Tie coverage and copays to the ESMO benefit scale
Oncology has two respected scales that grade how much a drug helps in each indication; payers could set low copays for high-grade uses and require a conversation for low-grade ones instead of blanket prior authorisation.
Overview
The ESMO Magnitude of Clinical Benefit Scale grades each indication from 1 to 5 (palliative) or A to C (curative); the ASCO Value Framework produces a net health benefit score; ICER publishes cost-effectiveness reviews. Value-based insurance design lowers cost sharing for high-value care. Applying the scales to oncology formularies (zero copay for ESMO-MCBS 4 and 5 indications, standard review for 1 and 2) would target scrutiny where benefit is smallest and remove it where the case is clear, without any payer inventing its own scoring.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
- Knowledge reaches practice too slowly · Knowledge diffusion is slow: it takes years for a proven result to change what most patients receive, and no one can keep up with the literature.
Pages like this
not linked directly; found by shared links- IdeaPrice a cancer drug by how well it works in each cancer
Shares ICER and health technology assessment, European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
- IdeaCap public prices for new cancer drugs to tiers of the ESMO and ASCO value scales
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains, Prices and value.
- IdeaMicro-learning pushed to community oncologists within 30 days of a practice change
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Knowledge reaches practice too slowly.
- IdeaGive negative trials plenary slots at the big cancer conferences
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Knowledge reaches practice too slowly.
- IdeaLaunch prices indexed to the ESMO benefit scale, revisited when survival matures
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains, Prices and value.
- IdeaEnd the abstract-to-paper gap: require full results with any conference presentation
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Knowledge reaches practice too slowly.
- IdeaLiving, machine-readable guidelines pushed to the point of care in every country
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Knowledge reaches practice too slowly.
- IdeaA guideline fast track for repurposed drugs with phase 3 evidence but no manufacturer
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Knowledge reaches practice too slowly.