ALITRETINOIN FOR HAND ECZEMA

Alitretinoin for severe chronic hand eczema: an assessment based on the manufacturer’s submission to NICE

Background

The aim of this NICE STA was to appraise the clinical and cost-effectiveness of alitretinoin within its licensed indication for the treatment of severe chronic hand eczema (CHE). CRD researchers together with researchers from the Centre for Health Economics (CHE) comprised the Evidence Review Group for this STA. The work involved a detailed assessment of the manufacturer’s submission to NICE on the clinical and cost-effectiveness of alitretinoin.

Findings

Although the evidence indicates that alitretinoin is efficacious in for the treatment of severe CHE, it gives little indication of alitretinoin’s efficacy relative to likely alternative treatment options or its efficacy and safety in the longer term. Although the ICERs estimated by the manufacturer suggested that alitretinoin may be cost-effective for use in the NHS, utilising the alternative HRQL estimates resulted in a two-fold increase in the ICER. Thus there was considerable uncertainty as to the true ICER of alitretinoin versus the relevant treatment comparators.

Conducted by: Mark Rodgers1, Susan Griffin2, Mike Paulden2, Russell Slack1, Steven Duffy1, John R Ingram3, Nerys Woolacott1, Mark Sculpher2

1 Centre for Reviews and Dissemination, University of York; 2 Centre for Health Economics, University of York; 3 UK Dermatology Clinical Trials Network, University Hospital of Wales

Further details

Project page on the NIHR HTA Programme website

Related guidance

Commissioned to inform NICE Technology Appraisal Guidance: Alitretinoin for the treatment of severe chronic hand eczema. London: National Institute for Clinical Excellence; 2009.

Publications

Paulden M, Rodgers M, Griffin S, Slack R, Duffy S, Ingram JR, Woolacott N, Sculpher M. Alitretinoin for the treatment of severe chronic hand eczema. a Single Technology Appraisal. Centre for Reviews and Dissemination and Centre for Health Economics. 2009.

Rodgers M, Griffin S, Paulden M, Slack R, Duffy S, Ingram JR, Woolacott N, Sculpher M. Alitretinoin for Severe Chronic Hand Eczema: A NICE Single Technology Appraisal. Pharmacoeconomics. 2010; 28(5):351-62.

Funding

Commissioned by the NIHR HTA Programme in support of NICE's Single Technology Appraisal process.

NICE’s single technology appraisal (STA) process is specifically designed for the appraisal of a single product, device or other technology, with a single indication. The STA process normally covers new technologies and is designed to provide recommendations in the form of NICE guidance soon after the technology is introduced into the UK market. The principal evidence in the STA process is submitted by the manufacturer or sponsor of the technology.