Abstract
PCN112 LESSONS LEARNED FROM HTA COST EFFECTIVENESS EVALUATIONS OF NEW CASTRATION-RESISTANT PROSTATE CANCER MEDICATIONS Moise P1, Fassler P2, Holmstrom S3 1Quintiles Global Consulting, Levallois-Perret, Ile-de-France, France, 2Quintiles Global Consulting, Hoofddorp, The Netherlands, 3Astellas Pharma Global Development, Leiderdorp, The Netherlands OBJECTIVES: Gain insights into Health Technology Assessment (HTA) agencies expectations regarding Health-Related Quality of Life (HRQoL) for cost-effectiveness evaluations of new medications for treating Castration-Resistant Prostate Cancer (CRPC). METHODS: In January 2012, 61 HTA agencies websites were scanned to identify HTAs of new medications for the treatment of CRPC published from 2005 to present. Only those evaluating the cost-effectiveness of new technologies were retained and analyzed for a better understanding of HTA agencies’ expectations regarding HRQoL in CRPC. RESULTS: 39 HTAs were identified, 12 of which are currently in progress. The 27 published reports comprised 12 technology appraisals, 9 horizon scanning reports and 6 literature reviews. Only 9 of the 12 technology appraisals evaluated cost-effectiveness, these included seven appraisals on three drugs: IQWiG (Germany) assessed abiraterone; NICE (England & Wales) accepted docetaxel and rejected cabazitaxel; SMC (Scotland) rejected docetaxel and cabazitaxel; CVZ (Netherlands) accepted cabazitaxel; PBAC (Australia) accepted docetaxel after two rejections and rejected cabazitaxel. Uncertainty regarding HRQoL measures was the most often cited negative comment. For both docetaxel and cabazitaxel, the absence of quality of life measures from the main phase III trials and uncertainty around utility values were cited as reasons for rejection by NICE, SMC and PBAC. The CVZ accepted cabazitaxel for temporary reimbursement on the understanding that further subpopulation analysis and more data on utilities will be needed. The IQWiG assessment of abiraterone commented on uncertainties regarding the validity of the QoL questionnaire and restrictions in subgroup analyses. CONCLUSIONS: Our review indicates the need to include comprehensive quality of life measures in phase III trials for new drugs to treat CRPC, ensure these can be mapped into robust utility values and conduct meaningful CRPC subpopulation analyses. Further insights will be gained in the near future with the publication of CRPC HTAs currently in progress.
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