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Disagreement on cancer drug decisions in Europe

Published online by Cambridge University Press:  15 June 2020

Laia Maynou
Health Policy, London School of Economics and Political Science, London, UK Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain
John Cairns
London School of Hygiene and Tropical Medicine, London, UK CCBIO, University of Bergen, Norway



Despite the efforts of the European Union (EU) to promote voluntary cooperation among Health Technology Assessment (HTA) agencies, different reimbursement decisions for the same drug are made across European countries. The aim of this paper is to compare the agreement of cancer drug reimbursement decisions using inter-rater reliability measures.


This study is based on primary data on 161 cancer drug reimbursement decisions from nine European countries from 2002 to 2014. To achieve our goal, we use two measures to analyze agreement, in other words, congruency: (i) percentage of agreement and (ii) the κ score.


One main conclusion can be drawn from the analysis. There is a weak to medium agreement among cancer drug decisions in the European countries analyzed (based on the percentage of agreement and the κ score). England and Scotland show the highest consistency between the two measures, showing a medium agreement. These results are in line with previous literature on the congruency of HTA decisions.


This paper contributes to the HTA literature, by highlighting the extent of weak to medium agreement among cancer decisions in Europe.

Copyright © The Author(s), 2020. Published by Cambridge University Press

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