The evolution of cancer therapies and their Implications for health technology assessment in Australia

Cutting edge cancer therapies are increasingly brought to market at high prices, creating a tension between getting new therapies to patients as quickly as possible, and doing so in a cost-effective manner. The earlier cancer therapies are granted market authorisation, the less mature data on efficacy, safety, and quality of life are. The resulting uncertainty can complicate health technology assessments (HTAs) and therefore delay reimbursement decisions, which the vast majority of patients rely on to gain access to expensive new medicines. This narrative review summarises recent innovations in cancer therapies from a health economic perspective in Australia. We describe how such therapies are financed on the Pharmaceutical Benefits Scheme and the challenges they bring to HTA, such as their increased reliance on surrogate endpoints, extrapolation of immature survival data, and high budget impact. We discuss current methods the field has developed to overcome these problems, including managed entry agreements, coverage with evidence development, early health economic modelling, and the use of real-world evidence. These strategies aim to balance innovation and affordability, ensuring that patients can access life-extending therapies while maintaining the sustainability of Australia’s healthcare system.