CVS Launching Program To Exclude New Drugs Deemed Not Cost Effective
Executive SummaryProgram would use cost per QALY determinations by the Institute for Clinical and Economic Review.
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Groups oppose use of quality-adjusted life year metric, noting ICER’s work is becoming more influential among payers. However, patient advocates do not suggest a uniform methodological alternative.
Program likely to generate fewer rebates so it remains to be seen whether payers will embrace the new model in a big way.
The independent value assessment organization’s draft assessment found that the prices for all five marketed biologics for severe asthma – Xolair, Nucala, Cinqair, Fasenra and Dupixent – far exceed standard cost-effectiveness thresholds.