Cancer Pharmaceuticals and the Value Equation

Conference Correspondent

How do you measure value in cancer care?

“That’s the key point that keeps us all up at night,” said Ravinder Dhawan, PhD, Vice President and Head of Oncology for Merck, in the October 23 webcast of the Association for Value-Based Cancer Care (AVBCC) 10th Annual Summit.

In this session, Dr Dhawan, along with Anna Kaltenboeck, MA, Senior Health Economist Program Director of the Center for Health Policy and Outcomes and the Drug Pricing Lab at Memorial Sloan Kettering Cancer Center, and Avi Mamidi, PharmD, BCPS, Senior Director of Market Access at PRECISIONvalue, debated quality-adjusted life-years, social determinants of health, companion diagnostics and biomarkers, and other measures to better define the value of cancer therapies.

Ms Kaltenboeck spoke frankly, saying: “I have yet to see any instance of real value-based care occurring in oncology. You have to differentiate between value-based care and value-based pricing. When you price a drug arbitrarily at the get-go, not at the expected value of what the drug is going to be, is that value-based care? I’d argue that it is not.”

They debated whether an international pricing index model, such as the one currently under development at the Centers for Medicare & Medicaid Services, could provide a way into value-based care, but noted that there are significant limitations. “There are going to be instances where you have a product with no direct competitor, which means you’re not going to have the same level of competitive dynamics,” Ms Kaltenboeck said. “You’re not going to solve value-based care overnight, whether with reference pricing or another strategy.”

There has to be a way to get at the “total cost of care equation,” Dr Dhawan said. “We are looking at a holistic approach. If we can sit down with payers and devise a way to look at value holistically and not just under a narrow definition, that’s something we aspire to for better value-based care in the future.”

To hear the full range of these experts’ insights on value-based care in cancer drugs register for the AVBCC Summit! There are 8 more weeks of webcasts and keynotes on the way, which are invaluable for anyone who wants to understand cancer care in the United States today.

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