Katharina Elisabeth Fischer1, Thomas Heisser2, Tom Stargardt3. 1. Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany; Columbia Business School, Columbia University, New York, USA. 2. Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany; Ludwig-Maximilians-University Munich, Munich, Germany. 3. Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany. Electronic address: Tom.Stargardt@wiso.uni-hamburg.de.
Abstract
BACKGROUND: Little is known on the performance of the newly introduced health benefit assessment process, AMNOG, in Germany compared to other health technology assessment agencies. OBJECTIVE: We analysed whether decisions of the German Federal Joint Committee (FJC) deviate from decisions of the UK National Institute for Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC) and the Australian Pharmaceutical Benefits Advisory Committee (PBAC). METHODS: We analysed decisions made for comparable patient subgroups by the four agencies between 2011 and 2014. First, decisions were compared (a) by their final outcome, i.e. whether a health benefit was identified, and (b) by the agencies' judgement on comparative effectiveness. Subsequently, we partially explored reasons for differences between HTA agencies. RESULTS: From the 192 FJC decisions, we identified 55 that overlapped with NICE, 166 with SMC and 119 with PBAC. FJC agreed with NICE in 40% in final outcome (Cohen's Kappa=-0.13). Similar results were obtained for FJC and SMC (47.6%, kappa=0.03) and FJC and PBAC (48.7%, kappa=0.07). Agreement increased when comparing judgements based on comparative effectiveness only. However, the FJC's final decision was positive only in 43.6%, 39.2% and 44.5% of the patient subgroups, as opposed to 74.5% (NICE), 68.7% (SMC), and 68.9% (PBAC), respectively. CONCLUSION: We show that the FJC - an agency relatively new in structurally assessing the health benefit of pharmaceuticals - deviates considerably in decisions compared to other HTA agencies. Our study also reveals that the FJC tends to appraise stricter than NICE.
BACKGROUND: Little is known on the performance of the newly introduced health benefit assessment process, AMNOG, in Germany compared to other health technology assessment agencies. OBJECTIVE: We analysed whether decisions of the German Federal Joint Committee (FJC) deviate from decisions of the UK National Institute for Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC) and the Australian Pharmaceutical Benefits Advisory Committee (PBAC). METHODS: We analysed decisions made for comparable patient subgroups by the four agencies between 2011 and 2014. First, decisions were compared (a) by their final outcome, i.e. whether a health benefit was identified, and (b) by the agencies' judgement on comparative effectiveness. Subsequently, we partially explored reasons for differences between HTA agencies. RESULTS: From the 192 FJC decisions, we identified 55 that overlapped with NICE, 166 with SMC and 119 with PBAC. FJC agreed with NICE in 40% in final outcome (Cohen's Kappa=-0.13). Similar results were obtained for FJC and SMC (47.6%, kappa=0.03) and FJC and PBAC (48.7%, kappa=0.07). Agreement increased when comparing judgements based on comparative effectiveness only. However, the FJC's final decision was positive only in 43.6%, 39.2% and 44.5% of the patient subgroups, as opposed to 74.5% (NICE), 68.7% (SMC), and 68.9% (PBAC), respectively. CONCLUSION: We show that the FJC - an agency relatively new in structurally assessing the health benefit of pharmaceuticals - deviates considerably in decisions compared to other HTA agencies. Our study also reveals that the FJC tends to appraise stricter than NICE.
Authors: Alice Varnava; Robert Bracchi; Karen Samuels; Dyfrig A Hughes; Philip A Routledge Journal: Pharmacoeconomics Date: 2018-05 Impact factor: 4.981
Authors: Irene Papanicolas; Jose F Figueroa; Andrew J Schoenfeld; Kristen Riley; Olukorede Abiona; Mina Arvin; Femke Atsma; Enrique Bernal-Delgado; Nicholas Bowden; Carl Rudolf Blankart; Sarah Deeny; Francisco Estupiñán-Romero; Robin Gauld; Philip Haywood; Nils Janlov; Hannah Knight; Luca Lorenzoni; Alberto Marino; Zeynep Or; Anne Penneau; Kosta Shatrov; Mai Stafford; Onno van de Galien; Kees van Gool; Walter Wodchis; Ashish K Jha Journal: Health Serv Res Date: 2021-08-14 Impact factor: 3.402