Seth Ginsberg, president of the Global Healthy Living Foundation, said that argument is the easy answer about why the proposed rule should not be implemented.
"The longer, harder answer is that the methodology is flawed, so regardless of whether that methodology is allowed, it's not right," he said.
"The immediate impact [of the rule] will be restricted access and limited availability [of medication], and denial of care, and worsening of disease," Ginsberg said.
He added that ICER's review process "focuses on financial, and only financial [considerations] instead of the health benefits."
"There are no patients involved in the process," Ginsberg said. "We're offended that patients aren't incorporated into this."
"They're ignoring so many metrics and so many variables that we patients value so much," he said. "They're ignoring quality of life. They're ignoring things like productivity."
Ginsberg also argued that ICER, which gets some of its funding from health insurance companies and whose advisory board has members from the insurance industry, is "an arm of the insurance industry."
Sarah Emond, chief operating officer of ICER, disputed that claim. She the group's evaluation process "includes input from all of the major sectors" in health care.
"We take into account the payor perspective," meaning insurers, "the same way we take into account the patient perspective and the clinician perspective," she said. Insurance companies' views, she added, do "not have more or less weight than another other piece of that coalition."
Emond also said that the QALY methodology is both "unfortunately named" and a "misunderstood metric."
"It in no way disadvantages patients with illness and disabilities," she said. "It really does come down to a way for people to compare the improvements that come in patients' lives from 'Drug A' compared to 'Drug B' versus 'Surgery C.' "
Emond said that QALY is just one component of ICER's analytical work. "It's not meant to be the only metric that's important when thinking about the value that drugs bring to patients," she said.
She added that ICER's "entire mission is to open up the black box about how judgments are made about the prices of these drugs," which "now happen behind closed doors."
"We don't set prices," she said. "We give decision makers another piece of information about what a price could be that reflects the value that the drug brings to the patient, as well as to society."