1687O - PRIMCAT: A novel approach to informing health technology assessment decision making in Australia

Background

Cancer is a major cause of mortality and high healthcare costs globally. Accurate and granular estimation of the number of patients requiring cancer care is crucial for healthcare planning and resource allocation. The PRIMCAT project provides evidence-based forecasts of the population health economic impact of new cancer treatments in Australia.

Methods

The PRIMCAT project takes a data-driven approach using real-world hospital and administrative data (RWD) for melanoma (MEL), non-small cell lung (NSCLC) and colorectal cancer (CRC). We analysed patterns of care for each cancer, refined using clinician-developed treatment algorithms. We estimated time-to-event analyses, treatment utilization, and progression rate based on retrospective data. We built a discrete event simulation (DES) model to forecast the number of individuals treated by line of treatment and stage of disease. To test the model, we identified the top 5 novel drugs through a systematic horizon scanning procedure and integrated scenario analyses to forecast the number of patients eligible for each drug.

Results

We included 90,522 patients with either MEL, NSCLC or CRC to populate the model with RWD. Treatment patterns provide an overview of how cancer care is managed in Victoria, and the DES estimates the number of patients currently treated. Scenario analyses estimate the numbers of patients likely to be treated with novel drugs for each cancer type based on forecasted incidence, stage distribution, and uptake of treatment. For example, the availability of pembrolizumab for deficient mismatch-repair in metastatic CRC as first line treatment from 2021 onwards would result in a range of 656-867 patients per year receiving this drug, depending on uptake.

Conclusions

Our simulation model estimates the impact of introducing new treatments at applicable points in treatment pathways, decreasing uncertainty associated with the eligible patient population for novel cancer therapies. We provide an invaluable tool for health technology assessment, allowing policymakers to plan and support decision-making for new drugs. Our model aims to ensure effective, affordable, and sustainable cancer care services with equitable access to high-quality care.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

University of Melbourne.

Funding

Medical Research Future Fund grant.

Disclosure

M. Alexander: Financial Interests, Personal, Advisory Board: BMS/Pfizer. J. Desai: Financial Interests, Personal, Invited Speaker: Pierre Fabre, Merck KGaA, Novartis; Financial Interests, Personal, Advisory Board: Bayer, GSK, Boehringer Ingelheim, Roche/Genentech, Pfizer, Amgen, Pierre Fabre, BeiGene; Financial Interests, Coordinating PI: Roche/Genentech, BeiGene; Financial Interests, Local PI: Amgen, AstraZeneca, GSK, Novartis; Financial Interests, Steering Committee Member: Pfizer; Non-Financial Interests, Member: ASCO; Non-Financial Interests, Leadership Role: Australia New Zealand Sarcoma Association. B.J. Solomon: Financial Interests, Institutional, Advisory Board: AstraZeneca, Novartis, Merck, Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Pfizer, AstraZeneca, Roche/Genentech; Financial Interests, Personal, Advisory Board: Amgen, Roche-Genentech, Eli Lilly, Takeda, Janssen; Financial Interests, Personal, Full or part-time Employment, Employed as a consultant Medical Oncologist at Peter MacCallum Cancer Centre: Peter MacCallum Cancer Centre; Financial Interests, Personal, Member of Board of Directors: Cancer Council of Victoria, Thoracic Oncology Group of Australasia; Financial Interests, Personal, Royalties: UpToDate; Financial Interests, Institutional, Steering Committee Member, Principal Investigator and Steering committee Chair: Roche/Genentech, Pfizer; Financial Interests, Institutional, Steering Committee Member: Novartis. P. Gibbs: Financial Interests, Personal, Advisory Board: Merck, Bayer, Amgen, Servier, Haystack Oncology; Financial Interests, Personal, Invited Speaker: MSD. G. McArthur: Financial Interests, Institutional, Coordinating PI, Financial interest is reimbursed costs for activities on clinical trials.: Genentech Roche; Financial Interests, Institutional, Coordinating PI, Financial interest is reimbursed costs for activities on clinical trials: Pfzier; Non-Financial Interests, Other, Advisory Board Member: Novartis, Bristol Myers Squibb, Canthera; Non-Financial Interests, Other, Director: Melanoma World Society. M. IJzerman: Financial Interests, Institutional, Advisory Board, Advisory Board about HTA of Genomic Sequencing in Blood Cancer (November 2022): Illumina; Financial Interests, Personal, Member of Board of Directors, Non-executive board member, compensated: Laboratory Microbiology Twente Achterhoek; Financial Interests, Institutional, Coordinating PI, Unrestricted research grant paid to my institution: Illumina; Non-Financial Interests, Leadership Role, Chair of the Health Sciences Policy Council: International Society for Pharmacoeconomics and Outcomes Research; Non-Financial Interests, Advisory Role, Member of technical assessment group (until June 2022): Medical Services Advisory Committee (MSAC) - Australian Government; Non-Financial Interests, Member of Board of Directors, Non-executive director, not-compensated: Rotterdam Global Health Institute. All other authors have declared no conflicts of interest.