Pharma-funded studies far more likely to find oncology drugs cost-effective
Click Here to Manage Email Alerts
Studies funded by pharmaceutical companies appeared significantly more likely to find oncology drugs cost-effective than studies without such funding, according to results of a cross-sectional study published in JAMA Network Open.
“To weigh the costs and benefits of a drug, researchers and organizations will conduct a cost-effectiveness analysis. As part of the analysis, there needs to be a certain threshold of cost per benefit, or a willingness-to-pay threshold, which is already established in certain countries like the U.K. but not the U.S.,” Alyson Haslam, PhD, researcher in the department of epidemiology and biostatistics at University of California, San Francisco’s Mission Bay Campus, told Healio. “When cost-effectiveness studies are conducted from a U.S. perspective, whoever conducts the cost-effectiveness analyses can select that threshold, which can sometimes be a bit arbitrary, potentially introducing bias into the results.”
The retrospective cross-sectional study included 254 cost-effectiveness analyses of 116 oncology drugs the FDA approved between 2015 and 2020.
Haslam and colleagues analyzed the characteristics of the studies to identify the factors associated with whether an oncology drug was found to be cost-effective. They analyzed each drug for the incremental cost-effectiveness ratio per quality-adjusted life year, the funding of the study, the authors’ conflict of interest, the threshold of willingness to pay, the country’s perspective from which the analysis was conducted and whether a National Institute for Health and Care Excellence cost-effectiveness analysis had been performed.
The odds of a study deeming a drug cost-effective served as the main outcome.
Overall, the researchers found 132 studies (52%) conducted from a U.S. perspective. Among the 78 drugs with cost-effectiveness studies, 47 (60%) had been shown to improve OS, whereas 15 (39%) of the 38 drugs without a cost-effectiveness study improved OS.
Moreover, studies funded by a pharmaceutical company had higher odds of finding a drug to be cost-effective than studies without funding (OR = 41.36; 95% CI, 11.86-262.23).
“Pharmaceutical companies have an interest in protecting their revenue, so it is in their best interest to make sure their drug is cost-effective,” Haslam said. “To reduce bias from financial conflict of interest, some have suggested that journals insist on disclosing financial conflict of interest at the end of published cost-effectiveness articles. There has been some progress in disclosures, as we found that conflict-of-interest disclosures have increased in recent years, but more can be done since the issue of conflict-of-interest bias is still very relevant.”
A stronger measure would be for journals to select independently conducted cost-effectiveness analyses for publication or have conflict-of-interest disclosures more apparent in the text/results of the analysis, Haslam added.
“The U.S. could fund independent groups to conduct cost-effectiveness analyses. The Institute for Clinical and Economic Review independently conducts cost-effectiveness analyses from a U.S. perspective, but their resources are limited, especially considering the number of drugs that can be evaluated,” Haslam said. “One line of subsequent research would be to determine what a meaningful willingness-to-pay threshold would be for the U.S. so that there is an actual benchmark for these types of analyses. Unfortunately, financial resources are limited in health care and, as a society, we need to have these kinds of discussions about how much we are willing to pay for our health and number of life years.”
For more information:
Alyson Haslam, PhD, can be reached at University of California, San Francisco, Mission Bay Campus, Mission Hall: Global Health and Clinical Sciences Building, 550 16th St., 2nd Floor, San Francisco, CA 94158; email: alyson.haslam@ucsf.edu.
Collapse
Click Here to Manage Email Alerts