OBJECTIVES: Influx of newer therapies and rising drug prices have prompted value-driven decision-making worldwide. The Magnitude of Clinical Benefit Scale (MCBS) from the European Society for Medical Oncology (ESMO) serves as a useful tool for evaluating the value of cancer medicines. This study examines the association between ESMO-MCBS scores and subsidy decisions of targeted therapies for solid tumors in Singapore.

METHODS: Indication specific targeted therapies for solid tumors listed on the national Cancer Drug List (CDL) by April 2023 were included. The scores were retrospectively obtained from ESMO website and if scores were not publicly available, ESMO-MCBS assessments were independently conducted. Drug-indication pairs with an ESMO-MCBS score of 4-5 or B-A were categorized as “substantial magnitude of clinical benefit”. The relationship between ESMO-MCBS and the subsidy decisions were investigated descriptively and by using logistic regression.

RESULTS: ESMO-MCBS scores were obtained for 128 drug- indication pairs of which 70 indications were subsidized. 63% of the subsidized indications had ESMO-MCBS scores of 4-5 or B-A which were higher than the percentage observed for the non-subsidized indications (p=0.005). Drug-indication pairs with ESMO-MCBS scores of 4-5 or B-A significantly predicted positive subsidy decisions (odds ratio 2.77 [1.35,5.68], p=0.004).

CONCLUSIONS: An association was observed between subsidy decision of cancer drugs and that of the ESMO-MCBS scores. ESMO-MCBS has the potential to guide the allocation of limited resources towards providing effective and affordable cancer care.