PCN208 - Do Nice Evidence Review Groups (ERG) Focus on Different Aspects of Manufacturer Submissions in Oncology?

Abstract

Evidence Review Groups (ERGs) provide a critical appraisal of the manufacturer submission in the NICE single technology appraisal (STA) process. As the academic centres may differ in experience and methodology, the objective of this study was to evaluate whether the focus areas and key criticisms differ between ERGs. The NICE website was searched for all NICE oncology STAs, published between June 2010 and June 2013. The ERG reports were retrieved, and the main critiques were categorised for the five centres that performed the most evaluations. The focus areas of the ERGs were further studied. A total of 27 STAs were identified with evaluations performed by 9 different ERGs. The most evaluations were performed by Liverpool (9), followed by Sheffield (4), and PenTAG, West Midlands and York (3 evaluations each). All ERGs would report uncertainties related to the extrapolation and gain in overall survival (OS), maturity of data, trial comparator, and the quality of life (QoL) data. In addition all critiques covered submission quality and disease specific challenges, yet variation was found in focus area between ERGs. For example a specific focus area of Liverpool was the OS modelling method. Proposed changes to survival modelling included separating the survival curves for pre- and post-progression, and removing any survival advantage post-progression where this was considered inappropriate. Comments from other agencies on OS were mainly limited to the choice of parametric survival function. Other areas that differed between ERGs were the systematic review methods (more often reported by Sheffield) and comments on the QoL data (York). Although all ERGs focus on uncertainty around the evidence and quality of the manufacturer submissions, the focus areas differed between the groups. The key difference seems to relate to research focus of the academic centre.