Relationship between costs and clinical benefits of new cancer medicines in Australia, France, the UK, and the US

Salas-Vega, Sebastian; Shearer, Emily; Mossialos, Elías

doi:10.1016/j.socscimed.2020.113042

Cited by 34 publications

(47 citation statements)

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“…Le différentiel est donc général et majeur : il est encore plus important en réalité pour le Royaume-Uni car les négociations des industriels avec l'organisme ad hoc NICE (National Institute for Health and Care Excellence) [9] (➜) aboutissent généralement à des rabais très importants mais confidentiels. Ce différentiel États-Unis/Europe fait l'objet de deux interprétations opposées : selon l'administration en place aux États-Unis, ces derniers subventionnent les systèmes de santé européens en les laissant profiter à bas prix de médicaments innovants développés grâce à des prix « domestiques » rétribuant la recherche des Big Pharma 4 ; selon les critiques de l'industrie pharmaceutique, l'ampleur des rabais accordés en Europe atteste l'importance de la marge bénéficiaire de ces entreprises qui peuvent se permettre de diviser leurs prix par trois tout en restant bénéficiaires……”

Section: Les Résultats : Confirmation Du Différentiel Europe/états-unisunclassified

“…Mais le résultat le plus important de cet article, qui confirme plusieurs études antérieures [2][3][4], est l'absence de corrélation entre le coût d'un médicament et le service rendu du point de vue clinique. Cela apparaît clairement sur le graphique de la Figure 2, qui compare les coûts de traitements mensuels pour les médicaments apportant un bénéfice clinique notable (en rouge) à ceux des autres médicaments (en bleu), selon l'échelle ASCO.…”

Section: Absence De Corrélation Entre Prix Et Bénéfice Thérapeutiqueunclassified

“…Mais on peut se demander si ce bénéfice clinique est bien en rapport avec le prix auquel sont commercialisés ces produits. Des études récentes portant sur quelques dizaines de médicaments récemment approuvés et utilisant des critères de bénéfice clinique reconnus montrent une absence de corrélation [2,4] ou même une corrélation négative [3] : plus un médicament est coûteux, moins il est efficace ! Un article récemment paru [5] reprend ces questions de manière plus systématique et en tire un ensemble de conclusions solides.…”

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“…https://www.esmo.org/content/download/288502/5736211/1/ESMO-MCBS-Booklet.pdf4 Grande entreprise pharmaceutique.…”

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Bénéfice clinique et coût des traitements anticancéreux

Jordan

2020

Med Sci (Paris)

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Section: Les Résultats : Confirmation Du Différentiel Europe/états-unisunclassified

Section: Absence De Corrélation Entre Prix Et Bénéfice Thérapeutiqueunclassified

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“…https://www.esmo.org/content/download/288502/5736211/1/ESMO-MCBS-Booklet.pdf4 Grande entreprise pharmaceutique.…”

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confidence: 99%

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Bénéfice clinique et coût des traitements anticancéreux

Jordan

2020

Med Sci (Paris)

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“…New therapeutics for cancer such as immune checkpoint inhibitors and chimeric antigen receptor t-cell therapy (CAR-T), have become available for treatment of advanced or metastatic tumors. Many of these drugs have been priced very highly, raising important debates about the degree to which they provide value [1] , [2] , [3] . When comparing the value gained from new cancer drugs, the United States is an outlier behind several high-income countries including Australia, Canada and the United Kingdom on health gains per dollar spent [4] .…”

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confidence: 99%

Cost-effectiveness of cancer drugs: Comparative analysis of the United States and England

et al. 2020

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Background: England's National Institute for Health and Care Excellence (NICE) and the US' Institute for Clinical and Economic Review (ICER) both conduct cost-effectiveness evaluations for new cancer drugs to help payers make drug coverage decisions. However, NICE and ICER assessments have been noted to reach different conclusions. We aim to better understand the degree to which their recommendations diverge and what drives these apparent differences. Methods: We compared the methods and results of publicly available cost-effectiveness evaluations performed by ICER and NICE of similarly assessed cancer drugs. Assessments were compared based on incremental cost-effectiveness ratio, comparator treatment, price, recommendation, and the design of the economic evaluation. Findings: Among 11 commonly assessed cancer drugs, ICER and NICE were in concordance for 7 evaluations and in discordance on the cost-effectiveness and coverage decisions for 4 drugs. Most new cancer drugs were not cost-effective in either the US (7/11) or England (7/11). Furthermore, NICE's capacity to negotiate price discounts and access schemes result in much lower cost per QALY valuations and more favourable recommendations than those of ICER for similarly assessed cancer drugs. Interpretations: NICE and ICER employ similar health technology assessment (HTA) methodologies and were aligned with most recommendations, finding that many new and expensive cancer drugs are cost ineffective. Growing use of ICER assessments will continue to send stronger price signals to manufacturers that cancer drugs with low value for money will be viewed less favourably by private insurers. NICE provides an important reminder of how much lower other countries pay for drugs when comparative effectiveness and valuebased pricing are integrated into public drug coverage decisions.

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Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries

2022

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IMPORTANCE Studies using data from before 2011 concluded that the cost of US cancer care is justified given improved outcomes compared with European countries. However, it is unclear whether contemporary US cancer care provides better value than that of other high-income countries.OBJECTIVE To assess whether cancer mortality rates in 2020 were lower in countries with higher cancer-related spending, and to estimate across countries the incremental cost per averted cancer death. DESIGN, SETTING, AND PARTICIPANTSCross-sectional, national-level analysis of 22 high-income countries, assessing the association between cancer care expenditures and age-standardized population-level cancer mortality rates in 2020, with and without adjustment for smoking. In addition, US incremental costs per averted death compared with the other countries were calculated.

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Relationship between costs and clinical benefits of new cancer medicines in Australia, France, the UK, and the US

Cited by 34 publications

References 41 publications

Bénéfice clinique et coût des traitements anticancéreux

Bénéfice clinique et coût des traitements anticancéreux

Cost-effectiveness of cancer drugs: Comparative analysis of the United States and England

Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries

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