Improving Health Outcomes and Assessing the
Value of Therapies in the Process

Although prescription drug spending slowed in the early part of this decade (2010 – 2013), estimates by the Kaiser Family Foundation (a non-profit organization that analyzes major health care issues in the United States) show rapid increases in prescription spending in 2014 and 2015. Specialty drug spending – which includes spending on treatments for moderate to severe psoriasis and psoriatic arthritis – has been identified by several analyses as a driver of this prescription spending. With the recent public dialogue around the costs of prescription drugs, more attention is also being paid to non-profit organizations that evaluate evidence on the “value” of medical tests, treatments and delivery system innovations. Known as value framework modelers, these entities aim to open the “black box” of drug pricing and help us to know if we are getting a good value for our therapies at their current costs.

While most of the value framework modelers have focused on assessing cancer treatments, the Institute for Clinical and Economic Review (ICER) is one of the major modelers looking at chronic disease. In late spring 2016, ICER began a review of treatments for psoriasis and is also in the process of reviewing therapies for rheumatoid arthritis, multiple sclerosis and atopic dermatitis. Here’s a video produced by ICER that explains how their organization operates.

 

 

In 2015, ICER announced it planned to conduct a review of psoriatic disease therapies in 2016. Following this announcement, the NPF reached out to the organization to introduce ourselves and begin a dialogue on the needs, challenges, and preferences of our community. As ICER has moved forward with their assessment, the NPF has pursued formal and informal avenues for sharing information that we hope will inform their work. There are four formal opportunities, once a topic is released, for interested stakeholders – including patients and patient organizations – to provide written or oral feedback to ICER. Written comments were invited three times from the public during the report preparation process including just recently when ICER released its draft report on “the comparative clinical effectiveness and value of targeted immunomodulators for adults with moderate-to-severe plaque psoriasis” on September 29, 2016.

As we have done on multiple occasions already, the NPF responded to the public comment opportunity and has submitted an official response to the draft ICER report. In early November 2016, ICER will finalize their report, and then the New England Comparative Effectiveness Public Advisory Council (New England CEPAC), a core program of the Institute for Clinical and Economic Review (ICER), will deliberate and vote on evidence presented in ICER's report on treatments for psoriasis at Harvard Medical School on November 18, 2016. The NPF will be in attendance at this meeting offering oral public comment and contributing to the policy roundtable taking place as part of the meeting.

NEW! ICER Blog on Including the Patient Perspective focuses on the work of the National Psoriasis Foundation to inform the recent ICER assessment of psoriasis therapies. (1/4/2017)

  • Leah Howard, NPF’s VP of Government Relations and Advocacy, provides an overview of the Final Report and Meeting Summary, and answered questions on the significance of the report findings and policy recommendations, and what comes next. 
  • To read a Q&A with National Psoriasis Foundation’s VP of Government Relations and Advocacy on why ICER decided to target psoriatic disease treatments, why value frameworks matter to patients, and more, click here.
  • To read the National Psoriasis Foundation’s official response to ICER’s draft evidence report on treatments for psoriasis (from September 29, 2016), please click here.
  • To read the National Psoriasis Foundation response to ICER’s draft scoping document on the psoriasis review, click here.
  • To read the National Psoriasis Foundation’s summary of concerns raised at the outset of the review, click here.
  • To read the National Psoriasis Foundation’s response to ICER’s open call for feedback on the value framework model, click here.
  • To read the National Psoriasis Foundation’s summary of comments on a possible joint Rheumatoid Arthritis and Psoriatic Arthritis review, click here. ICER elected after public comments were received to move forward with a Rheumatoid Arthritis review only.

As this issue evolves over the coming weeks, check back here frequently for updates and additional information about ICER’s review of psoriasis treatments. To discuss the review with NPF staff, please contact Leah Howard, VP of Government Relations and Advocacy at lhoward@psoriasis.org.