Government Reliance on Value Assessments in Medicare Part B
Over time, US payers have increasingly relied on the Institute for Clinical and Economic Review’s (ICER) recommendations to inform decision-making. ICER’s value assessments continue relying on cost per quality-adjusted life-year (QALY) cost-effectiveness analyses (CEAs) despite well-documented concerns over the metric. In 2018, Cencora examined how the blunt implementation of cost-effectiveness methods and findings, such as those employed by ICER, could affect patient access to medications. Cencora built upon the 2018 study and re-examined the original therapeutic areas including multiple sclerosis (MS), non-small cell lung cancer (NSCLC), and multiple myeloma (MM), rheumatoid arthritis (RA), and added asthma, a therapeutic area recently assessed by ICER, to understand how patients may continue to be impacted in 2020.
Download our issue brief to read the full findings from the analyses.

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