A systematic review of the effectiveness of adalimumab
A systematic review of the effectiveness of adalimumab
A systematic review of the effectiveness of adalimumab
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Glossary and list <strong>of</strong> abbreviations ............. vii<br />
Executive summary .................................... xi<br />
1 Aims <strong>of</strong> <strong>the</strong> <strong>review</strong> ..................................... 1<br />
2 Background ................................................ 3<br />
Summary .................................................... 3<br />
Description <strong>of</strong> underlying health<br />
problem ...................................................... 3<br />
Current service provision ........................... 8<br />
Description <strong>of</strong> <strong>the</strong> technology .................... 8<br />
Current NICE guidance for use <strong>of</strong> TNF<br />
inhibitors .................................................... 10<br />
Degree <strong>of</strong> diffusion and anticipated<br />
costs ............................................................ 11<br />
3 Effectiveness ............................................... 13<br />
Summary .................................................... 13<br />
Methods for <strong>review</strong>ing <strong>effectiveness</strong> .......... 13<br />
Results for <strong>effectiveness</strong> <strong>review</strong> .................. 16<br />
Summary <strong>of</strong> <strong>effectiveness</strong> <strong>review</strong> and<br />
additional evidence .................................... 69<br />
4 Health economics ...................................... 73<br />
Summary <strong>of</strong> <strong>review</strong> <strong>of</strong> existing economic<br />
evaluations .................................................. 73<br />
Systematic <strong>review</strong> <strong>of</strong> economic<br />
evaluations .................................................. 73<br />
Review <strong>of</strong> industry cost-<strong>effectiveness</strong><br />
submissions ................................................. 80<br />
Economic analysis used in this report ....... 86<br />
Results ........................................................ 100<br />
5 Implications for o<strong>the</strong>r parties .................... 113<br />
6 Factors relevant to <strong>the</strong> NHS ..................... 115<br />
7 Discussion ................................................... 117<br />
Summary .................................................... 117<br />
Principal findings ....................................... 117<br />
Assumptions, limitations and<br />
uncertainties ............................................... 120<br />
Implications for research ........................... 122<br />
Contents<br />
Health Technology Assessment 2006; Vol. 10: No. 42<br />
8 Conclusions ................................................ 123<br />
Acknowledgements .................................... 125<br />
References .................................................. 127<br />
Appendix 1 Details <strong>of</strong> key outcomes used<br />
in RA trials ................................................. 139<br />
Appendix 2 Searches: clinical<br />
<strong>effectiveness</strong> ................................................ 141<br />
Appendix 3 List <strong>of</strong> excluded studies for<br />
clinical <strong>effectiveness</strong> <strong>review</strong> ........................ 143<br />
Appendix 4 Additional tables for clinical<br />
<strong>effectiveness</strong> <strong>review</strong> .................................... 147<br />
Appendix 5 Searches: economic<br />
evaluations .................................................. 155<br />
Appendix 6 Searches: decision-analytic<br />
models ........................................................ 157<br />
Appendix 7 Searches: <strong>systematic</strong> <strong>review</strong>s <strong>of</strong><br />
DMARDs .................................................... 159<br />
Appendix 8 Existing economic evaluations:<br />
appraisal and data extraction .................... 161<br />
Appendix 9 Details <strong>of</strong> strategy sets used in<br />
BRAM ......................................................... 175<br />
Appendix 10 Sensitivity analysis ................ 179<br />
Appendix 11 Ongoing research ................ 229<br />
Health Technology Assessment reports<br />
published to date ....................................... 231<br />
Health Technology Assessment<br />
Programme ................................................ 245<br />
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