A tailored approach to horizon scanning for cancer medicines.
Date
2023-12-01ICR Author
Author
Soon, JA
To, YH
Alexander, M
Trapani, K
Ascierto, PA
Athan, S
Brown, MP
Burge, M
Haydon, A
Hughes, B
Itchins, M
John, T
Kao, S
Koopman, M
Li, BT
Long, GV
Loree, JM
Markman, B
Meniawy, TM
Menzies, AM
Nott, L
Pavlakis, N
Petrella, TM
Popat, S
Tie, J
Xu, W
Yip, D
Zalcberg, J
Solomon, BJ
Gibbs, P
McArthur, GA
Franchini, F
IJzerman, M
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Horizon scanning (HS) is the systematic identification of emerging therapies to inform policy and decision-makers. We developed an agile and tailored HS methodology that combined multi-criteria decision analysis weighting and Delphi rounds. As secondary objectives, we aimed to identify new medicines in melanoma, non-small cell lung cancer and colorectal cancer most likely to impact the Australian government's pharmaceutical budget by 2025 and to compare clinician and consumer priorities in cancer medicine reimbursement. METHOD: Three cancer-specific clinician panels (total n = 27) and a consumer panel (n = 7) were formed. Six prioritisation criteria were developed with consumer input. Criteria weightings were elicited using the Analytic Hierarchy Process (AHP). Candidate medicines were identified and filtered from a primary database and validated against secondary and tertiary sources. Clinician panels participated in a three-round Delphi survey to identify and score the top five medicines in each cancer type. RESULTS: The AHP and Delphi process was completed in eight weeks. Prioritisation criteria focused on toxicity, quality of life (QoL), cost savings, strength of evidence, survival, and unmet need. In both curative and non-curative settings, consumers prioritised toxicity and QoL over survival gains, whereas clinicians prioritised survival. HS results project the ongoing prevalence of high-cost medicines. Since completion in October 2021, the HS has identified 70 % of relevant medicines submitted for Pharmaceutical Benefit Advisory Committee assessment and 60% of the medicines that received a positive recommendation. CONCLUSION: Tested in the Australian context, our method appears to be an efficient and flexible approach to HS that can be tailored to address specific disease types by using elicited weights to prioritise according to incremental value from both a consumer and clinical perspective. POLICY SUMMARY: Since HS is of global interest, our example provides a reproducible blueprint for adaptation to other healthcare settings that integrates consumer input and priorities.
Collections
Subject
Biomedical
Cancer
Colorectal cancer
Community involvement
Decision making
Health care costs
Health policy
Health priorities
Melanoma
Non-small cell lung cancer
Technology assessment
Humans
Quality of Life
Carcinoma, Non-Small-Cell Lung
Australia
Lung Neoplasms
Evidence-Based Medicine
Pharmaceutical Preparations
Language
eng
Date accepted
2023-08-17
License start date
2023-12-01
Citation
Journal of Cancer Policy, 2023, 38 pp. 100441 -
Publisher
ELSEVIER SCI LTD