Doreen A Ezeife1, Francois Dionne2, Aline Fusco Fares3, Ellen Laura Rose Cusano1, Rouhi Fazelzad4, Wenzie Ng3, Don Husereau5, Farzad Ali6, Christina Sit7, Barry Stein8, Jennifer H Law3, Lisa Le3, Peter Michael Ellis9, Scott Berry10, Stuart Peacock11, Craig Mitton12, Craig C Earle13, Kelvin K W Chan13, Natasha B Leighl3. 1. Department of Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada. 2. Prioritize Consulting Ltd, Vancouver, British Columbia, Canada. 3. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. 4. Department of Medical Oncology and Hematology, Library and Information Services, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. 5. School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. 6. Pfizer Inc, New York, New York. 7. Lung Cancer Canada, Toronto, Ontario, Canada. 8. Colorectal Cancer Canada, Montreal, Quebec, Canada. 9. Juravinski Cancer Centre, Hamilton, Ontario, Canada. 10. Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada. 11. British Columbia Cancer Agency, Vancouver, British Columbia, Canada. 12. The University of British Columbia, Vancouver, British Columbia, Canada. 13. Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Globally, the rising cost of anticancer therapy has motivated efforts to quantify the overall value of new cancer treatments. Multicriteria decision analysis offers a novel approach to incorporate multiple criteria and perspectives into value assessment. METHODS: The authors recruited a diverse, multistakeholder group who identified and weighted key criteria to establish the drug assessment framework (DAF). Construct validity assessed the degree to which DAF scores were associated with past pan-Canadian Oncology Drug Review (pCODR) funding recommendations and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS; version 1.1) scores. RESULTS: The final DAF included 10 criteria: overall survival, progression-free survival, response rate, quality of life, toxicity, unmet need, equity, feasibility, disease severity, and caregiver well-being. The first 5 clinical benefit criteria represent approximately 64% of the total weight. DAF scores ranged from 0 to 300, reflecting both the expected impact of the drug and the quality of supporting evidence. When the DAF was applied to the last 60 drugs (with reviewers blinded) reviewed by pCODR (2015-2018), those drugs with positive pCODR funding recommendations were found to have higher DAF scores compared with drugs not recommended (103 vs 63; Student t test P = .0007). DAF clinical benefit criteria mildly correlated with ESMO-MCBS scores (correlation coefficient, 0.33; 95% CI, 0.009-0.59). Sensitivity analyses that varied the criteria scores did not change the results. CONCLUSIONS: Using a structured and explicit approach, a criterion-based valuation framework was designed to provide a transparent and consistent method with which to value and prioritize cancer drugs to facilitate the delivery of affordable cancer care.
BACKGROUND: Globally, the rising cost of anticancer therapy has motivated efforts to quantify the overall value of new cancer treatments. Multicriteria decision analysis offers a novel approach to incorporate multiple criteria and perspectives into value assessment. METHODS: The authors recruited a diverse, multistakeholder group who identified and weighted key criteria to establish the drug assessment framework (DAF). Construct validity assessed the degree to which DAF scores were associated with past pan-Canadian Oncology Drug Review (pCODR) funding recommendations and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS; version 1.1) scores. RESULTS: The final DAF included 10 criteria: overall survival, progression-free survival, response rate, quality of life, toxicity, unmet need, equity, feasibility, disease severity, and caregiver well-being. The first 5 clinical benefit criteria represent approximately 64% of the total weight. DAF scores ranged from 0 to 300, reflecting both the expected impact of the drug and the quality of supporting evidence. When the DAF was applied to the last 60 drugs (with reviewers blinded) reviewed by pCODR (2015-2018), those drugs with positive pCODR funding recommendations were found to have higher DAF scores compared with drugs not recommended (103 vs 63; Student t test P = .0007). DAF clinical benefit criteria mildly correlated with ESMO-MCBS scores (correlation coefficient, 0.33; 95% CI, 0.009-0.59). Sensitivity analyses that varied the criteria scores did not change the results. CONCLUSIONS: Using a structured and explicit approach, a criterion-based valuation framework was designed to provide a transparent and consistent method with which to value and prioritize cancer drugs to facilitate the delivery of affordable cancer care.
Authors: Sasha Thomson; Louis Everest; Noah Witzke; Tina Jiao; Seanthel Delos Santos; Vivian Nguyen; Matthew C Cheung; Kelvin K W Chan Journal: Cancer Med Date: 2021-12-01 Impact factor: 4.452
Authors: Dario Trapani; Kiu Tay-Teo; Megan E Tesch; Felipe Roitberg; Manju Sengar; Sara C Altuna; Michael J Hassett; Armando A Genazzani; Aaron S Kesselheim; Giuseppe Curigliano Journal: Curr Oncol Date: 2022-08-16 Impact factor: 3.109