Importance

Increasingly, cost-effectiveness analyses are being done to determine the value of rapidly increasing oncology drugs; however, this assumes that these analyses are unbiased.

Objective

To analyze the characteristics of cost-effectiveness studies and to determine characteristics associated with whether an oncology drug is found to be cost-effective.

Design, setting, and participants

This retrospective cross-sectional study included 254 cost-effectiveness analyses for 116 oncology drugs that were approved by the US Food and Drug Administration from 2015 to 2020.

Exposures

Each drug was analyzed for the incremental cost-effectiveness ratio per quality-adjusted life year, the funding of the study, the authors' conflict of interest, the threshold of willingness-to-pay, from what country's perspective the analysis was done, and whether a National Institute for Health and Care Excellence cost-effectiveness analysis had been done.

Main outcomes and measures

The main outcome was the odds of a study concluding that a drug was cost-effective.

Results

There were 116 drug approvals with 254 studies and country perspectives. Of the country perspectives, 132 (52%) were from the US. Forty-seven of 78 drugs with cost-effective studies had been shown to improve overall survival, whereas 15 of 38 of drugs without a cost-effectiveness study had been shown to improve overall survival. Having a study funded by a pharmaceutical company was associated with higher odds of a study concluding that a drug was cost-effective than studies without funding (odds ratio, 41.36; 95% CI, 11.86-262.23).

Conclusions and relevance

In this cross-sectional study, pharmaceutical funding was associated with greater odds that an oncology drug would be found to be cost-effective. These findings suggest that simply disclosing potential conflict of interest is inadequate. We encourage cost-effectiveness analyses by independent groups.

Objective

To systematically appraise the content within oncology podcasts and the individuals who speak on them.

Design

A cross-sectional study.

Setting

We obtained a list of 33 current podcasts with substantial oncologic content through queries of predetermined search terms on the Apple Podcast Platform.

Participants

98 oncology-related podcast episodes.

Main outcomes

The perceived attitude of the episode with predetermined categories including "Neutral," "Favorable," or "Negative," the number of conflicts of interest verbally disclosed by individuals featured on oncology podcasts, and the prevalence of general payments among featured physicians.

Results

Among 33 oncology podcasts, the median number of episodes was 81 (IQR: 25-129). Ninety-seven percent (n = 32/33) of the podcasts included guests. The median episode run time was 26:50 min (IQR: 18:00 - 41:75). Among the 98 episodes assessed, 47% of episodes (n = 46/98) mentioned oncologic drugs, of which 57% (n = 26) had a neutral disposition, 37% (n = 17) had a favorable disposition and 7% (n = 3) were negative. Across 98 episodes, we identified 194 featured individuals, of which 65% (n = 126) had a medical degree (MD), and 85% (n = 107/126) of these physicians received at least one general payment. Further, 83% (n = 105/126) of physicians did not disclose payments.

Conclusions and policy summary

Within oncology-related podcasts, the majority of conversations about oncologic drugs are perceived as either favorable or neutral, and a majority of individuals featured on podcasts do not disclose conflicts of interest, highlighting potential opportunities for improvement, including the need for standardization of financial conflict of interest disclosure.