CANCER DIGEST – June 23, 2015 – The American Society of Clinical Oncology (ASCO) today published an initial version of what it hopes to develop into a standardized tool to help patients and their doctors assess the value of cancer treatment options based on clinical benefit, side effects, and for the first time cost.
While cancer patients have long been confronted with discussions of complicated treatment options with varying degrees of effectiveness and side effects. Seldom is
cost discussed, even when the benefits may be measured in only a week or two of longer survival. Meanwhile cancer therapies are among the most expensive treatments patients ever undergo, some ranging from $10,000 to $30,000 per month. Cancer has become a leading cause of bankruptcy according to a 2013 Fred Hutchinson Cancer Research Center study.
As the US healthcare system moves from a fee-for-service based delivery system to value-based care, healthcare providers and payers are working to develop objective ways to measure healthcare value. In 2007 ASCO formed a large task force comprised of physicians, patient advocates, and representatives of the insurance and pharmaceutical industries to develop a framework for evaluating and assessing the relative value of cancer treatments.
The ASCO Value Framework, published in the June 22, 2015 Journal of Clinical Oncology, is their initial effort and was published to solicit comment and spur discussion and is expected to be revised and improved over time.
The ASCO Value Framework proposes to compare the relative clinical benefits, side effects, and costs of treatment regimens that have been tested head-to-head in randomized clinical trials. Data on the clinical benefits and side effects of each regimen are used to calculate a combined “Net Health Benefit” score, or NHB.
The NHB represents the added benefit that patients can expect to receive from the new therapy, versus 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. For patients with advanced cancer, a higher NHB is awarded for regimens that also offer relief from cancer-related symptoms or allow patients a treatment-free period.
ASCO is soliciting comments on the framework, which is available online at www.asco.org/value.
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