TABLE II.

Guiding principles governing Cancer Care Ontario’s prioritization framework

Principle	Definition	Sub-criteria
Strength of clinical evidence	Assesses the literature or studies used to demonstrate the clinical benefit in patients receiving the therapy	▪ Phase I/II/III data ▪ Quality of study design ▪ Appropriate comparator ▪ Prospective compared with retrospective ▪ Trial is properly powered ▪ Statistical significance of results
Magnitude of clinical benefit	Examines the effect the therapy would have on patient outcomes and the health care system	▪ Effectiveness ▪ Safety ▪ Burden of illness ▪ Toxicity ▪ Tolerability ▪ Quality of life
Effect for patients in Ontario	Examines the province-specific effect of the therapy on patient outcomes and the health care system	▪ Patient benefit and access ▪ Characteristics of defined patient population ▪ Factors associated with treatment administration (for example, oral compared with intravenous) ▪ Companion diagnostic (if required)
Patient need (unmet need)	Examines other therapies currently available to patients and the standard of care for the disease	▪ Availability and effectiveness of an alternative to the drug technology
Likelihood of success	Considers the strength of the overall submission and the likelihood of receiving a positive funding recommendation from Ontario Steering Committee for Cancer Drugs or the pan-Canadian Oncology Drug Review	▪ Strength of submission ▪ Adoption feasibility
Opportunity for cost savings	Considers economic factors that might support system sustainability, such as the effects for budgets or resources and the potential for system savings	▪ Value for money ▪ Budget impact ▪ System savings potential
Curative compared with palliative	Considers whether the treatment is of curative or palliative intent	▪ Treatment intent