Pcn366 Treatment Landscape and Key Drivers for Hta Decisions in Patients With Non-Small Cell Lung Cancer Without Egfr or Alk Alterations

Abstract

und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) assesses the benefits and harms of new drugs. IQWiG's guidelines specify that ratings of individual outcomes are based on the upper limit of confidence intervals thresholds of hazard ratio. In oncology, benefit in mortality typically drives the overall benefit, but other outcomes may also impact IQWIG's overall benefit rating. The objective was to identify what additional clinical outcomes may impact IQWIG's HTA decision-making in oncology. Oncology drug assessments from 2011-2018 were identified through the IQWiG website. Reported outcomes were reviewed in line with IQWiG's categorization overall survival (OS), safety, morbidity and HRQoL. The extent of benefit or harm of each individual outcome was correlated by category and subsequently to the overall benefit rating. 92 IQWIG oncology drug assessments covering 168 different subgroups were identified. In 116 of 168, the overall benefit rating matched the mortality benefit rating. For the 52 subgroups where overall ratings did not match mortality benefit rating, data on safety, morbidity and/or HRQoL drove a higher or lower benefit rating (18 and 34 subgroups, respectively). 'Major clinical benefits' in these outcome categories were correlated with a higher overall benefit rating as seen in 12 of the 18 subgroups with higher benefit ratings. Only for 1 subgroup did a 'major clinical benefit' not translate in a higher overall rating. In 5 out of 6 subgroups receiving a higher overall benefit rating without 'major clinical benefits', some extent of benefit in safety outcomes were identified. Mortality remains the main decision driver in IQWiG overall benefit rating for oncology. When no OS benefit can be demonstrated, or when additional data is available, a major benefit in safety, morbidity or HRQoL, is likely to lead a more favorable overall IQWiG rating.