In an effort to control the cost of care, health plans and policymakers are exploring the use of value assessments to determine whether or not a certain drug should be covered. Plans use value assessments -- sometimes called cost-effectiveness reviews -- to assess if a drug's price is justified by how effectively it treats a condition or disease. Payers use that information to decide if a new treatment will be covered for Patients.
Patients and innovation itself may be endangered by organizations like the Institute for Clinical and Economic Review (ICER), a Boston-based research group that uses a controversial method to determine the value of drugs, based on an arbitrary evaluation of the value of one year of perfect health. ICER ignores individual Patient preferences in its reviews and its one-size-fits all approach to drug value assessments could deny Patients access to new and life-savings drugs -- allowing ICER, rather than physicians, to make treatment decisions for Patients.
One estimate found that, if Medicare used an ICER-style model, 59 to 93 percent of prescriptions to treat complex conditions may not be covered. When Patients can't access treatments they need, it can lead to complications, increased doctor visits, trips to the ER and even death. Furthermore, ICER's approach to drug value assessment may be discriminatory, as it places a lower value on the lives of the disabled and elderly.
New Jersey's innovative life sciences industry is leading the way in discovering and developing groundbreaking treatments and cures that Patients everywhere depend on.
Because Patients Can't Wait, we are asking industry, health advocates, payers, policymakers and the full community to help us protect medical innovation and the Patient voice in drug value assessment, said BioNJ President and CEO Debbie Hart. BioNJ's new portal features information and tools that can be used to advocate for policies and solutions that help Patients access the medicines they need and promote a thriving life sciences industry in New Jersey and beyond.
Join BioNJ in its efforts to protect medical innovation. Any solution to control health care costs in New Jersey must promote innovation, incorporate the unique needs of Patients and ensure access to care. Sign up to receive email opportunities to take action online and in your community. More information can be found at www.BioNJ.org/Protect-Medical-Innovation.