Inequities in cancer drug development in terms of unmet medical need
Eliana Barrenho
(1, 2)
,
Réka Halmai
(3)
,
Marisa Miraldo
(1)
,
Iván Tzintzun
(3)
,
Setti Raïs Ali
(3)
,
Léa Toulemon
(3, 4)
,
Jean-Claude Dupont
(3, 5)
,
Lise Rochaix
(3, 6, 7)
1
Imperial College London
2 OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development
3 Hospinomics
4 IPP - Institut des politiques publiques
5 ETRES - Éthique, recherches, translations = Ethics, research, translations [CRC]
6 PSE - Paris School of Economics
7 PJSE - Paris Jourdan Sciences Economiques
2 OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development
3 Hospinomics
4 IPP - Institut des politiques publiques
5 ETRES - Éthique, recherches, translations = Ethics, research, translations [CRC]
6 PSE - Paris School of Economics
7 PJSE - Paris Jourdan Sciences Economiques
Eliana Barrenho
- Fonction : Auteur
- PersonId : 827346
- ORCID : 0000-0002-0084-2959
Marisa Miraldo
- Fonction : Auteur
- PersonId : 821982
- ORCID : 0000-0002-5772-7740
Setti Raïs Ali
- Fonction : Auteur
- PersonId : 827348
- ORCID : 0000-0002-3371-4769
- IdRef : 194643220
Léa Toulemon
- Fonction : Auteur
- PersonId : 964291
- ORCID : 0000-0002-0424-5924
Jean-Claude Dupont
- Fonction : Auteur
- PersonId : 790283
- ORCID : 0000-0002-8951-3704
- IdRef : 112492665
Lise Rochaix
- Fonction : Auteur
- PersonId : 1356826
- IdHAL : lise-rochaix
- ORCID : 0009-0005-2822-7439
Résumé
This study measures inequality and inequity in the distribution of clinical trials on cancer drug development between 1996 and 2016, comparing the number of clinical trials with cancer need, proxied by prevalence, incidence, or survival rates for both rare and non-rare cancers. We leverage a unique global database of clinical trials activity and costs between 1996 and 2016, constructed for 227 different cancer types to measure for rare and non-rare cancers: i) inequalities and inequity of clinical trial activity, considering all trials as well as split by R&D stage; ii) inequalities and inequity in R&D investment proxied by trial enrollment and duration; iii) evolution of inequity over time. Inequalities are measured with concentration curves and indices and inequities measured with the health inequity index. We find four important results. First, we show pro-low need inequity across cancer types for both rare and non-rare cancers, for all need proxies. Second, we show inequity differs across R&D stages and between rare and non-rare cancers. The distribution of clinical trials for non-rare cancers disproportionately favors low-need non-rare cancers from earlier to later stages of R&D, whilst for rare cancers this only occurs in Phase 2 trials. Third, inequity analyses in R&D investment show that only trial enrollment for rare cancers and trial duration for non-rare cancers are disproportionately concentrated among low-need cancers. Finally, while pro-low need inequity has persisted between 1996 and 2016 for non-rare cancers, it has faded for rare cancers post-EU orphan drugs’ legislation.
Domaines
Economies et financesFormat du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
Inequities in cancer drug development in terms of unmet medical need
|
Résumé |
en
This study measures inequality and inequity in the distribution of clinical trials on cancer drug development between 1996 and 2016, comparing the number of clinical trials with cancer need, proxied by prevalence, incidence, or survival rates for both rare and non-rare cancers. We leverage a unique global database of clinical trials activity and costs between 1996 and 2016, constructed for 227 different cancer types to measure for rare and non-rare cancers: i) inequalities and inequity of clinical trial activity, considering all trials as well as split by R&D stage; ii) inequalities and inequity in R&D investment proxied by trial enrollment and duration; iii) evolution of inequity over time. Inequalities are measured with concentration curves and indices and inequities measured with the health inequity index. We find four important results. First, we show pro-low need inequity across cancer types for both rare and non-rare cancers, for all need proxies. Second, we show inequity differs across R&D stages and between rare and non-rare cancers. The distribution of clinical trials for non-rare cancers disproportionately favors low-need non-rare cancers from earlier to later stages of R&D, whilst for rare cancers this only occurs in Phase 2 trials. Third, inequity analyses in R&D investment show that only trial enrollment for rare cancers and trial duration for non-rare cancers are disproportionately concentrated among low-need cancers. Finally, while pro-low need inequity has persisted between 1996 and 2016 for non-rare cancers, it has faded for rare cancers post-EU orphan drugs’ legislation.
|
Auteur(s) |
Eliana Barrenho
1, 2
, Réka Halmai
3
, Marisa Miraldo
1
, Iván Tzintzun
3
, Setti Raïs Ali
3
, Léa Toulemon
3, 4
, Jean-Claude Dupont
3, 5
, Lise Rochaix
3, 6, 7
1
Imperial College London
( 69530 )
- South Kensington Campus, London SW7 2AZ
- Royaume-Uni
2
OCDE -
Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development
( 310903 )
- Organisation for Economic Co-operation and Development (OECD)
2, rue André Pascal 75775 Paris Cedex 16
- France
3
Hospinomics
( 476518 )
- France
4
IPP -
Institut des politiques publiques
( 266522 )
- 48 boulevard Jourdan 75014 Paris
- France
5
ETRES -
Éthique, recherches, translations = Ethics, research, translations [CRC]
( 1003560 )
- Centre de Recherche des Cordeliers
15 rue de l’École de Médecine 75006 PARIS
- France
6
PSE -
Paris School of Economics
( 301309 )
- 48 boulevard Jourdan 75014 Paris
- France
7
PJSE -
Paris Jourdan Sciences Economiques
( 578027 )
- 48 boulevard Jourdan 75014 Paris
- France
|
Public visé |
Scientifique
|
Numéro d'article |
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2022-06
|
Volume |
302
|
Domaine(s) |
|
Mots-clés |
en
Equity, Rare and non-rare cancers, Clinical trials
|
DOI | 10.1016/j.socscimed.2022.114953 |
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