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Assessment of value for resource allocation in cancer care

Lindgren P, Jönsson & Wilking N

There has been an increased interest in ways of measuring the value of new therapeutic options inoncology. An example of this in a European context is the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS).

The purpose of this study is to analyse how the value scales, exemplified with ESMO-MCBS, developed mainly to assist decisions by physicians, relate to other measures of clinical benefit andvalue used by reimbursement agencies.We undertook a comparison of ESMO-MCBS with three different approaches to measure value; thepatient benefit scale (AMNOG) used in in Germany, the assessment of ASMR (Amélioration du ServiceMédicalRendu) used in France and estimates of gain in quality adjusted life years (QALY) used in severalcountries such England and Wales, Scotland and Sweden.

The criteria and metrics, as well as the purposeand decision making processes differs between the agencies, which makes it possible to study both differences and similarities between the three different approaches compared to the ESMO-MCBS value framework. Correlations between the scales were formally tested using the Spearmans rank test. There was reasonable agreement between ESMO-MCBS and the AMNOG. Although there was a statistically significant correlation between the scale and ASMR scores overall there is very little agreement between the two categories in the middle of the scale. The link between ESMO-MCBS and QALYs appearsto be very weak with very little differentiation between drugs receiving a ESMO-MCBS of 2, 3 or 4.

The special issue of Journal of Cancer Policy Vol 11 (March 2017) can be found here and all papers are freely available from Friday 27th January, for eight weeks.
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Journal of Cancer Policy 2017 11: 12-18
DOI: http://dx.doi.org/10.1016/j.jcpo.2016.10.001

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