PRM67 - UTILITIES IN ONCOLOGY SUBMISSIONS SUBMITTED TO NICE —APPROACH OF THE MANUFACTURERS

Abstract

To provide an overview of the collection and use of utility values in health economic models for oncology submissions to the National Institute for Health and Clinical Excellence (NICE). Oncology submissions to NICE from January 2012 to February 2018 were reviewed using publicly available evidence on the NICE website. Appraisal committee guidance and manufacturer submissions were examined. When not available, other sections of the committee papers were consulted. Data regarding the assessment, utility data collection, and approach to the incorporation of utilities were extracted from the most recent version of a submission. Data were extracted for each regimen. A total of 95 regimens were included in the study, after the exclusion of 10 regimens (2 were replaced and 8 lacked cost-effectiveness evidence). The most common source of utility values was the pivotal clinical trial of the submission, and the EQ-5D was overwhelmingly the most frequently employed instrument. When utility values were not available in the trial or the trial utilities were deemed implausible by the manufacturer, literature or previous submissions to NICE were referenced or were combined with trial data. The most often used type of utility values were health-state specific values corresponding to disease progression. Differentiation between treatment arm and being on or off treatment was also common, with time-dependent utilities also observed. Only 18 submissions made use of end-of-life utility values. Disutilities associated with adverse events were more likely to be derived from literature than health-state utilities, with a common source frequently used within several submissions for the same indication. When treatment-specific utility values were used, adverse events were often assumed to already be accounted for. There is increasing consistency in utility modelling and adherence to the NICE guidance on health-related quality of life, with a clear preference for using trial data.