VALUE FRAMEWORKS TO SET TONGUES WAGGING: ANALYSIS OF OPINIONS AND DISCUSSIONS ON THE MOST POPULAR VALUE FRAMEWORKS

• Published in: Value in health 2017-05, Vol.20 (5), p.A62
• Main Authors: Koczula, KM, Noon, K, Wickstead, RM, Ghosh, W, Uchea, C, Kusel, J
• Format: Article
• Language: English
• Subjects: Cancer; Economic models; Feedback; Health care; Internet; Literature reviews; Medical research; Oncology; Patient-centered care; Pharmaceutical industry; Physicians; Reproducibility; Transparency; Value
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.05.005

OBJECTIVES: Value frameworks are a new and emerging field in the United States (US). Since the establishment of the Institute for Clinical and Economic Review (ICER), there has been much online debate on the use of value frameworks. We aimed to explore online discussions and opinions on five existing value frameworks. METHODS: A pragmatic literature review was conducted in Google using search terms for the ICER, American Society of Clinical Oncology (ASCO), Memorial Sloan Kettering Cancer Center DrugAbacus (MSKCC), and National Comprehensive Cancer Network (NCCN) value frameworks and the National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK). The first 60 results for each term were screened against inclusion criteria. Eligible records included journal articles, blogs and open letters. Independent opinions were extracted for analysis and classified as positive/ negative/neutral. RESULTS: A total of 67 records were included, providing 252 opinions for analysis. ICER was the most frequently discussed framework (50% of all opinions), yet 82% of comments on ICER were negative. Commonly cited criticisms were lack of transparency and reproducibility of economic models and need for more patient-centered evidence. The majority of negative comments were from patient representatives, clinicians and pharmaceutical companies. NICE, ASCO and MSKCC had 62%, 58% and 50% negative opinions, respectively. In contrast, the NCCN framework had the highest percentage of positive opinions (76%) related to being of significant value to physicians, transparent for patients and affiliated with outstanding research. CONCLUSIONS: ICER was the most discussed framework, but had the most negative comments, possibly due to ICER’s call for feedback in July 2016. NCCN appeared to be the most positively received framework. Despite NICE being well established in the UK, the majority of opinions were negative. Limitations of this study include use of Google only and subjective opinion selection.