Rose Micah, Rice Stephen, Craig Dawn
Southampton Health Technology Assessments Centre, University of Southampton, The University of Southampton Science Park, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK.
Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Pharmacoecon Open. 2018 Jun;2(2):97-107. doi: 10.1007/s41669-017-0040-5.
Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.
自2004年以来，英国国家卫生与临床优化研究所（NICE）针对技术评估的方法学指南一直强调，强烈倾向于使用经过验证的欧洲五维健康量表（EQ-5D）来衡量患者或护理人员的健康状况，以及在经济评估中评估健康效益时，使用公众对不同健康状态的基于偏好的估值。本研究的目的是回顾NICE对乳腺癌治疗的所有单一技术评估（STA），以根据NICE的方法学指南探讨效用评分使用的一致性。我们使用每个纳入评估的所有公开可用的STA文件，对所有已发表的乳腺癌STA进行了回顾。评估效用评分与NICE首选方法和原始数据来源的一致性。此外，还审查了STA过程中进行的学术评估小组工作,以评估NICE首选的生活质量测量方法的重点。共识别出12项乳腺癌STA，许多STA所使用的证据未遵循NICE首选的效用评分测量方法。最近的STA提交材料显示，公司在使用EQ-5D和映射法。学术评估小组很少强调NICE首选的方法，对首选方法的质疑也很少见。虽然最近的STA提交材料似乎有遵循NICE方法学指南的趋势，但从历史上看，乳腺癌的STA指南一般未采用NICE的首选方法。未来乳腺癌的STA以及对旧指南的审查应确保效用测量方法与NICE参考案例一致，以帮助做出一致、公平的决策。
