Dr Alan Balch Explains the Difference Between Various Value Frameworks

Different value frameworks offer different things, as Alan Balch, PhD, CEO of the Patient Advocate Foundation, explained that each framework has various other objectives in mind. Balch differentiates frameworks based upon whether their objectives reach individual or population-based levels.

Transcript (slightly modified)

These are a number of different value assessment frameworks that have been created (NCCN, ASCO, ICER). How can patients and providers differentiate between them?

I think there will be differences between them just naturally because they often have different points of departure in terms of what they’re trying to address. So, some are very purposefully designed to deliver information to one stakeholder community than another. So for example, ICER is very explicit about having the outcomes of their information really being geared towards policy makers and providers whereas the NCCN evidence blocks is really geared towards generating a conversation between the patient and the provider and ASCO’s value framework is similar.

So given a sort of form follows function, so given that they have different purposes, you are going to see naturally the methodologies and the way they’re constructed will be different, depending upon what the purpose is of that value tool. So I do think there will be differences and probably the biggest thing that leads to differences in them is at what scale are they trying to define value, or define a particular variable.

And to me, the two more natural stratifications, there are individual level versus population level. So for example, when the evidence blocks for NCCN talks about affordability, it’s really at the population scale whereas the ASCO value framework, when they really talk about cost, it’s literally a blank right now because it’s meant to be personalized to the individual. At least for cost at the cost variable in that framework is very individualized whereas in other frameworks, the cost variable is very much at the population level. And that will lead naturally to differences in how that information is conveyed to patients and what information goes into creating, populating that particular variable in the framework.