ABSTRACT
The medical community has a direct impact on payer decision-making through clinical treatment guidelines, value frameworks, publications and their counsel in medical committees and advisory meetings. While medical experts often judge evidence of clinical improvement in more wholistic manner, taking all patient data in to consideration to form a reasonable evidence-based conclusion, payers and Health Technology Assessments can be much more dogmatic. Value frameworks have significantly grown in importance over the last few years, particularly in the management of cancer. The stated goal of the National Comprehensive Cancer Network evidence blocks are: to provide the health care provider and the patient information to make informed choices when selecting systemic therapies based upon measures related to treatment, supporting data, and cost. The American Society of Clinical Oncology has been very vocal about its concern over prescription drug cost. The European Society for Medical Oncology has introduced the “Magnitude of Clinical Benefit Scale” tool to evaluate the value of new drug treatments.
