As the American Society of Clinical Oncology (ASCO) Annual Meeting kicks off on June 3, topics of conversation among attendees are sure to include the organization’s updated value assessment framework that was published in the Journal of Clinical Oncology. While the framework is still far from perfect, ASCO should be commended for the steps it took to listen to outside stakeholders and incorporate a number of important improvements into its updated framework.
ASCO’s updated assessment framework is intended to “enable a physician and patient to assess the value of a particular cancer treatment regimen given the patient’s individual preferences and circumstances.” Given this focus, the updated framework now includes more factors that are of importance to patients, sharpens the methodology for measuring the benefits and toxicities of cancer treatments, and outlines plans to incorporate patient preference weighting in the software assessment tool under development. These are important and thoughtful changes.
However, the framework still falls short in the areas of cost and evidence evaluation. We continue to recommend that the framework developers include patient costs beyond treatment cost and ensure that patients receive cost information that is accurate and relevant to them. We also encourage ASCO to consider evidence beyond just randomized clinical trials (RCTs) or a single study and to clarify how it selects the evidence it uses for decision-making in the assessment. (See NPC's review of the updated ASCO framework.)
Although ASCO has taken a good step forward, there is still more work to be done. We hope that the updated framework continues to evolve as we gain new evidence and understanding about cancer treatments, and the National Pharmaceutical Council looks forward to being part of ongoing conversations.
Interested in learning more about value assessment frameworks? Check out NPC’s Current Landscape: Value Assessment Frameworks, which compares the main frameworks currently in development, our Guiding Practices for Patient-Centered Value Assessment, and our blog series exploring various aspects of value assessment.