Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Applying the ASCO Value Framework to CLL
J Oncol Pract; ePub 2017 Nov 16; Seymour, et al
The ASCO Value Framework can help quantify the value of therapies for chronic lymphocytic leukemia (CLL), but it has certain limitations, researchers concluded after analyzing 10 randomized trials. Referring to NCCN guidelines for CLL, investigators used the revised ASCO Value Framework to calculate net health benefit (NHB), and Medicare drug pricing to calculate treatment cost. Among the results:
- 49 studies were screened, but only 10 were deemed worthy of evaluation.
- When comparing regimens studied against the same control arm, ranking NHB scores were comparable to their preference in guidelines.
- NHB scores differed depending on which variables were used.
- There were no clinically validated thresholds for low or high values.
- Treatment-related deaths were not weighted in the toxicity scores.
- 6 studies used the least-preferred NCCN-recommended regimens for the control arms.
Seymour E, Schiffer C, de Souza J. Challenges in the clinical application of the American Society of Clinical Oncology Value Framework: A Medicare cost-benefit analysis in chronic lymphocytic leukemia. [Published online ahead of print November 16, 2017]. J Oncol Pract. doi:10.1200/JOP.2017.024778.