OBJECTIVES: Value frameworks are increasingly used to assess the added value of new oncology therapies. This narrative review explores attributes of value frameworks, using the example of EV, a Nectin-4–directed antibody–drug conjugate for patients with la/mUC previously treated with platinum-based chemotherapy and immunotherapy.

METHODS: Oncology value frameworks identified (January 2022–March 2023) from PubMed, “gray” literature, and official websites of relevant institutions were compared. Value of EV for la/mUC within available oncology value frameworks was assessed.

RESULTS: Six frameworks were analyzed: the American Society of Clinical Oncology’s value framework, the European Society for Medical Oncology’s (ESMO’s) Magnitude of Clinical Benefit Scale (MCBS), the National Comprehensive Cancer Network’s (NCCN’s) Evidence Blocks, the Memorial Sloan Kettering Cancer Center’s Drug Abacus, the Institute for Clinical and Economic Review’s value assessment framework, and the Drug Assessment Framework. Although all frameworks consider safety and efficacy when assessing new oncology treatments, some also include quality-of-life impact, supporting evidence (treatment-free interval, unmet need), and associated health care costs. The frameworks differ in terms of value definition, specific dimensions to consider, budget impact considerations, analytic approaches, and evaluation methods. Only 2 frameworks assessed EV: ESMO-MCBS (Europe) and NCCN’s Evidence Blocks (United States). ESMO-MCBS’s evaluation resulted in a high score of 4 out of 5 for EV after platinum-based chemotherapy and immunotherapy. NCCN’s Evidence Blocks evaluation designated EV as a preferred la/mUC regimen following treatment with platinum-based chemotherapy and immunotherapy.

CONCLUSIONS: Oncology value frameworks offer focused insights into the value of new treatments. However, varying assessment criteria pose challenges in interpretation and comparison across different frameworks despite using the same clinical evidence. EV scored high for effectiveness in 2 value frameworks in which it was assessed and emerged as a preferred therapy for patients with la/mUC previously treated with platinum-based chemotherapy and immunotherapy.