Further improvement is needed to ensure that the Institute for Clinical and Economic Review (ICER) assessments address relevant questions for target audiences, adhere to established research standards, and are reported in a manner that is easily interpreted and applicable to policy making, according to a recent study (J Manag Care Spec Pharm. 2020;26[12]:1548-1557. doi:10.18553/jmcp.2020.26.12.1548. PMID: 33251996).
ICER continuously adjusts its value framework, but uncertainty exists on whether the methodologies align with established research standards.
“This work evaluates ICER assessments relative to those standards, providing a benchmark with the release of ICER’s most recent value framework update,” wrote Denise Kruzikas, PhD, MPH, AESARA, Durham, North Carolina, and colleagues.
Authors reviewed all ICER final reports published between 2006 and August 31, 2019 to evaluate ICER economic assessments for trends, factors related to recommendations, and quality for use in US decision making.
ICER released an increasing number of reports each year, with the highest number released in 2018. Of the 58 evidence reports, 47 used the most commonly reported outcomes. In 30% of base-case analyses, ICER did not use a clinical comparator.
ICER value for money determinations generally aligned with cost-effectiveness results, although 2 of 33 (6%) interventions ranked as low value and 3 of 5 (60%) interventions ranked as low-moderate value, met a $150,000 per QALY threshold, and 14 of 37 (38%) moderate-value interventions exceeded this threshold.
“This study can help raise further awareness of the quality and attributes of ICER reports, which influence results and corresponding value to decision makers,” explained Dr Kruzikas and colleagues. “This assessment identifies areas for ICER to more closely align cost-effectiveness methodological approaches with widely accepted standards.”—Lisa Kuhns
