Oncologists’ perceptions of affordability in the NCCN evidence block value frameworks.

Abstract

6511 Background: The increasing prevalence of cancer coupled with approvals of new drugs and technologies used in therapy have brought increased scrutiny to the cost and value of treatments in oncology. To address the rising concern about oncology drug costs, NCCN has developed the Evidence Blocks (EB) framework to help assess the value of oncology regimens. The objective of this study was to assess and understand oncologist’s perceptions of affordability in the context of the NCCN EB framework. Methods: Data were collected from an electronic cross-sectional survey of 200 US-based oncologists recruited from an online panel. Using the NCCN EB framework, oncologists were asked to rate a variety of hypothetical cancer therapies and assign costs (in US dollars) to the five levels of affordability. Additional questions assessing perceived patient out-of-pocket costs and comfort level in assessing affordability were also included in the survey. Results: Oncologists’ ratings for an existing cancer immunotherapy were generally similar across the EBs (ratings of 4), however oncologists rated affordability higher (3: Moderately Expensive) vs. the actual NCCN panel affordability rating (1: Very Expensive). The affordability rating was similar across a variety of hypothetical cancer therapies and tumor types (rating of 3). Oncologists estimated the costs for this rating of 3 to range from $4600-$6000 per month, which was inconsistent with actual drug costs. Oncologists estimated the mean monthly out-of-pocket costs for patients with insurance to range from $1260 for a new oral medication to $1700 for a new infused medication. Only 26% of oncologists were comfortable or very comfortable with rating costs associated with affordability levels. Conclusions: Surveyed oncologists rated cancer therapies as more affordable than NCCN panel ratings. Costs associated with affordability were not consistent with actual treatment costs; however, most oncologists were not comfortable with rating affordability.