Overview of French databases available for studying anticancer drugs in real‐life setting

Abstract

Considering their novelty and cost, post‐marketing evaluation is highly relevant for new anticancer drugs. Identify and characterize available and potentially useful databases for post‐marketing evaluation of these specific drugs is necessary. A review was conducted to identify available and accessible databases to study the post‐marketing evaluation of drugs in real‐life care setting. Databases identified have been classified into medico‐administrative databases, medical record databases, and databases resulting from ad hoc collections. Taking as examples databases available in France, each type was described as well as its strengths and limits for a potential use in the oncology field. Record linkage of medico‐administrative databases could cover almost the whole population and is now used to evaluate anticancer drugs (e.g., Système National des Données de Santé). Large medical record databases are still lacking, but efforts are currently made to give access to hospital data warehouses for research purposes. Finally, databases resulting from ad hoc collections are also available for some cancer localizations and allow to obtain highly valuable clinical and biological data. A range of important and valuable databases exist but, individually, none is enough to answer to all questions from health authorities, healthcare professionals, and patients. In order to obtain a complete overview on utilization, associated health outcomes and costs of these drugs, it seems necessary to better interlink available databases.

Real-world effectiveness of pembrolizumab in advanced melanoma: analysis of a French national clinicobiological database

“…Databases such as MelBase serve as important sources of information about the outcomes of therapy for heterogeneous patient populations treated in oncology practice, outside of RCTs [12,24]. The strengths of this study include the large patient population with advanced melanoma treated in French clinical practice and the median follow-up of over 2 years.…”

Opportunities and Obstacles to the Development of Health Data Warehouses in Hospitals in France: The Recent Experience of Comprehensive Cancer Centers

“…Although it centralizes a very wide range of data, this megabase is, nevertheless, far from exhaustive, in particular because of the fragmentation of health data in France. Indeed, clinical data are not systematically transmitted to the French Health Insurance Fund and the Health Data Hub, which makes feeding and using this national database to conduct RWE studies difficult [ 17 ]. Hospitalization data collected in CCCs are extremely rich because they concentrate several sources and are essential for understanding care pathways in oncology.…”

“…Hospitalization data collected in CCCs are extremely rich because they concentrate several sources and are essential for understanding care pathways in oncology. These data are not exhaustively transmitted to the national database [ 17 ]. Indeed, the data transmitted to the French Health Insurance Fund are transmitted at a level of detail that is only intended to allow reimbursement by the public payer without going into the medical or technical details of the pathology or the treatment needed for implementing RWE studies.…”

The French Early Breast Cancer Cohort (FRESH): A Resource for Breast Cancer Research and Evaluations of Oncology Practices Based on the French National Healthcare System Database (SNDS)

“…The French national health insurance system covered 98.8% of the 67 million inhabitants of France in 2020 [ 2 ]. All the medical and administrative information relating to the reimbursement of French citizens for healthcare expenses are collected and aggregated in the National Health Data System (Système National des Données de Santé, SNDS) database [ 3 ].…”