Improving the methods of economic evaluation to support decision-making: CAR-T, uncertainty, and real-world evidence

The emergence of novel technologies in health care is associated with promising opportunities to improve patient health outcomes. Advances in health technologies also come at a substantial cost. New gene therapies have been estimated to cost between $300,000-$4,000,000 per patient. These new therapies offer promise, but do not offer certainty; decision-makers have to choose whether to reimburse the therapy with little evidence for how it might work in the real-world.

Health economics can be used to assess the value of a new therapy compared to current therapies. While the use of health economics seems to be supported, the extent to which it impacts decisions seems to be limited. The proposed research will improve health economics analyses to support decision-makers at BC Cancer. The approach will incorporate real-world evidence, expert and patient opinion, and effective communication with decision-makers. Chimeric antigen receptor T-cell (CAR-T) therapy will serve as a case study as it is promising, but is associated with high costs and uncertainty about long-term effectiveness.

This project will bridge the gap between the type of evidence that is provided by standard health economics analyses and that required by decision-makers.