Table 1.
The 5 Value Frameworks Differ in Emphasis
| Value Frameworks6–10 | |||||
|---|---|---|---|---|---|
| Emphasis | ASCO | NCCN | MSKCC | ICER | ESMO |
| Application | |||||
| Target stakeholder | Patient Physician |
Patient Physician |
Physician Policymaker |
Payer Policymaker |
Payer Policymaker |
| Conditions addressed | Oncology: solid, blood | Oncology: solid, blood, radiology, surgery | Oncology: solid, blood | All conditions, focus on new drugs of high impact | Oncology: solid, blood, radiology, surgery |
| Combination therapy evaluation | Yes | Yes | No | Yes | Yes |
| Clinical trial data | |||||
| Breadth of evidence | 1 trial, RCT | Published data, panel members' clinical experience, case reports | 1 trial, registration trial of first indication (FDA label) | RCT meta-analysis and manufacturer-provided data | 1 trial, RCT, comparative outcomes study, meta-analysis |
| Trial sample size accounted | No | Yes | Yes | Yes | Indirectly, through lower bound of 95% CI |
| Allows for single-arm trials | Partially | Likely | Yes | Yes | No |
| Acknowledges trial contamination | No | Likely | No | Yes | Yes |
| Accounts for patient preference | No | Yes | Yes | No | No |
| Readout | |||||
| Outcomes | Net health benefit score | Evidence Blocks scores | DrugAbacus price | Cost-effectiveness; budget impact | ESMO MCBS |
| Cost/price | Price (WAC or ASP+) per month or course of therapy | Affordability scale | Abacus price per month or course of therapy | Cost per year | Not specified, left to payers to evaluate |
ASCO indicates American Society of Clinical Oncology; ASP, average sales price; CI, confidence interval; ESMO, European Society for Medical Oncology; FDA, US Food and Drug Administration; ICER, Institute for Clinical and Economic Review; MCBS, Magnitude of Clinical Benefit Scale; MSKCC, Memorial Sloan Kettering Cancer Center; NCCN, National Comprehensive Cancer Network; RCT, randomized controlled trial; WAC, wholesale acquisition cost.