A report on rheumatoid arthritis treatment, which the Institute for Clinical and Economic Review (ICER) released last month at a meeting of the New England Comparative Effectiveness Public Advisory Council (CEPAC), risks restricting patients’ drug access, critics say.
“Insurers are going to use ICER’s report as justification for dramatically restricting access to these drugs. Full stop,”Global Healthy Living Foundation President Seth D. Ginsberg told MedPage Today.
An executive summary of the ICER report noted that targeted immune modulators (TIMs), including biologics, offer “substantial clinical benefit” compared to disease-modifying antirheumatic drugs (DMARDs) alone. But it adds that “their additional costs translate into cost effectiveness estimates that exceed commonly cited thresholds,” according to MedPage.
Generally, cost-effective thresholds range from $50,000 to $150,000 per quality-adjusted life year (QALY) gained, but TIMs are more in the range of $170,000 to $270,000 per QALY gained, according to the article.
The Arthritis Foundation, a nonprofit, questioned whether the findings would be different if ICER had modeled younger in addition to older patients.
“If patients with early diagnosed mild RA were included in the economic model, we would expect the population treated with targeted immune modulators to accrue greater additional quality adjusted life years,” it said in a statement, MedPage reported. “The Arthritis Foundation cannot support any recommendations that limit patient access to needed therapies or could result in a patient on a stable drug no longer having access to that drug.”
In a statement from the American College of Rheumatology, ACR President Sharad Lakhanpal noted, in part, “Our concern is that most trials provide only short-term data on drug efficacy and do not adequately reflect the numerous treatment changes required to control RA in clinical practice,” the article added.
Click here to read the response of CreakyJoints’ patient-council member Chantelle, who attended New England CEPAC.