One Organization is Denying Countless Patients Equal Access to Health Care
If you’ve ever taken prescription medication or participated in a medical treatment plan, chances are your health care has been impacted by the Institute for Clinical and Economic Review (ICER). But as Susan Peschin from the Alliance for Aging Research noted shortly after the onset of the coronavirus, it might not have been to your benefit. While the virus may have opened our eyes to the horrors of health care rationing, ICER has still not been held accountable for promoting a system that would have similarly harmful effects.
ICER is best known for the cost analysis reports it creates for health insurance companies and pharmacy benefit managers (PBMs). These third parties then use ICER’s reports to greatly limit which treatments they’ll cover for patients. That’s because ICER’s methodology assigns more “value” to someone who’s younger or in generally good health than it does to an older patient or someone with an existing health condition.
What’s the end result? Patients are often denied access to medical care based on their age, illness, or a disability.
This flawed system for valuing drugs and other medical treatments relies on a measurement known as Quality Adjusted Life Years (QALYs). With QALYS, a patient is given a higher value the closer they are to “perfect” health. Over 65 years old? Have cancer or another chronic illness? Then your life has less value. QALYs also don’t account for racial differences, including life expectancy or being predisposed to certain diseases. This can lead to a host of discriminatory outcomes when it comes to health care access.
When the coronavirus pandemic first began, hospitals across the country faced horrific rationing decisions, especially when it came to ventilator access. What many of us don’t realize is that ICER has been promoting a similar system for rationing care for years.
But regardless of age, race, illness, or any other condition, equal access to health care should never be up for debate.