Dr Scott Ramsey: Value Frameworks Are Moving Toward Harmonization

Value frameworks aren't at an ideal point in their development, yet, but it is important to keep in mind that different frameworks represent different perspectives, said Scott Ramsey, MD, PhD, of Fred Hutchinson Cancer Research Center.

Transcript

Finding common ground among stakeholders when using value frameworks has been difficult. Do you think we're any closer to an ideal or well-balanced value framework?

I think we are closer, we aren’t at an ideal, but the important thing that’s happened with value frameworks is that the organizations that are involved in providing care and financing care have been more explicit about their preferences. So the value frameworks that you see from organizations like ASCO {American Society of Clinical Oncology] and NCCN [National Comprehensive Cancer Network] represent the perspectives of those organizations. And just clarifying that is an important step towards finding harmonization.

What changes would you like to see within the existing frameworks in oncology, such as NCCN, Institute for Clinical and Econommic Review, and ASCO?

The initial thing I would like to see them do is be more transparent about what they’re accounting for in terms of costs and outcomes and also to understand the perspective that they’re taking when they make judgments about those particular aspects of the value frameworks. Those of us in cost-effectiveness generally favor the quality-adjusted life-year [QALY] and a more complete accounting of costs than most of the existing value frameworks that aren’t based on cost per QALY, and I think we need more explicit understanding of where those frameworks are coming from before we can move forward.