Value & Ethics in Drug Pricing

      1. What is the argument between high prices and value?

      2. How is value determined?

             a. ICER

             b. NICE

             c. Cochran Reviews

      3. How is pricing determined?

      4. What is the ethical question?

             a. Support prescription and prescriber’s plan

             b. 20% of standard Rx are for off-label

             c. 50% of cancer treatment is off-label or unapproved

      5. Actions to bridge value to price

             a. Value-based purchasing

             b. Non-inferiority trials

             c. Objective review of the literature

             d. Committee reviews, e.g., tumor boards, P&T Committees

      6. Outstanding question

             a. Cost vs. affordability

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