Increasing costs have given rise to concerns about the financial burden on the healthcare system in the face of an ever-growing portfolio of cutting-edge cancer drugs at our disposal. Major medical groups have taken an approach in 2015 to develop elaborate tools targeted at providing guidance and support in navigating the complex decision tree.
For instance, the American Society of Clinical Oncology (ASCO) released a conceptual framework to help assess the value of new cancer therapies based on treatment benefits, toxicities, and costs. Published in the Journal of Clinical Oncology, the framework is designed to ultimately serve as a basis for user-friendly, standardized tools that physicians can employ in the clinical setting with their patients to discuss the relative value of new cancer therapies as compared with established treatments. The “ASCO drug scorecard” is boiling down select data to a single number, rating treatment regimens on a scale from 0 to 100, or 130 in some cases, with bonus points. Not surprisingly, oncologists haven’t been shy about awarding low scores.
Other established players, such as the Memorial Sloan Kettering Cancer Center, have also come up with ways to re-evaluate “the cost of cancer care” by proposing a tool, the DrugAbacus, to calculate the “Abacus Price” of a treatment based on value. It offers an interactive exploration of drug pricing by factoring in a range of parameters beyond the ostensible—such as novelty and development costs of a drug, or rarity and population burden of a condition.
Finally a third organization that has taken on the challenge is the National Comprehensive Cancer Network (NCCN). Although it historically asks its panels not to consider cost when assembling NCCN guidelines, the national organization has added a new measure of affordability into their Evidence Blocks, which were presented to the public in October 2015. These new Evidence Blocks categorize treatments based on additional parameters beyond efficacy, safety, and pricing—to include quality and consistency of evidence, and affordability of regimen or agent.
US oncologists have gradually been declining to prescribe high-priced medicines, as top cancer specialists have said in interviews with Reuters. As prices for cancer therapies continue to rise, their value has become subject to scrutiny. The new assessment tools provide a standardized and methodical approach that takes into account a more holistic and less de-contextualized vision of the real world. This is an invitation for responsibility and sustainability, and ultimately a commitment to better medicine.
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