The Institute for Clinical and Economic Review (ICER) is a Boston-based independent nonprofit organization that seeks to place a value on medical care by providing comprehensive clinical and cost-effectiveness analyses of treatments, tests, and procedures.
[2] ICER uses a “value assessment framework” to decide prices for select medical treatments.
QALYs determine how much a treatment can improve a patient’s life while subtracting value for any negative side effects.
According to the Pioneer Institute, “A recent ICER review of two breakthrough treatments for Spinal Muscular Atrophy (SMA) concluded that neither therapy met ‘traditional cost-effectiveness thresholds.’” ICER has been criticized for being an “arbitrary, nontransparent, non-peer-reviewed report” which can determine whether a patient receives a treatment recommended by a doctor.
Critics also claim QALYs can be ableist or ageist because disabled or elderly individuals cannot have one year of perfect health based on its criteria.
[13] Critics also argue that the evLYG metric ignores additional dimensions of value, such as how a specific treatment may not add to a person's lifespan but could reduce the overall burden on the healthcare system, saving lives elsewhere.
[14] It issued a draft report that said Sovaldi wasn’t worth the list price of about $84,000 a year.
[15] It has criticized the high price of drugs for osteoporosis, multiple sclerosis, PCSK9 cholesterol meds, and immuno-oncology therapies.
[7] A preliminary list of drugs to be evaluated includes rociletinib, AZD-9291, necitumumab, nivolumab, and pembrolizumab for small-cell lung cancer; fingolimod, dimethyl fumarate, teriflunomide, alemtuzumab, and daclizumab for multiple sclerosis; and ixekizumab and brodalumab for psoriasis or psoriatic arthritis.