When Decision Meets Precision: Evolving Health Technology Assessments for the Evaluation of Precision Oncology Therapeutics

It Is Time to Evolve Current Approaches to Health Technology Assessments for the Evaluation of Precision Oncology Therapeutics.

Recognizing the need for equitable access to innovations that present a favourable benefit-risk proposition for all stakeholders, there is an opportunity to evolve current health technology assessment (HTA) approaches for the evaluation of precision oncology therapeutics by systematically extending the window for evidence generation and decision-making to the full lifecycle of a technology—from pre-market to market entry to the post -market stage. 

To this end, Shift Health facilitated a series of discussions with an Expert Working Group comprised of a patient advocate, a health economist, an oncologist and HTA experts to reflect on key challenges and opportunities and develop some initial thinking on an HTA framework that reflects the unique challenges of precision oncology therapeutics. The following report explores the key recommendations of this framework and highlights critical considerations for stakeholders looking to prepare health systems for the growing pipeline of precision oncology therapeutics.  

The emerging framework is characterized by the:  

• Application of criteria to determine which therapies would benefit from a greater emphasis on post-market data to overcome uncertainties that exist at market launch; 
• Early and broad engagement with all partners through a process that recognizes diverse stakeholder interests;  
• Use of broader value drivers in the assessment to reveal the full value of the technology and help manage uncertainty; 
• Establishment of performance-based agreements with predetermined performance targets and processes to adjudicate performance. This process could be supported by an independent third party to minimize payer burden, reduce bias, and balance competing interests; 
• Development of frameworks, processes, policies and infrastructure for real-world data collection to enable post-market reassessment; and 
• Harmonization and collaboration across all stakeholders contributing to a life cycle approach to assess precision oncology therapies and enable sustainable healthcare systems and equitable access for patients. 

Health systems around the world will need to find a way to assess the increasing number of precision oncology therapeutics under development to effectively prioritize the most promising of these technologies and provide patients with equitable access to potentially life-saving innovations. The life cycle HTA framework emerging from our Expert Working Group sessions provides some initial recommendations to overcome the key challenges associated with evidence generation and guide the evolution of HTAs for a future defined by precision medicine. 

For more information, access the full report HERE.