In recent years, the number of available oncology treatments has significantly increased and these treatments have become more costly, prompting a growing need for sustainable drug funding decision-making processes. In the United States, Canada, and many other countries around the world, cancer drug budgets are increasing at a much faster rate than the gross domestic product per capita. From a societal perspective, there are growing concerns that many of the expensive new cancer medicines that are being developed offer limited meaningful benefit to patients. Cost-constrained health care systems are struggling to provide timely access to new cancer treatments, and high drug acquisition costs inevitably result in significant delays in uptake.

Economically diverse countries face inconsistencies in access that have motivated major oncology societies to develop standardized tools for value assessment. The American Society of Clinical Oncology's (ASCO) framework evaluates new cancer drugs at the individual patient level to inform overall value for clinical decision making. The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) assesses clinical benefit and was proposed by ESMO to guide drug approval decisions, although the European Medicines Agency and individual European countries make their own independent funding decisions. In Canada, the pan-Canadian Oncology Drug Review (pCODR) provides national evidence-based funding recommendatio ns using a deliberative framework that considers additional factors beyond the traditional pillars of clinical benefit and cost. Although the dimensions of value considered by pCODR are clearly defined, to the best of our knowledge there is no explicit weighting scheme for these criteria.