REAL-WORLD EVIDENCE IN CANADA: BASELINE ESTIMATES TO SUPPORT HEALTH TECHNOLOGY ASSESSMENT
Author(s)
Matthew Badin1, Shalak Gunjal, PharmD2, Sayali Nerurkar, MSc3, Ronil Patel, MSc4, Petar Atanasov, MSc, MSPH5;
1AstraZeneca Canada, Mississauga, ON, Canada, 2AstraZeneca, Mississauga, ON, Canada, 3Amaris, Mississauga, ON, Canada, 4Amaris, Toronto, ON, Canada, 5Amaris Consulting, Barcelona, Spain
1AstraZeneca Canada, Mississauga, ON, Canada, 2AstraZeneca, Mississauga, ON, Canada, 3Amaris, Mississauga, ON, Canada, 4Amaris, Toronto, ON, Canada, 5Amaris Consulting, Barcelona, Spain
OBJECTIVES: As health technology assessments (HTAs) increasingly incorporate real-world evidence (RWE), there is a growing need for robust, Canadian-specific baseline data across multiple advanced cancer types. This study synthesizes clinical, epidemiological, and economic outcomes to provide a baseline comparison across a variety of tumor types.
METHODS: A targeted literature review (TLR) was conducted using EMBASE, MEDLINE, and HTA databases (CADTH, NICE), identifying 61 Canadian observational studies published between 2008 and 2024. The review covered nine tumor types: biliary tract, pancreatic, bladder, ovarian, cervical, endometrial, colorectal, non-small cell lung, and salivary gland cancers. Outcomes included overall survival (OS), progression-free survival (PFS), treatment patterns, healthcare resource utilization (HCRU), and costs.
RESULTS: Treatment attrition was observed across all tumor types, with 25-62% of patients transitioning from first- to second-line therapy. Median OS ranged from 3.5 to 40.1 months depending on cancer type and treatment line. Chemotherapy was dominant in first-line settings, while immunotherapies and targeted therapies were more common in later lines. Hospitalization costs were the largest contributor to total costs for most cancers, except pancreatic cancer where ambulatory care costs were higher. HER2 positivity was observed in 2.7% of tumors.
CONCLUSIONS: This TLR provides foundational Canadian RWE to inform HTA submissions and validate health economic models. Findings highlight variability in treatment access and outcomes across tumor types and underscore the need for improved treatment outcomes in a range of tumors with poor prognosis. These insights can guide evidence-based decision-making methods and support the development of more efficient and effective cancer care strategies.
METHODS: A targeted literature review (TLR) was conducted using EMBASE, MEDLINE, and HTA databases (CADTH, NICE), identifying 61 Canadian observational studies published between 2008 and 2024. The review covered nine tumor types: biliary tract, pancreatic, bladder, ovarian, cervical, endometrial, colorectal, non-small cell lung, and salivary gland cancers. Outcomes included overall survival (OS), progression-free survival (PFS), treatment patterns, healthcare resource utilization (HCRU), and costs.
RESULTS: Treatment attrition was observed across all tumor types, with 25-62% of patients transitioning from first- to second-line therapy. Median OS ranged from 3.5 to 40.1 months depending on cancer type and treatment line. Chemotherapy was dominant in first-line settings, while immunotherapies and targeted therapies were more common in later lines. Hospitalization costs were the largest contributor to total costs for most cancers, except pancreatic cancer where ambulatory care costs were higher. HER2 positivity was observed in 2.7% of tumors.
CONCLUSIONS: This TLR provides foundational Canadian RWE to inform HTA submissions and validate health economic models. Findings highlight variability in treatment access and outcomes across tumor types and underscore the need for improved treatment outcomes in a range of tumors with poor prognosis. These insights can guide evidence-based decision-making methods and support the development of more efficient and effective cancer care strategies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA65
Topic
Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
SDC: Oncology