Publication

Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

Witlox, W. J. A., van Asselt, A. D. I., Wolff, R., Armstrong, N., Worthy, G., Chalker, A., Buksnys, T., Stirk, L., Kleijnen, J., Joore, M. A. & Grimm, S. E., 9-Dec-2019, In : Pharmacoeconomics. 8 p.

Research output: Contribution to journalReview articleAcademicpeer-review

APA

Witlox, W. J. A., van Asselt, A. D. I., Wolff, R., Armstrong, N., Worthy, G., Chalker, A., Buksnys, T., Stirk, L., Kleijnen, J., Joore, M. A., & Grimm, S. E. (2019). Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Pharmacoeconomics. https://doi.org/10.1007/s40273-019-00870-w

Author

Witlox, Willem J. A. ; van Asselt, Antoinette D. I. ; Wolff, Robert ; Armstrong, Nigel ; Worthy, Gill ; Chalker, Annette ; Buksnys, Titas ; Stirk, Lisa ; Kleijnen, Jos ; Joore, Manuela A. ; Grimm, Sabine E. / Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer : An Evidence Review Group Perspective of a NICE Single Technology Appraisal. In: Pharmacoeconomics. 2019.

Harvard

Witlox, WJA, van Asselt, ADI, Wolff, R, Armstrong, N, Worthy, G, Chalker, A, Buksnys, T, Stirk, L, Kleijnen, J, Joore, MA & Grimm, SE 2019, 'Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal', Pharmacoeconomics. https://doi.org/10.1007/s40273-019-00870-w

Standard

Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer : An Evidence Review Group Perspective of a NICE Single Technology Appraisal. / Witlox, Willem J. A.; van Asselt, Antoinette D. I.; Wolff, Robert; Armstrong, Nigel; Worthy, Gill; Chalker, Annette; Buksnys, Titas; Stirk, Lisa; Kleijnen, Jos; Joore, Manuela A.; Grimm, Sabine E.

In: Pharmacoeconomics, 09.12.2019.

Research output: Contribution to journalReview articleAcademicpeer-review

Vancouver

Witlox WJA, van Asselt ADI, Wolff R, Armstrong N, Worthy G, Chalker A et al. Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Pharmacoeconomics. 2019 Dec 9. https://doi.org/10.1007/s40273-019-00870-w


BibTeX

@article{a1cc0f4f85124dd4a3e75f15c5c01db6,
title = "Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal",
abstract = "As part of the Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (AstraZeneca) of durvalumab (IMFINZI(TM)) to submit evidence for the clinical and cost effectiveness of durvalumab for the treatment of patients with locally advanced, unresectable, stage III non-small cell lung cancer whose tumours express programmed death-ligand 1 (PD-L1) on >= 1% of tumour cells and whose disease has not progressed after platinum-based chemoradiation therapy. Kleijnen Systematic Reviews Ltd, in collaboration with Maastricht University Medical Centre, was commissioned to act as the independent Evidence Review Group (ERG). This paper summarises the company submission (CS), presents the ERG's critical review on the clinical- and cost-effectiveness evidence in the CS, highlights the key methodological considerations, and describes the development of the NICE guidance by the Appraisal Committee. The CS included a systematic review that identified one randomised controlled trial, comparing durvalumab with SoC. Participants with tumours expressing PD-L1 on >= 1% of tumour cells accounted for approximately 40% of the total participants. In this subgroup, a benefit in progression-free survival (PFS) [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.31-0.63] and overall survival (HR 0.54, 95% CI 0.35-0.81) was reported. Adverse events were comparable between both treatments, but more serious adverse events were reported for durvalumab (64/213 [30%] vs. 18/90 [20%]). The ERG's concerns regarding the economic analysis included a likely overestimation of PFS for the durvalumab arm, the choice of timepoint for treatment waning, as well as the way treatment waning was incorporated in the model, and potential overestimation of utility values without applying an age- or treatment-related decrement. The revised ERG base-case resulted in a deterministic incremental cost-effectiveness ratio of 50,238 pound per quality-adjusted life-year gained, with substantial remaining uncertainty. NICE recommended durvalumab as an option for use within the Cancer Drugs Fund only in a subpopulation (concurrent platinum-based chemoradiation therapy) with a commercially managed access agreement in place.",
author = "Witlox, {Willem J. A.} and {van Asselt}, {Antoinette D. I.} and Robert Wolff and Nigel Armstrong and Gill Worthy and Annette Chalker and Titas Buksnys and Lisa Stirk and Jos Kleijnen and Joore, {Manuela A.} and Grimm, {Sabine E.}",
year = "2019",
month = dec,
day = "9",
doi = "10.1007/s40273-019-00870-w",
language = "English",
journal = "Pharmacoeconomics",
issn = "1170-7690",
publisher = "ADIS INT LTD",

}

RIS

TY - JOUR

T1 - Durvalumab for the Treatment of Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer

T2 - An Evidence Review Group Perspective of a NICE Single Technology Appraisal

AU - Witlox, Willem J. A.

AU - van Asselt, Antoinette D. I.

AU - Wolff, Robert

AU - Armstrong, Nigel

AU - Worthy, Gill

AU - Chalker, Annette

AU - Buksnys, Titas

AU - Stirk, Lisa

AU - Kleijnen, Jos

AU - Joore, Manuela A.

AU - Grimm, Sabine E.

PY - 2019/12/9

Y1 - 2019/12/9

N2 - As part of the Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (AstraZeneca) of durvalumab (IMFINZI(TM)) to submit evidence for the clinical and cost effectiveness of durvalumab for the treatment of patients with locally advanced, unresectable, stage III non-small cell lung cancer whose tumours express programmed death-ligand 1 (PD-L1) on >= 1% of tumour cells and whose disease has not progressed after platinum-based chemoradiation therapy. Kleijnen Systematic Reviews Ltd, in collaboration with Maastricht University Medical Centre, was commissioned to act as the independent Evidence Review Group (ERG). This paper summarises the company submission (CS), presents the ERG's critical review on the clinical- and cost-effectiveness evidence in the CS, highlights the key methodological considerations, and describes the development of the NICE guidance by the Appraisal Committee. The CS included a systematic review that identified one randomised controlled trial, comparing durvalumab with SoC. Participants with tumours expressing PD-L1 on >= 1% of tumour cells accounted for approximately 40% of the total participants. In this subgroup, a benefit in progression-free survival (PFS) [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.31-0.63] and overall survival (HR 0.54, 95% CI 0.35-0.81) was reported. Adverse events were comparable between both treatments, but more serious adverse events were reported for durvalumab (64/213 [30%] vs. 18/90 [20%]). The ERG's concerns regarding the economic analysis included a likely overestimation of PFS for the durvalumab arm, the choice of timepoint for treatment waning, as well as the way treatment waning was incorporated in the model, and potential overestimation of utility values without applying an age- or treatment-related decrement. The revised ERG base-case resulted in a deterministic incremental cost-effectiveness ratio of 50,238 pound per quality-adjusted life-year gained, with substantial remaining uncertainty. NICE recommended durvalumab as an option for use within the Cancer Drugs Fund only in a subpopulation (concurrent platinum-based chemoradiation therapy) with a commercially managed access agreement in place.

AB - As part of the Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (AstraZeneca) of durvalumab (IMFINZI(TM)) to submit evidence for the clinical and cost effectiveness of durvalumab for the treatment of patients with locally advanced, unresectable, stage III non-small cell lung cancer whose tumours express programmed death-ligand 1 (PD-L1) on >= 1% of tumour cells and whose disease has not progressed after platinum-based chemoradiation therapy. Kleijnen Systematic Reviews Ltd, in collaboration with Maastricht University Medical Centre, was commissioned to act as the independent Evidence Review Group (ERG). This paper summarises the company submission (CS), presents the ERG's critical review on the clinical- and cost-effectiveness evidence in the CS, highlights the key methodological considerations, and describes the development of the NICE guidance by the Appraisal Committee. The CS included a systematic review that identified one randomised controlled trial, comparing durvalumab with SoC. Participants with tumours expressing PD-L1 on >= 1% of tumour cells accounted for approximately 40% of the total participants. In this subgroup, a benefit in progression-free survival (PFS) [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.31-0.63] and overall survival (HR 0.54, 95% CI 0.35-0.81) was reported. Adverse events were comparable between both treatments, but more serious adverse events were reported for durvalumab (64/213 [30%] vs. 18/90 [20%]). The ERG's concerns regarding the economic analysis included a likely overestimation of PFS for the durvalumab arm, the choice of timepoint for treatment waning, as well as the way treatment waning was incorporated in the model, and potential overestimation of utility values without applying an age- or treatment-related decrement. The revised ERG base-case resulted in a deterministic incremental cost-effectiveness ratio of 50,238 pound per quality-adjusted life-year gained, with substantial remaining uncertainty. NICE recommended durvalumab as an option for use within the Cancer Drugs Fund only in a subpopulation (concurrent platinum-based chemoradiation therapy) with a commercially managed access agreement in place.

U2 - 10.1007/s40273-019-00870-w

DO - 10.1007/s40273-019-00870-w

M3 - Review article

C2 - 31814080

JO - Pharmacoeconomics

JF - Pharmacoeconomics

SN - 1170-7690

ER -

ID: 112900174