Advertisement

Approaches to Capturing Value in Oncology

  • Evelyn WalterEmail author
Chapter
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 213)

Abstract

This article sets out to describe different value frameworks in the field of new developments in oncology. Since the costs of new oncological therapies follow a steep path, their implementation and financing demand a thorough assessment. This is an ambitious task due to the complex nature of oncological treatments within overall health policy. Five value frameworks were reviewed: European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale, American Society of Clinical Oncology (ASCO) Value Framework (version 2.0), National Comprehensive Cancer Network (NCCN) Evidence Blocks, Memorial Sloan Kettering Cancer Center DrugAbacus, and the Institute for Clinical and Economic Review Value Assessment Framework. They are all based on a large set of criteria. However, all these frameworks differ considerably in their outcomes. Among the main differences one has to cite are the inclusion of costs and the use of different outcomes, as well as the fact that they address different target stakeholders, etc. Despite these shortcomings, the value frameworks serve the necessity to introduce more rationality in health decision making seen from the perspective of physicians, patients, and financing bodies.

Keywords

Value framework Quality-adjusted life year Incremental cost-effectiveness ratio Willingness-to-pay threshold 

References

  1. Austrian Economics Analytics OG. Eine Einführung in die Österreichische Schule der Nationalökonomie. http://www.austrianeconomicsanalytics.at/austrian-economics/eine-einfuehrung-in-die-oesterreichische-schule-der-nationaloekonomie/. Accessed 03 Feb 2018
  2. AVBCC 2013 Steering Committee: co-moderators, Beed G, Owens GM et al (2012) Defining value in cancer care: AVBCC 2012 steering committee report. Am Health Drug Benefits 5(4):202–217Google Scholar
  3. Barnett W (2003) The modern theory of consumer behavior: ordinal or cardinal? Quart. J. Austrian Econ 6(1):41–65CrossRefGoogle Scholar
  4. Becker DJ, Lin D, Lee S, Levy BP, Makarov DV, Gold HT, Sherman S (2017) Exploration of the ASCO and ESMO value frameworks for antineoplastic drugs. J Oncol Pract 13(7):e653–e665CrossRefGoogle Scholar
  5. Brouwer WB, Koopmanschap MA (2000) On the economic foundations of CEA. Ladies and gentlemen, take your positions! J Health Econ 19(4):439–459 (2000)CrossRefGoogle Scholar
  6. Carrera P, IJzerman MJ (2016) Are current ICER thresholds outdated? Valuing medicines in the era of personalized healthcare. Expert Rev Pharmacoecon Outcomes Res 16(4):435–437.  https://doi.org/10.1080/14737167.2016.1180980. Epub 6 May 2016CrossRefGoogle Scholar
  7. Cherny NI, Sullivan R, Dafni U, Kerst JM, Sobrero A, Zielinski C, de Vries EG, Piccart MJ (2015) A standardised, generic, validated approach to stratify the magnitude of clinical benefit that can be anticipated from anti-cancer therapies: the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Ann Oncol 26(8):1547–1573.  https://doi.org/10.1093/annonc/mdv249. Epub 30 May 2015CrossRefGoogle Scholar
  8. Cheng S, McDonald EJ, Cheung MC, Arciero VS, Qureshi M, Jiang D, Ezeife D, Sabharwal M, Chambers A, Han D, Leighl N, Sabarre KA, Chan KKW (2017) Do the American society of clinical oncology value framework and the European society of medical oncology magnitude of clinical benefit scale measure the same construct of clinical benefit? J Clin Oncol 35(24):2764–2771.  https://doi.org/10.1200/jco.2016.71.6894 Epub 2 June 2017CrossRefGoogle Scholar
  9. Clark S, Weale A (2012) Social values in health priority-setting: a conceptual frame-work? J Health Organ Manage 26(3):293–316CrossRefGoogle Scholar
  10. Cohen DJ, Reynolds MR (2008) Interpreting the results of cost-effectiveness studies. J Am Coll Cardiol 52(25):2119–2126.  https://doi.org/10.1016/j.jacc.2008.09.018CrossRefGoogle Scholar
  11. Collins M, Latimer N (2013) NICE’s end of life criteria: who gains, who loses. BMJ 346(27):22–23CrossRefGoogle Scholar
  12. Dafni U, Karlis D, Pedeli X, Bogaerts J, Pentheroudakis G, Tabernero J, Zielinski CC, Piccart MJ, de Vries EGE, Latino NJ, Douillard JY, Cherny NI (2017) Detailed statistical assessment of the characteristics of the ESMO magnitude of clinical benefit scale (ESMO-MCBS) threshold rules. ESMO Open 2(4):e000216.  https://doi.org/10.1136/esmoopen-2017-000216. eCollection 2017CrossRefGoogle Scholar
  13. Del Paggio JC, Sullivan R, Schrag D, Hopman WM, Azariah B, Pramesh CS, Tannock IF, Booth CM (2017) Delivery of meaningful cancer care: a retrospective cohort study assessing cost and benefit with the ASCO and ESMO frameworks. Lancet Oncol 18(7):887–894.  https://doi.org/10.1016/s1470-2045(17)30415-1. Epub 2 June 2017CrossRefGoogle Scholar
  14. Devlin NJ, Lorgelly PK (2017) QALYs as a measure of value in cancer. J Cancer Policy 11:19–25CrossRefGoogle Scholar
  15. Edwards RT, Boland A, Wilkinson C, Cohen D, Williams J (2003) Clinical and lay pre-ferences for the explicit prioritisation of elective waiting lists: survey evidencefrom Wales. Health Policy 63(3):229–37CrossRefGoogle Scholar
  16. Feeley TW, Fly HS, Albright H, Walters R, Burke TW (2010) A method for defining value in healthcare using cancer care as a model. J Healthc Manag 55(6):399–411 (discussion 411-2)CrossRefGoogle Scholar
  17. Garau M, Shah KK, Mason AR, Wang Q, Towse A et al (2011) Using QALYs in cancer. Pharmacoeconomics 29:673–685CrossRefGoogle Scholar
  18. Garell J (2007) Lessons Learned: What is Value? Depends on how/when you look at it. 16 Dec 2007. Accessed 15 Feb 2018Google Scholar
  19. GBD 2013 Mortality and Causes of Death Collaborators (2013) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet 385(9963):117–171.  https://doi.org/10.1016/s0140-6736(14)61682-2. Epub 18 Dec 2014
  20. Goldstein DA (2016) Using quality-adjusted life-years in cost-effectiveness analyses: do not throw out the baby or the bathwater. J Oncol Pract 12(6):500–502.  https://doi.org/10.1200/JOP.2016.011460. Epub 3 May 2016CrossRefGoogle Scholar
  21. Gyawali B, Parsad S, Feinberg BA, Nabhan C (2017) Real-world evidence and randomized studies in the precision oncology era: the right balance. JCO Precis Oncol 1:1–5Google Scholar
  22. Kenny N, Joffres C (2008) An ethical analysis of international health priority-setting. Health Care Anal 16:145–160CrossRefGoogle Scholar
  23. Kiesewetter B, Raderer M, Steger GG, Bartsch R, Pirker R, Zöchbauer-Müller S, Prager G, Krainer M, Preusser M, Schmidinger M, Zielinski CC (2016) The European society for medical oncology magnitude of clinical benefit scale in daily practice: a single institution, real-life experience at the Medical University of Vienna. ESMO Open 1(4):e000066. eCollection 2016CrossRefGoogle Scholar
  24. Lemieux J, Audet, S (2018) Value assessment in oncology drugs: funding of drugs for metastatic breast cancer in Canada. Curr Oncol 25:S161–S170.  https://doi.org/10.3747/co.25.3846CrossRefGoogle Scholar
  25. Lim CS, Lee YG, Koh Y, Heo DS (2014) International comparison of the factors influencing reimbursement of targeted anti-cancer drugs. BMC Health Serv Res 14:595.  https://doi.org/10.1186/s12913-014-0595-0
  26. Memorial Sloan Kettering Cancer Center. Drug abacus. Available at http://www.drugabacus.org/drug-abacus-tool. Accessed 03 Mar 2018
  27. Metcalfe S, Grocott R (2010) Comments on “Simoens, S. health economic assessment: a methodological primer. Int J Environ Res Public Health 6:2950–2966 New Zealand in fact has no cost-effectiveness threshold. Int J Environ Res Public Health 7(4):1831–1834.  https://doi.org/10.3390/ijerph7041831. Epub 20 Apr 2010CrossRefGoogle Scholar
  28. Milken Institute, Avalere (2016) Integrating the patient perspective into the development of value frameworks. Mar 2016. www.fastercures.org/assets/Uploads/value-coverage-framework-March-2016.pdf. Accessed 30 May 2018
  29. National Centre for Pharmacoeconomics. NCPE report on the cost effectiveness of nintedanib (Vargatef®) in combination with docetaxel for the treatment of adult patients with locally advanced, metastatic or locally recurrent non-small cell lung cancer of adenocarcinoma tumour histology after first line chemotherapy. http://www.ncpe.ie/wp-content/uploads/2015/02/Nintedanib-Vargatef-summary.pdf. Accessed 15 May 2018
  30. National Centre for Pharmacoeconomics. Cost-effectiveness of nivolumab (Opdivo®) for the treatment of locally advanced or metastatic non-squamous NSCLC after prior chemotherapy in adults. http://www.ncpe.ie/wp-content/uploads/2016/04/Summary-Nivolumab-in-non-sq-NSCLC.pdf. Accessed 15 May 2018
  31. National Centre for Pharmacoeconomics. NCPE report on the cost effectiveness of nivolumab (Opdivo®) for the treatment of locally advanced or metastatic squamous non-small cell lung cancer after prior chemotherapy in adults. http://www.ncpe.ie/wp-content/uploads/2016/03/Nivolumab-for-sq-NSCLC-summary.pdf. Accessed 15 May 2018
  32. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines) with NCCN evidence blocks. www.nccn.org/evidenceblocks/default.aspx. Accessed 08 Jan 2018
  33. National Institute for Health and Care. Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer. https://www.nice.org.uk/guidance/ta406/documents/final-appraisal-determination-document. Accessed 15 May 2018
  34. National Institute for Health and Care. Crizotinib for the treatment of previously treated non-small-cell lung cancer associated with an anaplastic lymphoma kinase (ALK) fusion gene. https://www.nice.org.uk/guidance/ta296/documents/lung-cancer-nonsmallcell-anaplastic-lymphoma-kinase-fusion-gene-previously-treated-crizotinib-evidence-review-group-report3. Accessed 15 May 2018
  35. National Institute for Health and Care. Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer. https://www.nice.org.uk/guidance/ta310/chapter/3-the-manufacturers-submission. Accessed 15 May 2018
  36. National Institute for Health and Care. Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer. https://www.nice.org.uk/guidance/ta192/documents/lung-cancer-nonsmallcell-first-line-gefitinib-final-appraisal-determination3. Accessed 15 May 2018
  37. Olsen JA, Smith RD (2001) Theory versus practice: a review of ‘willingness-to-pay’ in health and health care. Health Econ 10(1):39–52CrossRefGoogle Scholar
  38. Pettitt DA, Raza S, Naughton B, Roscoe A, Ramakrishnan A, Ali A, Davies B, Dopson S, Hollander G, Smith JA, Brindley, DA (2016) The limitations of QALY: a literature review. J Stem Cell Res Ther6(4) (Article: 1000334)Google Scholar
  39. Reuters (2018) As cancer drug prices climb, value not keeping pace. https://www.reuters.com/article/us-health-cancer-drug-costs/as-cancer-drug-prices-climb-value-not-keeping-pace-idUSKBN1HJ2GK. 12 Apr 2018. Accessed 02 May 2018
  40. Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, Palmero R, Garcia-Gomez R, Pallares C, Sanchez JM, Porta R, Cobo M, Garrido P, Longo F, Moran T, Insa A, De Marinis F, Corre R, Bover I, Illiano A, Dansin E, de Castro J, Milella M, Reguart N, Altavilla G, Jimenez U, Provencio M, Moreno MA, Terrasa J, Muñoz-Langa J, Valdivia J, Isla D, Domine M, Molinier O, Mazieres J, Baize N, Garcia-Campelo R, Robinet G, Rodriguez-Abreu D, Lopez-Vivanco G, Gebbia V, Ferrera-Delgado L, Bombaron P, Bernabe R, Bearz A, Artal A, Cortesi E, Rolfo C, Sanchez-Ronco M, Drozdowskyj A, Queralt C, de Aguirre I, Ramirez JL, Sanchez JJ, Molina MA, Taron M, Paz-Ares L (2012) Spanish Lung Cancer Group in collaboration with Groupe Français de Pneumo-Cancérologie and Associazione Italiana Oncologia Toracica. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 13:239–246CrossRefGoogle Scholar
  41. Schwartzberg L, Ettinger D, Jahanzeb M et al (2018) Op-Ed: our view on value frameworks in oncology: proposing principles for value framework development. OBR Green 11. http://obroncology.com/article/op-ed-our-view-on-valueframeworksin-oncology-proposing-principles-for-value-framework-development/. Accessed 15 Feb 2018
  42. Schnipper LE, Davidson NE, Wollins DS, Tyne C, Blayney DW, Blum D, Dicker AP, Ganz PA, Hoverman JR, Langdon R, Lyman GH, Meropol NJ, Mulvey T, Newcomer L, Peppercorn J, Polite B, Raghavan D, Rossi G, Saltz L, Schrag D, Smith TJ, Yu PP, Hudis CA, Schilsky RL (2015) American society of clinical oncology statement: a conceptual framework to assess the value of cancer treatment options. J Clin Oncol 33(23):2563–2577.  https://doi.org/10.1200/JCO.2015.61.6706 Epub 22 Jun 2015CrossRefGoogle Scholar
  43. Schnipper LE, Bastian A (2016) New frameworks to assess value of cancer care: strengths and limitations. Oncologist 21(6):654–658.  https://doi.org/10.1634/theoncologist.2016-0177CrossRefGoogle Scholar
  44. Sequist LV, Yang JC, Yamamoto N, O'Byrne K, Hirsh V, Mok T, Geater SL, Orlov S, Tsai CM, Boyer M, Su WC, Bennouna J, Kato T, Gorbunova V, Lee KH, Shah R, Massey D, Zazulina V, Shahidi M, Schuler M (2013) Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol 31:3327–3334CrossRefGoogle Scholar
  45. Shaw AT, Kim DW, Nakagawa K, Seto T, Crinó L, Ahn MJ, De Pas T, Besse B, Solomon BJ, Blackhall F, Wu YL, Thomas M, O'Byrne KJ, Moro-Sibilot D, Camidge DR, Mok T, Hirsh V, Riely GJ, Iyer S, Tassell V, Polli A, Wilner KD, Jänne PA (2013) Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med 368:2385–2394CrossRefGoogle Scholar
  46. Siddiqui M, Rajkumar SV (2012) The high cost of cancer drugs and what we can do about it. Mayo Clin Proc 87(10):935–943.  https://doi.org/10.1016/j.mayocp.2012.07.007CrossRefGoogle Scholar
  47. Simoens S (2010) Health economic assessment: cost-effectiveness thresholds and other decision criteria. Int J Environ Res Public Health. 7(4):1835–1840.  https://doi.org/10.3390/ijerph7041835 Epub 20 Apr 2010CrossRefGoogle Scholar
  48. Slomiany M, Madhavan P, Kuehn M, Richardson S (2017) Value frameworks in oncology: comparative analysis and implications to the pharmaceutical industry. Am Health Drug Benefits 10(5):253–260Google Scholar
  49. Smith TJ, Hillner BE (2011) Bending the cost curve in cancer care. N Engl J Med 364(21):2060–2065.  https://doi.org/10.1056/NEJMsb1013826CrossRefGoogle Scholar
  50. Solomon BJ, Mok T, Kim DW, Wu YL, Nakagawa K, Mekhail T, Felip E, Cappuzzo F, Paolini J, Usari T, Iyer S, Reisman A, Wilner KD, Tursi J, Blackhall F, et al (2014) First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med 371:2167–2177CrossRefGoogle Scholar
  51. Stafinski T, McCabe C, Menon D (2014) Determining social values for resource allocation decision-making in cancer care: A Canadian experiment. J Cancer Policy 2(3):81–88CrossRefGoogle Scholar
  52. Ting J, Tien Ho P, Xiang P, Sugay A, Abdel-Sattar M, Wilson L (2015) Cost-effectiveness and value of information of erlotinib, afatinib, and cisplatin-pemetrexed for first-line treatment of advanced egfr mutation-positive non-small-cell lung cancer in the United States. Value Health 18(6):774–782.  https://doi.org/10.1016/j.jval.2015.04.008 Epub 22 June 2015CrossRefGoogle Scholar
  53. Vallejo-Torres L, García-Lorenzo B, Castilla I, Valcárcel-Nazco C, García-Pérez L, Linertová R, Polentinos-Castro E, Serrano-Aguilar P (2016) On the estimation of the cost-effectiveness threshold: why, what, how? Value Health19(5):558–566.  https://doi.org/10.1016/j.jval.2016.02.020. Epub 23 Apr 2016CrossRefGoogle Scholar
  54. Vergnenegre A, Massuti B, de Marinis F, Carcereny E, Felip E, Do P, Sanchez JM, Paz-Arez L, Chouaid C, Rosell R (2016) Spanish lung cancer group, Italian association of thoracic oncology, and French lung cancer group. Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC. J Thorac Oncol 11(6):801–807.  https://doi.org/10.1016/j.jtho.2016.02.004. Epub 18 Feb 2016CrossRefGoogle Scholar
  55. Walleser S, Ray J, Bischoff H et al (2012) Maintenance erlotinib in advanced nonsmall cell lung cancer: cost-effectiveness in EGFR wild-type across Europe. ClinicoEcon Outcomes Res CEOR 4:269–275.  https://doi.org/10.2147/CEOR.S31794
  56. Wang S, Peng L, Li J, Zeng X, Ouyang L, Tan C, Lu Q (2013) A trial-based cost-effectiveness analysis of erlotinib alone versus platinum-based doublet chemotherapy as first-line therapy for Eastern Asian nonsquamous non-small-cell lung cancer. PLoS One 8(3):e55917.  https://doi.org/10.1371/journal.pone.0055917. Epub 8 Mar 2013CrossRefGoogle Scholar
  57. Wilson L, Lin T, Wang L, Patel T, Tran D, Kim S, Dacey K, Yuen C, Kroon L, Brodowy B, Rodondi K (2017) Evaluation of the ASCO value framework for anticancer drugs at an academic medical center. J Manag Care Spec Pharm 23(2):163–169.  https://doi.org/10.18553/jmcp.2017.23.2.163CrossRefGoogle Scholar
  58. Woods B, Revill P, Sculpher M, Claxton K (2016) Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value Health 19(8):929–935CrossRefGoogle Scholar
  59. World Health Organisation. Cancer key facts. http://www.who.int/en/news-room/fact-sheets/detail/cancer. Accessed 15 Feb 2018
  60. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, Wang C, Zhang S, Wang J, Zhou S, Ren S, Lu S, Zhang L, Hu C, Hu C, Luo Y, Chen L, Ye M, Huang J, Zhi X, Zhang Y, Xiu Q, Ma J, Zhang L, You C (2011) Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 12(8):735–742.  https://doi.org/10.1016/S1470-2045(11)70184-X. Epub 23 Jul 2011CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Institute for Pharmaeconomic ResearchViennaAustria

Personalised recommendations