INTERNATIONAL COMPARISON OF HEALTH TECHNOLOGY ASSESSMENT DECISIONS IN PERSONALIZED ONCOLOGY THERAPIES

OBJECTIVES: To identify the Health Technology Assessment (HTA) decision preferences of targeted therapies across the globe by comparing the decision rates and rationale of government-based HTA between Western and Eastern agencies. METHODS: A literature review was conducted to identify decision rates...

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Bibliographic Details
Published in:Value in health 2017-05, Vol.20 (5), p.A135
Main Authors: Ho, CY, Gless, P, Lawless, G
Format: Article
Language:English
Subjects:
Bevacizumab
Biological markers
Breast cancer
Cancer
Cancer therapies
Clinical outcomes
Colorectal cancer
Colorectal carcinoma
Comparative studies
Cost analysis
International comparisons
Literature reviews
Lung cancer
Medical technology
Monoclonal antibodies
Non-small cell lung carcinoma
Oncology
Reviews
Targeted cancer therapy
Technology assessment
Uncertainty
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Summary:OBJECTIVES: To identify the Health Technology Assessment (HTA) decision preferences of targeted therapies across the globe by comparing the decision rates and rationale of government-based HTA between Western and Eastern agencies. METHODS: A literature review was conducted to identify decision rates and rationale for targeted cancer therapies from five HTA agencies: NICE in UK, CADTH (pCODR) in Canada, PBAC in Australia, HIRA in South Korea and CDE in Taiwan. This study focused on cancer therapies with biomarkers in the top three cancer types - non-small cell lung cancer (NSCLC), breast, and colorectal cancer (CRC) - based on the GLOBOCAN 2012 report. 17 targeted therapies were selected. Bevacizumab and Alectinib for NSCLC and Ramucirumab for CRC were excluded due to absence of HTA reports in more than three HTA agencies. Consequently, four therapies in breast cancer and five in NSCLC and CRC were reviewed. RESULTS: Seventy HTA reports were identified and reviewed. 15 of 70 HTA reports were not available since the assessments were still in progress or have not been published. The positive decision rate for targeted therapies was 67% (n=37) including the conditional positive decision rate of 29% (n=16). Taiwan had the highest positive decision rate, 100% (n=7/7), while NICE was 50% (n=6/12). CRC therapies had the lowest positive decision rate, 52% (n=ll/21), while NSCLC had a positive decision rate of 90% (n=18/20). The reasons of negative decisions included the uncertainty of the clinical outcome (n=6), no comparative effectiveness to standard or current therapies (n=5) and insufficient cost-effectiveness (n=10). CONCLUSIONS: Based on the selected countries and cancer areas, Asian countries (Korea and Taiwan) were more favorable to targeted therapies than Western countries. CRC and breast cancer had lower positive decision rates compared to general cancer therapy which was 65% and 79% in NICE and CADTH respectively.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.05.005