ASCO Statement: A Conceptual Framework to Assess the Value of Cancer Treatment Options

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The work of the ASCO Value in Cancer Care Task Force has been guided by the following core principles:

• The physician-patient relationship is of central importance in defining management options for the patient. It is the view of ASCO that the oncologist is the patient's best advocate and resource for guidance in assessing the value of treatment options. To accomplish this, the oncologist must have the knowledge and tools necessary to assess the relative value of therapies for specific clinical scenarios and use these in discussing treatment options with the patient.
• To ensure informed decision making, patients need access to both clinical and cost information about their treatment options. Patients need a clear understanding of the possible clinical benefits and harms of treatment options available to them, along with an appreciation of how these options differ with respect to the relative financial consequences they will face...........
  
  Table 1:  Summary of International Value Determination Frameworks
  
   Fig 1. ASCO Value Framework: advanced disease
  

  Future versions of the framework will allow for patients weighting their preferences such that the fractional contribution of each element (clinical benefit, toxicity) to the overall score can be modified, thereby individualizing the net health benefit. ASCO, American Society of Clinical Oncology; CR, complete response; DAC, drug acquisition cost; OS, overall survival; PFS, progression-free survival; PR, partial response; RR, response rate. 

  
  

  
  

  CALL FOR COMMUNITY COMMENT

  We appreciate that developing a method for establishing value of specific cancer treatment regimens is a daunting task. ASCO views this as an iterative process and encourages comments from all interested parties regarding the elements we have included in the value framework and its utility in facilitating discussion between providers and patients on the value of available treatment options. Comments may be submitted through August 21, 2015, at www.asco.org/value.

  On the basis of these comments, ASCO envisions publishing additional iterations of the framework, practical applications, recommendations regarding the additional evidence needed to develop the most useful value tools, and more detailed examinations of value in these and other disease states.