The Institute for Clinical and Economic Review, a nonprofit organization that assesses evidence on the value of medical treatments and tests, held its inaugural Midwest Comparative Effectiveness Public Advisory Council meeting on May 26.

ICER’s goal was to create a value assessment of various treatment options for relapsed multiple myeloma.

I, along with others, have been concerned with the inappropriate application of such analysis to make decisions about insurance coverage of medications.

The purpose of such a meeting and report was to create an “independent” framework that would establish clinical usefulness — ie, “comparative effectiveness” or net health benefit — and a consequent medical economic analysis, or “care value,” in support of one of various therapeutic approaches for multiple myeloma.

To more accurately describe the proceedings that led to the final report, I reviewed the full video of the event. My primary concern is that reports like this could be used by payers to deny coverage for lifesaving pharmaceuticals.

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About the Author:

Rafael Fonseca, MD, is Getz family professor of cancer, chair of the department of medicine and distinguished Mayo investigator at Mayo Clinic in Phoenix, Arizona. He can be reached at

Disclosure: Fonseca has received a patent for the prognostication of multiple myeloma based on genetic categorization by fluorescence in situ hybridization. He reports consultant fees from Amgen, Bayer, Bristol-Myers Squibb, Celgene, Janssen, Millennium/Takeda, Novartis and Sanofi. He also is a member of the Scientific Advisory Board of Applied Biosciences.