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Last week, Jeff McIntyre of the Global Liver Institute introduced a draft report from the Institute for Clinical and Economic Review (ICER) on resmetirom and obeticholic acid for NASH. Jeff, an expert reviewer of the report, returns with the Surfers to expand on the contents, its shortcomings and potential implications. Among the panelists are Veronica Miller of the Liver Forum and new guest, Hannah Mamuszka, who is founder and CEO of Alva10.

This wrap-up conversation explores what the panels believe will be the impact of the ICER document for different stakeholder communities. Louise Campbell focuses on how stakeholders will look at price. Jörn Schattenberg uses Veronica phrase, "the genie is out of the bottle," to describe its impact. Veronica suggests that the paper will make an impression on how people think about the drugs, which is challenging given the analytical issues raised throughout the preceding conversations. Jeff asserts that patient involvement can help resolve some of these challenges and issues raised. He suggests the fact that ICER has introduced patients into the process as an excellent step forward. Hannah provides a variety of reasons why patients will be particularly important in this story. She notes that the generations of patients who are most affected by this disease, including Gen X and millennials, are people who tend not to visit primary care doctors. To hear the rest of her take and the final thoughts of Roger Green, tune in for this final session.

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