despite Stated Concern, ICER Doesn’t Plan to Make Meaningful Changes to Address Equity

On March 15, the Institute for Clinical and Economic Review (ICER) released a report on how health equity considerations can be better incorporated into health technology assessments. Though ICER noted that work needs to be done, the group did not recommend material changes to their value assessment methodology to help incentivize the development of therapeutics that advance equity. Further, ICER praised Medicare’s use of “coverage with evidence development,” a paradigm that has been shown to reinforce inequities and disproportionately limit access for medically underserved communities.  

Michael Ward, the Alliance’s Vice President of Public Policy and Government Relations, said about the report:

“ICER states that the status quo of traditional cost-effectiveness methodology is ‘no longer acceptable.’ That sounds encouraging; however, their report does little to advance health equity in value assessment. Promising to meet with a few more groups that represent communities of color in the future is not enough. Making up new equity metrics for “contextual considerations,” rather than doing the hard work of wholesale reform of their base assessment, is not enough. Acknowledging that incentivizing innovation to addresses health disparities is valuable, while also saying it isn’t necessarily worth paying for, is rank hypocrisy. Unfortunately, this report makes clear that ICER does not plan to meaningfully value therapeutics that help advance equitable health outcomes.”