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, 22 December 2014

Eculizumab, a NHS risk-bearing scheme not a risk-sharing scheme?

The most expensive drug in the world has got a yes form NICE.  The ICERs were not published this time round, but previously published work produced ICERs between £350,000 per QALY and £520,000 per QALY.  The evidence review group for NICE was ScHARR-TAG.

There are conditions to the recommendion.  Eculizumab is recommended for funding for treating aHUS, only if all the following arrangements are in place:
  • coordination of eculizumab use through an expert centre
  • monitoring systems to record the number of people with a diagnosis of aHUS and the number who have eculizumab, and the dose and duration of treatment
  • a national protocol for starting and stopping eculizumab for clinical reasons
  • a research programme with robust methods to evaluate when stopping treatment or dose adjustment might occur.
But will these conditions be enforced?  Who will assess whether the research programme adopts robust methods?  Even with robust methods, what’s the expected value of the research?