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, 21 September 2015

Rheumatoid arthritis technology appraisal finishes!

After two and a half years, the NICE RA appraisal has been completed and is available in a handy 92 page FAD.  So here’s a summary, yes, in severe disease, if other treatments have failed, if discounts are available and only continued after 6 months if there is a moderate response, and if patients are started on the cheapest drug (including infliximab biosimilars).

Even with all of these provisos, it looks like an ICER of well over £30K per QALY:

“The Committee considered that the most plausible incremental cost-effectiveness ratio (ICER) for biological DMARDs used in severe active rheumatoid arthritis previously treated with methotrexate, was likely to lie between the Assessment Group’s base-case ICER (that is, £41,600 per quality-adjusted life year [QALY] gained) and the Assessment Group’s ICER for the severe group with the fastest Stanford Health Assessment Questionnaire (HAQ) progression (that is, £25,300 per QALY gained).”

The ERG for this appraisal was ScHARR-TAG, with the research team being Matt Stevenson, Rachel Archer, Jon Tosh, Emma Simpson, Emma Everson-Hock, John Stevens, Allan Wailoo, Monica Hernandez, Suzy Paisley and Kath Williams.  The work also spawned additional work for the NICE DSU, principally around HAQ progression, by Laura Gibson, Mónica Hernández-Alava and Allan Wailoo.

All documents are available here.