With the cancer drug market recently having hit US$100 billion, and some industry experts concerned that cancer drug prices are unsustainable, two groups have started working towards calculating the values of cancer drugs.

First, the American Society of Clinical Oncology (ASCO)'s Value in Cancer Care Task Force proposed a conceptual framework under which ASCO working groups will assess cancer drug value on a scale of up to 130 points (J. Clin. Oncol. 22 Jun 2015 [epub ahead of print]). Clinical benefit will be scored on the basis of improvements in median overall survival or progression-free survival to provide a maximum score of up to 80. A drug's toxicity profile can add or subtract up to 20 points. Up to 30 bonus points can also be added for relief from cancer-related symptoms or for drugs that offer improvements in treatment-free intervals. The authors propose that the calculated drug scores could eventually be presented alongside drug cost details “to assist the physician and patient in shared decision making as they work toward defining value and identifying an appropriate intervention for that individual patient”.

Separately, Peter Bach, at Memorial Sloan Kettering Cancer Center in New York, USA, and colleagues launched an interactive calculator called the DrugAbacus to explore the value of 54 approved cancer drugs. The tool embraces the different possible underlying assumptions that can be used to value drugs. DrugAbacus users set a baseline value in terms of 'dollars per life-year provided' for all drugs, and then select toxicity discounts and 'novelty', 'cost of development', 'rarity' and 'burden of disease' premiums. DrugAbacus then calculates 'value-based prices' and compares these to the actual market cost of drugs.

When the value of a year of life is set at US$120,000 and the toxicity discount is set at 15%, only 9 out of 54 drugs (16%) are currently priced lower than their 'value-based price'.