Doctors consider 'efficacy' over cost on anticancer Rx

Results of the 1st, 2nd, 3rd perception survey

Use of stakeholder survey valuation tool 94% opinion

Domestic oncologists have considered more efficacy and safety than the medicne expense when they prescribe anticancer drugs It implies that health authorities need to mix the ratio of anticancer efficacy and toxicity when applying the valuation tools of the European Society for Medical Oncology(ESMO) and the American Society of Clinical Oncology(ASCO).

 

Korean Cancer Study Group (KCSG) has been conducting researches on 'Analysis of valuation tools for foreign cancer drugs and their application in Korea' as a service project of the HIRA (Health Insurance Review & Assessment Service) since June.

 

KCSG conducted perception survey of 17 oncologists (1st), 165 stakeholders(2nd), and 20 specialists in hematology and oncology(3rd) in order to explore Wertform model of Korean anticancer drugs to evaluate the value of high-priced anticancer drugs using ESMO and ASCO.

 

Prof.

 

Ryu, Min-hee

Prof Ryu, Min-hee, trustee of KCSG director presented the results of the 1st, 2nd and 3rd perceptions at the public hearing on Oct 23, and many respondents responded positively to using the value evaluation tool as an anticancer health insurance benefit or afterlife assessment criteria.

 

In the first survey of 17 oncologists, efficacy was considered ranked first when prescribing general anticancer drugs and immune chemotherapy, 94.1% and 75%, respectively.

 

Only 1 (5.9%) responded that the MD considered costs for generic anticancer drugs, while 3 (18.75%) answered that they considered costs for immune chemotherapy.

 

Anticancer drug evaluation items of ASCO and ESMO consists of efficacy and toxicity.

 

When asked about the appropriate ratio in Korea, 58.8% of respondents answered that 70% efficacy and 30% toxicity.

 

The other 23.5% said 60% efficacy and 40% toxicity, and the remaining 17.6% said 80% efficacy and 20% toxicity.

 

The ASCO anti-cancer drug value evaluation reflects additional scores in improving the quality of life (QoL) besides efficacy and toxicities.

 

If the sum of the importance of anticancer efficacy and toxicity is 100, 47.4% answered 20% of the appropriate quality of life ratio.

 

the remaining 37.5% chose 10%, and 6.3% over 30%.

 

As a result of asking the oncologist about the cost of drugs that are not included in the two valuation tools, 43.8% of the respondents consider it to be 60% to 80%.

 

Domestic clinicians are also considering the burden of drug costs.

 

When the Korean anti-cancer drug value evaluation tool developed by the government is developed, 50% of respondents said 'use it as evaluation standard when applying health insurance', and 31.3% said 'use it for evaluating the efficacy of anti-cancer drug after marketing' and the rest ‘ used by MD to decide on patient treatments.'' The second perception survey was conducted by oncologists, nurses, and pharmacists at the ASCO in Busan in last August.

 

Occupation rate was 49.4% of doctors, 35.5% of nurses, and 11.4% of the pharmaceutical industry.

 

The rest chose a duplicate with the others.

 

In the survey of stakeholders, more than half of the respondents said that more than half of the respondents chose to choose generic anticancer drugs or immunocancer drugs with the most importance of efficacy.

 

In addition, 97.6% of the respondents said that it is necessary to develop an anti-cancer drug clinical evaluation tool for the Korean situation.

 

In particular, the majority of opinions that the valuation tool should be used as a standard of health insurance benefits or afterlife assessment.

 

90.4% of respondents said that value evaluation tools that reflect clinical effects, toxicity, and quality of life should be used as criteria for determining health insurance benefits.

 

93.4% of respondents said they needed to use a value evaluation tool as a post-registration evaluation tool for conditionally listed anticancer drugs.

 

The third recognition survey was conducted with 20 hematological oncologists from MM working party.

 

More than 90% of the respondents consider the effects of selecting general anticancer drugs and immunocancer drugs.

 

The drug costs were 5% and 10%, respectively.

 

Respectively 80%, 90% of the respondents commented on the need to use a value evaluation tool as a basis for reimbursement decision and a​fterlife assessment.

 

Prof.

 

Ryu said, "The results showed that they takes count of the efficacy the most when prescribing general anticancer drugs and immunocancer drugs.

 

Education and seminars were needed to utilize and apply the research tools." The response was positive for being used as reimbursement standards or ​fterlife assessment standards” Prof.

 

Ryu said, "New Bio drugs such as anticancer drugs are shifting the paradigm of disease treatment with new treatment mechanisms and improved effects.

 

However, some high-cost anticancer drugs raise questions about the uncertainty of cost effectiveness compared to the therapeutic effect." "We need to consider introducing an objective and standardized drug valuation tool for fiscal integrity and sustainability."