Implementing value assessment in oncology practice: A single-center experience

• Published in: Journal of oncology pharmacy practice Vol. 25; no. 4; p. 947
• Main Authors: Saunders, Katherine, Mably, Mary S, Shull, Sara S, Jones, Heather, Leal, Ticiana A, Bergsbaken, Jason J
• Format: Journal Article
• Language: English
• Published: England 01.06.2019
• Subjects: Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Carcinoma, Non-Small-Cell Lung - drug therapy; Humans; Lung Neoplasms - drug therapy; Medical Oncology; Nivolumab - therapeutic use; non-small cell lung cancer; value; Immunotherapy; oncology
• ISSN: 1477-092X
• DOI: 10.1177/1078155218815741

Cancer treatment costs in the United States are rising. Evidence suggests that increased costs do not always correlate with improved outcomes. Several organizations have developed tools and frameworks to assess cancer treatment value; however, many centers have reported difficulty in implementing these tools and effectively incorporating value-based decision making into clinical practice. After evaluating existing frameworks, the Carbone Cancer Center at UW Health set out to create a value-based tool that could be used to inform the decisions of clinicians and patients. This tool was piloted in metastatic or advanced non-small cell lung cancer, specifically in the second-line setting to assess the value of immune checkpoint inhibitors nivolumab, atezolizumab, and pembrolizumab. The results of the pilot suggest that atezolizumab is the best value of the three agents in this patient population. Challenges and opportunities for improvement that were identified during the pilot process have helped refine the tool for use in a variety of disease states within oncology.