Value-Based Care in Lung Cancer

Abstract

Since the beginning of the 21st century, the treatment of lung cancer has changed dramatically. New treatments are improving survival outcomes for patients but have led to dramatic increases in cost. In a value-based payment system, patients should have access to comprehensive outcome measurements, including survival rates, quality of life, and cost. High value in cancer care will optimize the outcomes that matter to patients relative to cost.

Pemetrexed/carboplatin plus gefitinib as a first-line treatment for EGFR-mutant advanced nonsmall cell lung cancer: a Bayesian network meta-analysis

“…Using the NCCN’s guidelines on efficacy, safety, quality, consistency of evidence, and affordability, first-generation EGFR-TKIs are high in efficacy and quality with moderate affordability, while osimertinib is quite expensive with low affordability. 45,46 In China, pemetrexed, carboplatin and gefitinib are covered by medical insurance making them more affordable. 47–49 From the perspective of cost-effectiveness, PC plus gefitinib showed better efficacy and costs less, therefore, is an excellent option for EGFR-mutant NSCLC as a first-line treatment.…”

Validity and Reliability of Value Assessment Frameworks for New Cancer Drugs

“…With the exception of the NCCN framework developers, each of the other framework developers published transparent descriptions of their development processes, which included multiple stakeholders. Evaluating the frameworks' construct validity-the extent to which they actually measure the latent variable "value"-is challenging, because multiple definitions of value have been offered [16,[21][22][23][24]. The Institute of Medicine defined the six elements of value as effectiveness, safety, patient-centeredness, timeliness, efficiency, and equity [18].…”

Papel de la persona navegadora del paciente en el cáncer de pulmón

“…Por otro lado, el cáncer de pulmón es la neoplasia de mayor incidencia en el mundo 3 e impone una carga significativa en la vida de las personas 4 . Desde principios del siglo XXI, el manejo ha cambiado drásticamente, y los nuevos tratamientos están mejorando los resultados de supervivencia, pero han implicado aumentos notables en los costos 5 . En tal sentido, resulta de particular importancia contar con un equipo de salud que se ocupe de la asistencia de esta población desde las etapas iniciales (rastreo y/o diagnóstico temprano) hasta el final de la vida.…”