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Cancer Drugs Reimbursed with Limited Evidence on Overall Survival and Quality of Life: Do Follow-Up Studies Confirm Patient Benefits?
School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Örebro University, School of Health Sciences. Örebro University Hospital. School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-2325-5375
Karlstad Business School, Faculty of Arts and Social Sciences, Karlstads Business School, Karlstad University, Karlstad, Sweden.
School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Centre for Societal Risk Management, Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden.
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2023 (English)In: Clinical drug investigation, ISSN 1173-2563, E-ISSN 1179-1918, no 43, p. 621-633Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVE: Cancer drug costs have increased considerably within healthcare systems, but many drugs lack quality-of-life (QoL) and overall survival (OS) data at the time of reimbursement approval. This study aimed to review the extent of subsequent literature documenting improvements in OS and QoL for cancer drug indications where no such evidence existed at the time of reimbursement approval.

METHODS: Drug indications with claims of added therapeutical value but a lack of evidence on OS and QoL that were reimbursed between 2010 and 2020 in Sweden were included for review. Searches were conducted in PubMed and ClinicalTrial.gov for randomized controlled trials examining OS and QoL.

RESULTS: Of the 22 included drug indications, seven were found to have at least one trial with conclusive evidence of improvements in OS or QoL after a mean follow-up of 6.6 years. The remaining 15 drug indications either lacked subsequent randomized controlled trial data on OS or QoL (n = 6) or showed no statistically significant improvements (n = 9). Only one drug demonstrated evidence of improvement in both OS and QoL for its indication.

CONCLUSIONS: A considerable share of reimbursed cancer drug indications continue to lack evidence of improvement in both OS and QoL. With limited healthcare resources and an increasing cancer burden, third-party payers have strong incentives to require additional post-reimbursement data to confirm any improvements in OS and QoL.

Place, publisher, year, edition, pages
Springer, 2023. no 43, p. 621-633
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Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-107493DOI: 10.1007/s40261-023-01285-4ISI: 001039851200001PubMedID: 37505421Scopus ID: 2-s2.0-85169757424OAI: oai:DiVA.org:oru-107493DiVA, id: diva2:1786823
Funder
University of GothenburgThe Jan Wallander and Tom Hedelius FoundationTore Browaldhs stiftelse, P21-0018Available from: 2023-08-10 Created: 2023-08-10 Last updated: 2023-12-08Bibliographically approved

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Johansson, Naimi

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