Definition of "Value" in Cancer Care Varies

The concept of value may be, and is, interpreted differently among healthcare stakeholders, and not only do cancer patients define value differently from policy makers, but also from other patients.

In a study of 769 patients with metastatic breast cancer, nearly half gave 2 different responses, according to research from the Cancer Support Community presented at the 5th Annual Conference of the Association for Value-Based Cancer Care.

“Decisions are currently being made regarding how cancer care will be delivered and reimbursed in the future. These decisions must be based on real patient needs and expectations,” Linda House, president of CSC, said in a statement. “These study results reveal a disconnect in how patients define value and how it is being measured now by healthcare policy makers.”

After being asked the open-ended question “How do you define value?” 38.4% of patients defined value in terms of personal value, while 7.41% defined it in terms of exchange value, whether that was economic or health specific. In addition, 11% of patients indicated they did not fully understand the question and 3% reported “no value.” Nearly half didn’t even answer the question.

Of the patients who had a health-specific response, 76% described treatment benefit as being engaged with or feeling close to their healthcare provider (HCP). For instance, one patient responded, “I would define value as my warm and caring association with my healthcare team.”

Meanwhile, professional organizations and trade associations are defining value in cancer treatments by factoring in clinical benefit, toxicity, and cost.

“When defining value relative to health care, patients emphasized the importance of their relationship with HCPs rather than the benefit of cost-effective treatment,” the researchers concluded. “Although quality, efficiency, and cost transparency in value-based care are essential, patients may be more focused on quality care as it relates to the HCP—patient relationship than on value relative to efficiency/cost.”