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ALCF Statement Regarding ICER Scoping Document
The following statement was issued by the Bonnie J. Addario Lung Cancer Foundation (ALCF) in response to the scoping document evaluating certain lung cancer drugs released by the Institute for Clinical Economic Review (ICER).
SAN CARLOS, Calif. (September 19, 2016) — In concert with our partners in the Lung Cancer Action Network (LungCAN), we are submitting our concerns with the ICER Draft Evidence Report evaluating certain lung cancer drugs. As a patient focused organization founded by a Stage 3b lung cancer survivor we have additional concerns that must be addressed in terms of ICER’s mission and the lack of transparency, the patient’s role in the process, and the unintended consequences of a one-sided approach to evaluating “value” and “cost”.
ICER’s stated mission is to conduct analyses to determine whether a new drug’s benefit is worth its cost. In other words – it puts a price on the value of a patient’s life. If assessing value to patients, why were so few included in the assessment? Did you ask patients the value of living three more months to see your baby turn one-year-old? Seeing your child graduate from college? Getting married? Ask any patient and they will tell you those moments are priceless.
Treatment options for patients should not be determined based on perceived costs by payers. This method does not allow for weighing the value of medications to the overall health care system. And interestingly, ICER has determined the majority of drug treatments it has reviewed to date are too expensive, yet they do not take into account offsets within the healthcare system.
Patients treated with the most innovative treatment options actually drive down the cost of healthcare by reducing the number of doctor visits, ER trips, drug failure costs, related palliative care, etc. It appears that ICER was created to provide the health insurance industry a third party expert to exclude treatments from coverage, which may even create disincentives to new drug development, and create price controls.
We know that personalized medicine is extending the lives of lung cancer patients and the quality of those years. At ALCF we work with patients who are alive today because of this groundbreaking research. I can’t imagine how many of them wouldn’t be here today if a payer used information from ICER to deem their treatment not worth the cost. Although the survival rate after 5 years has only increased by 3%, the survival rate between 1 and 5 years is increasing daily and preparing to burst through that 5-year barrier. Now is not the time to put the brakes on it, it is time to accelerate the process.
We are on the cusp of innovative medical research that will redefine cancer treatment in the coming years with immuno-oncology being a prime example. We must not prematurely review these therapies when this science is in its infancy and already shows such promise. Data is still being developed and new combinations are in the works as physicians and clinicians on the front lines are determining which patients respond best to which combination. Nothing must stall this remarkable research as new drug development is crucial for the lung cancer community. We know that treatments eventually fail patients, and it is imperative to have multiple lines of therapy available.
ICER’s report goes in the complete opposite direction and ignores the transformative, cumulative nature of Personalized Medicine. It moves us back to a one-size-fits-all approach, based on cost of treatment that did not serve patients well.
Finally, we believe that ICER’s assessments must be peer-reviewed in the future by outside experts and information should be made public related to their modeling and methodology. Case in point, the data used to evaluate the TKIs was old data sometimes involving solely Asian populations. There are thousands of expert clinicians on the front lines who could provide additional information to ICER in order to develop a more accurate assessment.
The war on cancer was launched in 1971, by President Richard Nixon, but in most ways the war on lung cancer is just beginning. Vice President Joe Biden’s Cancer Moonshot is a call to action for the entire cancer community – patients, physicians, biopharmaceutical companies and NIH-funded researchers to come together to accelerate the race to treat and cure cancer – to save lives. Lung cancer patients deserve this focus. They have been stigmatized and ignored for too many years. They deserve better.
About the Bonnie J. Addario Lung Cancer Foundation
The Bonnie J. Addario Lung Cancer Foundation (ALCF) is one of the largest philanthropies (patient-founded, patient-focused, and patient-driven) devoted exclusively to eradicating Lung Cancer through research, early detection, education, and treatment. The Foundation’s goal is to work with a diverse group of physicians, organizations, industry partners, individuals, patients, survivors, and their families to identify solutions and make timely and meaningful change and turn lung cancer into a chronically managed disease by 2023. The ALCF was established on March 1, 2006 as a 501c(3) non-profit organization and has raised nearly $30 million for lung cancer research and related programs. For more information about the ALCF please visit www.lungcancerfoundation.org or follow us on Facebook or Twitter.