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What is good value in terms of cancer treatment?  The question, amid rising cancer care costs, has prompted a surge of oncology value models in recent years.  These models mean to link the price of care with a drug’s proven benefit. But as a newly released policy paper from the Institute for Patient Access explains, models must serve as tools, not replacements, for physician decision-making.

Authored by oncologist Joanne Dragun, MD, and Mary Ann Chapman, PhD, “Oncology Value Models” acknowledges a number of challenges.  For instance, while policymakers and health plans may focus on quantifiable measures such as price and outcomes, patients may define value in terms of their own quality of life.  Even models that do incorporate patient values may not encompass the precise values that matter to a given patient – or prioritize them in the same way that a patient does.

Yet price must be part of the care conversation, the authors concede.  Doctors cannot present a patient with a care plan “in a vacuum” that ignores factors such as high out-of-pocket costs.

The paper briefly considers four of the most prominent value models created in recent years:

Although oncology value models can be useful, the paper explains, they come with “real dangers.”  Health plans may use data from these models to restrict access to medications prescribed by patient’s doctors, undermining physicians’ ability to make patient-specific decisions.  Or cancer care centers may pressure physicians to recommend medications based on how they fare in a given oncology value model.

To keep cancer care personalized, effective and rooted in the physician-patient relationship, the paper concludes, these models cannot be misused as tool for rationing care and limiting access.

To learn more, read, “Oncology Value Models.” 

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