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Mittmann N, Evans WK, Rocchi A, Longo CJ, Au HJ, Husereau D, Isogai PK, Krahn M, Coyle D. Economic guidelines for oncology products: Adaptation of the Canadian Agency for Drugs and Technologies in Health (CADTH) technology assessment guidance document. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e17572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17572 Background: Economic evaluations (EE) are routinely used by decision-makers in Canada. CADTH's “Guidelines for the Economic Evaluation of Health Technologies: Canada” Third edition, 2006, provide guidance on the conduct of EEs for all therapeutic products. The consistency and quality of oncology EEs are variable and therapeutics in the cancer care environment presented unique challenges in decision making. Several chapters of the CADTH document adequately defined methods for the conduct of an oncology EE. However, some chapters required more specific guidance to improve the quality of oncology EEs. The goal was to provide direction on methods for the conduct of high quality EEs in oncology. Methods: The Working Group on Economic Analysis, NCIC CTG and CADTH jointly initiated this project and formed a working group (WG) of oncologists, health economists, decision makers and economic analysts. The WG identified CADTH chapters where oncology-specific guidance would be required. In-person and teleconference meetings provided content and structure for the document. Formal reviews by external academic experts, cancer agencies, patient groups and the pharmaceutical industry were conducted. Feedback was reviewed by the WG and incorporated as appropriate. Results: Chapters requiring guidance included: target population, comparators, perspective, effectiveness, modeling, type of evaluation, valuing health, time horizon, costs and resources, sensitivity analysis and equity. Guidance included clarity around CADTH methodology and recommendations for oncology products. For example for the effectiveness chapter, there was guidance around the use of intermediate outcomes (progression free survival vs. overall survival) and type of evidence (phase II vs. phase III). Overall recommendations for chapters will be presented. Conclusions: The oncology adapted economic guidelines provide specific guidance on the conduct of EEs for oncology products and will be published as an addendum to CADTH's third edition document. Their use should lead to more consistent application of EE methodologies for anti-cancer drugs and higher quality information for decision-makers at a national and perhaps international level. No significant financial relationships to disclose.
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Affiliation(s)
- N. Mittmann
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - W. K. Evans
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - A. Rocchi
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - C. J. Longo
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - H. J. Au
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - D. Husereau
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - P. K. Isogai
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - M. Krahn
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
| | - D. Coyle
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Axia Research, Hamilton, ON, Canada; McMaster University, Hamilton, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Canadian Agency for Drugs and Technologies Health, Ottawa, ON, Canada; Toronto Health Economics and Technology Assessment, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Working Group on Standardized Pharmacoeconomic Guidelines in Oncology
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