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Experts Weigh in on Controversial Issue of Determining Value of Cancer Care at NCCN Conference
Date:3/16/2009

cost.

"What's debatable," said Dr. Newcomer, "is what people consider affordable." He noted that "no one can demonstrate value" according to this definition, however, because the necessary data are not readily available.

A. Mark Fendrick, MD, of the University of Michigan, known as an expert in the area of value-based insurance design (VBID), noted that individuals have not been asking for information on cost and quality when purchasing health care. Dr. Fendrick also raised the issue of the economic stimulus package; provisions in the stimulus legislation about comparative effectiveness research had sparked contentious debate in Washington, as some stakeholders are pushing for cost to be "explicitly eliminated" from the value equation.

Dr. Bailes concurred with Dr. Fendrick's view and stressed again the difficulty of assessing value in the absence of cost.

Bringing the focus back on the government, Scott Gottlieb, MD, of the American Enterprise Institute explained that increased government focus on cancer spending as a target for cost control has been driven by the growth trajectory of cancer care cost. He also discussed the political feasibility of cost control measures, comparing the relative ease of limiting access to technology rather than the difficulty of changing physician behavior.

Dr. Goodman sought a response on this issue from Robert Mass, MD, of Genentech, Inc. as to whether these discussions made industry uneasy. Dr. Mass responded that discussions on value were not uncomfortable for industry "because our goal is to create new products to help patients --that's value in cancer care."

Questioned about the cost and benefit of drugs and biologics manufactured by Genentech, Dr. Mass relayed that "our job is to provide the data to physicians so that they can make informed decisions. We set a price based on the value we perceive [the therapy]
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SOURCE National Comprehensive Cancer Network
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