Interest to listen to Lowell Schnipper- their primary motivation was to reduce out-of-pocket expenses for patients.
ASCO framework includes costs, but only rudimentarily and focuses on the out-of-pocket costs of the patients.
Should frameworks differ according to purpose? Lowell Schnipper says YES.
Should patients bear the cost if they derive no benefit from the therapy? NO.
ESMO Magnitude of Clinical Benefit Scale
Elisabeth De Vries
earlier study could only score comparative studies- needs to be able to grade single arm studies for 'orphan disease' and 'high unmet need'
There will be a workshop for patients (rather patient advocates though ;-))
Where the scale is used:
1. ESMO organisation
- included in the ESMO Guidelines (so this will affect Melanoma patients)
- also used for mapping access: valuable drugs not available, not valuable drugs were available
2. Doctors in patient care
Physicians use the scale to explain the benefit of medicines to patients
3. Training of oncologists
4. Academic groups
'uses the scale to advertise for drugs. When the scores are good'
WHO considers it a valuable tool
Countries begin to use the scale for policy decisions
EHA performing field-testing
Tested for radio-therapy
The Value of Pathways
Aetna Medicare Project reduced hospitalisation and costs with the same outcomes.
- Pathway planning
- Tight follow-up
- Advanced care planning