Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Assessment of the clinical and cost-effectiveness evidence in the reimbursement decisions of new cancer drugs
University of Gothenburg.
University of Gothenburg.
Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).ORCID-id: 0000-0002-7143-8793
Örebro University.
Vise andre og tillknytning
2022 (engelsk)Inngår i: ESMO Open, E-ISSN 2059-7029, Vol. 7, nr 5, artikkel-id 100569Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: This study aimed to describe the clinical and cost-effectiveness evidence supporting reimbursementdecisions of new cancer drugs and analyze the influence of trial characteristics and the cost per quality-adjusted lifeyears (QALYs) on the likelihood of reimbursement in Sweden.Patients and methods: Data were extracted from all appraisal dossiers for new cancer drugs seeking reimbursement inSweden and claiming added therapeutical value between the years 2010 and 2020. The data were analyzed usingdescriptive statistics, and logistic regression models were also used with the cost per QALY, study design,comparator, and evidence on final outcomes in the clinical trials as predictors of reimbursement.Results: All 60 included appraisals were based on trial evidence that assessed at least one final outcome (overallsurvival [OS] or quality of life [QoL]), although rarely as a primary outcome. Of the appraisals with a final decision(n ¼ 58), 79% were approved for reimbursement. Among the reimbursed drugs, only half had trial evidencedemonstrating improved OS or QoL. Only one drug had trial evidence supporting improvements in both OS andQoL. The average cost per QALY for reimbursed cancer drugs was estimated to be 748 560 SEK (V73 583). A highercost per QALY was found to decrease the likelihood of reimbursement by 9.4% for every 100 000 SEK (V9830)higher cost per QALY (P ¼ 0.03). For cost-effectiveness models without direct evidence of improvements in finaloutcomes, a larger QALY gain was observed compared with those with evidence mainly relying on intermediate andsurrogate outcomes.Conclusions: There are substantial uncertainties in the clinical and cost-effectiveness evidence underlyingreimbursement decisions of new cancer drugs. Decision makers should be cautious of the limited evidence onpatient-centered outcomes and the implications of allocating resources to expensive treatments with uncertainvalue for money.

sted, utgiver, år, opplag, sider
Elsevier, 2022. Vol. 7, nr 5, artikkel-id 100569
Emneord [en]
reimbursement, health technology assessment, decision making, cancer drugs
HSV kategori
Identifikatorer
URN: urn:nbn:se:kau:diva-91815DOI: 10.1016/j.esmoop.2022.100569ISI: 000861347400004PubMedID: 36037568Scopus ID: 2-s2.0-85136473924OAI: oai:DiVA.org:kau-91815DiVA, id: diva2:1693855
Forskningsfinansiär
The Jan Wallander and Tom Hedelius Foundation, P21-0018Tore Browaldhs stiftelseTilgjengelig fra: 2022-09-08 Laget: 2022-09-08 Sist oppdatert: 2022-10-27bibliografisk kontrollert

Open Access i DiVA

fulltext(467 kB)141 nedlastinger
Filinformasjon
Fil FULLTEXT01.pdfFilstørrelse 467 kBChecksum SHA-512
7c460d24d383076e320b3cf606ec1fcd379b8a97599a7b96cbc639c5700246b81f1d2f48a314c081f1edd482494bb897d9e5bb79af78d8ae0884e734bbc2b5f6
Type fulltextMimetype application/pdf

Andre lenker

Forlagets fulltekstPubMedScopus

Person

Jakobsson, Niklas

Søk i DiVA

Av forfatter/redaktør
Jakobsson, Niklas
Av organisasjonen
I samme tidsskrift
ESMO Open

Søk utenfor DiVA

GoogleGoogle Scholar
Totalt: 141 nedlastinger
Antall nedlastinger er summen av alle nedlastinger av alle fulltekster. Det kan for eksempel være tidligere versjoner som er ikke lenger tilgjengelige

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 189 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf