PCN354 RECENT HEALTH TECHNOLOGY ASSESSMENT (HTA) DECISIONS ACROSS THE GLOBE: A FOCUS ON PROSTATE CANCER: RESULTS, RATIONALE, AND TRENDS

About 1 in 9 men will be diagnosed with prostate cancer during his lifetime, making it the second most common cancer in men behind lung cancer. Compared to other cancer types, prostate cancer usually progresses slowly and can initially be managed successfully with watchful waiting, radiation, surgery, or hormone therapy. However, there is a need for therapies that can better delay progression, and improve survival and quality of life for castration-resistant prostate cancer (CRPC). This analysis evaluated recent HTA decisions for prostate cancer therapies and their rationales to identify trends in selected countries. HTA surveillance was conducted for Australia, Canada, France, Germany, the United Kingdom (UK), and the United States (US) from January 1, 2012 to June 1, 2019. HTAs for prostate cancer therapies were evaluated by indication, drug class, decision, and rationale for the decision. Decisions were categorized as favorable, unfavorable, neutral (deferred decision), or mixed (both favorable and unfavorable aspects). There were 38 HTA decisions for 8 unique prostate cancer treatments, including 5 androgen deprivation therapies (ADTs), published during the study period. Across the studied countries, 26 (68%) decisions were favorable, 6 (16%) were unfavorable, 5 (13%) were mixed, and 1 (3%) was neutral. All of the decisions in France and the US were favorable, but budget impact concerns were raised in the US. In Canada, 4 (80%) of the decisions were mixed with conditional recommendations based on achieving a price reduction. Appraisals for non-metastatic CRPC therapies represented just 18% of decisions, and were favorable 43% of the time compared to 74% of the time for other appraisals. The majority of prostate cancer therapies have received favorable HTA decisions across all studied countries. However, HTA’s have been more critical of the value of non-metastatic CRPC treatments, and demonstrating cost-effectiveness will be challenging with new generic entrants.