Disagreement on cancer drug decisions in Europe.
OBJECTIVES
Despite the efforts of the European Union (EU) to promote voluntary cooperation among Health Technology Assessment (HTA) agencies, different reimbursement decisions for the same drug are made across European countries. The aim of this paper is to compare the agreement of cancer drug reimbursement decisions using inter-rater reliability measures.


METHODS
This study is based on primary data on 161 cancer drug reimbursement decisions from nine European countries from 2002 to 2014. To achieve our goal, we use two measures to analyze agreement, in other words, congruency: (i) percentage of agreement and (ii) the κ score.


RESULTS
One main conclusion can be drawn from the analysis. There is a weak to medium agreement among cancer drug decisions in the European countries analyzed (based on the percentage of agreement and the κ score). England and Scotland show the highest consistency between the two measures, showing a medium agreement. These results are in line with previous literature on the congruency of HTA decisions.


CONCLUSIONS
This paper contributes to the HTA literature, by highlighting the extent of weak to medium agreement among cancer decisions in Europe.
['Maynou|Laia|L|https://orcid.org/0000-0002-0447-2959', 'Cairns|John|J|']
D000970:Antineoplastic Agents D016208:Databases, Factual D003657:Decision Making D034462:Dissent and Disputes D005062:European Union D012051:Reimbursement Mechanisms D013673:Technology Assessment, Biomedical
Inter-rater reliability Congruency κ score Drug reimbursement system