What Is the Predictable Cost of Care (PCC) Working Group?

The Predictable Cost of Care (PCC) Working Group was established to address a long-standing challenge in oncology: the lack of a standardized, industry-wide methodology for assessing and comparing the total cost of cancer treatment regimens. While efficacy and safety remain paramount in pathway development, the financial dimension of care—often exceeding hundreds of thousands of dollars annually—demands a consistent, transparent, and clinically relevant approach. The PCC Working Group seeks to meet this need by developing an industry-standard cost model designed to capture the predictable total cost of care for oncology therapies.

The idea for the PCC originated at Pharma Day 2023, where pathway developers voiced frustrations over the inconsistent cost models received from various pharmaceutical companies. Each model used different assumptions, data sources, and timeframes, rendering comparisons nearly impossible. As one pathway developer noted, “we have neither the time nor the staff to deconstruct and rebuild these models, so we don’t look at them at all.” Recognizing that such variability obstructed transparency and informed decision-making, stakeholders from both the pharmaceutical industry and pathway development community united to design a model that could be universally adopted.

The goal was not to create a mandated framework, but rather an industry-standard methodology that any company or developer could use to improve the comparability, reliability, and utility of cost data in oncology pathways.

The mission of the PCC Working Group is to develop a standardized cost-of-care model that quantifies both drug and nondrug costs associated with cancer therapies. By incorporating predictable, measurable components of care—such as infusion services, lab tests, and monitoring visits—the model provides a holistic perspective on the economic impact of treatment options. Importantly, the PCC model intentionally excludes unpredictable or unrelated costs, such as comorbidities or baseline care expenses, ensuring that the resulting comparisons remain focused, practical, and actionable.

The Working Group consists of representatives from 7 leading pathway organizations, each with experience spanning academic medical centers, community oncology practices, payer-driven programs, and value-based care initiatives. Through a modified Delphi method, the group collaborated across 5 virtual meetings to identify consensus-based cost elements, beginning with metastatic non-small cell lung cancer (mNSCLC) as the pilot disease state.

The PCC model provides a shared language for cost assessment in oncology, creating opportunities that extend beyond pathway development. Its applications include supporting payers in constructing value-based bundles, assisting actuaries and consultants in modeling care costs, and helping advocacy groups estimate financial burdens for patients.

As oncology marks 2 decades of pathway-driven care, the PCC Working Group envisions its model as a cornerstone for a new era of transparency and consistency in cost evaluation—one where evidence-based, patient-centered, and economically sustainable treatment decisions become the standard across the cancer care continuum.

References

Arrowsmith E, Golla V, Henschel R, et al. Predictable cost of care model for treatment decisions: working group consensus statements for metastatic non-small cell lung cancer. J Clin Pathways. 2025;11(4):27-32.

Kuntz G, Tremonti C. Advancing value-based oncology with the predictable cost of care working group: part 1. J Clin Pathways. Published March 11, 2025. Accessed Oc-tober 9, 2025. https://www.hmpgloballearningnetwork.com/site/jcp/videos/advancing-value-based-oncology-predictable-cost-care-working-group-part-1

Kuntz G, Tremonti C. Advancing value-based oncology with the predictable cost of care working group: part 2. J Clin Pathways. Published March 17, 2025. Accessed Oc-tober 9, 2025. https://www.hmpgloballearningnetwork.com/site/jcp/videos/advancing-value-based-oncology-predictable-cost-care-working-group-part-2

Musick H. Building a transparent framework for predictable cost of care in oncology pathways. J Clin Pathways. Published September 10, 2025. Accessed October 9, 2025. https://www.hmpgloballearningnetwork.com/site/jcp/conference-coverage/building-transparent-framework-predictable-cost-care-oncology-pathways