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ASCO presents value-based solutions to promote affordability, preserve innovation of cancer drugs
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ASCO today issued a position statement that proposes a wide range of cost-cutting strategies that can be tested to help lower drug costs based on a standard definition of value.
Strategies addressed included to allow Medicare to negotiate drug prices and to legalize the importation of drugs. Any solution must preserve patients’ access to care, promote affordability and foster innovation in drug development, according to the statement.
“In what, undoubtedly, is one of the most difficult times in their lives, individuals with cancer should be focused on getting the best care possible, not worrying about financial strain on their families,” Clifford A. Hudis, MD, FACP, FASCO, CEO of ASCO, said in a press release. “As cancer doctors, we’re accountable for ensuring our patients receive the right drug at the right time, but that alone isn’t going to rein in costs. We need our nation’s leaders to tackle the major drivers of patients’ cost burdens, including rising prices.”
In the position statement — the goal of which is to contribute to the national dialogue regarding the rise of cancer drug prices — the society analyzed options and recommended solutions from policymakers.
“We propose a number of modest ‘experiments’ to determine if any model can help rein in drug costs without jeopardizing innovation or access to care,” the statement said.
As guidance for ongoing and future efforts, ASCO recommended the following:
- Solutions to address the affordability of cancer drugs should be identified, evaluated, prioritized and tested before a wide-scale, national launch;
- The larger community — including providers, patient advocates, payers, hospitals, experts in health economics and health outcomes, representatives from the pharmaceutical and biotechnology industries, Members of Congress, and Administration policymakers — must actively participate in dialogue and engagement to develop policy solutions to address the affordability of cancer drugs; and
- A diverse group of stakeholders — possibly convened by Congress and/or the Administration — from across the health care sector can identify, prioritize and test potential solutions to address the affordability of cancer drugs, as well as help define a standard approach to assessing the value of drugs that could be applied broadly to inform drug pricing and reimbursement.
“With appropriate authorization by Congress to identify a standardized, value-based evaluation of therapeutics, the community at large could deliver a model in short course,” the statement said. “Moreover, with a standard framework for defining and assessing value, testing multiple value-based pricing models is possible. A valid and reliable framework, one that is evidence-based and patient-centered, could support value-based approval of new therapies.”
New oncology drugs typically cost more than $100,000 per year. Those prices are expected to increase by more than 20% per year; however, despite entering the marketplace at high prices, only 19% of recently approved cancer drugs met ASCO’s 2014 policy statement goals for producing clinically meaningful survival outcomes for patients, the statement said.
“Drug pricing is clearly too complex and political to tackle without evidence-based solutions,” Hudis said. “We’re focused on finding out what works and what the potential downsides and unintended consequences might be with each intervention. However, ASCO believes we must develop approaches that will protect patients from rising costs while improving care.”
ASCO suggested the FDA limit its approval for indications to those that meet or exceed the society’s recommended incremental benefits to ensure development of high-value drugs.
The society also recommended testing different value-based pricing strategies, including value-based pathways, indication-specific pricing and outcomes-based pricing. ASCO also recommended Medicare test a value-based pathway approach to reimbursement to determine its feasibility.
However, the statement did not support the use of payment bundles to control drug costs, which bundle all costs for treating a patient into a single episode-based payment. These payments do not affect price directly and could force providers to make lower value choices, according to the statement.
Lastly, ASCO noted the importance of transparent drug costs and the reimportation of drugs.
“We must balance these principles with recognition of the financial toll of drug costs on private and public budgets,” the statement said. “ASCO contends that solutions centered on value stand the best chance of achieving this balance in the most equitable and effective way. Drawing on the collective knowledge of its more than 40,000 members, ASCO stands ready to work together with the larger community to define, test and agree upon solutions to ensure access, affordability and innovation — with the ultimate goal of ensuring the health and well-being of the patients our members serve.” – by Kristie L. Kahl