1687O PRIMCAT: A novel approach to informing health technology assessment decision making in Australia

Cancer is a major cause of mortality and high healthcare costs globally. Accurate and granular estimation of the number of patients requiring cancer care is crucial for healthcare planning and resource allocation. The PRIMCAT project provides evidence-based forecasts of the population health economic impact of new cancer treatments in Australia. The PRIMCAT project takes a data-driven approach using real-world hospital and administrative data (RWD) for melanoma (MEL), non-small cell lung (NSCLC) and colorectal cancer (CRC). We analysed patterns of care for each cancer, refined using clinician-developed treatment algorithms. We estimated time-to-event analyses, treatment utilization, and progression rate based on retrospective data. We built a discrete event simulation (DES) model to forecast the number of individuals treated by line of treatment and stage of disease. To test the model, we identified the top 5 novel drugs through a systematic horizon scanning procedure and integrated scenario analyses to forecast the number of patients eligible for each drug. We included 90,522 patients with either MEL, NSCLC or CRC to populate the model with RWD. Treatment patterns provide an overview of how cancer care is managed in Victoria, and the DES estimates the number of patients currently treated. Scenario analyses estimate the numbers of patients likely to be treated with novel drugs for each cancer type based on forecasted incidence, stage distribution, and uptake of treatment. For example, the availability of pembrolizumab for deficient mismatch-repair in metastatic CRC as first line treatment from 2021 onwards would result in a range of 656-867 patients per year receiving this drug, depending on uptake. Our simulation model estimates the impact of introducing new treatments at applicable points in treatment pathways, decreasing uncertainty associated with the eligible patient population for novel cancer therapies. We provide an invaluable tool for health technology assessment, allowing policymakers to plan and support decision-making for new drugs. Our model aims to ensure effective, affordable, and sustainable cancer care services with equitable access to high-quality care.