Amarin Corp Plc (AMRN)

[lettruthringout]

ICER examines insurance coverage policies pertaining to Vascepa

On May 12, 2021, the Institute for Clinical and Economic Review (ICER or the Institute) released plans to begin an annual examination into health insurance drug coverage policies to assess “fair access” to prescription drugs. The purpose of the examination and resulting report is to promote dialogue with regard to whether “insurers are providing appropriate access for drugs that have been responsibly priced.”

The Institute’s decision to look at payer policies that may limit access to care appears to be a signal of its independence and willingness to explore concerns involving both manufacturers and payers. Those who have followed ICER closely will know that the organization has worked productively with a number of patient groups and has issued final assessments that include recommendations that payers abolish or limit the use of certain utilization management tools in certain cases.

In its latest endeavor, ICER plans to examine the coverage policies — including cost sharing, clinical eligibility criteria, prior authorization processes and step therapy protocols — of 15 U.S. commercial payers to determine if they provide fair patient access to 28 commonly used prescription drugs (as assessed by ICER according to a subset of its fair access criteria).

ICER’s report is projected to be released in the fall of 2021. Any payer with policies that ICER deems not to meet its fair access criteria will be provided an opportunity to provide comment on the assessment prior to publication.

https://www.faegredrinker.com/en/insights/publications/2021/6/icer-turns-attention-to-health-insurers-new-report-will-examine-whether-plans-provide-fair-access-to