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.

Thursday, 8 November 2012

NICE ‘yes’ to vertebroplasty kyphoplasty

The National Institute for Health and Clinical Excellence (NICE) has issued an ACD provisionally recommending the use of two treatments for fractured vertebrae caused by osteoporosis.
The draft guidance recommends percutaneous vertebroplasty and percutaneous balloon kyphoplasty as options for treating osteoporotic vertebral compression fractures, but only in people:

  • who have severe ongoing pain after a recent vertebral fracture (within 6 weeks) despite optimal pain management and
  • in whom the pain has been confirmed to be at the level of the fracture (by physical examination and imaging).
This was a multiple technology appraisal, with Johnson and Johnson and Medtronic submitting models relating to their products.  The independent group reviewing these models and developing their own was ScHARR-TAG, based within HEDS.  Their report “Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis” was produced by  Matt Stevenson, Tim Gomersall, Myfanwy Lloyd Jones, Andrew Rawdin, Monica Hernández, Sofia Dias (University of Bristol), David Wilson (Oxford University Hosptials) and Angie Rees.

At 400 pages long, report covers a number of complex issues that were raised in the appraisal including the use of registry data, rare but serious adverse events and the appropriateness of some Reference Costs.