ISSUE: The World Health Organization (WHO) defines health equity as the absence of unfair, avoidable, or remediable differences in health among population groups defined socially, economically, demographically, or geographically. According to this definition, an increase in distributional fairness in health outcomes across these groups implies a positive health equity impact. Attention and commitment to improving health equity has grown, as evidenced by initiatives like the Centers of Medicare and Medicaid Services (CMS) updating the basis of 2027 Star Ratings to “Health Equity Index” (HEI) from the current “Reward Factor”. Consequently, methods like DCEA, have evolved from conventional CEA to also quantify health equity impact. This session will feature a debate among a methodologist, physician, and payer on whether and how DCEA can inform and improve health equity, with an oncology focus.

OVERVIEW: DCEA is an intuitively appealing extension of conventional CEA to quantify health inequality impact of a medical intervention. The purpose of this panel is to posit the question, how far can DCEA go in informing health equity-related decision-making in oncology from multi-dimensional perspectives including a methodologist, clinician, and payer. After a session introduction and opening statement on the oncology context of DCEA (Grossman ~5 minutes), panel members will discuss its methodological considerations (Jansen), clinical relevance (Trinh), and payer value (Lopes) (~10 minutes each). Subsequently, panel members will have a debate led by the moderator (25 minutes). In addition to audience questions, the following will be addressed: Is DCEA credible, useful, implementable, impactful, or even the right measure for health equity? How does DCEA fit in with existing frameworks that address health equity such as CMS AHEAD Model, Enhancing Oncology Model (EOM), and National Committee for Quality Assurance (NCQA) Health Equity Accreditation for health plans? How can methodologists best work with physicians and payers to operationalize and optimize DCEA in practice?