The rapid development of immuno-oncology (I-O) therapies has transformed the cancer treatment landscape, but health technology assessment (HTA) agencies can decide against covering or reimbursing such treatments because of their complexity and high cost. As experts in achieving market access for immuno-oncology therapies, Symmetron is committed to helping its clients maximise the chances of success for their I-O appraisals to HTA agencies.

Anna Pagotto PhD is a Health Outcomes Associate at Symmetron trying to identify what the National Institute for Health and Care Excellence (NICE) requires to enable market access for immuno-oncology therapies in the UK. Anna has a strong academic background in oncology and, before joining Symmetron, she led cancer immunotherapy research in the pharma industry. We spoke with her about her current research into the factors that lead NICE to accept or reject I-O drug appraisals.

Anna, what are the main objectives of the project?

We are analysing around 100 NICE appraisals of I-O treatments in an attempt to understand what factors reduce or increase their chances of success. Every year, NICE evaluates around 15-20 I-O appraisals and the success rate is about 50%, excluding the Cancer Drugs Fund. This is comparable to what is reported for several countries. We want to help the pharma industry and other stakeholders understand what it takes to create an I-O product that can win broad enough support that a national insurer would wish to accept it among its reimbursable treatments.

Why does the industry need this project?

A study of HTA approvals of I-O treatments across several countries between 2012 and 2017 showed that I-O appraisals face numerous obstacles, but it did not deeply analyse barriers or facilitators of success. In addition, the landscape of available I-O treatments has expanded since that study. The time is ripe to clarify the rationale behind HTA decisions in an updated I-O context.

What challenges do you foresee during this project?

We need to gather quite a large amount of heterogeneous, and often qualitative, data, yet we want to extract themes and patterns that can lead to clear, rigorous conclusions. This will not be easy, but it is par for the course when examining something so complex as oncology treatments and their appraisal by HTAs.

Why is Symmetron a good home for this project?

Symmetron has conducted several oncology projects, from support on technology appraisals and reimbursement, assessment of the societal costs of cancer and cost-effectiveness of oncology drugs. We have helped several clients win approval of their oncology products from NICE and the Scottish Medicines Consortium based on HTA appraisals that we co-wrote. We have also extensively researched factors affecting reimbursement decisions by the Cancer Drugs Fund in the UK, which is analogous to the questions we are examining about NICE and I-O treatments.

What motivates you to do this study?

From my own experience as an oncology scientist, first in academia and then in the pharma industry, I am acutely aware of how much research and resources companies invest in I-O, from preclinical drug discovery to clinical validation. I would like to help companies invest in the most effective way to ensure that what they have worked so hard on, can ultimately be adopted by healthcare payers. This means success for the drug manufacturer but also for patients, who gain access to new therapeutic options.