To the Editor In 2010, the UK National Health Service initially examined value-based drug pricing but found many issues preventing implementation, including “potential discriminatory effects and how unmet need…innovation and real world evidence could be taken into account.”1 The American Society of Clinical Oncology (ASCO) has recently proposed examining the “net health benefit” of a drug or regimen based on efficacy and tolerability and has espoused the use of the net health benefit score in conjunction with the drug cost when discussing treatment options with patients.2 Within this framework, however, ASCO provides no estimate on the cost savings (if any) of such an approach or how the actual cost of oncology drugs might be affected as a result of its application. In a recent issue of JAMA Oncology, Goldstein and colleagues3 describe a true value-based pricing proposal whereby drugs are priced per cycle based on cost-effectiveness analyses to achieve a desired incremental cost-effectiveness ratio per quality-adjusted life-year using the approved monoclonal antibody necitumumab as an example.