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UnitedHealthcare's Episode-Based Payment Model Program Cuts Cost.

Necitumumab is currently being considered by the US Food and Drug Administration’s (FDA) Oncology Drugs Advisory Committee for the treatment of metastatic squamous-cell lung cancer. According to an economic analysis presented at ASCO 2015 by Daniel Goldstein, MD, of Emory University, Atlanta, GA, the drug must cost less than $1300 per cycle to be cost-effective at the currently accepted willingness-to-pay threshold of $150,000. The modeling done in this study could apply across the drug development process, according to Dr Goldstein, who suggested, “Our study is not only useful for evaluating this drug in this disease, but provides a framework for establishing value-based prices for all new cancer drugs entering the marketplace.” Leonard B. Saltz, MD, of Memorial Sloan Kettering Cancer Center, NY, agreed. “I like Dr Goldstein’s approach,” he told American Health & Drug Benefits. “I think he’s showing exactly what we need to do: anticipate what would be value-based, cost-effective medicine, which is not saying that we don’t need the drug, but that we can’t afford the drug at prices that don’t deliver value.” “I also like the idea of establishing goals in advance and having agreed-upon targets,” he continued, “and saying that in order for a drug to be acceptable it’s got to deliver benefit at a price commensurate with the amount of benefit.”