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Advocacy > Issues > ICER Review of PARP Inhibitors for Ovarian Cancer


12/17/2019 - A FORCE staff member made comments at the FDA ODAC hearing in favor of olaparib as maintenance therapy for BRCA+ metastatic pancreatic cancer patients.

12/9/2019 - FORCE and 100+ orgs advocated that legislators complete FY20 Defense Appropriations Act negotiations and quickly pass/enact the bill to ensure continued funding of the DoD CDMRP.

12/4/2019 - We wrote South Carolina Senate medical affairs committee members asking that they support genetic counselor licensure in the state.

12/4/2019 - We joined the MedEx Coalition in asking elected officials to co-sponsor the Medical Expense Savings Act, legislation making the 7.5% threshold for medical expense deductions permanent.

11/4/2019 - FORCE, along with hundreds of medical and patient advocacy orgs, expressed support for a long-term reauthorization of PCORI.

ICER Review of PARP Inhibitors for Ovarian Cancer

Treatments & Therapies


In July 2017, the Institute for Clinical and Economic Review (ICER) released a draft evidence report titled, “Poly ADP-ribose polymerase (PARP) Inhibitors for Ovarian Cancer: Effectiveness and Value.” FORCE expressed significant concerns about the report's conclusions via written comments and testified at the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC) meeting on September 14, 2017, in St. Louis, MO. ICER released its final report later that month. Despite our efforts and those of many others, the final report does not reflect the value of PARP inhibitors to the broader ovarian cancer community, or to the hereditary cancer community we serve. 

The Institute for Clinical and Economic Review (ICER) is an independent nonprofit organization that evaluates evidence on the value of medical tests, treatments and delivery system innovations to help stakeholders interpret and apply evidence to improve patient outcomes and control costs. Its reports may impact access to care. As such, its review of PARP Inhibitors is of great interest to the hereditary cancer community.

ICER’s report reviews evidence on the comparative clinical effectiveness and value of PARP inhibitors for treatment of ovarian cancer. Currently, these therapies include Rucaparib (Rubraca™, Clovis Oncology), Niraparib (Zejula™, Tesaro, Inc.) and Olaparib (Lynparza™, AstraZeneca). These treatments represent significant progress and provide hope to those impacted by hereditary cancer.

PARP inhibitors offer a number of benefits over traditional chemotherapy including the fact that they are taken orally, so there is no need to commute to an infusion center; they have minimal adverse effects compared to those typically experienced with cytotoxic chemotherapy regimens and invasive surgeries; and, dosing flexibility allows patients and their health care team to manage such symptoms.

ICER admits, “Although substantial uncertainty remains about the impact of PARP inhibitors on overall survival and quality of life, these agents appear to provide additional benefit over existing ovarian cancer therapies that may not be adequately captured in the clinical literature.”

The report indicates that "these agents are much more expensive than existing therapies." However, to evaluate cost, we must also consider savings in productivity, quality-of-life, and the ability to keep patients from wasting precious time on agents that won’t work for them. For personalized medicine to succeed, it is critical that these agents, upon FDA-approval, are accessible to patients and incorporated into clinical practice. This is the large-scale societal benefit of personalized or precision medicine. 

FORCE hopes ICER will revisit its analysis and take a closer look at the research methods and data utilized in this report to ensure that they adequately represent those who stand to benefit most from PARP inhibitors. Restricting coverage and reimbursement for these agents will set back progress and send a discouraging message to scientists, patients, families, biotech companies, and society.

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