PCN229 A MULTINATIONAL COMPARISON OF HTA DECISIONS FOR NEW TREATMENT OPTIONS IN ONCOLOGY

Abstract

New agents in oncology continue to be scrutinised as payers consider innovative medicines with premium pricing. A retrospective analysis was carried out on health technology assessments (HTA) by NICE in the UK, compared to the assessment of these medicines by the SMC (Scotland), HAS (France), G-BA (Germany), PBAC (Australia) and CADTH (Canada). New treatment options in oncology were recorded in an internal database containing all oncology NICE appraisals from 2010 to the current date. The assessment of these therapies by the SMC, HAS, G-BA, PBAC and CADTH were reviewed and results analysed. The Oncology HTA database includes over 200 HTA decisions, including clinical and economic data used to support each submission. NICE published guidance from 43 treatments in 2018. 81.4% of appraisals received a positive recommendation, in comparison to 2016 (77.5%) and 2017 (94.1%). In 2018, 4.7% of new treatments were recommended by NICE without a patient access scheme (PAS) or managed access agreement (MAA), 76.7% were recommended with a PAS, or were reimbursed with an MAA via the cancer drugs fund. As expected, the ICER is an important element in NICE decision making. Where the accepted base-case ICER was under £30,000, 100% of appraisals received a positive recommendation, compared with 87.5% of appraisals with an ICER between £30,000 to £50,000. Where the ICER was between £50,000 to £100,000, 62.5% received a positive recommendation. Technologies assessed by NICE received a positive outcome in 79.2% of corresponding SMC assessments; 42.4% of HAS HTAs reported an ASMR score of IV or III, and 65.2% of G-BA assessments reported added benefit. Positive outcomes were reported in 94.1% of CADTH and 68% of PBAC submissions. HTA decision making varies country by country based upon the key criteria required for assessment. Analysis of the main drivers behind decision-making will assist in further understanding country differences.