HEALTH-ECONOMICS EVALUATIONS IN FRANCE, ENGLAND, CANADA AND AUTRALIA- COMPARISON OF METHODOLOGIES AND IMPACT ON DRUGS’ ACCESS TO PATIENTS
Author(s)
Bucher D1, Abalan M1, Allou A1, Dumon L1, Vialard L1, Troubat A2, Maurel F1
1QuintilesIMS, La Défense Cedex, France, 2QuintilesIMS, Paris La Défense, France
OBJECTIVES: To compare health-economics methodologies between four Health Technology Assessment (HTA) bodies (CEESP, NICE, CADTH and PBAC) and evaluate their impact on drugs’ access. METHODS: Each agency’s methodologies were compared based on their official guidance. An assessment grid with common key criteria was created for the analysis. Then, using HTA-Accelerator™, drugs were selected if they had a public assessment report available in each of the four agencies. Patient access was assessed by volumes reported in MIDAS™ database. The final opinions were analyzed and balanced with the effective drugs’ access to patients. RESULTS: The four agencies’ guidelines assessed similar criteria, but their expectations differed mostly in terms of perspective, numerical values, comparators and Incremental Cost-Effectiveness Ratio thresholds with different impacts on the decision-making process. This was mainly due to different objectives in the results’ interpretation between countries: access versus price negotiation. A total of nine drugs were selected, including three hepatitis C products, three oncology drugs and three immunology therapies. Some discrepancies could be pointed out across the four agencies’ final opinions. In France, the nine drugs was commercialized and publicly funded, whatever the methodology limitations pointed out by CEESP. In England, Canada, and Australia, a third of these evaluations led to a negative or a deferred recommendation. Despite of these unfavorable evaluations, some drugs were covered by public or private funds. Patient access has sometimes been restricted to sub-populations, especially for hepatitis. CONCLUSIONS: Health-economic evaluations are more and more used by HTA authorities in their decision-making process. Despite similarities in their methodologies, the outcomes drove to heterogeneous drugs’ access. In some cases, a negative recommendation could have led to some restrictions rather than a total access deny. Despite it reflects each countries’ cultural context, there are some opportunities to create a global evaluation framework.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN146
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology