Multicriteria Health Technology Assessments for High-Cost Oncology Drugs in Peru: A Cross-Sectional Study of RENETSA Records 2023-2024
Author(s)
Karina Mayra Aliaga Llerena, MD1, Jazmin Figueroa, MD2, Raul Mantilla, BSc3, Luis Mas, MD3, Victor Castro Oliden, MD3.
1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru, 2Gestion en Salud, Universidad Nacional Mayor de San Marcos, Lima, Peru, 3Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru, 2Gestion en Salud, Universidad Nacional Mayor de San Marcos, Lima, Peru, 3Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
OBJECTIVES: To characterize the health technology assessments (HTAs) of high-cost oncology drugs conducted by the National Network for Health Technology Assessment (RENETSA) in Peru, and to explore the association between multicriteria decision-making elements and final recommendations.
METHODS: A cross-sectional descriptive study analyzed RENETSA reports published until December 31, 2024. Reports were included if they applied the official multicriteria framework for high-cost oncology drugs. Data were extracted using a standardized matrix. Chi-square tests were used for categorical variables, and Mann-Whitney U tests for non-normally distributed continuous variables. Analyses were conducted in R, with significance at p < 0.05.
RESULTS: Among the 61 HTAs reviewed, 32.8% (20/61) received favorable recommendations. Most focused on solid tumors (63.9%), advanced-stage disease (84.6%), and first-line therapies (63.3%). The median overall survival (OS) gain was greater for recommended drugs (8.6 months [IQR: 5.5-13.6]) versus non-recommended (3.9 months [IQR: 2.8-10.7]).
Favorable recommendations were significantly associated with absence of therapeutic alternatives (80%), moderate-to-large desirable effects (75%), minimal undesirable effects (65%), a favorable balance of effects (89.4%), and increased or probably increased equity (90%).
In contrast, most drugs lacked cost-effectiveness data (86.9%), were considered non-innovative (90%), and had evidence rated as very low certainty (85%)—none of which were significantly associated with recommendation status.
CONCLUSIONS: Recommendations were primarily driven by clinical need, desirable and undesirable effects, balance of effects, and equity considerations. Factors such as evidence certainty, innovation, cost-effectiveness, and resource requirements showed no significant influence on the final recommendation.
METHODS: A cross-sectional descriptive study analyzed RENETSA reports published until December 31, 2024. Reports were included if they applied the official multicriteria framework for high-cost oncology drugs. Data were extracted using a standardized matrix. Chi-square tests were used for categorical variables, and Mann-Whitney U tests for non-normally distributed continuous variables. Analyses were conducted in R, with significance at p < 0.05.
RESULTS: Among the 61 HTAs reviewed, 32.8% (20/61) received favorable recommendations. Most focused on solid tumors (63.9%), advanced-stage disease (84.6%), and first-line therapies (63.3%). The median overall survival (OS) gain was greater for recommended drugs (8.6 months [IQR: 5.5-13.6]) versus non-recommended (3.9 months [IQR: 2.8-10.7]).
Favorable recommendations were significantly associated with absence of therapeutic alternatives (80%), moderate-to-large desirable effects (75%), minimal undesirable effects (65%), a favorable balance of effects (89.4%), and increased or probably increased equity (90%).
In contrast, most drugs lacked cost-effectiveness data (86.9%), were considered non-innovative (90%), and had evidence rated as very low certainty (85%)—none of which were significantly associated with recommendation status.
CONCLUSIONS: Recommendations were primarily driven by clinical need, desirable and undesirable effects, balance of effects, and equity considerations. Factors such as evidence certainty, innovation, cost-effectiveness, and resource requirements showed no significant influence on the final recommendation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA239
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
Oncology