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Defining Value in Cancer Care

Eli Lilly and Company  | January 30, 2020

This article comes from Eric Dozier, vice president of North American oncology at Lilly. 

We are living in a transformational time in health care, discovering more treatments that help people live longer, healthier, more active lives. However, rising costs and chronic disease rates place significant pressure on patients and the health care system. Lilly Oncology is working with other health care stakeholders to explore new ways to deliver value for patients. 

Value-based payment arrangements (VBAs), which depart from the traditional fee-for-service model, are one potential solution that allow our industry to stand behind the health outcomes we expect our medicines to deliver when appropriately used. In these types of arrangements, a manufacturer can agree to provide rebates to institutions or group purchasing organizations (GPOs) based on how well a medicine performs compared to a predefined performance-based metric, rather than based on utilization alone. Moreover, because of the information they generate about our medicines, VBAs can also be a tool in our mission to help improve patient outcomes. 

I recently joined other health care experts at the 2019 Association for Value-Based Cancer Care (AVBCC) Summit to discuss the evolving landscape of VBAs in cancer care. Together, we explored a fundamental question many stakeholders have about VBAs: How do we define “value”? 

Most of us understand value as an abstract concept: improving health outcomes while reducing costs. However, it can be challenging for all members of the health care system to agree on patient outcomes that are both substantial and measurable. 

At Lilly Oncology, we believe that true outcomes-based agreements with more meaningful outcomes measures are the gold standard. But, it is often challenging for stakeholders to capture and share clinical outcomes measures such as progression-free or overall survival. To that end, we’re pursuing a number of ways to measure or approximate the value of our treatments, so that we can continue aligning the payment for our medicines with the value they create. 

For example, from an asset-development standpoint, we rely on endpoints such as time to treatment discontinuation, reduced treatment complications or side effects, levels of treatment adherence, and changes in patient functional status such as time required to return to work. In each partnership, we aim to work with stakeholders that are committed to innovating, advancing capabilities and, ultimately, improving patient outcomes through these agreements. 

At Lilly, we see VBAs as a way to stand behind the clinical value of our medicines. With each agreement, we aim to advance our real world understanding of the clinical benefit our medicines are providing to patients. Collectively, that takes us one step forward in our ongoing quest to discover and develop life-changing medicines for people living with cancer.