Matching-Adjusted Indirect Comparisons in the assessment of hemato-oncological drugs

Matching-Adjusted Indirect Comparison is a methodology that has been developed to assess new treatments vs alternatives when a direct comparison is not available through a randomized controlled trial. These comparisons are of particular interest in the areas of oncology and hematology where uncertainty in decision-making on the inclusion of new drugs is frequently accentuated by both the severity of the disease and the high cost of treatment. The objective of this study was to describe how Matching-Adjusted Indirect Comparison methodology has been used to date in the assessment of hematological cancer drugs by international agencies.

Between January 2015 and October 2019, an exhaustive search was conducted of the websites of European National Agencies that provided public information on the assessment process. The assessments provided by these agencies were reviewed to obtain a list of hematological cancer drugs for which the presentation of a Matched-Adjusted Indirect Comparison was recorded. For this list of drugs, the role of the comparison in the assessment process was analyzed for each selected agency.

Thirteen hematological and oncological treatments were found in which the pharmaceutical marketing authorization holder had presented Matching-Adjusted Indirect Comparisons: most of this information referred to the first half of 2018. Acceptance of this methodology diverges among agencies, ranging from 50% in the case of the British National Institute for Health and Clinical Excellence, to 40% in the case of French National Authority for Health, to not having been taken into account in any of the 3 cases assessed by the German Institute for Quality and Efficiency in Health Care. The main cause of non-acceptance was matching-related problems.

Matching- Adjusted Indirect Comparison methodology is a tool that is being utilized in the decision-making process for assessing new hematological cancer treatments.