Chicago, IL—Escalating drug prices have put value frameworks in the spotlight, and the identification of the key questions and the audience addressed in each value framework is vital to understanding the value landscape, said Kasia Shields, PharmD, MBA, BCOP, BCPS, Director, Medical Communications, Xcenda/AmerisourceBergen, at the 2016 Hematology/Oncology Pharmacy Association Oncology Pharmacy Practice Management Program.
Value can be simply defined as benefit that exceeds cost, suggested Dr Shields. “We want to make sure that patients have better access to therapies, and don’t have a penalty based on the cost of the drugs. When we have better alternatives and outcomes, hopefully we will spark innovation,” she said.
Dr Shields summarized the 5 current value frameworks in oncology.
“Not every area of oncology has standard of care. Things are moving really fast, and we’re left comparing apples to oranges, removing the value from the equation,” said Dr Shields. “But I think it’s better to have 5 groups trying to arrive at a definition of value than having the government telling us how we should go about it, so having this discussion is beneficial,” she added.
Dr Shields warned that because these new methodologies have not been fully tested or validated, the value frameworks lack uniformity, and it is still unclear how these findings will be used in treatment and reimbursement decisions. Some methods lack transparency, none of the methods focus on every component of healthcare and disease management, and all of the value frameworks may undergo considerable revision from their first published versions.
The current value frameworks require work before they can be considered as effective tools for shared decision-making, because they must fit into the workflow of a busy clinical practice, said Dr Shields. These value frameworks may be less pertinent to patients and physicians and more applicable to policymakers. Overall, more work is needed to determine how best to consider factors, other than cost, that matter to patients (eg, adverse events, ancillary benefits).
“This is the era of value frameworks in oncology, and I don’t think it’s going anywhere. But the bottom line is, these frameworks are early in development, so awareness is half the battle,” said Dr Shields.