Undermining Patient Values: The ASCO Value in Cancer Care Task Force Framework




As stated in a recent article in the Journal of Clinical Oncology, ASCO established a Value in Cancer Care Task Force, with the goal of “developing a framework for comparing the relative clinical benefit, toxicity, and cost of treatment in the medical oncology setting. “  In developing this framework or tool, the Task Force runs roughshod over basic facts to create a metric that – while established to promote patient centered care – strives mightily to achieve the exact opposite outcome.



IMS Health Finds Global Cancer Drug Spending Crossed $100 Billion Threshold in 2014


Agency for Healthcare Research and Quality. Total Expenses and Percent Distribution for Selected Conditions by Type of Service: United States, 1996-2012. Medical Expenditure Panel Survey Household Component Data. Generated interactively.(June 09 2015)


Howard, David H., Peter B. Bach, Ernst R. Berndt, and Rena M. Conti. 2015. "Pricing in the Market for Anticancer Drugs." Journal of Economic Perspectives, 29(1): 139-62.

An Economic Evaluation of the War on Cancer Eric C. Sun, Anupam B. Jena, Darius N. Lakdawalla, Carolina M. Reyes, Tomas J. Philipson, and Dana P. Goldman NBER Working Paper No. 15574 December 2009. We arrived at the number of life-years gained using the approach in this paper and updating it. We multiplied the average increase in life years (2 million) by the number of years between 1995 and 2013. (18) 2x18=36 million

We then multiplied the additional life-years by a conservative estimate ($82,000) of what people think (in dollar amounts) they would gain by living another year.

x82=2.952 trillion.

Pharmacy Cost Sharing Limits for. Individual Exchange Benefit Plans: Actuarial Considerations. Milliman Client Report, March 5 2015. http://bit.ly/1F4mKQ0

Agency for Healthcare Research and Quality. Total Expenses and Percent Distribution for Selected Conditions by Type of Service: United States, 1996-2012. Medical Expenditure Panel Survey Household Component Data. Generated interactively.(June 09 2015)

Terminal Care and The Value of Life Near Its End Tomas J. Philipson, Gary Becker, Dana Goldman, and Kevin M. Murphy NBER Working Paper No. 15649 January 2010 JEL No. H0,I0


Using Disability Adjusted Life Years to Value the Treatment of Thirty Chronic Conditions in the U.S. from 1987-2010Tina Highfill and Elizabeth Bernstein - BEA Working Paper (WP2014-9)

“ASCO acknowledges that this method of calculating the NHB does not permit assessment of the relative value of regimens that were not directly compared in clinical trials and that the observed improvement in NHB for a new regimen might be influenced by whether the comparator was best supportive care or active treatment. Nevertheless, ASCO believes this method to be one that is well grounded in the available medical evidence and provides the most objective assessment of NHB.â€

Lichtenberg, F. R. (2007), Benefits and costs of newer drugs: an update. Manage. Decis. Econ., 28: 485–490. doi: 10.1002/mde.1355

Frank R. Lichtenberg Has medical innovation reduced cancer mortality?

NBER Working Paper No. 15880 Issued in April 2010

Int J Cancer. 2015 Feb 15;136(4):E136-45. doi: 10.1002/ijc.29105. Epub 2014 Sep 4.

Measuring the societal burden of cancer: the cost of lost productivity due to premature cancer-related mortality in Europe.

Hanly P1, Soerjomataram I, Sharp L.

BMC Cancer. 2014 Mar 26;14:224. doi: 10.1186/1471-2407-14-224.

The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden.

Hanly PA1, Sharp L. See also J Natl Cancer Inst. 2008 Dec 17;100(24):1763-70. doi: 10.1093/jnci/djn384. Epub 2008 Dec 9.

Productivity costs of cancer mortality in the United States: 2000-2020.

Bradley CJ1, Yabroff KR, Dahman B, Feuer EJ, Mariotto A, Brown ML.

Association of Specialty Drug Prescription Abandonment with Increasing Member Out of Pocket Expense

https://www.primetherapeutics.com/specialty/assets/pdf/AMCP_2014_Spring_Specialty_Rx_Cost_Share_Associated_Abandonment.pdf. See also, Gleason, P.P., G.C. Alexander, C.I. Starner, et al. Health Plan Utilization and Costs of Specialty Drugs within Four Chronic Conditions. Journal of Managed Care Pharmacy 2013;19(7):542–48 and

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