Public Release: 

Rheumatology community responds to ICER Rheumatoid Arthritis Report

American College of Rheumatology

ATLANTA - American College of Rheumatology President Sharad Lakhanpal, MBBS, MD, today issued the following statement regarding the publication of the Institute for Clinical and Economic Review's (ICER) Review of Treatments for Rheumatoid Arthritis.

"The Institute for Clinical and Economic Review (ICER) has issued its final report on the Review of Treatments for Rheumatoid Arthritis, which evaluates health and economic outcomes of various medications used for the treatment of rheumatoid arthritis (RA). Based on our in-depth review of ICER's early draft and our preliminary and ongoing review of the final report, we would like to express our concerns over ICER's approach, methodology, and conclusions as we think ICER's report may result in reduced patient access to medically necessary treatment for RA.

"The American College of Rheumatology (ACR) is an active supporter of comparative effectiveness research (CER) as this type of research has the potential to powerfully inform physician and patient decisions about the relative merits of one treatment compared to another. CER should not, however, be employed to limit therapeutic options and force patients toward therapies that are not medically appropriate. Ideally, CER would highlight the need for multiple treatment options to address heterogeneous groups of patients with individual and unique co-morbidities. Unfortunately, studies that lack long-term follow-up and do not take into consideration patient heterogeneity, co-morbidities, preferences and tolerances must be interpreted within their limitations. The ACR is concerned that the ICER report, while based on a commonly used method to assess cost-effectiveness, provides insufficient information on model structure and validation.

"Furthermore, while the final report confirms the important clinical impact of biologic therapies for RA patients, the analysis fails to address the rising cost of these therapies, how these artificial economic forces impact the conclusions of the study, and how to make the drugs more affordable. For all these reasons, we are concerned that the report will limit access to effective treatment for RA patients for whom there are no medically appropriate alternatives.

"The ACR will continue to review the final ICER report and provide more detailed comments in the coming weeks.

"The rheumatology community appreciates ICER compiling this report as more research is needed to help address the various treatment options available for patients living with RA."


The American College of Rheumatology (ACR) is the nation's leading advocacy organization for the rheumatology care community, representing more than 9,500 rheumatologists and rheumatology health professionals. As an ethically driven, professional membership organization committed to improving healthcare for Americans living with rheumatic diseases, the ACR advocates for high-quality, high-value policies and reforms that will ensure safe, effective, affordable and accessible rheumatology care.

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