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 benchmarking studies that compare health outcomes across countries using real-world data. Using data on 9,937 patients from the US-based Flatiron Health Research Database and on 486 patients from the GermanOncology Registry, this study examines whether overall survival (OS) estimates from patients with multiple myeloma (MM) in the US can be transported to Germany. Researchers were limited in their ability to make population adjustments, due to the small number of patients in the GermanOncology registry and concerns over the quality of data on these patients. As a result, uncertainty remains regarding the transportability of OS from the US to Germany in MM.
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. These findings are crucial for guiding population adjustment in transportability analyses of real-world outcomes between countries and underscore the need for further exploration into how variations in dataset composition and healthcare systems impact RWE. 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.