Comparison of Utility Values Implemented in Disease Models of Metastatic Melanoma

  • Gorry C
  • Barry M
  • McCullagh L
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Abstract

Objectives: The purpose of this study is to compare the methods employed in the estimation of utility values in health technology assessments (HTAs) for treatments for metastatic melanoma submitted to the National Centre for Pharmacoeconomics (NCPE) in Ireland. Methods: HTA submissions were identified via the NCPE submissions database. A review template was created based on the NCPE submission template to assess compliance with NCPE requirements. Methodology in each submission was compared and critically appraised. Results: Nine HTAs were included in the study. All studies presented a cost utility analysis in line with the Irish reference case. Three submissions did not present systematic reviews for published quality of life (QOL) data; 2 of these used values from the literature in their submission. Eight submissions used generic QOL instruments in the pivotal clinical trials to estimate utilities for the economic model; 7 used EQ-5D data in line with NCPE reference case. The impact of adverse events on utility was assumed to be captured within trial based QOL estimates in 7 submissions. Only 1 submission directly considered the relevance of the trial based QOL data to the Irish population. Mapping of utility values and addition of age-related utility decrements were employed in only 2 submissions. The level of detail provided on response rates, missing data and the analysis undertaken to produce the utility values was generally inadequate and required further clarification by the NCPE in almost every case.The utility values implemented in the HTAs differed greatly between submissions, and sensitivity analyses showed significant impact on model outcomes in some cases. Conclusions: Submissions did not address all of the requirements for health outcome data specified in the NCPE submission template. Greater adherence to the NCPE submission template could reduce requests for clarification by the NCPE and reduce delays in the review process.

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Gorry, C., Barry, M., & McCullagh, L. (2017). Comparison of Utility Values Implemented in Disease Models of Metastatic Melanoma. Value in Health, 20(9), A447–A448. https://doi.org/10.1016/j.jval.2017.08.280

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