ICER Reports PARP Inhibitor Comparative Effectiveness Evidence Lacking

10/27/17

The Institute for Clinical and Economic Review (ICER) confirmed in a recent report that evidence is lacking for outcomes comparisons of ploy-ADP ribose polymerase (PARP) inhibitors to treat ovarian cancer, and that prices should be lowered to increase affordability and patient access.

ICER’s Final Evidence Report focused on the effectiveness and value of PARP inhibitors in treating women who receive maintenance therapy for recurrent disease that has responded to platinum-based chemotherapy, and in women with BRCA-mutated recurrent disease. An independent council voted on the evidence in ICER’s report.

After reviewing the report, the council voted that niraparib has shown evidence of great net health benefit in both patient populations. Health benefit was demonstrated for olaparib in women taking it as a maintenance therapy. On the contrary, no consensus was reached on the net benefit of rucaparib in patients with recurrent disease.

The council further voted on added benefits for patients taking PARP inhibitors, among which were less complicated treatment regimens, less caregiver burden, and the new mechanism of action of the drugs.

The report recommends policy amendments, including the need to address gaps in evidence about effectiveness in order to better inform clinicians and patients of treatment decisions. ICER also recommended lowering the prices and broadening the eligibility for patient assistance programs.

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“Our report and meeting highlighted the need for further research on the long-term efficacy and safety of PARP inhibitors…Further, the high costs of the drugs do not align with their benefit to patients, “ said Dan Ollendorf, PhD, chief scientific officer, ICER, in a press release (September 29, 2017).

Dr Ollendorf continued: “Stakeholders must collaborate to conduct additional research that provides more clarity on the appropriate clinical use of these drugs, and to ensure that the high costs do not lead to restricted access for patients with already limited options.”—Zachary Bessette