Overall, we respect and encourage the trend toward value and will continue to lead meaningful
conversations and a deeper dialogue around the meaning of value-related initiatives for patients.
We believe patients’ voices need to be a part of defining and assessing the value of their
treatment plans along with the cost of all aspects of their care – including patient’s direct out of
pocket costs and patient’s costs related to their ability to work, their need to travel for care, and
other costs arising from either their medical conditions or care. As Mandelblatt et al., noted, “in
frameworks to evaluate drug treatments, economic impacts would include drug costs, provider
time and delivery costs, staff time, facilities and equipment overhead and costs, costs of
treatment-related side effects and supportive care medications required, patient time and travel
costs, and costs of all downstream events until death from the disease or other causes. To the
extent that frameworks exclude portions of these costs, they result in biased recommendations.”

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