Abstract Purpose A novel value assessment framework (VAF) for evaluating oncology and nononcology medications for formulary addition was developed and validated at UT Southwestern Medical Center (UTSW). Methods The novel VAF was developed based on literature examples while incorporating UTSW institutional priorities in the formulary decision process. Six criteria were selected to be evaluated in the VAF: efficacy, safety/tolerability, novelty/unmet need, quality of evidence, cost (by administration site), and operational logistics. The study included a retrospective review of the monographs of medications considered for formulary addition between October 2021 and October 2024, with scores evaluated for inter-rater reliability via the intraclass correlation coefficient (ICC) among 3 reviewers. Monographs for diagnostic or nontherapeutic targeted agents, drug class reviews, and otherwise incomplete monographs were excluded from the study. Results The novel UTSW VAF was determined to have good inter-rater reliability overall among the 3 reviewers (ICC, 0.75; 95% confidence interval CI, 0.61-0.85). For oncology medications, the VAF had moderate inter-rater reliability (ICC, 0.63; 95% CI, 0.29-0.82). The UTSW VAF showed excellent overall inter-rater reliability for nononcology medications (ICC, 0.80; 95% CI, 0.62-0.90), with each individual criterion also showing moderate to excellent reliability, among 3 reviewers. Conclusion This study showcases the development and retrospective evaluation of the inter-rater reliability of a novel institution-specific VAF for medication formulary review at UTSW. The VAF was determined to have good inter-rater reliability overall, with moderate, good, or excellent reliability across all categories. Most monographs scored in the low-intermediate to high-intermediate scoring range, with 3 monographs scoring in the high category.
Wilcox et al. (2026) studied this question.