Very few patients have noticed an epic struggle taking place among policy wonks, lobbyists, hedge fund managers and economists in the drug and insurance industries. Some want to describe the fight as being about drug pricing and value, but it might actually be about limiting access to newly approved and emerging myeloma therapies.
Patients are mostly in the dark because they have been intentionally left out of the argument. But they can find it if they know where to look.
The controversy revolves around recommendations by the Institute for Clinical and Economic Review (ICER), a Boston-based nonprofit that is mostly supported by the insurance industry and investor-funded foundations, to create “value-based” or “indication-specific pricing” drug reimbursement rules for insurers.