Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-15T07:13:46.623Z Has data issue: false hasContentIssue false


Published online by Cambridge University Press:  28 December 2012

Koonal Kirit Shah
Office of Health Economics
Jorge Mestre-Ferrandiz
Office of Health Economics
Adrian Towse
Office of Health Economics
Emily Nash Smyth
Eli Lilly and Company – Global Health Outcomes


Pharmaceutical manufacturers, regulators, patients, providers, and payers all have a shared interest in improving health outcomes for patients with cancer. Each plays an important role in helping to achieve this common goal. Pharmaceutical manufacturers seek to develop new medicines that are supported by robust and clinically meaningful evidence of their safety, efficacy, and effectiveness. Regulators authorize these medicines based on evaluations of their safety and efficacy. Patients and providers together make treatment decisions and desire access to the most effective treatment options. Payers appraise new medicines with the goal of ensuring access to those medicines that constitute efficient uses of healthcare expenditure. Profits generated from the sale of the medicines provide a return to the manufacturer, which helps to drive continued research and development in an effort to improve patient health outcomes and societal well-being. Many payers have initiated health technology assessment (HTA) activities to inform decision making in light of the rising costs of health care. Given the financial constraints imposed as a result of the global economic crisis, HTAs are likely to become increasingly important as payers seek value for money solutions to major health problems. Successful collaboration and aligning incentives across stakeholders is critical to ensuring that patients are able to access the most effective medicines.

Copyright © Cambridge University Press 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)



1.Wilking, N, Jönsson, B, Hogberg, D. Comparator Report on Patient Access to Cancer Drugs in Europe. Stockholm: Karolinska Institutet and Stockholm School of Economics; 2009.Google Scholar
2.Berry, DA, Cronin, KA, Plevritis, SK, et al.Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353:1784-92.CrossRefGoogle Scholar
3.Cancer Intervention and Surveillance Modeling Network (CISNET) Breast Cancer Collaborators. The impact of mammography and adjuvant therapy on U.S. breast cancer mortality (1975-2000): collective results from the cancer intervention and surveillance modeling Network. J Natl Cancer Inst. 2006;36:1126.Google Scholar
4.Sun, E, Jena, AB, Lakdawalla, D, et al.The contributions of improved therapy and earlier detection to cancer survival gains, 1988-2000. Forum for Health Econ Policy. 2010;13:120.CrossRefGoogle Scholar
5.Association of the British Pharmaceutical Industry (ABPI). Target Breast Cancer. London: ABPI; 2005.Google Scholar
6.European Medicines Agency. [cited 2011 November 21]. Available from: Scholar
7.Kanavos, P, Schurer, W. The burden of colorectal cancer: prevention, treatment and quality of services. Eur J Health Econ. 2010;10:S13.CrossRefGoogle ScholarPubMed
8.International Society for Pharmacoeconomics and Outcomes Research. [cited 2011 November 21]. Available from: Scholar
9.MOHLTC. Ontario Drug Benefit. [cited 2011 November 23]. Available from: Scholar
10.Kanavos, P, Nicod, E, van den Aardweg, S, Pomedli, S. The impact of health technology assessments: an international comparison. Euro Observer. 2010;12:19.Google Scholar
11.McCabe, C, Bergmann, L, Bosanquet, N, et al.Market and patient access to new oncology products in Europe: a current, multidisciplinary perspective. Ann Oncol. 2009;20:403–12.CrossRefGoogle ScholarPubMed
12.Axelrod, RC. The significance of progression free survival as a clinical end point in oncology. Drug Benefit Trends. 2010;22.Google Scholar
13.Saad, ED, Katz, A, Buyse, M. Progression-free survival as surrogate and as true end point: insights from the breast and colorectal cancer literature. Ann Oncol. 2010;21:712.CrossRefGoogle ScholarPubMed
14.European Medicines Agency. Assessment Report for AVASTIN. London: European Medicines Agency; 2011.Google Scholar
15.Aaronson, NK, Ahmedzai, S, Bergman, B, et al.The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.CrossRefGoogle ScholarPubMed
16.Cella, DF, Tulsky, DS, Gray, G, et al.The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.CrossRefGoogle ScholarPubMed
17.Messina, J, Grainger, DL. A pilot study to identify areas for further improvements in patient and public involvement in health technology assessments for medicines. Patient. 2012;5:199211.Google ScholarPubMed
18.Roché, H, Fumoleau, P, Spielman, Met al., 6 cycles of FEC 100 followed by 3 cycles of docetaxel for node-positive breast cancer patients: analysis at 5 years of the adjuvant PACS 01 trial. Paper presented at the San Antonio Breast Cancer Symposium, San Antonio, TX, 2004.Google Scholar
19.Clement, FM, Harris, A, Li, JJ, et al.Using effectiveness and cost-effectiveness to make drug coverage decisions: a comparison of Britain, Australia, and Canada. JAMA. 2009;302:1437–43.CrossRefGoogle ScholarPubMed
Supplementary material: File

Shah et al. supplementary material

Supplementary tables

Download Shah et al. supplementary material(File)
File 133.1 KB