A range of innovative, targeted anti-cancer therapies have been developed over the past 20 years. More recently, companies have been developing combinations of these drugs. While this promises substantial efficacy benefits, dual-brand oncology therapy combinations may potentially create substantial economic burden. Obtaining a positive health technology assessment (HTA) recommendation and public reimbursement can be a major challenge, and may be more difficult when each constituent monotherapy is marketed by a different company. We evaluated whether dual-brand oncology therapies developed by a single manufacturer had faster or better outcomes than those developed by two separate manufacturers.
Recent combination oncology drug products were screened in November 2018 to identify whether one or two manufacturers were involved. The websites of various HTA organizations were screened and the relevant data extracted.
A total of 78 recommendations for dual-brand oncology treatments were identified across the HTA agencies screened: 26 of these were for combinations by the same manufacturer and 52 were for combinations with two manufacturers. Dual-brand therapies developed by a single manufacturer were more likely to receive full or optimized/conditional recommendations (58% “recommended” and 12% “optimized/conditional”) than those marketed by two separate manufacturers (42% “recommended” and 8% “optimized/conditional”). Dual-brand therapies with two manufacturers were more likely to receive negative HTA recommendations than those marketed by a single manufacturer (50% versus 31%). However, the median time from marketing authorization to recommendation in European countries was the same (6 months), regardless of whether each constituent monotherapy was marketed by one or two manufacturers.
HTA agencies were more likely to issue negative recommendations for dual-brand oncology treatments marketed by two separate companies, compared with those marketed by a single company. A single company may have more flexibility in price setting, which may facilitate more positive HTA recommendations.