Toward Best Practices for Economic Evaluations of Tumor-Agnostic Therapies: A Review of Current Barriers and Solutions

Paving the path for implementation of clinical genomic sequencing globally: Are we ready?

“…Traditional HTA processes, designed for “on/off” health system decisions and often for drug assessments, and the siloed nature of resource allocation decisions across and within systems may limit the optimization of CGS-related health and economic outcomes. 69 , 70 A unified HTA pathway with model- and data-sharing is crucial to avoid opportunity costs from uncoordinated, unstandardized, and delayed prioritization of HTA assessments. Neglecting these issues may result in structural inefficiencies, with a lack of consideration for technological changes, fiscal sustainability, and evidentiary uncertainty compromising the optimal and equitable adoption of genomic technologies.…”

“…Establishing a unified, life-cycle HTA (LC-HTA) approach towards incremental evidence development, based on real-world data, could be one approach to facilitating CGS implementation. 69 , 72 Life-cycle HTA is defined as standardized data and methods that enable iterative and ongoing evidence appraisals throughout technology life-cycles as part of a learning health care system. 69 Its framework incorporates standard HTA concepts with on-market evidence that follows initial regulatory authorization and conditional health system reimbursement and risk-based pricing strategies based on the value of information analysis and payers’ risk tolerance for increased flexibility.…”

“… 69 , 72 Life-cycle HTA is defined as standardized data and methods that enable iterative and ongoing evidence appraisals throughout technology life-cycles as part of a learning health care system. 69 Its framework incorporates standard HTA concepts with on-market evidence that follows initial regulatory authorization and conditional health system reimbursement and risk-based pricing strategies based on the value of information analysis and payers’ risk tolerance for increased flexibility. 72 Managed and time-limited access in reimbursing expensive therapies is central to LC-HTA and has been piloted in many countries worldwide, including publicly funded health care systems, such as the United Kingdom, Canada, and Australia, and primarily private systems such as the United States.…”

Bayesian Hierarchical Modelling for Histology-Independent Time-to-Event Outcomes in the NICE Single Technology Appraisal of Pembrolizumab for Solid Tumours with MSI-H/dMMR: External Assessment Group Perspective

“…Nevertheless, the approach does maintain the possibility of assessing histological subtypes individually, in addition to pooling the assessment. Such dual reporting is particularly useful in facilitating transparency in histology-independent technology appraisals [ 2 , 5 , 6 ].…”

Impact on costs and outcomes of multi-gene panel testing for advanced solid malignancies: a cost-consequence analysis using linked administrative data

“…Moreover, there are significant costs and resource allocation considerations required for testing all patients with advanced solid tumors. 3 In managed health care systems where universal panel testing is often not reimbursed, additional questions remain to be addressed including whether all cancer types benefit from testing and how testing impacts downstream health care utilization, such as clinical trials where precision matched drug treatments are provided by the sponsor, the burden of visits for outpatient management, hospital admissions or end-of-life care.…”