Health technology assessment and value: the cancer value label (CAVALA) methodology

In modern health care systems, the soaring prices of drugs pose at least three major challenges: the growing economic burden of diseases, the uncertainty regarding innovation in health care, and the use of generic drugs and new indications. In this context, the assessment of health care technology is not just about drugs, it is about ensuring that the system’s resources, namely financial, yield maximum health benefits. So, the assessment is about relating inputs with outputs; and also, resources with health-related outcomes. However, this method is based on specific assumptions and has its shortcomings. This paper proposes a methodology called Cancer Value Label (CAVALA) which is a holistic and flexible concept of value. CAVALA overcomes the rationale that suffers from the communicational trap of having to discuss money versus life years gained. Some examples of CAVALA demonstrate that it has the potential to support health care decisions. Using a step-by-step approach, we show how CAVALA can be implemented and further extended. We discuss its main uses to assess outcome selections, the pricing of drugs, and the decisions on the reimbursement of new drugs and indications.