OBJECTIVES

Health technology assessment (HTA) of pharmaceutical oncology treatments may vary between EU countries. This study aimed to compare HTA decisions on oncology treatments in Germany, France, Spain and the UK.

METHODS

Assessments were observed from the websites of German (G-BA), French (HAS), Spanish (AEMPS) and UK (NICE) HTA bodies as of April 2019. Assessments with a reimbursement recommendation (GER: added benefit; FRA: major to minor therapeutic progress (ASMR); ESP: inclusion in the national reimbursement list; UK: reimbursement recommendation with/without restrictions) were interpreted as positive decisions.

RESULTS

The study included 726 oncology-related assessments on 155 distinct agents including agent combinations (GER: 153 assessments on 69 agents (10/2011-03/2019); FRA: 180 assessments on 106 agents (03/2009-05/2018); ESP: 72 assessments on 46 agents (11/2013-04/2019); UK: 321 assessments on 120 agents (05/2000-03/2019)). The average annual number of assessments was highest in GER (19.1), followed by FRA (18.0), the UK (16.1) and ESP (10.3). Similarly, the average number of assessments per agent was highest in GER (2.0), followed by FRA (1.7), UK (1.6) and ESP (1.3). The percentage of positive assessments was 73.9% in Germany, whereas this percentage was significantly lower in other countries (p<0.001; Spain, 65.3%; the UK, 53.6%; France, 53.3%). 26 agents (out of 155; 214 assessments in total) were assessed at least once in all four countries; percentage of positive decisions on an assessment/aggregated agent level was: 76.2%/96% in GER, 60.8%/81% in FRA, 75.0%/81% in ESP, 75.0%/92% in the UK.

CONCLUSIONS

Even if there are considerable differences in the assessment methodology of HTA bodies on oncology-related submissions, success rates are often similar across these countries.