Treatment switching in oncology trials and integration into economic modelling practices скачать в хорошем качестве

Treatment switching in oncology trials and integration into economic modelling practices

Treatment switching is where patients recruited into a randomised controlled trial (RCT) switch away from the treatment to which they were randomised. This is common in trials of oncology treatments. In health technology assessment (HTA), we need to estimate the clinical and cost-effectiveness of inserting new treatments into the treatment pathway. If the treatment pathways followed in the RCT from which we are taking evidence does not reflect the treatment pathways that would be followed in clinical practice, standard intention-to-treat (ITT) analyses will not provide the evidence we need to inform HTA decision-making. Instead, we need to estimate outcomes that would have been observed had relevant treatment pathways been followed, which may involve needing to adjust for treatment switches that occurred in the RCT.