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Expert Rev Pharmacoecon Outcomes Res. 2019 Jun 26:1-5. doi: 10.1080/14737167.2019.1635458. [Epub ahead of print]

Appraisal of cancer drugs: a comparison of the French health technology assessment with value frameworks of two oncology societies.

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a Clinical Epidemiology Unit , Greater Paris University Hospitals (AP-HP) , Paris , France.
b Judge Business School , University of Cambridge , Cambridge , UK.
c Faculty of Medicine , Paris XII University , Créteil , France.
d UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM , University Paris Descartes , Paris , France.
e Department is Oncology Business Unit , LILLY FRANCE , Neuilly-sur-Seine , France.
f URC Eco IdF , Greater Paris University Hospitals (AP-HP) , Paris , France.


Objectives: Our primary objective was to compare the grading of the value of cancer drugs ('Amélioration du Service Médical Rendu' [ASMR] level) by the French health technology assessment authority ('Haute Autorité de santé' [HAS]) with that by the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Our secondary objective was to study the drivers of the French grading system. Methods: We included new drugs for solid tumors assessed by the HAS between 2010 and 2016 and compared their ASMR level to scores calculated by the 2016-updated ASCO-VF and 2015 ESMO-MCBS. Results: We investigated 27 new cancer drugs assessed by the French HAS between 2010 and 2016. Among the 17 drugs eligible for comparison, the correlation between ASMR levels and ASCO and ESMO scores was weak (r = 0.34 and r = 0.27, respectively). The agreement between the HAS and ESMO regarding the level of meaningful additional benefit was moderate (kappa = 0.43). We found no significant association between 12 potential variables and ASMR level of additional benefit of drugs. Conclusion: Our findings show inconsistencies in cancer drug appraisals among the three appraisers.


Health technology assessment; Value framework; antineoplastic drugs; resource allocation; single-payer system; value-based purchasing

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