The American Society of Clinical Oncology (ASCO) published an initial version of a conceptual framework for assessing the value of new cancer treatment options based on clinical benefit, side effects, and cost.1 The framework is designed to serve as a user-friendly, standardized tool that physicians can use with their patients to discuss the relative value of new cancer therapies compared with established treatments.
ASCO noted that newly approved cancer drugs now cost an average of $10,000 per month, with some exceeding $30,000 per month and many patients are feeling the impact because they pay a significant share of drug costs.
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The ASCO Value Framework proposes a methodology to compare the relative clinical benefits, side effects, and costs of treatment regimens that have been tested head-to-head in randomized clinical trials.
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Data on the clinical benefits and side effects of each regimen are used to calculate a combined net health benefit (NHB) score.
The NHB represents the added benefit that patients can expect to receive from the new therapy compared to the current standard of care. The NHB is calculated based on improvement in overall or progression-free survival, and on the number and severity of toxicities.
The NHB is presented alongside the patient’s expected out-of-pocket costs for the regimens being compared, as well as the overall drug acquisition cost. The framework, which is still under development, is intended for physicians to use on an individual basis with their patients. It would not provide generalizable scores or rankings.
References
- American Society of Clinical Oncology. Value in cancer care. ASCO website. http://www.asco.org/practice-research/value-cancer-care. Accessed October 26, 2015.
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) with NCCN Evidence Blocks. National Comprehensive Cancer Network website. http://www.nccn.org/evidenceblocks/. Accessed October 26, 2015.
- Kantarjian H, Rajkumar SV. Why are cancer drugs so expensive in the United States, and what are the solutions? Mayo Clin Proc. 2015; 90(4):500-504. 4. Bach PB. Limits on Medicare’s ability to control rising spending on cancer drugs. N Engl J Med. 2009; 360(6):626-633.
