J Korean Med Sci.  2021 Jul;36(29):e191. 10.3346/jkms.2021.36.e191.

Should We Consider Value Frameworks for Cancer Drugs as Oncology's Landscape Evolves?; from an Oncologist Perspective in Korea

• Kim DY
• Ha H
• Bae S
• Kang JH

• KMID: 2518738
• DOI: http://doi.org/10.3346/jkms.2021.36.e191

Abstract

Background
As the role of immunotherapies and personalized medicine grow, cancer patients have faced many choices in treatments and have suffered financial toxicity. These challenges brought the need for the value framework (VF) to guide treatment decision making.
Methods
A survey was taken to 102 oncologists about perception for VF. They were asked about priorities among several considerations when they prescribe cancer drugs. Their views on the need for development and potential implications of VF in Korea were assessed, also.
Results
The survey shows that 90% of the respondents choose clinical efficacy as the most important value in cancer drugs selection, and the cost of drug was more weighted value in immune checkpoint inhibitors (13.7%). Approximately half (53.9%) answered that they were aware of the existing VFs. Over 90% of respondents agreed with the need for development of a VF for cancer drugs based on Korean healthcare system and further usefulness for decisions about reimbursement issues. Seventy-one percent answered that two representative VFs (American Society Clinical Oncology-VF and European Society for Medical OncologyMagnitude of Clinical Benefit Scale) should be reflected in value measurement of cancer drugs in Korea.
Conclusion
The Korean oncologists recognized the necessity for the clinical application of VF. Further discussion between the stakeholders should be followed to alleviate the financial burden through the value-based decision making of cancer drugs.

Keyword

Value Framework; Anticancer Drug; Korea

Figure

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  Fig. 1 Summary of consideration when prescribing anticancer drugs and ICIs.In final survey, we asked what factor is most considered when prescribing anticancer drugs and ICIs. Most medical oncologist and hematologist considered efficacy than any other factors. However, they considered cost when prescribing ICIs than anticancer drugs.ICI = immune checkpoint inhibitor.

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  Fig. 2 Awareness of value evaluation tools.Approximately 55% of medical oncologist and hematologist had heard of the value framework for anticancer drugs, however none of the respondents had experience in using the value frameworks practically.

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