The Influence of Value Frameworks on Payer and Oncologist Decision-Making in the United States (US)
Speaker(s)
Runyan A1, Yi J2, Saha S2, Schoenwaelder T3, Quintero T4
1Envision Pharma, San Diego, CA, USA, 2Envision Pharma Group, San Francisco, CA, USA, 3Envision Pharma, Garner, NC, USA, 4Envision Pharma Group, Philadelphia, PA, USA
Presentation Documents
OBJECTIVES: In the US, there is no formal, centralized, health technology assessment process for reviewing new oncology drugs. However, value frameworks can help provide value-based care. This research explores both payers’ and oncologists’ awareness of value frameworks and their influence on decision-making.
METHODS: An online survey was developed and sent to 21 payers and 120 oncologists in the US. Respondents were asked whether they were aware of Institute for Clinical and Economic Review (ICER), American Society of Clinical Oncology (ASCO), National Comprehensive Cancer Network (NCCN), Memorial Sloan Kettering Cancer Center (MSKCC), and European Society for Medical Oncology (ESMO) value frameworks. They were also asked to rate the influence of each on their decision-making, on a scale of 1 to 7 where 1 was low and 7 was high.
RESULTS: Twenty of 21 (95%) payers and 91 of 120 (76%) oncologists were aware of ASCO. Twenty one of 21 (100%) payers and 99 of 120 (83%) oncologists were aware of NCCN. Sixteen of 21 (76%) payers and 61 of 120 (51%) oncologists were aware of MSKCC. Ten of 21 (48%) payers and 61 of 120 (51%) oncologists were aware of ESMO. Nineteen of 21 (90%) payers and 53 of 120 (44%) oncologists were aware of ICER. NCCN has the greatest influence on payers’ and oncologists’ decision-making (6.6 and 5.8 respectively). ASCO also has a high influence on both payers and oncologists (5.2 and 4.9 respectively). ICER has a high influence on payer decision-making, but a lower influence on oncologists (4.8 and 3.7 respectively). ESMO and MSKCC have a more moderate influence on both stakeholders.
CONCLUSIONS: Value frameworks play an important role in US payer and oncologist decision-making. It is critical for manufacturers to consider how to best position their products on value frameworks, especially ICER, ASCO, and NCCN.
Code
HPR185
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Reimbursement & Access Policy, Value Frameworks & Dossier Format
Disease
Drugs, Oncology