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Searching for value in cancer: Accenture and the National Cancer Institute

Debating the cost and value of current and future therapies at the 2015 ASCO Annual Meeting.

Overview

As our understanding of human biology progresses, pharmaceutical companies are developing breakthrough drugs that radically change our life expectancy. We are seeing significant advances in our ability to treat even the most difficult and historically unresponsive cancers. Although these developments are encouraging, the potential scope of application and treatment models are challenging some countries’ ability to pay; no longer are therapeutics hitting one percent to three percent of the total population but rather a third to a half. And an increase in combined treatment approaches only complicates matters. This is particularly germane to cancer treatments where a paradigm shift in disease management risks putting an insurmountable financial burden on public and private health insurers.

In this context, Accenture and the U.S. National Cancer Institute held an event at the ASCO Annual Meeting to debate the cost and value of current and future therapies. Co-chaired by industry and academic leaders, two parallel workshops debated these issues in depth.

Creating Value

Despite the complexities and lack of actionable and commonly accepted definitions of value, the notion of value is increasingly accepted as a key metric when deciding a drug’s price. And real progress is being made on the topic across academia, industry, payers and governments.

As innovation and science breakthroughs lead the way towards better drugs, examining the value associated with novelty and rarity becomes unavoidable. It requires quantifying the role that risk plays in innovation, and factors the R&D failures into the price of successful and truly innovative drugs. Payers acknowledge this risk in their willingness to pay beyond simple production costs.

Experts will also need to assess:

  • The willingness to pay from non-consumers, who share the overall burden of these expensive therapies.

  • The enormous value given to an extra month of life in terminal care settings or cancers currently considered as incurable.

  • How much society and individuals are willing to pay before one’s own diagnosis?

  • What level of insurance premiums is society willing to pay before and after such an event?

Improving Access

Despite having similar GDP per capita ratios and comparable quality of life metrics, developed countries are not equal in their access to cancer therapies. Even within Western Europe, patients in Germany might have access to different drugs and treatment regimens than in France or the United Kingdom. Cancer treatment is not only linked to the type of cancer but also to where patients, prescribers and payers live.

How can payers, industry and reimbursement entities pay for highly expensive drugs while supporting long-term economic stability? First, experts will need a common understanding of that medication’s value. The industry needs to investigate Quality of Life (QoL) and other proxy metrics more rigorously when filing for reimbursement as these are more important to the holistic value of a therapy than traditional endpoints such as progression free survival (PFS) and overall survival (OS).


Authors

 

Jeff Elton

Jeff Elton Ph.D.

Managing Director – Strategy and Life Sciences





 

Edouard Lassalle

Edouard Lassalle

Managing Director – Life Sciences