Background: The ASCO value framework allows comparisons of cancer treatments based on Net Health Benefit (NHB) and cost. We aimed to assess the value of treatments for recurrent, platinum-sensitive ovarian cancer using patient-assigned importance weights to NHB. Methods: 30 patients prospectively enrolled in a preferences study assigned ‘tokens of importance’ to each component of NHB (clinical benefit, toxicity, symptom palliation, and treatment free interval), and to components of clinical benefit (OS, PFS, RR). Patient-preference weights were scaled to reflect point totals utilized in the ASCO framework. Using patient- and ASCO-assigned weights, value assessments of available treatments for recurrent ovarian cancer were constructed: chemotherapy + bevacizumab (CMB), carboplatin + liposomal doxorubicin (CD), and maintenance olaparib (MO). NHB were presented alongside additional cost of novel therapy and a ‘benefit-cost ratio’ (NHB per additional cost). Results: Patient-weighted (P) versus expert-assigned (E) NHB component totals were: clinical benefit: 77 vs 80; toxicity -14 to +14 vs -20 to +20; symptom palliation: 26 vs 10; TFI: 18 vs 20. Clinical benefit component totals were OS: 15 vs 16, PFS: 10 vs 11, RR: 14 vs 8. Patient-weighted NHB/cost were: CMB: 20/$7,245; CD: 19/$2,692; and MO: 16/$8,400. Benefit-cost ratio of novel therapies was: CMB 0.003; CD 0.007; MO 0.002. Conclusions: P- and E-value assessments are similar. The value of maintenance regimens for recurrent ovarian cancer is limited by toxicity and cost.

CB = clinical benefit; TS = toxicity score; PB = palliation bonus; TFI = treatment free interval *Compared to standard in RCT.