Dynamic Assessment of Value During High-Cost Cancer Treatment: A Response to American Society of Clinical Oncology and European Society of Medical Oncology

Given, Charles W.; Given, Barbara; Krauss, John C.; Sikorskii, Alla; Vachon, Éric

doi:10.1200/jop.2016.012401

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…Financial hardship screening should be conducted multiple times throughout the treatment trajectory to reflect changes in the treatment plan and patients' lives. 52 Screening alone is inadequate without a management plan. Such a plan includes referrals to social services, compassionate care programs, legal aid societies, and financial management services.…”

Section: Role For Quality Metricsmentioning

confidence: 99%

“…Ultimately, the domains chosen should be those agreed upon by key stakeholders who experience and bear the financial burdens associated with cancer and its treatment. Financial hardship screening should be conducted multiple times throughout the treatment trajectory to reflect changes in the treatment plan and patients' lives 52 …”

Section: Role For Quality Metricsmentioning

confidence: 99%

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Time to add screening for financial hardship as a quality measure?

Yabroff

Zafar

Shih

2020

CA A Cancer J Clinicians

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Cancer treatment is associated with financial hardship for many patients and families. Screening for financial hardship and referrals to appropriate resources for mitigation are not currently part of most clinical practices. In fact, discussions regarding the cost of treatment occur infrequently in clinical practice. As the cost of cancer treatment continues to rise, the need to mitigate adverse consequences of financial hardship grows more urgent. The introduction of quality measurement and reporting has been successful in establishing standards of care, reducing disparities in receipt of care, and improving other aspects of cancer care outcomes within and across providers. The authors propose the development and adoption of financial hardship screening and management as an additional quality metric for oncology practices. They suggest relevant stakeholders, conveners, and approaches for developing, testing, and implementing a screening and management tool and advocate for endorsement by organizations such as the National Quality Forum and professional societies for oncology care clinicians. The confluence of increasingly high-cost care and widening disparities in ability to pay because of underinsurance and lack of health insurance coverage makes a strong argument to take steps to mitigate the financial consequences of cancer.

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Section: Role For Quality Metricsmentioning

confidence: 99%

Section: Role For Quality Metricsmentioning

confidence: 99%

Time to add screening for financial hardship as a quality measure?

Yabroff

Zafar

Shih

2020

CA A Cancer J Clinicians

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“…Given et al [6] suggest a strategy of dynamic assessment of value in the context of highcost cancer treatment. In particular, they discuss oral molecular agents similar to Expensivimab in the context of metastatic disease.…”

Section: Patient-centered Drug Coverage Policiesmentioning

confidence: 99%

How Should Therapeutic Decisions about Expensive Drugs Be Made in Imperfect Environments?

Fleck

Danis

2017

AMA Journal of Ethics

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Clinicians must inevitably make therapeutic decisions under nonideal conditions. They practice in circumstances that involve incomplete evidence. They deliver care in health care systems that are complex and poorly coordinated. Each of the patients that they take care of is unique while research offers evidence regarding relatively homogeneous populations of patients. Under these circumstances, many partiesmedical scientists, reviewing agencies, insurers, and accountable care organizations-can and should contribute to optimizing the development, approval, funding, and prescription of therapiesparticularly expensive and marginally beneficial therapies. In aggregate, they should aspire to achieve a pattern of fair, cost-effective therapeutic decisions to ensure a sustainable health care system. Here we offer some suggestions regarding decisions that physicians might pursue to facilitate fair and cost-effective patient care. CaseDr. C sits on a committee as part of his tertiary care center's accountable care organization (ACO) that is considering whether a new biologic, Expensivimab, should be included in the organization's bundled treatment plan for its patients. Expensivimab is a new humanized antibody that targets an apoptotic receptor. One study suggests that it increases tumor-free survival in late stage non-small cell lung cancer (NSCLC) by a median of six months relative to a drug approved several years ago. Another suggests that it increases overall survival by a month-and-a half relative to the same drug. Yet no research on the comparative effectiveness of Expensivimab relative to other interventions for NSCLC exists, and even data on the risks of Expensivimab relative to the older drug is scant.Furthermore, assessing Expensivimab's cost-benefit ratio is difficult. Although Expensivimab costs $750,000 per patient, the United States Food and Drug Administration (FDA) did not request any data on trial participants' perceptions of their quality of life. Hence, no assessment of quality-adjusted life years (QALYs) or disability-

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“…The reorganization and chaos introduced into the health care system by recent congressional, regulatory, and judicial action, makes the discussion of value even more complex. The accompanying article by Given et al 1 3 Porter proposes measures for determining quality that prioritize outcomes over processes and tier-rank outcomes. In cancer, the top tier outcome is survival; however, survival often takes years to measure.…”

mentioning

confidence: 99%

Where Does Dynamic Value Assessment Fit Into Our Role as Agents Advising Our Patients With Cancer?

Blayney

2016

JOP

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Dynamic Assessment of Value During High-Cost Cancer Treatment: A Response to American Society of Clinical Oncology and European Society of Medical Oncology

Cited by 4 publications

References 31 publications

Time to add screening for financial hardship as a quality measure?

Time to add screening for financial hardship as a quality measure?

How Should Therapeutic Decisions about Expensive Drugs Be Made in Imperfect Environments?

Where Does Dynamic Value Assessment Fit Into Our Role as Agents Advising Our Patients With Cancer?

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