Efthymiadou, Olina and Kanavos, Panos ORCID: 0000-0001-9518-3089
(2021)
Determinants of managed entry agreements in the context of Health Technology Assessment: a comparative analysis of oncology therapies in four countries.
International journal of technology assessment in health care, 37 (1).
ISSN 1471-6348
![]() |
Text (Efthymiadou_determinants-of-managed-entry-agreements--published)
- Published Version
Available under License Creative Commons Attribution. Download (359kB) |
Abstract
BACKGROUND: Managed Entry Agreements (MEAs) are increasingly used to address uncertainties arising in the Health Technology Assessment (HTA) process due to immature evidence of new, high-cost medicines on their real-world performance and cost-effectiveness. The literature remains inconclusive on the HTA decision-making factors that influence the utilization of MEAs. We aimed to assess if the uptake of MEAs differs between countries and if so, to understand which HTA decision-making criteria play a role in determining such differences. METHODS: All oncology medicines approved since 2009 in Australia, England, Scotland, and Sweden were studied. Four categories of variables were collected from publicly available HTA reports of the above drugs: (i) Social Value Judgments (SVJs), (ii) Clinical/Economic evidence submitted, (iii) Interpretation of this evidence, and (iv) Funding decision. Conditional/restricted decisions were coded as Listed With Conditions (LWC) other than an MEA or LWC including an MEA (LWCMEA). Cohen's κ-scores measured the inter-rater agreement of countries on their LWCMEA outcomes and Pearson's chi-squared tests explored the association between HTA variables and LWCMEA outcomes. RESULTS: A total of 74 drug-indication pairs were found resulting in n = 296 observations; 8 percent (n = 23) were LWC and 55 percent (n = 163) were LWCMEA. A poor-to-moderate agreement existed between countries (-.29 < κ < .33) on LWCMEA decisions. Cross-country differences within the LWCMEA sample were partly driven by economic uncertainties and largely driven by SVJs considered across agencies. CONCLUSIONS: A set of HTA-related variables driving the uptake of MEAs across countries was identified. These findings can be useful in future research aimed at informing country-specific, "best-practice" guidelines for successful MEA implementation.
Item Type: | Article |
---|---|
Official URL: | https://www.cambridge.org/core/journals/internatio... |
Additional Information: | © 2021 The Authors |
Divisions: | ?? MTRG ?? |
Subjects: | R Medicine > RA Public aspects of medicine |
Date Deposited: | 31 Jan 2022 10:24 |
Last Modified: | 16 Aug 2024 21:45 |
URI: | http://eprints.lse.ac.uk/id/eprint/113577 |
Actions (login required)
![]() |
View Item |