Value and cancer medicines-A personal view

The discussion of value assessment is structured in three parts; accepted elements of clinical value, questionable clinical value and doubtful clinical value. A review of non-acceptance decisions reveal that cost-effectiveness considerations sometimes played a role for the decision, but it is clear that other factors, such as limited information on clinical benefit, concerns about extrapolation from trial data and failure to take account of prevailing clinical practice, were part of the failure to demonstrate the value of these medicines.