When everyone is required to pay the same out-of-pocket amount for oncology services for which benefits depend on patient characteristics and clinical indication, there is enormous potential for both under- and overutilization. Unlike most current health plan designs, the value-based insurance design (V-BID) explicitly acknowledges and responds to patient heterogeneity across the entire continuum of cancer care. By adding “clinical nuance” to benefit design, V-BID encourages the use of services when the clinical benefits exceed the cost, and likewise discourages the use of services when the benefits do not justify the expenditure. This manuscript further describes the concept of V-BID, creates a framework for its development in oncology, and outlines how this concept aligns with ongoing research, care delivery, and payment reform initiatives.
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Hamdy A. Azim, Abdul-Rahman Jazieh, and Mohammad Jahanzeb
to advanced technology and novel agents incorporated in current oncology practice. Cost–benefit analysis studies conducted in the West are difficult to apply to this region because of the differences in health systems among the developing and
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given examples of treatments withheld on the grounds of unconvincing evidence and based on an unfavorable cost/benefit analysis were erlotinib, bevacizumab, and other antibodies ( Table 3 , Q5 and Q7). Typical examples for withholding treatments because
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use in most patients in the MENA region. Additionally, the modest benefit in survival improvement means that both patients and physicians question the cost/benefit analysis. Shortage of trained staff is a major problem in many countries in the region
Robert McNulty
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Courtney P. Williams, Andres Azuero, Kelly M. Kenzik, Maria Pisu, Ryan D. Nipp, Smita Bhatia, and Gabrielle B. Rocque
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