[PDB6 Relative effectiveness management of type II diabetes in Europe: can the agencies’ demands be met?

[PDB6 Relative effectiveness management of type II diabetes in Europe: can the agencies’ demands be met?

2010 Value in health

Hemels, M. | Jensen, R.C.Ã | Toumi, M. | Adalsteinsson, E. | Volume: 13, Issue: 3, Pages: A55, E,

OBJECTIVES: As decision-makers and the citizens they serve demand stronger evidence
to support coverage, prioritization, and pricing, the need for relative effectiveness
research has come to the fore. Whilst it is well known and documented that
differences in costing structures, practise patters and unit costs can lead to differences
in cost effectiveness estimates for any given clinical effect, less is known about the
heterogeneity of treatments and their utilization to demonstrate Relative Effectiveness
(RE) among EU countries. This study investigated differences in treatment availability
and utilization using recommendations from HTA agencies as a proxy. METHODS:
HTA reports were searched using 7 European HTA agencies websites (i.e., NICE,
SMC, IQWIG, HAS, CAHTA, CVZ, TLV with the following keywords: pioglitazone,
rosiglitazone, sitagliptin, vildagliptin, exenatide, glargine, detemir, aspart, glulisine
and lispro. Recommendation was classified in three categories: recommended,
restricted recommended, and not recommended in relation to indication based on
marketing authorisation. RESULTS: No HTA agency had similar recommendations
for all treatments. IQWIG recommended none of the products assessed (8), while
Sweden recommended 86% of the products assessed (7). NICE, SMC, HAS, CAHTA
and CVZ assessed 18, 8, 18, 15, and 10 products, recommending 22%, 50%, 56%,
13% and 0%, restricting 78%, 50%, 22%, 47% and 50% respectively. CONCLUSIONS:
Large differences in recommendation of products among EU countries exist.
As diabetes is a well established disease area, one would expect a more uniform
armamentarium of recommended treatments. In light of the RE management plans,
this research questions whether it is possible and desirable to develop a unified
approach. Future research should focus on standardization of methods and address
questions about acceptable methodology and its limitations.

https://www.doi.org/10.1016/S1098-3015(10)72253-1