The unexploited potential of data systems tracking medicines utilization: An opportunity to improve access to oncology combination therapies

Steven Simoens^1*David Dodwell²Michael Hartevelt³Peter Lindgren^4,5Michele Pistollato⁶Lisa§ G Pont⁷Caridad Pontes⁸Alexander Roediger³Antun Sablek⁹Eric Van Ganse¹⁰Qinyi Wang¹¹Chris Wenger¹²Tim Wilsdon⁶Entela Xoxi¹³Brian Godman^14,15

• ¹KU Leuven, Leuven, Belgium
• ²Oxford Population Health, University of Oxford, Oxford, United Kingdom
• ³Global Oncology Policy, Merck, Rahway, New Jersey, United States
• ⁴Swedish Institute for Health Economics, Lund, Sweden
• ⁵Karolinska Institutet (KI), Solna, Stockholm, Sweden
• ⁶Charles River Associates, London, United Kingdom
• ⁷Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
• ⁸Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Barcelona, Spain
• ⁹Charles River Associates, Brussels, Belgium
• ¹⁰Pharmacoepidemiology Unit, Claude Bernard University Lyon 1, Lyon, France
• ¹¹Charles River Associates, Cambridge, United Kingdom
• ¹²Aquantic AG, Zeiningen, Switzerland
• ¹³Postgraduate School of Health Economics and Management (ALTEMS), Catholic University of the Sacred Heart, Rome, Italy
• ¹⁴Strathclyde Institute of Pharmacy and Biomedical Sciences, Faculty of Science, University of Strathclyde, Glasgow, Scotland, United Kingdom
• ¹⁵Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa

Background: While progress has been made in oncology treatments, including the introduction of combination therapies, barriers affect patient access. There are approaches that could improve access including combination-specific pricing that allow the price to reflect whether a product is used in monotherapy or in combination. The feasibility of this solution requires data on the utilization of combination therapies.Aim: To investigate the ability of data systems across Belgium, England, France, Italy, Spain, Sweden, Switzerland and Australia to track drug utilization of combination therapies, particularly in oncology.Methods: A targeted literature review was conducted to investigate the attributes of the key data systems. One-on-one semi-structured interviews were subsequently conducted with country experts to validate the research, who were screened based on their expertise and knowledge of the respective data and reimbursement systems in their countries, followed by an advisory board to align on policy recommendations. Country-specific and cross-border insights were gathered from nine experts across these countries.Results: There are data systems that routinely collect medicine utilization data across seven European countries and Australia. These datasets can potentially be leveraged to track the utilization of combination therapies. Where available, administrative data systems, such as reimbursement claims data, can be leveraged, though other types of systems, such as product registries, may be more suitable in some countries, emphasizing the need to consider country-specific nuances. Using existing data systems is likely to be less resource-intensive than setting up a novel system for this application. While viable sources of data exist in most countries, many need improving to fully harness their tracking potential. There are several common areas where improvement is needed to track combination therapies effectively. These include data quality, access for different stakeholders, minimizing the burden of data entry and management, and increasing support from national authorities to foster multi-stakeholder engagement. Conclusion: While most countries possess data systems that could serve as a foundation for tracking combination oncology therapies, these systems require optimization and proper implementation. Our core recommendation is for policymakers to explore the expansion and enhancement of data infrastructures.