Value = clinical benefit, side effects, and cost.
This simple formula comprises the American Society of Clinical Oncology’s (ASCO’s) initial version of a conceptual framework created to assess the value of new cancer treatment options compared with existing ones.
Few tools are available to help physicians and patients objectively assess costs and benefits. And, with newly approved drugs approaching $10,000 per month (some exceeding $30,000), ASCO is acknowledging with its framework the need to address the “financial toxicity” many patients with cancer face when they seek treatment.
“We developed the value framework to help doctors guide their patients to the treatment that is best for them based on expected benefits, potential side effects, and likely costs,” Richard L. Schilsky, MD, ASCO Chief Medical Officer and a member of ASCO’s Value in Cancer Care Task Force, told Cancer Therapy Advisor.
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These elements “are readily measured, ascertainable from high-quality medical evidence, and central to the mission of the clinical oncologist,” stated a Journal of Clinical Oncology article published online ahead of print.1
To create this personalized value assessment, a treatment regimen is assigned a “net health benefit” score from 0 to 100; for patients with metastatic disease, up to 30 bonus points are added if the regimen is palliative or extends the treatment-free interval.
When asked if he anticipated any pushback from insurance companies that might only cover the cost of a regimen based on the net health benefit score, Dr. Schilsky replied, “We don’t know if, or how, insurance companies might use the framework to reach coverage decisions, but we hope that such decisions will ensure that patients have access to all potentially beneficial treatments, and not limit a patient’s choice in any way.”
The value framework is not intended to limit the prescribing options available to physicians.