Dr Lee Newcomer on Value Calculators and New Immuno-Oncology Agents

Although there have been a number of new value calculators created recently, UnitedHealthcare does not plan to use any just now. Instead, it will continue covering regimens recommended by the National Comprehensive Cancer Network and in a few years the company will use data from its prior authorization tool to analyze performance of regimens, explained Lee Newcomer, MD, MHA, senior vice president, Oncology, Genetics and Women’s Health, UnitedHealthcare.

Transcript (slightly modified for readability)

Does UnitedHealthcare have plans to leverage any of the value calculators that have been created?

No. We're still saying, as always, that if you're using a regimen recomended by the National Comprehensive Cancer Network (NCCN), we will cover it. There may come a day, as our prior authorization tool becomes to show us performance of those regimens, we'll be displaying the data on the tool about how each regimen is doing with UnitedHealthcare patients. So if we find regimens that are causing more toxicity, or that are so expensive without showing better results, then eventually we may winnow those out. But that is at least 3 years in the future.

How is UnitedHealthcare expecting to integrate new immuno-oncology agents into its payment program?

No differently than any other drug. If the evidence is there, it will be covered. Again, we will rely on the NCCN to help us with that determination.