In the latest fracas over pharmaceutical pricing, several large drug makers are objecting to the value assigned to their multiple myeloma treatments by a controversial nonprofit, which is increasingly influencing coverage decisions made by insurers.
In a recent report, the value of three medications was determined to be significantly below their list prices, which run from $8,000 to $14,000 a month. And the findings may cause a showdown at a May 26 meeting that the Institute for Clinical and Economic Review is holding to review its analysis.
In its analysis, the nonprofit found that a vial of Kyprolis, which is sold by Amgen, costs $1,862, but ICER determined the medicine should be priced anywhere from $673 to $1,267 in order to be cost effective. The wide range reflects different benchmarks for assessing the value known as QALY, or quality-of-life years. This measures both the quantity and quality of life generated by providing a treatment or some other health care intervention. More specifically, a QALY measures life expectancy and the quality of the remaining years of life when using a treatment.
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Rationalization is typical when people are used to a well established scam. It feels like normal behavior after a while.