OBJECTIVES : Different agencies incorporate economic evaluation as key driver in decision making. Economic evaluation demonstrates value-for-money of the health technology, also its discussion is responsible for delays in the final decision of the agency. This research navigates, shows and classifies the limitations of economic evaluations underlined by the agencies for oncology products.

METHODS : Using the Prism HEOR platform we identified economic evaluations submitted for oncology products between Jan 2015- Jun 2019 in UK (NICE, SMC), France (CEESP) and Canada (pCODR). For all economic evaluations we reviewed discussions and limitations behind the final guidance. We classified these limitations according to key parameters: model design, comparators, assumptions, effectiveness and cost sources, extrapolation, uncertainty of clinical parameters, measurement of long-term outcomes and price.

RESULTS : The study included 172 economic evaluations and decisions across UK, France and Canada. Key limitations come from clinical uncertainty and model design. Using radar charts we mapped each limitation per therapeutic sub-area, comparing the weaknesses and difficulties in the economic analysis identifying common trends.

CONCLUSIONS : In summary we revealed the weaknesses of the economic evaluations submitted by manufacturers. This analysis can be used to inform future submissions and can be a reference for global public agencies for future evaluations. Having prior knowledge of the limitations of previous economic evaluations can help equip manufacturers to prepare a better submission and reduce potential delays in approval.