A nonprofit the government is pushing to use to help calculate payments for seniors’ drugs under Medicare Part B may be using a flawed method, which could lead to patients being prescribed less effective and cost-friendly treatment plans.

The Institute for Clinical and Economic Review (ICER) is a Boston-based nonprofit largely funded by health insurance companies, health trade associations and pharmacy benefit managers. It uses a model to calculate the value of drug prices similar to what is used in the United Kingdom. The drug payment model incorporates data using quality-adjusted life years (QALYs), a tool used for rationing health care by measuring disease burden.

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Juliegrace Brufke Capital Hill Reporter