Comparison of U.S. Oncology Value Frameworks and Integration with Performance-based Pricing

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  • September 20, 2019
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  • Lin, Wen
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Abstract
  • Rising cancer drug costs within the United States have raised questions regarding the accessibility and affordability of these treatments to patients. To curb costs, several organizations created value frameworks for oncology drugs. These frameworks calculate value by measuring the clinical benefit of the drug and dividing it by the cost of the drug. Currently, four U.S. value frameworks exist: the American Society of Clinical Oncology (ASCO) Value Framework, the National Comprehensive Cancer Network (NCCN) Evidence Blocks, the Institute for Clinical and Economic Review (ICER), and the Memorial Sloan Kettering Cancer Center (MSKCC) Drugabacus. These frameworks are defined by their inclusion of three perspectives: the physician, the patient, and the payer. Each of the frameworks weighs clinical, cost, and value metrics differently based on the predominant perspective(s) associated with the framework. For example, the ASCO and NCCN frameworks are primarily used as a shared decision making tool due to their emphasis of the physician and patient perspectives while the ICER and MSKCC Drugabacus frameworks focus on the payer perspective and include population level data and health system ramifications. Due to these different interpretations of value, an integrated value frameworks approach does not exist. However, these frameworks can still be used to change the price of oncology drugs by combining them with performance-based pricing. The frameworks can drive alignment across stakeholders to define and measure clinical outcomes for performance-based pricing. More importantly, the frameworks can be used to create a new pricing process where the framework-generated value output can raise or lower the price of oncology drugs. This will facilitate purchase negotiations between manufacturers and payers based on the value of the drug to patients. While limitations like transparency concerns and regulatory barriers still exist, there is an opportunity to improve the overall value of oncology drugs and match them to the best care pathways by providing patients with the appropriate drug at the right time.
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  • In Copyright
Advisor
  • Dusetzina, Stacie
Degree
  • Master of Healthcare Administration
Academic concentration
  • Health Policy Management
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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  • aa0c65a1-592d-4ed5-833d-e83792387654

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