An increasingly influential nonprofit is undercutting medical innovation and building barriers to access between patients and their medicines – all under the guise of a cost-cutting scheme that puts the sickest among us on the chopping block.
While lawmakers and reporters hold their magnifying glass up to the pharmaceutical industry, corporate insurers and the pharmacy industry have skirted public scrutiny and used research from a nonprofit, the Institute for Clinical and Economic Research (ICER), to help them deny patients higher cost-medications, even if they need and deserve them.
ICER provides analysis that effectively functions as a price control on medicine. It targets a disease, writes a report to inform health insurers on the supposed cost-effectiveness of a drug and then insurers can decide whether or not to use that recommendation.
It does this through mathematical calculations known as “value frameworks” to justify the nonprofit’s preference to target certain drugs. But this is no unbiased test or dispassionate statistical measurement. It’s a Catch-22 in which patients can’t win because the ICER process determines they have a lesser quality of life than a healthy person – forever.