HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Monday, 5 December 2011

NICE ‘yes’ for follicular lymphoma treatment

In a review of technology appraisal guidance 110, NICE has concluded that rituximab (MabThera, Roche Products), in combination with cyclophosphamide, vincristine and prednisolone (CVP) cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) mitoxantrone, chlorambucil and prednisolone (MCP) cyclophosphamide, doxorubicin, etoposide, prednisolone and interferon-α (CHVPi) or chlorambucil is recommended as an option for the treatment of symptomatic stage III and IV follicular lymphoma in previously untreated people.

This appraisal was undertaken under the multiple technology appraisal process, which meant that HEDS, who were the evidence review group (ERG), were required to produce their own model in addition to that submitted by the manufacturer. 

Whilst the manufacturer’s submission  used a markov model, ScHARR-TAG developed an individual patient simulation.  Once again suvival analysis and extrapolation played a central role with the manufacturer using exponential distributions to “avoid over-complicating” the model despite the fact that, in most cases, the they did not fit the data well.  In addition, there were the usual errors in the MS (are they ever checked?) and also other differences in the parameters used.  However, overall the two approaches produced similar baseline ICERs that were generally less than £10,000 per QALY gained.

The HEDS team involved in producing the ERG report were Rachid Rafia, John Rathbone, Matt Stevenson and Helen Buckley Woods.