Use of Value of Information in the Context of the Cancer Drug Fund in the UK

OBJECTIVES: The Cancer Drug Fund (CDF) relies on collecting further evidence to address clinical uncertainty to assess the relevance of routine commissioning by the NHS. The Value of information (VOI) analysis offers a methodological framework that assesses the value of collecting additional information to inform decision making. This study aimed to establish the extent of the use of VOI methods within England and Wales in the last years and how it could become a valuable tool for CDF.

METHODS: A literature review of HTA reports, funded by the NIHR on behalf of NICE to inform its national clinical guidance to the NHS, was undertaken to identify all reports that had used some form of VOI methods. An electronic search of published reports in the NIHR database was conducted between January 2014 and April 2022. A structured search using the terms “value of information”, “VOI”, “EVI”, “EVPI”, “EVPPI”, “PEVPI”, “EVSI”, and “ENBS” was conducted.

RESULTS: A total of 693 NIHR-commissioned HTA reports were identified between January 2014 and May 2022. Of these, 115 were systematic review and evaluation studies and 15 model-based economic evaluation. 30 studies met the inclusion criteria. Regarding the use of VOI, 14 studies conducted an EVPI analysis, 10 studies conducted an EVPI and EVPPI and only two studies conducted an EVPI, EVPPI and EVSI analyses.

CONCLUSIONS: This review shows that VOI methods remain scarcely employed in HTA reports within model-based economic evaluations in line with Mohiuddin et al 2014. The CDF does not require VOI analysis even when it is recommended in current frameworks for handling uncertainty outlined in NICE’s Methods guide and might be key to quantify to what extent the real-world evidence to be collected as part of the CDF agreement will help resolve the uncertainty in the decision problem.