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Jonas A. de Souza, Mark J. Ratain, and A. Mark Fendrick

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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Fumiko Chino

: 10.1001/jamaoncol.2019.0818 9. Seymour EK , Schiffer CA , de Souza JA . Challenges in the clinical application of the American Society of Clinical Oncology Value Framework: a Medicare cost-benefit analysis in chronic lymphocytic leukemia . J

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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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Stefan W. Krause, Jan Schildmann, Christian Lotze, and Eva C. Winkler

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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Muhammed Aasim Yusuf, Vinay Kumar Kapoor, Refaat Refaat Kamel, Ather Kazmi, Najam Uddin, Nehal Masood, and Abdulmajeed Al-Abdulkareem

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

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Robert McNulty

multiple-day continuous infusions . Support Care Cancer 2000 ; 8 : 131 – 133 . 5. Barrajon E de las Penas R . Randomised double blind crossover study comparing ondansetron, granisetron and tropisetron. A cost-benefit analysis . Support Care

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Aida Bujosa, Consolación Moltó, Thomas J. Hwang, José Carlos Tapia, Kerstin N. Vokinger, Arnoud J. Templeton, Ignasi Gich, Agustí Barnadas, Eitan Amir, and Ariadna Tibau

clinical benefit of cancer drugs in the USA and Europe: a cost-benefit analysis . Lancet Oncol 2020 ; 21 : 664 – 670 . 10.1016/S1470-2045(20)30139-X 32359489 12. Booth CM , Del Paggio JC . Approvals in 2016: questioning the clinical

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Meena A. Prasad and Laura M. Kulik

randomized clinical trial . Oncologist 2012 ; 17 : 359 – 366 . 45. Vitale A Volk ML Pastorelli D . Use of sorafenib in patients with hepatocellular carcinoma before liver transplantation: a cost-benefit analysis while awaiting data on sorafenib

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Jan Philipp Bewersdorf, Scott F. Huntington, and Amer M. Zeidan

myeloid leukemia: current progress and future directions . Blood Cancer J 2021 ; 11 : 41 . 33619261 3. Vokinger KN , Hwang TJ , Grischott T , Prices and clinical benefit of cancer drugs in the USA and Europe: a cost-benefit analysis

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Courtney P. Williams, Andres Azuero, Kelly M. Kenzik, Maria Pisu, Ryan D. Nipp, Smita Bhatia, and Gabrielle B. Rocque

, Lopes G , . Bevacizumab in the treatment of metastatic breast cancer: friend or foe? Curr Oncol Rep 2012 ; 14 : 1 – 11 . 10.1007/s11912-011-0202-z 22012632 23. Montero AJ , Avancha K , Glück S , . A cost-benefit analysis of bevacizumab