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New CADTH Guidance on RWE Is Now Available, but Critical Aspects Are Still Missing

By Grammati Sarri, Evie Merinopoulou, Vinusha Kalatharan, and Jason Simeone

The Canadian Agency for Drugs and Technologies in Health’s (CADTH) long-expected guidance on real-world evidence (RWE) is now in the public domain; however, it solely provides standardized (core) reporting practices for manufacturers submitting RWE studies to support their drugs applications, and important aspects of the incorporation of RWE in decision-making are missing.
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Living SLRs and the Rise of Digital Technology

Written by Marie Diamond and Maria Rizzo

Systematic literature reviews (SLR) are essential to informing healthcare decision-making and are pivotal for reimbursement submissions to health technology assessment (HTA) bodies. One limitation of SLRs, however, is that they quickly become outdated due to the continuous publication of new literature. The living systematic review (LSR) model can overcome this challenge by incorporating relevant new evidence as it is published. Read more »

Global Planning to Local Execution Market Success

Moving beyond static evidence development to ensure local market access success; responding to recent changes in governmental drug regulations and the role of automation

The worldwide drug regulation landscape is rapidly changing. The introduction of the EU Health Technology Assessment (HTA) Regulation (EU) 2021/2282 and US Inflation Reduction Act (IRA) created a need for pharmaceutical companies to develop strategies to generate data through diverse patient data sources and use complex methodologies while keeping pace with evolving evidentiary requirements for their products across healthcare decision-making bodies. Read more »

Differentiating Your Inflammatory Disease Product: Common Challenges

Launching a treatment for inflammatory diseases can be a make-or-break endeavor. A robust evidence base and a compelling value story are crucial to success, but current challenges and unexpected bumps in the road will require creative solutions.

Here we describe three case study examples of common issues faced in the inflammatory disease space and how these challenges were overcome using novel solutions, ultimately leading sponsors to submission success.

 

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Bayesian Hierarchical Modelling for Histology-Independent Therapies

Pharmaceutical research in oncology is increasingly focused on the development of therapies targeted at newly identified driver mutations. However, the rarity of many of these mutations presents new challenges for trial design and patient recruitment. In particular, it may be difficult in practice to recruit enough patients with the same mutation and tumor histology. One solution has been to evaluate these histology independent therapies (HITs) in basket trials, which recruit patients across multiple histologies that all share a common targetable driver mutation.

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5 Steps to Adjust for Effect Modifiers for Treatment Comparisons

Many thanks to Grammati Sarri and Michael Groff for their comments in developing this blog.

An indirect treatment comparison compares two trials A and B, by first comparing the results of Trial A to Trial C, and then comparing the results of Trial C to Trial B. Unlike head-to-head comparisons where these trials (A and B) would be directly compared with each other, indirect treatment comparisons, or ITCs, utilize at least one other trial to create a network for comparison.

Often, there are fundamental differences between the trials, such as population, or the interaction of the treatment with features of the population (e.g., age, sex, etc.). These are either caused by prognostic variables or by effect modifiers. The methods with which we handle the complexities raised by each differ slightly. Population-Adjusted Indirect Treatment Comparisons (PAICs) use individual patient data from one or more trials to adjust for characteristics of patients and ensure populations across all trials are reasonably comparable.

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