The Context Matters team presented two studies at the ISPOR 18th Annual International Meeting in New Orleans. The first, a presentation, demonstrated agreement by more than 73 percent on reimbursement decisions across five of the major HTA agencies, and that this agreement on the clinical and economic aspects of the reviews mirrors agreement on the decisions to reimburse. The second, a poster, showed that regardless of geographic location, health technology assessments generally valued the same set of outcomes for new treatment entries in three different treatment categories. The first study was an assessment of reimbursement decisions among five major HTA agencies. A total of 366 reviews for 94 regulatory approved drugs were assessed to determine similarities and disparities in their reimbursement decisions. The study showed that the level of agreement between any two agencies was generally between 58 and 85 percent, but these high levels of agreement were potentially due to chance. The study also looked deeper into agreement and discovered that when agencies are agreeing on the fundamentals of the reviews they are more likely to agree on the recommendation. All but one of the agencies positively recommended the drugs at a rate of above 82 percent.
"This is an important finding as it demonstrated that if there is pressure among the different reimbursement agencies to provide some uniformity of reimbursement, we will have to look for this influence within the fundamentals of the review, not necessarily at the recommendation level," said Dr. Yin S. Ho, one of the study authors and CEO of Context Matters, which conducted the study. "This analysis provides a platform for looking at how agencies potentially influence each other and provides us with variables to include in our next steps, which is multivariate analysis."
The second study examined the consistency of outcomes measures in ongoing interventional clinical trials for multiple sclerosis, Hepatitis C and HIV. The study demonstrated a statistical consistency among the 39 multiple sclerosis trials as well as among the 33 HIV trials. Conversely, four of the 11 Hepatitis C studies showed different outcome measures, which the study authors believed to be a result of a recent surge in Hepatitis C drug development.
"Both of these studies indicate that despite differences in policies and other approaches, the methodologies and decision-making across the globe remain markedly similar," continued Dr. Ho. "Although there are different regulatory and reimbursement pathways, the global approach to pharmaceutical development, approval and reimbursement are largely the same, and provide us with unique opportunities to learn from one another."