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Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021
INTRODUCTION: We examined overall survival (OS) benefits for targeted cancer drugs recommended for List of Essential Medicines (EMLs) since 2015. We assessed consistency of decisions in 2019 and 2021 with more specific criteria: OS benefit >4 months and high scores on European Society for Medical...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546158/ https://www.ncbi.nlm.nih.gov/pubmed/37775106 http://dx.doi.org/10.1136/bmjgh-2023-012899 |
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author | Zhou, Yue Naci, Huseyin Chen, Dingyi Bai, Lin Shi, Luwen Guan, Xiaodong Wagner, Anita Katharina |
author_facet | Zhou, Yue Naci, Huseyin Chen, Dingyi Bai, Lin Shi, Luwen Guan, Xiaodong Wagner, Anita Katharina |
author_sort | Zhou, Yue |
collection | PubMed |
description | INTRODUCTION: We examined overall survival (OS) benefits for targeted cancer drugs recommended for List of Essential Medicines (EMLs) since 2015. We assessed consistency of decisions in 2019 and 2021 with more specific criteria: OS benefit >4 months and high scores on European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS). METHODS: We identified applications for cancer drug in WHO EMLs from 2015 to 2021. We extracted evidence of OS benefit documented in WHO Technical Report Series (TRS) and compared it to evidence from pivotal trial(s) documented in Food and Drug Administration-approved labels. We retrieved published ESMO-MCBS scores. We summarised availability and magnitude of OS benefit and ESMO-MCBS scores and assessed consistency of inclusion decisions against WHO criteria. RESULTS: 22/54 targeted cancer drug indications were recommended. Among them, 68.2% and 31.8% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Among those not recommended, 59.4% and 56.3% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Of 11 cancer drug indications recommended in 2019 and 2021, 54.5% and 9.1% had evidence of OS benefit >4 months in WHO-TRS and pivotal trials, respectively; 45.5% met ESMO-MCBS criteria. Ten targeted cancer drugs had more than one application for the same indications. Five of those were eventually recommended, including three without new evidence of OS benefit. Additional factors, such as reduced cost, and increased treatment options, seemed to be important factors in the selection. CONCLUSION: While WHO has defined approval criteria for cancer drugs EML, we identified areas where adherence of these criteria and communication of the EML approval decision-making processes can be improved. |
format | Online Article Text |
id | pubmed-10546158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-105461582023-10-04 Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 Zhou, Yue Naci, Huseyin Chen, Dingyi Bai, Lin Shi, Luwen Guan, Xiaodong Wagner, Anita Katharina BMJ Glob Health Original Research INTRODUCTION: We examined overall survival (OS) benefits for targeted cancer drugs recommended for List of Essential Medicines (EMLs) since 2015. We assessed consistency of decisions in 2019 and 2021 with more specific criteria: OS benefit >4 months and high scores on European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS). METHODS: We identified applications for cancer drug in WHO EMLs from 2015 to 2021. We extracted evidence of OS benefit documented in WHO Technical Report Series (TRS) and compared it to evidence from pivotal trial(s) documented in Food and Drug Administration-approved labels. We retrieved published ESMO-MCBS scores. We summarised availability and magnitude of OS benefit and ESMO-MCBS scores and assessed consistency of inclusion decisions against WHO criteria. RESULTS: 22/54 targeted cancer drug indications were recommended. Among them, 68.2% and 31.8% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Among those not recommended, 59.4% and 56.3% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Of 11 cancer drug indications recommended in 2019 and 2021, 54.5% and 9.1% had evidence of OS benefit >4 months in WHO-TRS and pivotal trials, respectively; 45.5% met ESMO-MCBS criteria. Ten targeted cancer drugs had more than one application for the same indications. Five of those were eventually recommended, including three without new evidence of OS benefit. Additional factors, such as reduced cost, and increased treatment options, seemed to be important factors in the selection. CONCLUSION: While WHO has defined approval criteria for cancer drugs EML, we identified areas where adherence of these criteria and communication of the EML approval decision-making processes can be improved. BMJ Publishing Group 2023-09-28 /pmc/articles/PMC10546158/ /pubmed/37775106 http://dx.doi.org/10.1136/bmjgh-2023-012899 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Zhou, Yue Naci, Huseyin Chen, Dingyi Bai, Lin Shi, Luwen Guan, Xiaodong Wagner, Anita Katharina Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title | Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title_full | Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title_fullStr | Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title_full_unstemmed | Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title_short | Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015–2021 |
title_sort | overall survival benefits of cancer drugs in the who model list of essential medicines, 2015–2021 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546158/ https://www.ncbi.nlm.nih.gov/pubmed/37775106 http://dx.doi.org/10.1136/bmjgh-2023-012899 |
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