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Empower Patients, Not ICER


By Wayne Winegarden

An obscure institute that most people have never heard of threatens to impose unwarranted restrictions on medically-advised treatments for patients. The Institute for Clinical and Economic Review, or ICER as it is commonly known, assesses whether medicines are cost effective, based on ICER’s definition, of course.

These assessments are intended to influence which drugs are made available to patients. From a patient perspective, it is disconcerting that an outside group, which is not an attending doctor, is influencing which FDA approved drugs are appropriate.

Worse, the problems plaguing NICE in the U.K. (a government-sponsored version of ICER) foreshadow ICER’s likely future. NICE’s recommendations are routinely criticized by practitioners as “detached from day-to-day general practice” and not in patients best interest.

In its self-appointed role as arbiter of cost-effectiveness, ICER has chosen to examine whether the value provided by abuse-deterrent opioids (ADF) are worth the costs. The results from their draft study exemplify why patients and doctors should be wary of ICER’s recommendations.

The U.S. is suffering from a large and growing opioid abuse and diversion problem. Approximately 2.1 million people were addicted to opioids as of 2012. The abuse of opioids were involved in over 16,000 deaths (as of 2013), and annually impose $72 billion in medical costs.

However, the problem of opioid abuse should not be separated from the even larger problem of managing chronic pain.

Around 76 million Americans over the age of 20 have endured pain that has lasted more than 24 hours. And, for those patients suffering the most, chronic pain can lead to other health problems. These include problems of severe depression, and adverse impacts on the cardiovascular, immune, and musculoskeletal systems.

There are also financial consequences, as people who suffer from chronic pain miss work more often, and are less productive at work due to their chronic pain. All told, the financial cost of chronic pain has been estimated to be between $560 billion and $635 billion...

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