Value assessment in oncology is an emerging area of interest, as demonstrated by the multiple value assessment tools launched in the last 5 years to help stakeholders analyze the efficacy, tolerability, and affordability of oncology treatments. With the definition of value being slightly different depending on the stakeholder and the pace of change in oncology therapeutics, creation of value assessment tools is quite complex, to say the least. The articles in this issue address various points of contention within the value conversation, such as inclusion of the patient’s perspective and transparency of data, with one column providing an overview of four currently available value assessment tools and their evolution over time.
The value conversation for a drug, especially from a patient’s perspective, extends well beyond drug cost. In addition to utilization of cost-effectiveness analyses, decision makers need access to all relevant data to assist informed decisions around suitable and appropriate care. Surabhi Dangi-Garimella, PhD, asserts that transparent, collaborative, and iterative approaches are essential to create and define the success of value assessment tools. She highlights the Innovation and Value Initiative’s (IVI) Open-Source Value Platform (OSVP) for providing a unique contribution in these areas.
Building upon Dr Dangi-Garimella’s views, Tom Valuck, MD, JD, and Matthew Castner, MHA, applaud the IVI OSVP as a promising development, while also noting that the open source approach to value assessment may struggle to make value judgments, as there is not a consensus definition of value; participants may pursue their own motivations to different ends. Regardless of the theoretical strengths and weaknesses of an open source approach, they say, commitment to openness and transparency in the value assessment process promotes patient autonomy—a bedrock principle of patient centeredness.
Over the last 5 years, a handful of value assessment tools have been created, including the Drug Abacus, the American Society of Clinical Oncology Value Framework, the National Comprehensive Cancer Network Evidence Blocks, and the Institute for Clinical and Economic Review Value Assessment Framework. In this month’s Pharma Insights column, Jeremy Schafer, PharmD, MBA, and Larry Blandford, PharmD, explore how these four different frameworks have evolved over time and the role they play in value assessment in light of the staggering rate of change in oncology treatment.
Finally, demonstrative of the rapid pace of change in oncology therapeutics, Mark G Faber, DO, and colleagues provide a review of the current state of myelodysplastic syndromes (MDS) and therapies in development. Despite years of therapeutic stagnation, several promising agents have recently emerged as front runners for potential approval, potentially breaking the 10-year drought in approvals for this disease. In addition to current disease management standards, authors discuss the novel MDS therapies in development, with a focus on those that seem most likely to reach regulatory approval.
