PCN88 HTA Evaluations of Oncology Drugs in APAC - Comparison of Trends and Drivers of Success in 5 Countries

Abstract

HTA is a rapidly growing area interest for healthcare systems in APAC. The APAC HTA landscape comprises a patchwork of emerging and developed economies, levels of experience, capabilities, requirements and recommendation frameworks. Cancer drugs represent expensive treatments that benefit from HTA to optimize resource use. APAC has one of the fasting growing cancer populations and an increasing demand for quality care. The current research considers HTA reviews from APAC countries for the last 5 years, assessing number of evaluations, trends in drugs evaluated, probability of success, drivers of success and evidence considerations. Secondary research of HTA reports in Japan, South Korea, Taiwan, Singapore and Indonesia, narrative synthesis of Information meeting study objectives. 89 reports were identified, overwhelmingly from Korea and Taiwan (79/89). All countries primarily evaluated targeted therapies/immunotherapy drugs (82%-100%) apart from Singapore where chemotherapies were common (40%). CEAs were submitted for 16% of Taiwanese and 60% of Korean submissions. Korea offers CEA waivers for select drugs, instead developing RSAs with manufacturers. CEAs are not mandated for Taiwanese submissions. For all other countries CEAs are universally considered. Taiwan and Singapore considered external HTA evaluations where there was limited data for an economic model. The proportion of successful submissions varied from 0% (Japan) to 86% (Korea, 98% including resubmissions). All except Taiwan have rejected submissions on solely economic grounds. Budget impact was most explicitly considered in Taiwan, where uncertain/high budget impact were used to drive MEAs or price reductions. Korea and Taiwan made extensive use of recommendations with MEAs, RSAs and price reductions. Decisions informed public reimbursement in Korea, Singapore and Taiwan while informing pricing adjustments in Japan. Indonesian decisions informed formulary optimization, uniquely including recommendations for disinvestment. HTA oncology review processes in APAC differ considerably across countries in all categories evaluated. Pan-APAC market access strategies will benefit from country-specific tailoring.