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In an unusual move, the Institute for Clinical and Economic Review has reversed course and decided a pair of new drugs for treating acute migraine attacks have greater value than thought initially. And the cost-effectiveness watchdog is pointing to its decision as an example of its willingness to exercise greater flexibility in the face of long-standing criticism of its approach to evaluating new medicines.

The nonprofit reassessed the drugs — Ubrelvy from Allergan (AGN) and another from Biohaven Pharmaceuticals (BHVN) that is not yet available — after reviewing a re-analysis of clinical trials it asked Allergan to conduct. ICER determined the Allergan tablet deserved a revised value closer to the $4,900 list price. Given both drugs are quite similar, ICER also determined the Biohaven drug should be priced the same.


The findings contrast with a previous assessment released only last month that pegged the value for the medicines at $2,200 to $3,200 a year, which is a substantial difference. “We now think a fair price (for the Allergan and Biohaven drugs) is between $4,150 and $4,640,” said David Rind, the ICER chief medical officer. “We’re only suggesting a 5% to 15% discount to achieve our value-based thresholds.”

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