2018 Update: ICER is conducting a 2018 psoriasis condition update. Scroll down for more information about the NPF’s engagement in this review.

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. Here’s a video produced by ICER that explains how their organization operates.



In 2016, ICER conducted a review of eight psoriasis therapies finding that all eight of these systemic treatments were “of good value” and recommending that insurers expand access to these treatments. This was a great result for our community! The NPF was pleased to have been able to contribute throughout the review via multiple comment letters, teleconferences, and participation in the day-long review meeting in November 2016. The feedback offered by the National Psoriasis Foundation and the experts we introduced ICER to including experienced clinicians and individuals living with psoriatic disease enabled the review to much more accurately reflect the needs and challenges of the psoriatic disease community. Read more below on the 2016 process, final report, and NPF role in the assessment.


In late 2017, ICER announced plans to conduct a psoriasis condition update in 2018. According to ICER, the “objective of this Condition Update is to assess the comparative clinical effectiveness and value of new targeted immunomodulators for moderate-to-severe plaque psoriasis” and “incorporate any new evidence generated with respect to the populations and outcomes of interest for the agents evaluated in the original 2016 review.” Just as in 2016, the NPF is engaging with ICER to ensure that this condition update takes in to account considerations important to the psoriatic disease community. Read more below on the 2018 psoriasis condition update.


New: NPF comments on  ICER Proposed Updates to 2020 Value Assessment Framework Methods and Procedures (10/18/2019)

New: Oral Remarks offered by Leah Howard J.D., NPF Chief Operating Officer, during July 12, 2018 ICER meeting (7/12/2018)

New: National Psoriasis Foundation comment letter to ICER on psoriasis condition update draft evidence report (5/25/2018)

New: Avalere formulary analysis of systemic psoriasis therapies across multiple markets (2015 - 2017)

New: NPF COO Leah Howard comments on engaging in value assessments during a May 23rd panel on Defining Value as part of The Atlantic’s The State of Care: Patient Access & Affordability event

  • National Psoriasis Foundation comment letter to ICER on the psoriasis condition update, click here. (12/22/2017)
  • 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 Chief Operating Officer, 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 Chief Operating Officer 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 months, check back here frequently for updates and additional information about ICER’s condition update on psoriasis treatments. To discuss the review with NPF staff, please contact Leah Howard, Chief Operating Officer at [email protected]