Can a Joint Assessment Provide Relevant Information for National/Local Relative Effectiveness Assessments? An In-Depth Comparison of Pazopanib Assessments

Value Health. 2015 Jul;18(5):663-72. doi: 10.1016/j.jval.2015.03.1790. Epub 2015 Jun 10.

Abstract

Background: In many European jurisdictions, relative effectiveness assessments (REAs) of pharmaceuticals are performed during the reimbursement decision-making process. International collaboration in the production of these assessments may prevent the duplication of information in various jurisdictions. A first pilot of a joint REA (pazopanib for the treatment of renal cell carcinoma) was published in 2011.

Objective: The objective was to investigate how well the methods used in the joint REA match the methods used in the national/local assessments on the same topic.

Methods: National/local assessments from European jurisdictions, available in English language, were identified through a literature search and an e-mail request to health technology assessment organizations. Data were abstracted from joint and national/local assessments using a structured data abstraction form. Results were compared for differences and similarities.

Results: In total, five national/local reports were included (Belgium, England/Wales, France, The Netherlands, and Scotland). The general methods (indication, main comparator, main end points, main trial) were similar. The details of the assessment (e.g., exact wording of indication, additional comparators, additional trials included, and method of indirect comparison), however, varied. Despite these differences, the joint REA included nearly all comparators, end points, trials, and methods of analysis that were used in national/local REA reports.

Conclusions: This study has shown overlap in the methods national/local REA bodies in Europe have chosen for a pazopanib REA for renal cell carcinoma, except for the use and methods of indirect comparisons. Although some additional comparators and outcomes differed between national/local REAs, they can be captured in a comprehensive joint REA.

Keywords: comparative effectiveness; health technology assessment; pharmaceuticals; reimbursement.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / economics*
  • Angiogenesis Inhibitors / therapeutic use*
  • Carcinoma, Renal Cell / diagnosis
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / economics*
  • Comparative Effectiveness Research
  • Cooperative Behavior
  • Cost-Benefit Analysis
  • Decision Support Techniques
  • Drug Costs*
  • Europe
  • Humans
  • Indazoles
  • Insurance, Health, Reimbursement
  • International Cooperation
  • Kidney Neoplasms / diagnosis
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / economics*
  • Models, Economic
  • Prohibitins
  • Pyrimidines / adverse effects
  • Pyrimidines / economics*
  • Pyrimidines / therapeutic use*
  • Sulfonamides / adverse effects
  • Sulfonamides / economics*
  • Sulfonamides / therapeutic use*
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Indazoles
  • PHB2 protein, human
  • Prohibitins
  • Pyrimidines
  • Sulfonamides
  • pazopanib