Authors
Kimberley Tran (M.A.); Brett J Skinner (Ph.D.)
Introduction
In the Canadian health technology assessment (HTA) process, drugs are evaluated for clinical and cost-effectiveness following Health Canada marketing approval. Usually, each drug indication is evaluated by HTA bodies individually in line with the specific indication granted by Health Canada. However, when a cancer drug is reviewed for its initial indication, HTA evaluators are not fully able to assess the future additional benefits that accrue from successive approved indications. Subsequently, at the payer level, the discussion and review is focused more around price rather than value. Many cancer drugs are approved for multiple indications over the course of their product life-cycle. The next generation of cancer therapies, especially immuno-oncology treatments, are being studied for multiple indications. The expanded utility provided by cancer drugs is not fully captured in the HTA process.
Objective
Empirically demonstrate the utility-expansion that occurs over the product life-cycle of health technology by use of a case study focused on new cancer drugs in Canada, and discuss how the HTA process can be enhanced to consider the value of the utility-expansion.
Data
Clinical trial data of the drugs examined in the analysis derive from each drug’s product monographs, Health Canada, the Canadian Cancer Society, Statistics Canada and the U.S. Food and Drug Administration (FDA).
Results
The study identified 11 cancer drugs approved in Canada during 2004-2014 which were subsequently approved for 22 additional cancer indications. The annual potential economic value from the utility-expansion provided by these cancer drugs is an estimated $1.9 billion to $8.4 billion in 2015.
Conclusions
Utility-expansion is evidenced in a number cancer drugs that are approved in Canada for multiple cancer indications. HTA evaluations of new cancer drugs that can respond to the utility-expansion occurring over the product life-cycle would lead to reimbursement recommendations that are more optimal in maximizing health and economic returns from the adoption of the new health technologies.
