Posted by Michael Wonder on 05 Sep 2018
Publication of final base-case ICERs (ICURs) by health technology assessment agencies
6 September 2018 - The Department of Health is dragging its heels on this issue.
Below are some recent examples on the publication of information on final base-case ICERs (ICURs) by health technology assessment agencies in Europe and North America. The examples have been selected at random.
Brentuximab vedotin (Adcetris) - NICE TA524 (June 2018)
"The most plausible ICER is between £16,000 and £18,000 per QALY gained for population 3"
Patisiran sodium (Onpattro) - ICER Final Report (August 2018)
"The value-based benchmark price for a therapy is defined as the price range that would achieve incremental cost-effectiveness ratios between $100,000 and $150,000 per QALY gained.For inotersen, price discounts of 94% to 97% from the assumed placeholder list price would be required to reach the $100,000 to $150,000 per QALY thresholds. For patisiran, price discounts of 90% to 95% from the list price would be required to reach the $100,000 to $150,000 per QALY thresholds."
https://icer-review.org/wp-content/uploads/2018/02/ICER_Amyloidosis_Evidence_Report_082918.pdf
Benralizumab (Fasenra) - CADTH Pharmaceoeconomic Report (August 2018)
"CDR reanalyses indicated the ICUR for benralizumab + SOC versus SOC alone is likely to be approximately $1.5 million per QALY. Results were highly sensitive to utility value assumptions, continued usage of biologics for nonresponders, and the proportion of chronic OCS users. When considering only patients with chronic OCS use (at least six months), the ICUR for benralizumab + SOC compared with SOC alone is approximately $62,000 per QALY. A price reduction of more than 95% is required to achieve an ICUR below $50,000 per QALY for the reimbursement request population; while a price reduction of 15% is required to achieve an ICUR below $50,000 per QALY for the population that is on chronic OCS use."
https://cadth.ca/sites/default/files/cdr/pharmacoeconomic/SR0561_Fasenra_PE_Report.pdf
The French Transparency Commission also publishes information on final base-case ICERs but for the time being only in French.
What will it take for the folks in Canberra to publish important information that is current standard practice of other comparable health technology assessment agencies? Some will recall that the PBAC Public Summary Documents were introduced in 2005 as part of a free trade agreement between Australia and the US. Action in Australia's capital on this issue might only take place if Donald Trump cancels the current free trade agreement and seeks to negotiate another one!
