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Aimed Alliance Says Health Care Rationing Proposals Ignore Patients, Undermine Progress, and Are Inconsistent with Health LawThe Alliance for the Adoption of Innovations in Medicine (Aimed Alliance) - a not-for-profit organization seeking to improve health care in the US through access to evidence-based treatments and technologies - challenged drug rationing formulas, referred to as "value assessment frameworks," proposed by the Institute for Clinical and Economic Review (ICER). Aimed Alliance argued that the formulas ignore the way patients define the value of their treatments, and are inconsistent with current law, the Patient Protection and Affordable Care Act (ACA). According to Aimed Alliance, ICER aims to assign a price cap to medications and medical services in the US, resulting in a rationing of health care in conflict with the tenets of the ACA. While the ACA was intended to prevent discrimination on the basis of health condition, improve access to individualized care, and allow for long term treatment, ICER has been advancing price control strategies as a means to reduce access to innovative treatments for individuals with specific rare, chronic, and life threatening conditions. ICER intends to produce 15 to 20 reports a year, targeting treatments for such conditions. Its current proposals target multiple myeloma, a blood cancer of cells in the bone marrow. In a white paper entitled Institutional Health Care Rationing Ignores Patients, Undermines Progress, and Leads to Deterioration of Care, Aimed Alliance says similar programs in other countries have led to decreased access to treatment, elays in care, increases in mortality, and a stifling of innovation. After the establishment of rationing formulas in the United Kingdom, "the survival rate for patients with cancer plummeted. According to a recent study, British patients are less likely to survive certain types of cancer than those in less developed countries, such as Malaysia and Indonesia … In fact, [the British government] has not approved a single breast cancer drug in over seven years." Like the British government, ICER calculates the value of a new treatment based on a measurement called a "QALY," a quality-adjusted life year. ICER uses this formula to determine a price cap for a drug based on the level of a person's health and the impact of illness with and without treatments. Only a healthy person gets a full QALY. Anyone with an illness is given just a fraction of value. Testifying at a forum convened by ICER, Stacey L. Worthy, Esq, Director of Public Policy at Aimed Alliance, said, "QALYs put a price tag (News - Alert) on the value of a human life … They treat individuals' lives and health as a commodity and ignore the patients' and practitioners' concept of the value of treatment." The use of the QALY, in particular, is inconsistent with the ACA. The white paper states, "Recognizing that value-based frameworks can result in an inappropriate rationing of care, Congress added language to the ACA that prohibited [use of QALYs] in the Medicare program." The ban reflected a long-standing concern that QALYs can lead to discrimination on the basis of age and health status, unfairly favoring younger and healthier populations. According to Aimed Alliance, a better approach to reduce health care costs in the US is to align the interests of patients, providers, insurers, and pharmaceutical manufacturers. Studies show that where insurers motivate patients to adhere to effective therapies, costs can be reduced while improving health care, instead of undermining current law and patient needs. The white paper can be read at: http://www.aimedalliance.org/wp-content/uploads/2016/05/Aimed-Alliance-ICER-Paper-160523-FINAL-1.pdf.
View source version on businesswire.com: http://www.businesswire.com/news/home/20160527005127/en/ |
