Definition of the decision problem | Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation

Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation · Definition of the decision problem

Definition of the decision problem

Decision problem addressed by the Assessment Group

The decision problem for this appraisal, as described in the final scope issued by NICE,53 is summarised in Table 2.

TABLE 2 Decision problem summarised in the final scope issued by NICE53 and addressed by the AG

Parameter	In the NICE scope53	Addressed by the AG
Interventions	Lenvatinib Sorafenib	As per scope
Population	Adults with progressive, locally advanced or metastatic, differentiated thyroid carcinoma refractory to radioactive iodine	As per scope
Comparators	The interventions listed above will be compared with each other BSC	Explore the feasibility of comparing lenvatinib with sorafenib Comparisons of interventions with BSC
Outcomes	The outcome measures to be considered include:OSprogression-free survivalresponse rateadverse effects of treatmentHRQoL	As per scope
Economic analysis	The reference case stipulates that the cost-effectiveness of treatments should be expressed in terms of incremental cost per quality-adjusted life-year The reference case stipulates that the time horizon for estimating clinical effectiveness and cost-effectiveness should be sufficiently long to reflect any differences in costs or outcomes between the technologies being compared Costs will be considered from a NHS and Personal Social Services perspective	As per scope
Other considerations	If the evidence allows, consideration will be given to subgroups based on previous treatment with TKIs Guidance will only be issued in accordance with the marketing authorisation. When the wording of the therapeutic indication does not include specific treatment combinations, guidance will be issued only in the context of the evidence that has underpinned the marketing authorisation granted by the regulator	As per scope

The overall aims and objectives of the assessment

The aim of this research was to assess the clinical effectiveness and cost-effectiveness of lenvatinib versus sorafenib, within their respective EU marketing authorisations,45,46 for the treatment of patients with RR-DTC. The research objectives are given below:

To carry out systematic reviews to compare the clinical effectiveness and cost-effectiveness of –
- treatment with lenvatinib with treatment with sorafenib for RR-DTC
- treatment with lenvatinib with BSC for RR-DTC
- treatment with sorafenib with BSC for RR-DTC.
To develop an economic model to compare the cost-effectiveness of –
- treatment with lenvatinib with treatment with sorafenib for RR-DTC
- treatment with lenvatinib with BSC for RR-DTC
- treatment with sorafenib with BSC for RR-DTC.

Attribution. Nigel Fleeman; Rachel Houten; Adrian Bagust; Marty Richardson; Sophie Beale; Angela Boland et al. (2020). Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation. NIHR Journals Library. Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Fleeman et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK. Licensed under CC BY 4.0. NCBI Bookshelf NBK552390. CC BY 4.0. Original source ↗. Text reproduced from the Bookshelf XML without changing wording; figures, images and supplements are not reproduced.