Utility of Cancer Value Frameworks for Patients, Payers, and Physicians

In recent years, novel cancer therapies have improved the expected survival of patients but have also increased treatment costs. As a result of these increases, patients are concerned about increasing out-of-pocket costs, clinicians must assess whether “do no harm” includes patient financial harm, and payers want to know if novel therapies are worth the cost.1 To answer these questions, some organizations have created value frameworks that can be applied to cancer therapies. The American Society of Clinical Oncology (ASCO),2 European Society for Medical Oncology (ESMO),3 Institute for Clinical and Economic Review (ICER),4 Memorial Sloan Kettering Cancer Center (MSKCC),5 and National Comprehensive Cancer Network (NCCN)6 have all developed value frameworks. These organizations define value conceptually as a measure of treatment benefits relative to cost, but each organization uses a different method for measuring value. This Viewpoint describes the methodological differences across these frameworks and provides recommendations for improving them for clinicians, patients, and payers.