Real-world evidence is used frequently in the Institute for Clinical and Economic Review (ICER) scoping process but infrequently in ICER comparative clinical effectiveness (CCE) assessments, according to a recent study published in the Journal of Managed Care and Specialty Pharmacy (2020;26[12]:1590-1595. doi:10.18553/jmcp.2020.26.12.1590).
“There has been growing interest in using real-world evidence for health technology assessment (HTA) in the United States. [ICER] is an independent US-based HTA organization that focuses primarily on pharmaceuticals,” wrote Boshen Jiao, MPH, The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington School of Pharmacy, Seattle, and colleagues.
“[Real-world evidence] is used to inform ICER’s scoping and comparative clinical effectiveness (CCE) assessments, but the extent to which it is used has not been quantified,” they continued.
This study aimed to systematically evaluate the use of real-world evidence in the scoping and CCE assessment sections of the ICER health technology assessment (HTA) reports on pharmaceuticals.
All ICER reports of pharmaceuticals published between January 2014 and June 2019 were reviewed for the average number of instances and proportion of real-world evidence use in the scoping documents. Real-world evidence was also examined in CCR assessments. In addition, the use of real-world evidence in clinical guidelines used to create the CCR assessments was evaluated.
In the ICER scoping documents, the mean number of instances of real-world evidence use was 3.8 per document. In ICER CCE assessments, the mean number of instances per assessment was 0.7 per drug. In clinical guidelines, real-world evidence was used in 1.6 per drug per guideline.
“[Real-world evidence] was frequently used in the ICER scoping process, particularly to inform selection of outcomes. [Real-world evidence] was used infrequently in ICER CCE assessments, while more often used to inform effectiveness, safety, and treatment patterns in relevant clinical guidelines,” concluded Dr Jiao and colleagues.—Lisa Kuhns
