Survey: ICER Assessments Impact Payer Decision-Making

Formulary Watch, Daniel Faraci and Kimberly Westrich

Payers see value in the cost-effectiveness analyses and policy reports conducted by the Institute for Clinical and Economic Review (ICER), according to a recent survey conducted by Xcenda and presented at the annual meeting of the Professional Society of Health and Economics and Outcomes Research (ISPOR) in May 2022. In fact, three quarters of the surveyed payers noted that ICER reports are at least somewhat impactful in their decision making process. “The assessments are most commonly used as a supporting source, but rarely the main source for coverage or formulary decision. In terms of formulary management, the results from ICER assessments are most often used in pricing negotiations, and to implement prior authorizations,” Daniel Faraci, research associate intern, market research, at Xcenda, said in an interview. Xcenda researchers conducted a double-blind, web-based survey of 50 of the company’s advisory group of payer experts, which represented health plans, integrated delivery networks, and pharmacy benefit managers.

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