Overview
Health technology assessment (HTA) agencies around the world increasingly rely on real-world evidence (RWE) to understand how cancer treatments perform in everyday clinical practice. Many HTA bodies prefer data collected locally or regionally because healthcare delivery systems, patient populations, and treatment practices often differ between countries. However, this preference creates a challenge when local data are limited or unavailable–raising an important question: can RWE from one country be reliably used to inform decisions in another?
The Flatiron FORUM (Fostering Oncology RWE Uses and Methods) research consortium is addressing this gap by conducting a series of benchmarking studies that compare health outcomes across countries using real-world data. In this study, data from the US-based Flatiron Health Research Database and the Austrian AGMT registry was used to compare time to treatment initiation for patients with metastatic breast cancer across countries. Researchers found that the overall time from mBC diagnosis to first-line (1L) treatment initiation was similar between the Austrian and US cohorts, although some numerical variation was observed across molecular subtypes.
Why this matters
As cancer care becomes more global and data-driven, the ability to use RWE from different countries could help fill evidence gaps and support faster, more informed HTA decisions—especially when new treatments come to the US market months or years earlier than other countries. This research highlights that the healthcare systems and cancer care in the US and Austria may not be so different from each other, allowing for evidence on certain patient experiences to be shared. Continuing to expand this research will improve understanding of when and how evidence is transportable in oncology, and whether there are circumstances in which underlying differences in healthcare systems necessitate the use of local data.