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A Comparative Analysis of Anticancer Drug Appraisals Including Managed Entry Agreements in South Korea and England

Author

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  • Iyn-Hyang Lee

    (Yeungnam University
    University of York)

  • Karen Bloor

    (University of York)

  • Eun-Young Bae

    (Gyeongsang National University)

Abstract

Objectives This study aimed to compare appraisal decisions about anticancer drugs between the health technology assessment (HTA) agencies in Korea and England, and investigate whether the decisions and supporting evidence are comparable. Methods This study identified 49 anticancer drugs listed by the Korean Ministry of Health and Welfare between January 2014 and December 2019. Of those, 46 anticancer drugs for 58 indications were included for analysis. Official appraisal documents from both countries for 58 drug–indication pairs were compared and assessed in terms of clinical and economic evidence. Evidence items and their groups for analysis were predefined. Results Three-quarters of cases were recommended with managed entry agreements (MEAs) in England and three-fifths in Korea. Finance-based MEA types were most common in both countries. Korean and English authorities made consistent decisions in 48 cases (83%) when classifying decisions as ‘recommended’ and ‘not recommended’, while the degree of agreement lowered to 16 cases (28%) when subdividing decisions according to MEA types. When the evidence base was identical, their decisions were more likely to be consistent. Regarding clinical evidence, while the majority of cases referred to the same pivotal studies, differences between the committees’ recognized comparators and the appraisal date caused discrepancies in decisions. Economic evidence, including incremental cost-effectiveness ratio (ICER) estimates, was identical in only 12 cases (21%), which contributed to discrepancies. Conclusion England relies on economic evaluation, with increasing use of data collection agreements, in contrast with Korea’s new procedure exempting companies from providing economic evaluation. While there is possibility for international cooperation in the assessment of clinical evidence, transferability issues exist, particularly with regard to economic evidence.

Suggested Citation

  • Iyn-Hyang Lee & Karen Bloor & Eun-Young Bae, 2023. "A Comparative Analysis of Anticancer Drug Appraisals Including Managed Entry Agreements in South Korea and England," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 347-359, March.
    • Handle: RePEc:spr:aphecp:v:21:y:2023:i:2:d:10.1007_s40258-022-00778-1
    DOI: 10.1007/s40258-022-00778-1
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    References listed on IDEAS

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    1. Vogler, Sabine & Paris, Valérie & Ferrario, Alessandra & Wirtz, Veronika J. & Joncheere, Kees de & Schneider, Peter & Pedersen, Hanne Bak & Dedet, Guillaume & Babar, Zaheer-Ud-Din, 2017. "How can pricing and reimbursement policies improve affordable access to medicines? Lessons learned from European countries," LSE Research Online Documents on Economics 68862, London School of Economics and Political Science, LSE Library.
    2. Rumona Dickson & Angela Boland & Rui Duarte & Eleanor Kotas & Nerys Woolacott & Robert Hodgson & Rob Riemsma & Sabine Grimm & Bram Ramaekers & Manuela Joore & Nasuh Büyükkaramikli & Eva Kaltenthaler &, 2018. "EMA and NICE Appraisal Processes for Cancer Drugs: Current Status and Uncertainties," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 429-432, August.
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