Authors: Kimberley Tran (M.A.); Brett J Skinner (Ph.D.)
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. This study 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 discusses how the HTA process can be enhanced to consider the value of the utility-expansion.
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