The German Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA), the French Haute Autorité de Santé (HAS) as well as the British National Institute for Health and Care Excellence (NICE) are broadly considered as HTA agencies following high methodological standards and transparent assessment procedures. The aim of our study was to explore the association between different HTA methods and heterogeneous assessment outcomes, focusing on new implemented cancer drugs. We extracted data from all publicly available G-BA appraisals between January 2011 – when early benefit assessments were officially implemented in Germany – and June 2018, as well as all published HAS reports and NICE single technology appraisals (STAs) during the same period. We compared benefit assessment results of matched drug pairs by G-BA, HAS and NICE overall. We also considered additional criteria with regard to cancer treatments, such as the orphan drug status in Germany and Cancer Drugs Fund (CDF) reconsiderations in England. During the study period, we found 102 matched condition-intervention pairs; of which, nearly two-thirds (64/102) differ by assessment outcome. NICE recommended 85/102 (83%) of the drugs, whereas HAS and G-BA reported added benefit for 59/102 (58%, including 7/102 non-reimbursable drugs) and 72/102 (71%) treatments, respectively. Findings for matched cancer drug pairs show, however, substantial differences in assessment outcomes. While NICE recommended 42/58 (72%) cancer technologies (another 12 drugs were recommended for use in the CDF only), HAS and G-BA reported 37/58 (64%, including 5/58 non-reimbursable drugs) and 49/58 (85%, including 12 drugs with an orphan designation) treatments with added benefit, respectively. Notwithstanding that far more than half (33/58) of the cancer-related HTA outcomes differ, discrepancies by therapeutic area apparently exist. Our results confirm that different methodological choices are indeed associated with differences in HTA outcomes, which may be amplified by some well-defined exceptions in national HTA systems.
© 2019 Published by Elsevier Inc.