TABLE 9-1 Proposed Value Attributes, Value Metrics, and Stakeholder Perspectives

Attributes of Value

Metrics of Value

Pertinent Stakeholder Perspectives

Outcome Attributes

Economic Metrics

Patient perspective, including families or other social supports

Physician or clinician perspective

Health insurer perspective—public and private

Pharmaceutical manufacturer perspective

Societal perspective—the public at large

Survival—duration of life

Quality of life

Adverse events

Time to progression

Tumor response

Cost per QALY

Equity Metrics

Variation in care

Financial hardship

Workforce or service shortages

Access to insurance and appropriate services

Disparities in care


Care Attributes

Access to care

Quality of care


Social equity

Innovation Metrics

Willingness to pay for cancer treatment research

FDA new drug applications

Generic treatments


Patient-Centered Attributes

Compassion and respect

Opportunity for treatment benefit



Care Metrics

Quality of clinician–patient communication

Coordination of care

Innovation and Future Discovery

SOURCE: Ramsey presentation, February 10, 2009.

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