Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-12T19:43:52.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Disagreement on cancer drug decisions in Europe

Part of: Special Collection - Methods

Published online by Cambridge University Press:  15 June 2020

Laia Maynou Open the ORCID record for Laia Maynou [Opens in a new window]  and
John Cairns
Laia Maynou
Affiliation:
Health Policy, London School of Economics and Political Science, London, UK Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain
John Cairns
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK CCBIO, University of Bergen, Norway
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Despite the efforts of the European Union (EU) to promote voluntary cooperation among Health Technology Assessment (HTA) agencies, different reimbursement decisions for the same drug are made across European countries. The aim of this paper is to compare the agreement of cancer drug reimbursement decisions using inter-rater reliability measures.

Methods

This study is based on primary data on 161 cancer drug reimbursement decisions from nine European countries from 2002 to 2014. To achieve our goal, we use two measures to analyze agreement, in other words, congruency: (i) percentage of agreement and (ii) the κ score.

Results

One main conclusion can be drawn from the analysis. There is a weak to medium agreement among cancer drug decisions in the European countries analyzed (based on the percentage of agreement and the κ score). England and Scotland show the highest consistency between the two measures, showing a medium agreement. These results are in line with previous literature on the congruency of HTA decisions.

Conclusions

This paper contributes to the HTA literature, by highlighting the extent of weak to medium agreement among cancer decisions in Europe.

Keywords

Drug reimbursement systemκ scoreInter-rater reliabilityCongruency
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 3 , June 2020 , pp. 232 - 238
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Franken, M, Le Polain, M, Koopmanschap, M, Cleemput, I. Similarities and differences between five European drug reimbursement systems. Int J Technol Assess Health Care. 2012;28:349–57.CrossRefGoogle ScholarPubMed
Barneih, L, Manns, B, Harris, A, Blom, M, Donaldson, C, Klarenbach, S et al. A synthesis of drug reimbursement decision-making processes in organisation for economic co-operation and development countries. Value Health. 2014;17:98–108.CrossRefGoogle Scholar
Franken, M, Stolk, E, Scharringhausen, T, de Boer, A, Koopmanschap, M. A comparative study of the role of disease severity in drug reimbursement decision making in four European countries. Health Policy. 2015;119:195–202.CrossRefGoogle ScholarPubMed
Oortwijn, W, Determann, D, Schiffers, K, Tan, SS, Van der Tuin, J.Towards integrated health technology assessment for improving decision making in selected countries. Value Health. 2017;20:1121–30.CrossRefGoogle ScholarPubMed
Fischer, K. A systematic review of coverage decision-making on health technologies-evidence from the real world. Health Policy. 2012;107:218–30.CrossRefGoogle ScholarPubMed
Allen, N, Liberti, L, Walker, SR, Salek, S. A comparison of reimbursement recommendations by European HTA agencies: Is there opportunity for further alignment? Front Pharmacol. 2017;8:384. doi: 10.3389/fphar.2017.00384.CrossRefGoogle ScholarPubMed
Clement, F, Harris, A, Li, J, Yong, K, Lee, K, Manns, B. Using effectiveness and cost-effectiveness to make drug coverage decisions: A comparison of Britain, Australia, and Canada. JAMA. 2009;302:1437–43.CrossRefGoogle ScholarPubMed
Nicod, E, Kanavos, P. Commonalities and differences in HTA outcomes: A comparative analysis of five countries and implications for coverage decisions. Health Policy. 2012;108:167–77.CrossRefGoogle ScholarPubMed
Franken, MG, Nilsson, F, Sandmann, FG, Boer, AD, Koopmanschap, MA. Unravelling drug reimbursement outcomes: A comparative study of the role of pharmacoeconomic evidence in Dutch and Swedish reimbursement decision making. PharmacoEconomics. 2013;31:781–97.CrossRefGoogle ScholarPubMed
Grepstad, M, Kanavos, P. A comparative analysis of coverage decisions for outpatient pharmaceuticals: Evidence from Denmark, Norway and Sweden. Health Policy. 2015;119:203–11.CrossRefGoogle ScholarPubMed
Maynou, L, Cairns, J. Why do some countries approve a cancer drug and others don't? J Cancer Policy. 2015;4:21–25.Google Scholar
Nicod, E. Why do health technology assessment coverage recommendations for the same drugs differ across settings? Applying a mixed methods framework to systematically compare orphan drug decisions in four European countries. Eur J Health Econ. 2017;18:715–30.CrossRefGoogle ScholarPubMed
Allen, NJ, Walker, SR, Liberti, LE, Salek, S. Health Technology Assessment (HTA) case studies: Factors influencing divergent HTA reimbursement recommendations in Australia, Canada, England, and Scotland. Value Health. 2017;20:320–8.CrossRefGoogle ScholarPubMed
Dakin, H, Devlin, N, Odeyemi, I. “Yes”, “No” or “Yes, but”? Multinomial modelling of NICE decision-making. Health Policy. 2006;77:352–67.CrossRefGoogle ScholarPubMed
Cerri, K, Knapp, M, Fernandez, JL. Decision making by NICE: Examining the influences of evidence, process and context. Health Econ Policy Law. 2014;9:119–41.CrossRefGoogle Scholar
Dakin, H, Devlin, N, Feng, Y, Rice, N, O'Neill, P, Parkin, D.The influence of cost-effectiveness and other factors on NICE decisions. Health Econ. 2015;24:1256–71.CrossRefGoogle ScholarPubMed
Charokopou, M, Majer, IM, Raad, J, Broekhuizen, S, Postma, M, Heeg, B.Which factors enhance positive drug reimbursement recommendation in Scotland? A retrospective analysis 2006–2013. Value Health. 2015;18:284–91.CrossRefGoogle Scholar
Maynou, L, Cairns, J. What is driving HTA decision-making? Evidence from cancer drug reimbursement decisions from 6 European countries. Health Policy. 2019;123:130–9.CrossRefGoogle ScholarPubMed
Habl, C, Laschkolnig, A, Habimana, K, Stürzlinger, H, Röhrling, I, Bobek, J et al. Study on impact analysis of policy options for strengthened EU cooperation on health technology assessment (HTA). Luxembourg: Publications Office of the European Union. [Accessed 14 February 2018: https://ec.europa.eu/health/sites/health/files/technology_assessment/docs/2018_ia_policyoptions_en.pdf].Google Scholar
Cohen, J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46.CrossRefGoogle Scholar
McHugh, M. Interrater reliability: The kappa statistic. Biochem Med (Zagreb). 2012;22:276–82.CrossRefGoogle ScholarPubMed
Feinstein, AR, Cicchetti, DV. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol. 1990;43:543–8.CrossRefGoogle ScholarPubMed
Tang, W, Hu, J, Zhang, H, Wu, P, He, H. Kappa coefficient: A popular measure of rater agreement. Shanghai Arch Psychiatry. 2015;27:62–67.Google ScholarPubMed
Flight, L, Julious, SA. The disagreeable behaviour of the kappa statistic. Pharm Stat. 2015;14:74–78.CrossRefGoogle ScholarPubMed
Proposal for a Regulation (EC) No 2018/0018(COD)of the European Parliament and of the Council on health technology assessment and amending Directive 2011/24/EU (2018). [Accessed 14 February 2018 https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52018PC0051#document1].Google Scholar
Supplementary material: File

Maynou and Cairns Supplementary Materials

Maynou and Cairns Supplementary Materials

Download Maynou and Cairns Supplementary Materials(File)
File 88.7 KB