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Cost-effectiveness of cancer drugs: comparative analysis of the United States and England

Cherla, Avi, Renwick, Matthew, Jha, Ashish and Mossialos, Elias (2020) Cost-effectiveness of cancer drugs: comparative analysis of the United States and England. EClinicalMedicine, 29-30. ISSN 2589-5370

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Identification Number: 10.1016/j.eclinm.2020.100625

Abstract

Background England's National Institute for Health and Care Excellence (NICE) and the US’ Institute for Clinical and Economic Review (ICER) both conduct cost-effectiveness evaluations for new cancer drugs to help payers make drug coverage decisions. However, NICE and ICER assessments have been noted to reach different conclusions. We aim to better understand the degree to which their recommendations diverge and what drives these apparent differences. Methods We compared the methods and results of publicly available cost-effectiveness evaluations performed by ICER and NICE of similarly assessed cancer drugs. Assessments were compared based on incremental cost-effectiveness ratio, comparator treatment, price, recommendation, and the design of the economic evaluation. Findings Among 11 commonly assessed cancer drugs, ICER and NICE were in concordance for 7 evaluations and in discordance on the cost-effectiveness and coverage decisions for 4 drugs. Most new cancer drugs were not cost-effective in either the US (7/11) or England (7/11). Furthermore, NICE's capacity to negotiate price discounts and access schemes result in much lower cost per QALY valuations and more favourable recommendations than those of ICER for similarly assessed cancer drugs. Interpretations NICE and ICER employ similar health technology assessment (HTA) methodologies and were aligned with most recommendations, finding that many new and expensive cancer drugs are cost ineffective. Growing use of ICER assessments will continue to send stronger price signals to manufacturers that cancer drugs with low value for money will be viewed less favourably by private insurers. NICE provides an important reminder of how much lower other countries pay for drugs when comparative effectiveness and value-based pricing are integrated into public drug coverage decisions.

Item Type: Article
Official URL: https://www.thelancet.com/journals/eclinm/home
Additional Information: © 2020 The Authors
Divisions: Health Policy
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Date Deposited: 12 Nov 2020 10:15
Last Modified: 20 Sep 2021 02:19
URI: http://eprints.lse.ac.uk/id/eprint/107429

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