LAUSR

With concern increasing that the prices of medications are poorly aligned with the value they generate for patients and society, several US organizations have developed value frameworks, the common goal of which is to articulate the specific ways in which medicines create value for patients and society and, in some instances, to compare these benefits against the costs of these medicines. For example, within oncology, Memorial Sloan Kettering [1] and the American Society of Clinical Oncology [2] have developed guidelines for determining the value of new cancer therapies, with the former framework specifically comparing the prices of new drugs with the estimated monetary value these drugs create. In an effort to broadly capture ways in which new therapies may create value for patients, the Memorial Sloan Kettering framework also attempts to assess value based on additional metrics besides drug efficacy, including toxicity, disease burden and novelty. In addition to these organizations, the Institute for Clinical and Economic Review has developed an overall approach to valuing new healthcare treatments, which relies in part on how the population cost of new therapies impacts on short-term healthcare spending. Tying the prices of new medical therapies to the value they create is critically important, and recent efforts to do so mirror changes happening in other sectors of healthcare, where reimbursements to hospitals and providers are increasingly being tied to value of care as opposed to volume of care. Indeed, by 2019, half of all US Medicare payments to physicians will be tied to quality or value [3]. But, arguably, in no other sector than pharmaceuticals has there been as much scrutiny in trying to quantify value. Accurately assessing the value of new drugs requires an understanding of how patients and society value the benefits of treatment and how prices evolve over time. This article outlines four reasons why a longer-term view of valuing innovation is needed and four reasons why a broader view is also required.