CCHE Seminar Series: Jaclyn Beca, Ontario Health (Cancer Care Ontario)

Economic Evaluations for Cancer Drug Reimbursement Policy-Making in Practice

Abstract: Health technology assessment is an essential component of decision making for public reimbursement of new technologies. Pharmaceutical products are assessed using rigorous and formal evaluative frameworks prior to reimbursement through public drug programs. For example, the Canadian Agency for Drugs and Technologies in Health (CADTH)’s pan-Canadian Oncology Drug Review (pCODR), which provides recommendations on cancer drugs to provinces and territories in Canada, considers clinical benefit and cost-effectiveness of the intervention compared to existing treatment options, along patient values and adoption feasibility for every drug reviewed. Cost-effectiveness is assessed with an economic evaluation estimating the relative costs and outcomes of a new intervention compared to existing alternatives, using economic models to combine data from multiple sources and to project health and economic outcomes into the future. The clinical data supporting the use of new products typically lack long-term outcomes at the time new pharmaceuticals are being considered for reimbursement.

In this session, we will explore the drug funding process in Canada and the role of pharmacoeconomic evidence in assessment and decision-making, with cancer as a focus. We will delve into the policy needs of the system and some of the challenges in the development and interpretation of pharmacoeconomic evidence for reimbursement in practice. We will compare and constrast two main economic evaluation modelling methods seen in cancer reimbursement: Markov models and partitioned survival models. We will highlight the importance of analysis of survival data for assessing cancer drugs and some of the issues and challenges that accompany survival modelling in oncology. We will explore some of the common features of cancer drug reimbursement consideration affecting economic evidence, along with future directions for the field.

Jaclyn Beca is a health economist and Manager of the Pharmacoeconomics Research Unit at Ontario Health (Cancer Care Ontario), where she helps policy-makers assess and interpret cost-effectiveness of new therapies. Her research interests include economic evaluations, health services research, real-world evidence in oncology, and in enhancing the role of pharmacoeconomic evidence in reimbursement decision-making. She is pursuing her PhD in Health Systems Research with a primary area of focus in Health Technology Assessment at the University of Toronto