[PRM1] Comparison of the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (Esmo-Mcsb) and the American Society of Clinical Oncology (Asco) Framework for Assessing Value in Cancer Care

[PRM1] Comparison of the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (Esmo-Mcsb) and the American Society of Clinical Oncology (Asco) Framework for Assessing Value in Cancer Care

2016

Rémuzat, C. | Chouaid, C. | Auquier, P. | Borget, I. | Kornfeld, A. | Toumi, M. | Volume: 19, Issue: 7, Pages: A357,

OBJECTIVES: In 2015, ESMO and ASCO published two different frameworks to assess value of cancer therapies. The objective of this research was to compare these two value frameworks for oncology products. METHODS: ESMO and ASCO value frameworks for cancer therapies were reviewed and compared for objectives, content and scoring. RESULTS: ESMO developed the Magnitude of Clinical Benefit Scale (ESMO-MCBS) for solid cancers to influence policy decision makers, while ASCO value framework has been developed for all cancers as tool to facilitate dialogue between physicians and patients in assessing value of new cancer therapies. ESMO-MCBS is applied to comparative studies, while ASCO value framework allows for single-arm trials by using response rate. Both tools are subdivided in 2 sub-frameworks to reflect curative and palliative settings, computing clinical benefit (with hazard ration (HR) as key variable), toxicities, and quality of life (QoL). QoL is only part of ASCO value framework for palliative care, while considered in curative setting in ESMO-MCBS. For palliative setting framework, ESMO-MCBS clinical benefit is modulated according to OS or PFS in the control arm, which is not the case in ASCO framework. ESMO-MCBS allows for immature data with high disease-free survival for curative products, while ASCO framework awards bonus point depending on tail of survival curve for both settings. ASCO framework additionally includes bonus points for palliation of symptoms and/or treatment-free interval for palliative care. Finally, ASCO framework considers therapy cost (but not part of scoring), which is not taken into account in ESMO-MCBS. CONCLUSIONS: Even if some convergences have been seen between ASCO and ESMO value framework following revised version of ASCO tool, with inclusion of QoL and HR as preferred variable instead of median overall survival/progression-free survival, these tools will display different results. Further discussions with patients, physicians, payers and other stakeholders are required toward a harmonisation and wider practicability.

https://www.doi.org/10.1016/j.jval.2016.09.064