Does Icer's One-Size-Fits-All Approach Fit Your #Migraine?

For women and men with migraine, the only thing better than making a headache stop is preventing it altogether. New drugs known as CGRP inhibitors may allow just that – if patients can access them.

The question of access may be heavily influenced by a report from the Institute for Clinical and Economic Review. The group aims to determine the value of drugs to patients and the health care system. When it comes to migraine, that’s no easy task.



ICER, as the organization is known, calculates new drugs’ long-term cost effectiveness and short-term budget impact. These figures lead ICER’s analysts to define the price at which these drugs are, in ICER’s review, worth their cost.

This may be problematic for patients, especially given ICER’s:

• Funding. Critics have made an issue of ICER’s funding, some of which comes directly from health insurers or from nonprofit foundations supported by health insurers.
• Approach. ICER’s concept of a value-based price suggests that the value of life-altering drugs for individual patients can be lumped into a generic, population-based calculation.
• Timing. ICER often times its analyses in a way that precludes use of real-world data, which can reveal critical insights about how a drug actually impacts patients.
• Metrics. ICER uses quality adjusted life years as its metric, even though QALYs have been described as discriminatory for people with disabilities.

The impact of migraine, and the value of effective treatments, is as varied as the women and men who live with it. Migraine is an invisible disease, easy to underestimate and difficult to quantify. Its impact is far-reaching, touching the workplaces, families and communities of those who have the disease. And the comorbidities affecting migraine patients are likewise varied and complex.

Help bring the patient voice to ICER’s valuation process through social media, a letter response to ICER’s report, or by attending ICER’s June 14 meeting on CGRP therapies.
Economists alone can’t measure migraine – or the value of life-changing treatment.

ICER’s Draft Evidence Report on erenumab for migraine, is open to public comment until May 8, 2018. For more information on submitting a public comment, please visit their stakeholder engagement page at https://icer-review.org/methodology/stakeholder-engagement/.

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