Drug Assessment Framework for Evaluation of Cancer Drugs

Researchers recently developed an algorithm to examine the value of cancer therapies. This algorithm was outlined within a report published in Cancer.¹

A Canada-based research team recruited participants to help establish a drug assessment framework (DAF) for evaluating cancer drugs. Multiple types of stakeholders participated, some of whom were patients, oncologists, members of industry, a representative from Canada’s Ministry of Health, and individuals involved in the pan-Canadian Oncology Drug Review (pCODR) process.

In designing the DAF, the researchers suggested several criteria for determining drug value in a survey given to participants for feedback. Using participants’ evaluations of criteria, the researchers chose a set of 10 final criteria to use in the DAF. Each criterion was given a weight from 1 to 100. Criteria and their weights were defined as follows:

• Quality of life (weight, 19)
• Overall survival (weight, 15)
• Unmet clinical need (weight, 15)
• Progression-free or disease-free survival (weight, 12)
• Toxicity (weight, 10)
• Response rate (weight, 8)
• Equity (weight, 6)
• Feasibility (weight, 6)
• Disease severity (weight, 5)
• Caregiver well-being (weight, 4)

Each criterion in the DAF is rated on a scale of 0 to 3, with 3 having the highest value, and with modifications allowed based on strength of evidence. The highest possible score for a drug in this DAF is 300.

The mean score was 94 (range, 18-179) for a set of 60 cancer drugs analyzed using the DAF. When examined against pCODR funding recommendations for drugs included in this analysis, the researchers found significant agreements between DAF scores and funding recommendations.

In an analysis of 37 drugs for solid tumors, scores for DAF criteria relating to clinical benefit showed some correlation with values on the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (correlation coefficient, 0.33; 95% CI, 0.009-0.59, P =.045).

“The DAF quantifies stakeholders’ expectations of meaningful advances in patient outcomes,” the study investigators wrote. They indicated that the DAF will be adjusted as cancer treatments change.

Reference

1. Ezeife DA, Dionne F, Fares AF, et al. Value assessment of oncology drugs using a weighted criterion-based approach. Cancer. doi:10.1002/cncr.32639