A systematic literature review of revealed preferences of decision-makers for recommendations of cancer drugs in health technology assessment

Abstract

Objectives This review intends to provide an overview of revealed preferences of decision-makers for recommendations of cancer drugs in health technology assessment (HTA) among the different agencies. Methods A systematic literature search was performed in MEDLINE and EMBASE databases from inception to July 2020. The studies were eligible for inclusion if they conducted a quantitative analysis of HTA’s previous decisions for cancer drugs. The factors with p-values below the significance level of .05 were considered as the statistically significant factors for HTA decisions. Results A total of nine studies for six agencies in Australia, Belgium, France, South Korea, the UK, and Canada were eligible to be included. From the univariable analysis, improvements in clinical outcomes and cost-effectiveness were found as significant factors for the agencies in Belgium, South Korea, and Canada. From the multivariable analysis, cost-effectiveness was found as a positive factor for the agencies in the UK, South Korea, and Canada. Few factors related to characteristics of disease and technology were found to be significant among the included agencies. Conclusions Despite the different drug reimbursement systems and the socioeconomic situations, cost-effectiveness and/or improvement on clinical outcomes seemed to be the most important factors for recommendations of cancer drugs among the agencies.

Association of exogenous factors with the access to innovative pharmaceutical products in Hungary

“…At the moment, the existence of RSAs attached to pharmaceutical products are public, with a categorical description of the type of manufacturer payment (simple discount, price-volume, outcome-based schemes). A further limitation to this study is that it does not assess important potential explanatory variables that are endogenous factors of submissions, for example, the conclusion on their clinical added benefit or their cost-effectiveness, although these factors can be seen as confirmed contributors to recommendations on cancer drugs for a number of agencies, as concluded by a recent systematic literature review [ 21 ]. Unfortunately, a conclusion on the clinical added benefit was not implemented in the health technology assessment procedure in Hungary at the time of the implementation of the current research.…”