PNS121 DOES THE CHOICE OF INDEPENDENT EXPERT COMMITTEE AFFECT ICER OUTCOMES?

Abstract

Objectives: The Institute for Clinical and Economic Review (ICER) publishes reports on the clinical and economic value of drugs for US payers. Each report is subject to a public meeting by one of three independent expert committees (the California Technology Assessment Forum [CTAF], Midwest Comparative Effectiveness Public Advisory Council [CEPAC], and New England CEPAC) discusses the report and votes on the evidence presented. This research compares and contrasts outcomes by committee. Methods: All publicly available final ICER reports of pharmaceuticals (01/01/2014-12/31/2019) were screened and key data extracted. Results: 38 ICER reports of pharmaceuticals were identified (CTAF: 11; Midwest CEPAC: 12; New England CEPAC: 15), encompassing 110 drugs in 78 conditions/subgroups. Clinical ratings were provided for 277 drug comparisons (CTAF: 41; Midwest CEPAC: 46; New England CEPAC: 190). For the CTAF, Midwest CEPAC, New England CEPAC, respectively, 19 (46%), 23 (50%), and 33 (17%) drug comparisons achieved a rating of A, B, or B+; 3 (7%), 9 (20%), and 80 (42%) achieved a rating of C, C+, C-, or D; 19 (46%), 14 (30%), and 77 (41%) achieved a rating of P/I or I. Cost-utility assessments were undertaken for 117 treatment settings (CTAF: 35; Midwest CEPAC: 32; New England CEPAC: 50). At a willingness-to-pay threshold of $150,000/QALY, 11 therapies (31%) were deemed cost-effective/cost-saving by the CTAF, 9 (28%) by the Midwest CEPAC, and 21 (42%) by the New England CEPAC. Of the 51 votes for healthcare value, most drugs had a majority vote of low or intermediate value: CTAF: 9 (90%); Midwest CEPAC: 12 (86%); New England CEPAC: 22 (81%). Conclusions: There are generally few differences between ICER committee outcomes, although there are some variances, which are likely due to therapy area focus. Considering healthcare value, ICER committees are generally consistent in reporting that most drugs provide low to intermediate value.