Evidence map›Paper›PMID 37950824›Full record

ArticleApplied health economics and health policy2024

Use of Health Technology Assessment for the Continued Funding of Health Technologies: The Case of Immunoglobulins for the Management of Multifocal Motor Neuropathy.

Constanza Vargas, Rebecca Addo, Milena Lewandowska, Philip Haywood, Richard De Abreu Lourenco, Stephen Goodall

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Article in Applied health economics and health policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact, top 68% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Constanza VargasCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia. Constanza.vargas@uts.edu.au.ORCID 0000-0002-8667-1926
Rebecca AddoCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia.
Milena LewandowskaCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia.
Philip HaywoodCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia.
Richard De Abreu LourencoCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia.
Stephen GoodallCentre for Health Economics Research and Evaluation, University of Technology Sydney, Level 5, Building 20, 100 Broadway, Chippendale NSW 2008, PO Box 123, Broadway, NSW, 2007, Australia.
University of Technology Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFunding decisions for many health technologies occur without undergoing health technology assessment (HTA), in particular, without assessment of cost effectiveness (CE). Immunoglobulins in Australia are an interesting case study because they have been used for a long time for various rare disorders and their price is publicly available. Undertaking an HTA enables us to assess CE for an intervention for which there is limited clinical and economic evidence. This study presents a post-market review to assess the CE of immunoglobulins for the treatment of multifocal motor neuropathy (MMN) compared with best supportive care.

methodsA Markov model was used to estimate costs and quality-adjusted life-years (QALYs). Input sources included randomised controlled trials, single-arm studies, the Australian clinical criteria for MMN, clinical guidelines, previous Medical Services Advisory Committee (MSAC) reports and inputs from clinical experts. Sensitivity analyses were conducted to assess the uncertainty and robustness of the CE results.

resultsThe cost per patient of treating MMN with immunoglobulin was AU$275,853 versus AU$26,191when no treatment was provided, with accrued QALYs of 6.83 versus 6.04, respectively. The latter translated into a high incremental cost-effectiveness ratio (ICER) of AU$317,552/QALY. The ICER was most sensitive to the utility weights and the price of immunoglobulins. MSAC advised to continue funding of immunoglobulins on the grounds of efficacy, despite the high and uncertain ICER.

conclusionsBeyond the ICER framework, other factors were acknowledged, including the high clinical need in a patient population for which there are no other active treatments available. This case study highlights the challenges of conducting HTA for already funded interventions, and the efficiency trade-offs required to fund effective high-cost therapies in rare conditions.

Indexed as

ImmunoglobulinsNeuromuscular DiseasesTechnology Assessment, BiomedicalAustraliaCost-Benefit AnalysisHumansQuality-Adjusted Life YearsImmunoglobulins

Identifiers

PMID37950824
OpenAlexW4388594018

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.