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A high ESMO-MCBS score (1), which indicates that a new cancer medicine offers significant clinical benefits, increases the likelihood of a faster, positive decision from Health Technology Assessment agencies (HTAs) such as NICE and the Scottish Medicines Consortium in the UK, according to a new study published in The Lancet Oncology.
Cancer medicines treating rare diseases, as well as factors like unmet medical need and ease of administration, were also more likely to receive approval from HTA agencies for use in publicly funded health systems, including the NHS.
The research found that HTA agencies are more inclined to reject medicines when there is significant uncertainty about their clinical benefit or economic evidence. However, risk-sharing agreements between health care systems and manufacturers can improve the chances of coverage by providing a way to manage potential risks and costs.
HTA outcomes can differ widely from one country to another, as each nation interprets evidence and sets priorities in its own way. Even treatments with high clinical benefit scores may face rejection in some countries, due to a combination of factors including differences in the perception of the clinical benefit provided, affordability constraints, and low cost-effectiveness.
Dr Panos Kanavos, Associate Professor of International Health Policy and Director of the Medical Technology Research Group (MTRG) at the London School of Economics and Political Science (LSE) and lead author of the paper, said: "Our analysis suggests that HTA processes can be improved by routine use of a standardised value framework such as the ESMO-MCBS score in conjunction with other parameters of benefit. In doing so, we can also come closer to the harmonisation of methods across settings with respect to assessing the value of new cancer medicines."
The study examined 67 cancer medicine-indication pairs used in non-curative treatment settings, which constitute treatment efforts for patients whose disease is unresponsive to approaches with curative intent and involves life-prolonging treatment, improvements in quality of life and managing symptoms. It analysed 360 assessments of these treatments conducted by six different Health Technology Assessment (HTA) agencies(2).