The Well News: Ensuring Medicare Rx Price Negotiations Help Patients

By: Peter Rubin

“Buried amidst the recent wave of headlines about Medicare’s forthcoming round of drug price negotiations, there was an announcement from a little-known economic group attempting to shape how those negotiations will unfold — with potentially devastating consequences for patients today and in the future.

The Institute for Clinical and Economical Review submitted a report to Medicare in early October purporting to offer advice on how the government should determine the price of two widely used drugs included in the initial round of negotiations, Eliquis and Xarelto. The group is aiming to influence Medicare to have it adopt its own faulty and outdated approach to cost-effectiveness analysis for setting all prices of drugs.

ICER openly acknowledges that its approach is flawed. In a separate report released a week earlier, ICER admitted that its analysis of the value of drugs omits several important factors, such as the emergence of generic drugs and evolving patient populations, making it favorable for insurers but detrimental for Medicare beneficiaries.

Unfortunately, the group is slow-walking these much-needed updates, and its report to Medicare remains riddled with fundamental flaws that would lead to inaccurate assessments of value.”