Bloomberg opinion writer Max Nisen believes that CVS should use ICER’s drug pricing recommendations to exclude
breakthrough drugs, including those for orphan diseases. Would he want his wife or daughter
to have their access limited by CVS and Aetna (who is being acquired by CVS)?
He may not know that ICER is funded by CVS. He may not know that ICER never talks about
sharing the increased rebates or fees that CVS would pocket if their lower prices are used. He
may not know that even with the price cuts he thinks ICER should set, patients will still pay
retail or be forced to try other treatments. He may not know that breakthroughs are
breakthroughs because they are first in class. And he may not know that the step therapy or
exclusions ICER also recommends are also based on containing costs, not increasing
affordability. And he may not know that limiting access to drugs to generate rebates and fees
comes at the expense of the sickest 2 percent of patients or that limiting access to drugs
considered by ICER as cost effective is associated with worse outcomes and more spending
But now he knows and now he should ask himself if G-d forbid he, his wife or children had their
access to treatment denied by CVS and ICER would he embrace it. If he does, that͛s fine. But
leave me and everyone else out of an approach that in my opinion violates the spirit of
Nuremberg code on human experimentation.
breakthrough drugs, including those for orphan diseases. Would he want his wife or daughter
to have their access limited by CVS and Aetna (who is being acquired by CVS)?
He may not know that ICER is funded by CVS. He may not know that ICER never talks about
sharing the increased rebates or fees that CVS would pocket if their lower prices are used. He
may not know that even with the price cuts he thinks ICER should set, patients will still pay
retail or be forced to try other treatments. He may not know that breakthroughs are
breakthroughs because they are first in class. And he may not know that the step therapy or
exclusions ICER also recommends are also based on containing costs, not increasing
affordability. And he may not know that limiting access to drugs to generate rebates and fees
comes at the expense of the sickest 2 percent of patients or that limiting access to drugs
considered by ICER as cost effective is associated with worse outcomes and more spending
But now he knows and now he should ask himself if G-d forbid he, his wife or children had their
access to treatment denied by CVS and ICER would he embrace it. If he does, that͛s fine. But
leave me and everyone else out of an approach that in my opinion violates the spirit of
Nuremberg code on human experimentation.
