PCN438 ECONOMIC EVALUATION METHODS IN ONCOLOGY: ONWARDS AND UPWARDS

Abstract

Economic evaluation has evolved over time from relatively simple comparisons to sophisticated statistic analyses. However, the adoption of new methods into economic evaluation practice may not be identical across various jurisdictions, and this heterogeneity could impact health technology decision making. An important step in assessing implications of variation in methods uptake is to identify and describe the distribution of economic evaluation methods used in practice over time and across jurisdictions. A systematic search of the published oncology literature was conducted to identify economic evaluations of advanced or metastatic cancers published between 2012-2019 using PUBMED, Ovid MEDLINE, and EMBASE databases. 7336 abstracts were identified and 1531 duplicates were removed. 4951 studies were excluded in level 1 screening. Of the remaining 854 studies, an additional 559 were removed through level 2 screening. A total of 295 studies studies met the eligibility criteria. A 20% random sample, representative over the 2012-2019 timeframe, was then taken and 59 papers were abstracted. Characteristics of the abstracted studies were assessed and compared over time and across jurisdictions. Greater sophistication of methods was observed in countries with well-developed health technology assessment frameworks. Nearly half of all identified economic evaluations utilized Markov models, and a quarter were partitioned survival models. A lifetime horizon was most commonly reported, and nearly all studies were comparative. Twice as many studies utilized clinical data from clinical trials than from real-world evidence. Studies reporting methods for extrapolation of survival curves typically used fitted parametric distributions. Adjustment for crossover was addressed in just five of the studies, and only two studies tested the proportional hazards assumption. Funding sources were balanced between public grants and industry sponsorship. Sophistication of economic evaluation methods has steadily increased over time, but uptake of new methods has been geographically uneven. This heterogeneity could impact economic evaluation results across jurisdictions.