OBJECTIVES: To assess the impact of PRO data collected after clinical progression (i.e., postprogression) on payer decision making in oncology.
METHODS: One-on-one interviews were conducted with 16 payers and payer advisors from 14 countries in 2014. An online assessment was conducted (December 8, 2014, to March 4, 2015) with 20 completed surveys (China, France, Germany, Spain, Taiwan, the UK, the US) and 7 partially completed surveys (Australia, South Korea, the US) by payers from the RTI Health Solutions Global Payer Advisory Panel.
RESULTS: PRO data are commonly collected during trials; however, collection of PRO data postprogression is less common. When asked about the value of collecting PRO data postprogression, payers indicated that they consider this particularly important in cancer types with relatively long survival and those that involve palliative and/or long-term care. All payers in the one-on-one interviews advised collecting postprogression PRO data in both the control and comparator arms. Eleven of the 16 respondents in the one-on-one interviews indicated that it is worthwhile to collect PRO data postprogression and that positive PRO data may support continued therapy, even if the tumor is progressing. Results from the online assessment indicated that payers outside the US considered postprogression PRO data more useful than US payers did. When queried about specific types of postprogression data, payers generally thought that all types of PRO data examined (stability of disease, improvement in health-related quality of life, improvement in symptom severity or frequency, improvement in functional status, slower rate of functional deterioration compared to control/comparator arm) were important to decision making. Payers generally deferred to clinical experts on the length and frequency of postprogression PRO data collection.
CONCLUSIONS: PRO data provide compelling evidence even after tumors have progressed clinically and may help differentiate products, especially in situations where therapies do not provide significant survival benefits.
