Over 4 years of Long Term Collaboration on a Lung Cancer Therapy

Aim

A pharmaceutical company first approached our health economics team in September 2020 for economic modelling and systematic literature review (SLR) support for a novel therapy in non-small cell lung cancer. Initially, we were commissioned to develop a patient population calculator covering nine countries (Belgium, France, Germany, Italy, the Netherlands, Spain, Sweden, Switzerland, UK), as well as a European budget impact model (BIM) and European cost-effectiveness model (CEM) with UK base cases, and an alternative cost-effectiveness model focusing on a response-based partitioned survival approach. The project subsequently expanded to include further adaptations of these models to support health technology assessment (HTA) submissions across ten European countries, including England, Scotland, Ireland, Italy, Belgium, Spain, Portugal, Denmark, Sweden, and Hungary. While the initial project focused on a , it recently increased in scope to additionally develop early cost-effectiveness estimates in three further indications. As a result, we now provide economic modelling and HTA writing support for these new indications in the UK and Ireland.

Approach

Given the nature of the project work, which involved several intersecting and various HTA submissions, we recognised the need for flexibility in project management. The various project workstreams were resourced with a diverse team to cover a range of technical and scientific skillsets and to ensure maintenance of a core group of senior leadership for overall cohesion and ongoing continuity. This hybrid approach allowed us to remain adaptable to the changing demands of HTA submissions while providing high-level strategic advice and coordinating multiple product workstreams. This was particularly beneficial as it alleviated the strategic burden on the client.

Over the course of these projects, we worked with numerous teams at both regional and local levels across different simultaneous workstreams. Exceptional internal and external communication and collaboration were essential for efficient project delivery. Throughout the project, our team provided continuity across these different local client teams; a number of our team members from the original team continue to work on projects involving this therapy. This consistency facilitated the smooth transfer of expertise between client teams and different project types.

We conducted clinical and economic SLRs, updating each several times to incorporate the latest developments and emerging therapeutic options. Throughout the project, we worked on a wide range of economic models, using a variety of methods, while providing insights into product optimisation. This included a hybrid response-based partitioned survival model, which first segregated patients by initial response and then modelled these groups independently before recombining them to present aggregated outcomes. Alongside this innovative response-based model, we developed several other CEMs tailored to specific requirements. This included models designed for early assessments of cost-effectiveness, overcoming data gaps and with an emphasis on pragmatism, as well as others which were comprehensive European-wide models focusing on flexibility and testing a full range of modelling possibilities. Numerous local HTA models prioritised robustness and optimisation of outcomes and, lastly, a patient population model centred on usability and ease of updates, given its needs and varied target audiences across multiple countries.

Impact

We have supported the economic modelling required for twelve HTA Submissions (across 10 countries). Over the course of this portfolio of work, we have become a trusted partner for both European and local affiliate client teams, across various service offerings and geographies. Our team has developed considerable expertise in the drug and lung cancer disease area, enabling us to provide valuable strategic insights and proactively contribute to the client’s product strategy. This is evidenced by the long-lasting nature of the collaboration, which continues to this day. By harnessing our substantial knowledge base of the drug and disease area and maintaining continuity in the project team across the development of the full range of models, we have also been able to deliver these projects with increasing efficiency, providing a consistent and highly streamlined experience for the client.