OBJECTIVES: Value assessment frameworks (VAFs) have had increased prominence in the United States (US) in the context of rising healthcare costs and greater interest in assessing the value of therapeutics. This study aims to provide updated insights on current trends, perceptions, and utilization of VAFs in decision-making processes among US payers.

METHODS: Double-blinded, web-based surveys were fielded in November 2016 (N=56), November 2018 (N=47), and October 2020 (N=47) to a panel of managed care professionals through Xcenda’s Managed Care Network (MCN). Descriptive statistics were used to assess trends in payer familiarity with VAFs, and the one-way analysis of variance (ANOVA) was used to evaluate mean differences across survey years.

RESULTS: Compared to 2016, respondents in 2020 were significantly more familiar with the Institute for Clinical and Economic Review’s (ICER) VAF and the National Comprehensive Cancer Network’s (NCCN) Evidence Blocks (EBs) (P<0.001). In contrast, average familiarity with the Memorial Sloan Kettering Cancer Center’s (MSKCC) DrugAbacus did not significantly differ between 2016 and 2020 (P=0.08). payers were significantly more familiar with ICER and NCCN EB VAFs compared to MSKCC (P<0.001). Use of ICER and NCCN EBs to inform payer decisions generally increased over time. In 2016, 30% and 16% of payers reported no use of ICER or NCCN EBs, respectively, while only 4% reported no use of either VAF by 2020. Across years, NCCN EBs were used most frequently to inform major clinical decisions (45–55%), while were used more frequently for major economic decisions (23–45%).

CONCLUSIONS: Results suggest that payers are becoming more familiar with VAFs and are generally using them more frequently in decision-making processes. Given the influence of VAFs on payers’ coverage decisions, stakeholders should remain informed about current VAF practices and proactively engage in assessments and methodology design when possible.