Using ICER’s Value Assessments Would Limit Access to Life-Saving Medicines in Medicare Part B

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According to a new analysis by Xcenda, if Medicare were to utilize one-size-fits-all value assessments like the Institute for Clinical and Economic Review (ICER)’s framework as the basis for coverage, 62 to 93 percent of patients with serious, complex conditions would face access barriers to life-saving medicines. The study compared ICER’s assessments regarding what treatments are of “highest value” to utilization of Medicare Part B medicines for four diseases. The data show of the more than 200,000 Medicare Part B beneficiaries with rheumatoid arthritis (RA), multiple sclerosis (MS), non-small cell lung cancer (NSCLC) and/or multiple myeloma (MM), nearly 140,000 patients might lose access to the treatments their physicians determined were best for them if an ICER-like standard were imposed. Download the report to learn more.