Utility of Cancer Value Frameworks for Patients, Payers, and Physicians

Chandra, Amitabh; Shafrin, Jason; Dhawan, Ravinder

doi:10.1001/jama.2016.4915

Cited by 56 publications

(54 citation statements)

References 4 publications

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“…Alternatives to the use of clinician-reported adverse event data derived from randomized controlled trials Although of many of the studies reviewed here identified one or more shortcomings of RCT-derived AE data, only three (17%) of the publications on value frameworks proposed the future incorporation of data from sources outside of an RCT setting [102][103][104]. Similarly, only 18% of the cost models used data sources outside of RCTs for AEs [72,74,75,87,88].…”

Section: Synthesis Of Results Of Literature Evaluationsmentioning

confidence: 97%

“…Although the construct of these five frameworks and their intended audiences have been compared previously, this study further characterizes the current and future utility of these frameworks with respect to integration of AEs and patient reported outcome (PRO) information [102][103][104][105][106]. Specifically, this review addressed the following: What recommendations have been promoted to improve the quality and/or relevance of AE-related input data for value frameworks?…”

Section: Resultsmentioning

confidence: 99%

“…This review captures recommendations and perspectives from a total of 17 peer-reviewed publications [95,[102][103][104][106][107][108][109][110][111][112][113][114][115][116][117][118]. The reviewed studies were almost evenly split between those including a narrative/qualitative comparison of different frameworks and those incorporating case study/quantitative comparisons across different value frameworks.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, enhanced clarity and transparency as to the intended audience for the framework outputs [103,104,110,111,121] and improved guidance to enhance reproducibility were common recommendations [107,108,111,114,119,122].…”

Section: Icer Provide Synthesis For Use By Policymakers and Payers/ Fmentioning

confidence: 99%

“…Additionally, more comprehensive insights into methodological and data input assumptions across these studies could be gleaned by review of key underlying studies cited by the studies reviewed here. [103,112,119,138] Frameworks should incorporate data from sources other than clinical trials (e.g., observational studies) 3 of 17 (18%) [102] Frameworks should incorporate more robust and/or detailed safety and/or toxicity data 7 of 17 (41%) [103,104,108,112,115,116] Frameworks should use integrated quality of life measures in lieu of safety data 1 of 17 (6%) [117] Frameworks should incorporate more longitudinal data 2 of 17 (12%) [102,103] Frameworks should engage patients in the data evaluation and input process 3 of 17 (18%) [102,103,110] …”

Section: Limitations Of These Reviewsmentioning

confidence: 99%

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Do current approaches to assessing therapy related adverse events align with the needs of long-term cancer patients and survivors?

Pettit

Kirch

2018

Cardio-Oncology

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The increasing efficacy of cancer therapeutics means that the timespan of cancer therapy administration is undergoing a transition to increasingly long-term settings. Unfortunately, chronic therapy-related adverse health events are an unintended, but not infrequent, outcome of these life-saving therapies. Historically, the cardio-oncology field has evolved as retrospective effort to understand the scope, mechanisms, and impact of treatment-related toxicities that were already impacting patients. This review explores whether current systemic approaches to detecting, reporting, tracking, and communicating AEs are better positioned to provide more proactive or concurrent information to mitigate the impact of AE's on patient health and quality of life. Because the existing tools and frameworks for capturing these effects are not specific to cardiology, this study looks broadly at the landscape of approaches and assumptions. This review finds evidence of increasing focus on the provision of actionable information to support long-term health and quality of life for survivors and those on chronic therapy. However, the current means to assess and support the impact of this burden on patients and the healthcare system are often of limited relevance for an increasingly long-lived survivor and patient population.

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Section: Synthesis Of Results Of Literature Evaluationsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Icer Provide Synthesis For Use By Policymakers and Payers/ Fmentioning

confidence: 99%

Section: Limitations Of These Reviewsmentioning

confidence: 99%

See 3 more Smart Citations

Do current approaches to assessing therapy related adverse events align with the needs of long-term cancer patients and survivors?

Pettit

Kirch

2018

Cardio-Oncology

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The Past and Future of the Affordable Care Act

Skinner

Chandra

2016

JAMA

Self Cite

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But he also stresses the lesson of appreciating pragmatism in legislation and implementation. That is a good lesson, yet it does not contradict the importance of also being guided by philosophical principle. If it were a separate economy, the US health system would be equivalent to the fifth or sixth largest economy in the world. It is both pragmatic and principled to recognize that achieving agreement on how to redesign an economy that large, or to do it successfully in 1 piece of legislation, is beyond the capabilities of the federal government. That is why core parts of the ACA need to be reassessed and revised and why empowering the US system of federalism to adapt and experiment with the law is so important.

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