International HTA Experience with Targeted Therapy Approvals for Lung Cancer

Area of Science:

• Oncology
• Health Economics
• Health Technology Assessment

Background:

• Novel lung cancer therapies face varying regulatory review processes globally.
• Health Technology Assessment (HTA) agencies evaluate cost-effectiveness and clinical utility.
• International comparisons of drug listing processes are crucial for understanding market access.

Purpose of the Study:

• To compare listing success rates and timelines for recently approved lung cancer medications.
• To analyze differences in cost-effectiveness recommendations among Australia, Canada, and England.
• To identify limitations and uncertainties impacting HTA recommendations for lung cancer drugs.

Main Methods:

• Comparative analysis of listing status and time-to-listing across three countries.
• Evaluation of HTA agencies' recommendations regarding cost-effectiveness.
• Identification of common uncertainties and limitations in HTA processes.

Main Results:

• Low listing success rates observed: 33% in Canada, 17% in England, and 8% in Australia.
• Variations in comparator selection and altered effectiveness/economic analyses by HTA agencies.
• Significant uncertainties identified, including indirect analyses (70%) and survival extrapolation (100%).
• Despite being deemed not cost-effective, 47% of indications were listed with price reductions or access programs.

Conclusions:

• Novel lung therapies exhibit low international listing success rates across different HTA jurisdictions.
• Persistent uncertainties in HTA processes are common across countries.
• International collaboration and standardized solutions are needed to address common challenges in drug listing.