HTA methods for evaluating oncology survival benefit were introduced when most drug treatments were cytotoxic regimens for advanced disease, delivering moderate survival benefit. Immunotherapies now offer the potential for transformative benefit in many indications. Adjuvant drug therapies with curative intent in earlier disease stages are also expanding. The increased diversity in survival benefit delivered by new technologies adds complexity and presents new challenges for HTA evaluation of oncology therapies. 

The 2018 annual report of the Comité Economique de Produits de Santé (CEPS), provides valuable insights into France’s stance on innovative pricing schemes for drugs. CEPS has published the annual value of rebates, split by type of pricing scheme.

The last 5 years has seen a dramatic evolution in treatments for multiple myeloma. Previously, bortezemib, lenalidomide and pomalidamide, in combination with steroids and used sequentially, was the mainstay of treatment for transplant ineligible patients. With the introduction of carfilzomib, panobinostat, elotuzumab, daratumumab and ixazomib as add-ons to existing therapies, there is now a much large number of possible combinations and sequences.

The UK’s National Institute of Health and Care Excellence (NICE) has published an update to its methods and processes for health technology appraisal. The update comes after a year long review and includes a number of significant changes to how innovative medicines will be evaluated for pricing and reimbursement in the UK.