Relative Effectiveness in Breast Cancer Treatment: A Health Production Approach

Ruth Puig-Peiro; Anne Mason; Jorge Mestre-Ferrandiz; Adrian Towse; Clare McGrath; Bengt Jonsson

doi:10.1017/S0266462315000720

Relative Effectiveness in Breast Cancer Treatment: A Health Production Approach

Ruth Puig-Peiro, Anne Mason, Jorge Mestre-Ferrandiz, Adrian Towse, Clare McGrath, Bengt Jonsson

Centre for Health Economics

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Pharmaceuticals' relative effectiveness has come to the fore in the policy arena, reflecting the need to understand how relative efficacy (what can work) translates into added benefit in routine clinical use (what does work). European payers and licensing authorities assess value for money and post-launch benefit-risk profiles, and efforts to standardize assessments of relative effectiveness across the European Union (EU) are under way. However, the ways that relative effectiveness differs across EU healthcare settings are poorly understood.

METHODS: To understand which factors influence differences in relative effectiveness, we developed an analytical framework that treats the healthcare system as a health production function. Using evidence on breast cancer from England, Spain, and Sweden as a case study, we investigated the reasons why the relative effectiveness of a new drug might vary across healthcare systems. Evidence was identified from a literature review and national clinical guidance.

RESULTS: The review included thirteen international studies and thirty country-specific studies. Cross-country differences in population age structure, deprivation, and educational attainment were consistently associated with variation in outcomes. Screening intensity appeared to drive differences in survival, although the impact on mortality was unclear.

CONCLUSIONS: The way efficacy translates into relative effectiveness across health systems is likely to be influenced by a range of complex and interrelated factors. These factors could inform government and payer policy decisions on ways to optimize relative effectiveness, and help increase understanding of the potential transferability of data on relative effectiveness from one health system to another.

Original language	English
Pages (from-to)	371-379
Number of pages	9
Journal	International Journal of Technology Assessment in Health Care
Volume	31
Issue number	6
Early online date	20 Jan 2016
DOIs	https://doi.org/10.1017/S0266462315000720
Publication status	Published - 2016

Bibliographical note

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© 2016, Cambridge University Press. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details
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Cite this

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title = "Relative Effectiveness in Breast Cancer Treatment: A Health Production Approach",

abstract = "BACKGROUND: Pharmaceuticals' relative effectiveness has come to the fore in the policy arena, reflecting the need to understand how relative efficacy (what can work) translates into added benefit in routine clinical use (what does work). European payers and licensing authorities assess value for money and post-launch benefit-risk profiles, and efforts to standardize assessments of relative effectiveness across the European Union (EU) are under way. However, the ways that relative effectiveness differs across EU healthcare settings are poorly understood.METHODS: To understand which factors influence differences in relative effectiveness, we developed an analytical framework that treats the healthcare system as a health production function. Using evidence on breast cancer from England, Spain, and Sweden as a case study, we investigated the reasons why the relative effectiveness of a new drug might vary across healthcare systems. Evidence was identified from a literature review and national clinical guidance.RESULTS: The review included thirteen international studies and thirty country-specific studies. Cross-country differences in population age structure, deprivation, and educational attainment were consistently associated with variation in outcomes. Screening intensity appeared to drive differences in survival, although the impact on mortality was unclear.CONCLUSIONS: The way efficacy translates into relative effectiveness across health systems is likely to be influenced by a range of complex and interrelated factors. These factors could inform government and payer policy decisions on ways to optimize relative effectiveness, and help increase understanding of the potential transferability of data on relative effectiveness from one health system to another.",

author = "Ruth Puig-Peiro and Anne Mason and Jorge Mestre-Ferrandiz and Adrian Towse and Clare McGrath and Bengt Jonsson",

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