Value Continues to be the Hot Topic at Asembia Oncology Panel Discussion

A panel discussion, titled “The Future of Oncology and Impact on the Pharmaceuticals Supply Chain,” at Asembia’s 2018 Specialty Pharmacy Summit focused heavily on value in the oncology drug space and who gets to determine what the definition of value is.

The panel discussion, moderated by Burt Zweigenhaft, Managing Partner Upstream, included Lyn Fitzpatrick, senior vice president of US and global development at NCCN, Phil Hagerman, RPh, has been chairman emeritus and a member of Diplomat’s Board of Directors, Bill McGiviney, principal at McGivney Global Advisors, and Jayson S Slotnik, principal and founding member of Health Policy Strategies. 

Mr Zweigenhaft started the discussion with a question about who should get to determine value in an oncology drug space that is becoming more and more crowded with new, high-cost treatments. 

Mr McGiviney noted that currently value frameworks are scarcely being used by either payers or providers to determine the cost of oncology drugs. He explained that as more and more treatments with the same mechanism of action come to the market, value will be determined on the pharmacy side. He noted that price will have to be the determining factor in which product is used.

“If your agent is not clinically differentiated, then you’re going to have to go the route of financial differentiation,” he said. 

Mr McGiviney also highlighted a recent program that is using the blockchain to determine value by analyzing big data. He said that individual adjudication on case-by-case basis is difficult for humans, but practical for machines.

Ms Fitzpatrick agreed, stating that payers are going to determine the value through the huge amounts of data they gather, and this definition will surely be beneficial to the payer-perspective. She also noted that value is still a very difficult concept to define, even among providers.

“An interesting thing is that there was a study published a couple of weeks ago that found that even oncologists cannot agree on the definition of value,” she said.

Mr Slotnik explained that value is different based on perspective, and that each stakeholder has a different idea of what value should encompass. 

He explained that integration of pharmacists into the patient-provider relationship could help make for more valuable treatment decisions. He noted that currently, almost every stakeholder that comes into play in a treatment episode is calculated within a physician’s reimbursement; however, pharmacists participation is not included in this. Mr Slotnik said that this discourages a relationship between these two caregivers, and that this barrier will need to be addressed in order to improve value in the oncology space.

Ms Fitzpatrick also explained that value needs to take into account safety and burden on the patient, and that the patient perspective needs to be integrated into value-based decisions. She said that despite recent rhetoric to the contrary, that patient’s need to ask their provider if they are being given the full scope of treatment choices or if those choices are being narrowed based on value-based decision making that they are not aware of. 

“What is the value to the patients?” Ms Fitzpatrick asked the audience. “Life.”

—David Costill