BACKGROUND: Soaring prices for oncology treatments have prompted a discussion of ‘value’ in the clinical community. Several “value-assessment frameworks” (VAFs) for oncology treatments have emerged and a previous paper (Bentley et al., 2017) compared the American Society of Clinical Oncology (ASCO), National Comprehensive Cancer Network (NCCN), European Society of Medical Oncology (ESMO), and Institute of Clinical and Economic Review (ICER) VAFs in terms of how closely they rank ordered the health benefit of fifteen recently released cancer treatments across three cancer types (lung, breast and prostate).

OBJECTIVES: To extend the work of Bentley and colleagues by estimating the quality-adjusted life years (QALYs) and cost per QALY rankings for the same fifteen treatments.

METHODS: The principal trial results reviewed by Bentley and colleagues were digitised to reproduce the Kaplan-Meier curves for progression-free and overall survival. Area under these curves was calculated using extended mean analysis that assumes an exponential tail. Utilities for quality adjustment were taken from the literature and were consistently applied to all treatments within each of the three diseases. Treatment costs were taken from the British National Formulary. Cost-effectiveness was calculated from a UK perspective using net monetary benefit.

RESULTS: The rank ordering for the fifteen drugs using the QALY did not correspond closely to the previously published rank orderings of value produced by alternative VAFs. These rankings changed again, once cost was taken into consideration.

CONCLUSIONS: New oncology VAFs result in variable rank orderings of the same treatments. We demonstrate the use of the QALY as an easily implementable measure of clinical benefit in oncology. Due to the generalisability of the QALY and its role in identifying opportunity costs, we believe it should be considered the gold standard VAF.