Health Services Research (HSR) in oncology: Analysis of Austrian data

Supported by DexHelpp (data-requirements and -acquisition), Martin Robausch
Duration: January 2018 – December 2019

Background:
Austria is among the leading countries with regard to the early adoption and availability of new cancer drugs [1, 2]. Therefore, an early awareness system called ‘Horizon Scanning in Oncology’ (HSO) was developed and implemented by the Austrian Ludwig Boltzmann Institute for Health Technology Assessment (LBI–HTA) in 2009. The HSO system shall provide information to decision makers (hospital administrators, drug commissions, social insurance organisations) to contribute to rational decision making and facilitate estimations on budget implications (https://hta.lbg.ac.at/page/horizon-scanning-in-der-onkologie-berichte/en). Due to the increasing uncertainty of the benefit-risk profiles of some oncological therapies there is a need of more stringent benefit assessments [3, 4, 5]. In Austria some (but not all, n = 33 in 2017) cancer therapies are included in the national hospital benefit catalogue. Decisions on specific oncological treatment schemes are exclusively taken within the regional public hospital cooperation´s. Some of the oncology drugs listed in the Austrian hospital benefit catalogue were uniformly assessed negatively regarding their efficacy as well as their cost-effectiveness [2].

Project aim and research question:
The project aims to provide an overview on both the frequency of reimbursement of those oncological therapies included in the national hospital benefit catalogue for different tumour patients (diagnosis and indications) as well as the respective patient characteristics (age, socio-economic status) and also therapy-related information (follow-up therapies, treatment of side effects, survival etc.). The overview will provide a general picture for all reimbursed oncological therapies in Austria.

Potential questions to be answered:

• Regional variances in the use of oncological therapies included in the national hospital benefit catalogue (in different tumour indications)
• Regional variances with regards to age, gender and socio-economic status
• Frequency and duration of hospitalisations
•  Quantity and quality of different physician contacts
•  Quantity and quality of additional extramural care, incl. mental health, pain etc. interventions
• Sick leaves

Methods:

(1)  Analysis of routine data

(2)  Aggregated presentation of results at the level of the nine federal states

(3)  Investigation and analysis of pre-marketing and post-marketing clinical studies of oncological therapies in Austria

Time management:

• Jan–March 2018: Definition data-requirements, -acquisition
• April–Dec 2018: Data-analysis
•  Jan–December 2019: Reporting, Peer-Review

Literature:

[1]    Bengt Jönsson et al., (2016) Comparator Report on Patient Access to Cancer Medicines in Europe Revisited, http://ihe.se/wp-content/uploads/2016/08/IHE-Report_2016_4.pdf

[2]    Grössmann, N., Wild, C., Mayer, J. (2016) Onkologika: Übersicht zu Nutzenbewertungen und Refundierungspolitiken in Europa. Rapid Assessment LBI-HTA Nr. 08. 2016. Wien: Ludwig Boltzmann Institut für Health Technology Assessment.

[3]    Deutsches Ärzteblatt (2017): Ruf nach schärferer Nutzenbewertung von Krebsmedikamenten. 18. Dez. https://www.aerzteblatt.de/nachrichten/87079/Ruf-nach-schaerferer-Nutzenbewertung-von-Krebsmedikamenten

[4]    Light DW, Lexchin J. Why do cancer drugs get such an easy ride? BMJ 2015; 350:h2068.

[5]          Apolone G, Tafuri G, Trotta F, et al. A new anti-cancer drug in the market: good news for investors or for patients? Eur J Cancer 2008; 44:1786–8.