A HTA landscape review to assess surrogate endpoint acceptability in early-stage oncology settings
Targeted health technology assessment (HTA) review to gain insights into the utilization of surrogate endpoints (SEs) and how these endpoints have contributed to decision-making by key HTA agencies
To inform the strategy for oncology products in early treatment settings, our client was keen to understand which SEs have been utilised for oncology treatments submitted for HTA in key markets. In addition, it was important to ascertain how these SEs have been perceived by HTA agencies and whether the use of SEs influenced decision-making, either positively or negatively. Whether decision-making had altered over time was also of interest.
As our client was interested in publishing the outputs of this project, a comprehensive landscape review of shortlisted HTA agencies was conducted in line with a robust study protocol.
In order to efficiently capture not only the overall recommendation from HTAs, but also the perceptions of SEs, a traffic light rating system was established as a clear method of representing of the totality of evidence (Figure 1).
Alongside HTA perceptions, we reviewed the evidence offered in support of SE use, and whether the presence, absence, or nature of the supporting evidence was a factor influencing decision-making.
Key publications and clinical trial data were also mapped to a timeline of HTA submissions to identify any relationship between peer-reviewed data availability and SE acceptance.
We presented key insights and general trends identified across the HTA agencies, as well as an indepth review of each individual technology appraisal, its rating, and example quotes from the agencies pertaining to their opinion on the SE in each context. A comprehensive data extraction form supplemented a visual summary of the findings with additional data, which enabled our client to probe further into factors influencing decision-making.
Value to the client
We provided our client with a robust and comprehensive review of a wealth of data disseminated into key insights and trends, informing the clients strategy for current and future oncology projects. As a result, these results were also developed into a poster at ISPOR 2021, and as a manuscript for wider dissemination of the findings.