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Oncology drug health technology assessment recommendations: Canadian versus UK experiences
BACKGROUND: Canada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The obje...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106959/ https://www.ncbi.nlm.nih.gov/pubmed/25075196 http://dx.doi.org/10.2147/CEOR.S66309 |
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author | Chabot, Isabelle Rocchi, Angela |
author_facet | Chabot, Isabelle Rocchi, Angela |
author_sort | Chabot, Isabelle |
collection | PubMed |
description | BACKGROUND: Canada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The objective of the research was to review and compare the recommendations of these two agencies alongside an international comparator – the National Institute for Health and Care Excellence (NICE) in the United Kingdom – with respect to their recommendations records and the influence of clinical and cost-effectiveness evidence on the recommendations. METHODS: Recommendations were identified from the three agencies from January 1, 2002 to June 1, 2013. Recommendations were limited to five cancer sites (lung, breast, colon, kidney, blood) and to metastatic/advanced settings. Descriptive analyses examined the frequency of positive recommendations and factors related to a positive recommendation. For each recommendation, only publicly available information posted on the agency website was used to abstract data. RESULTS: There was a wide variation in the rate of positive recommendations, ranging from 48% for NICE to 95% for Canada’s national process (among the 74% of its recommendations that were publicly posted). Interagency agreement was low, with full agreement for only six of the 14 drugs commonly reviewed by all three agencies. Evidence of a survival gain was not necessary for a positive recommendation; progression-free survival was acceptable. Different approaches were taken when addressing unacceptable cost-effectiveness. NICE was most likely to yield a negative recommendation on these grounds, whereas Canada’s national process was most likely to yield a positive recommendation with a required pricing arrangement. CONCLUSION: In this analysis, the primary reason for the observed divergence between agency recommendations appeared to be the availability of mechanisms in each jurisdiction to address cost-effectiveness subsequent to the HTA assessment process. Furthermore, caution is needed when interpreting cross-agency comparisons between HTA agencies, as recommendations may not correspond directly to subsequent funding decisions and actual patient access. This may be a concern, given the high international profile of assessments conducted by the reviewed HTA agencies. |
format | Online Article Text |
id | pubmed-4106959 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-41069592014-07-29 Oncology drug health technology assessment recommendations: Canadian versus UK experiences Chabot, Isabelle Rocchi, Angela Clinicoecon Outcomes Res Perspectives BACKGROUND: Canada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The objective of the research was to review and compare the recommendations of these two agencies alongside an international comparator – the National Institute for Health and Care Excellence (NICE) in the United Kingdom – with respect to their recommendations records and the influence of clinical and cost-effectiveness evidence on the recommendations. METHODS: Recommendations were identified from the three agencies from January 1, 2002 to June 1, 2013. Recommendations were limited to five cancer sites (lung, breast, colon, kidney, blood) and to metastatic/advanced settings. Descriptive analyses examined the frequency of positive recommendations and factors related to a positive recommendation. For each recommendation, only publicly available information posted on the agency website was used to abstract data. RESULTS: There was a wide variation in the rate of positive recommendations, ranging from 48% for NICE to 95% for Canada’s national process (among the 74% of its recommendations that were publicly posted). Interagency agreement was low, with full agreement for only six of the 14 drugs commonly reviewed by all three agencies. Evidence of a survival gain was not necessary for a positive recommendation; progression-free survival was acceptable. Different approaches were taken when addressing unacceptable cost-effectiveness. NICE was most likely to yield a negative recommendation on these grounds, whereas Canada’s national process was most likely to yield a positive recommendation with a required pricing arrangement. CONCLUSION: In this analysis, the primary reason for the observed divergence between agency recommendations appeared to be the availability of mechanisms in each jurisdiction to address cost-effectiveness subsequent to the HTA assessment process. Furthermore, caution is needed when interpreting cross-agency comparisons between HTA agencies, as recommendations may not correspond directly to subsequent funding decisions and actual patient access. This may be a concern, given the high international profile of assessments conducted by the reviewed HTA agencies. Dove Medical Press 2014-07-16 /pmc/articles/PMC4106959/ /pubmed/25075196 http://dx.doi.org/10.2147/CEOR.S66309 Text en © 2014 Chabot and Rocchi. This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed. |
spellingShingle | Perspectives Chabot, Isabelle Rocchi, Angela Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title | Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title_full | Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title_fullStr | Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title_full_unstemmed | Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title_short | Oncology drug health technology assessment recommendations: Canadian versus UK experiences |
title_sort | oncology drug health technology assessment recommendations: canadian versus uk experiences |
topic | Perspectives |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106959/ https://www.ncbi.nlm.nih.gov/pubmed/25075196 http://dx.doi.org/10.2147/CEOR.S66309 |
work_keys_str_mv | AT chabotisabelle oncologydrughealthtechnologyassessmentrecommendationscanadianversusukexperiences AT rocchiangela oncologydrughealthtechnologyassessmentrecommendationscanadianversusukexperiences |