Value Assessment Platforms for Oncology
Oncology is an area of immense clinical need and a primary driver of healthcare spending, making it a prime target for assessment of the value of available medical interventions. IVI’s next Open-Source Value Project (OSVP) model will focus on non-small cell lung cancer (NSCLC). Specifically, the IVI-NSCLC model will focus on sequential treatment strategies for patients with epidermal growth factor receptor positive (EGFR+) NSCLC.
IVI’s open-source value model for EGFR+ NSCLC treatments will facilitate patient-centered, robust, and relevant evaluation of the value of care for an often devastating disease. Development of this model reflects IVI’s vision of a transparent process for understanding value in the local setting, especially from the patient perspective.
Why Non-Small Cell Lung Cancer?
Lung cancer is the leading cause of cancer-related deaths worldwide.(1) The American Cancer Society estimates that of the 1,735,000 new cancer cases in the U.S. in 2018, 13.5% will be lung cancer. NSCLC accounts for an estimated 85% of lung cancer cases and comprises adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.(2)
Given the rapid pace of development in lung cancer treatment, the scope of the initial IVI-NSCLC model needed to be limited to a specific sub-population. Our focus on EGFR+ NSCLC provides a strong opportunity to demonstrate the typical areas of uncertainty in value assessment in oncology and the need for customized analyses to inform local decision-making. In the future, IVI may expand the model to other NSCLC subpopulations of interest.
What Will IVI Achieve?
IVI is developing a flexible model to measure the benefits, risks and costs, for a range of treatment sequences across successive lines of therapy for EGFR+ NSCLC. Centered on the patient perspective, these models will support value assessment using cost-effectiveness analysis (CEA) and multi-criteria decision-analysis (MCDA) frameworks. The model is accessible to both technical and non-technical end-users and allows evaluating the impact of scientific uncertainty, novel concepts of value, and different decision-maker perspectives on the estimates of value. The model will accommodate new clinical evidence as it emerges and allow user-driven customization to yield timely and user-relevant value assessment results.
IVI will deliver the following:
Patient Perspective at the Heart of Model Development
Patients are an indispensable voice in developing any platform or model that may affect healthcare decision-making. IVI actively seeks patients and patient organizations as partners to collaborate to develop research that seeks to understand their drivers of value. Many opportunities exist for interested patient partners to contribute to the OSVP effort, and we encourage any interested patients or patient organizations to contact us to learn about joining our existing partners.
IVI is conducting qualitative research with NSCLC patients to better understand their perspectives on value, what they consider and worry about when making treatment decisions, and how they prioritize one aspect versus another. The findings from this research will directly inform the development of the IVI-NSCLC model, particularly the content and structure of the multi-criteria decision analysis portion that allows for customized decision analysis. Findings from the qualitative research will also feed directly into a related “Quantifying the Patient Experience” study in which IVI is developing NSCLC-specific measures of quality of life incorporating different treatment modalities. The results of this latter study will be incorporated into Version 2 of the OSVP model.