IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v33y2015i3p225-233.html
   My bibliography  Save this article

Alteplase for the Treatment of Acute Ischaemic Stroke: A NICE Single Technology Appraisal; an Evidence Review Group Perspective

Author

Listed:
  • Michael Holmes
  • Sarah Davis
  • Emma Simpson

Abstract

The National Institute for Health and Care Excellence (NICE) invited Boehringer Ingelheim GmbH, the manufacturer of alteplase, to submit evidence for the clinical and cost-effectiveness of alteplase for the prevention of strokes within a 0–4.5 h window. The comparator was standard medical and supportive management that does not include alteplase. This paper provides a description of the company submission, the Evidence Review Group (ERG) review and NICE's subsequent decisions. Clinical effectiveness evidence for alteplase was derived from 5 trials. For the 3–4.5 h treatment window, alteplase did not show a statistically significant treatment effect on death or dependency at three months follow-up. For the 0–4.5 h treatment window data from a meta-analysis of 3 trials indicated that the reduction of death and dependency was statistically significant. In both cases there was a significant increase in symptomatic intracranial haemorrhage. The economic model described in the manufacturer's submission was considered by the ERG to meet the NICE reference case. The model structure was considered to be appropriate and the ERG has no major concerns regarding the selection of data used within the model. The incremental cost-effectiveness ratios (ICER) for all treatment windows were well below accepted willingness to pay thresholds. The ERG had no major concerns regarding the completeness of the submission or the robustness of the evidence presented. For all treatment windows considered, alteplase was found to be cost-effective compared with standard treatment. Copyright Crown Copyright 2015

Suggested Citation

  • Michael Holmes & Sarah Davis & Emma Simpson, 2015. "Alteplase for the Treatment of Acute Ischaemic Stroke: A NICE Single Technology Appraisal; an Evidence Review Group Perspective," PharmacoEconomics, Springer, vol. 33(3), pages 225-233, March.
    • Handle: RePEc:spr:pharme:v:33:y:2015:i:3:p:225-233
    DOI: 10.1007/s40273-014-0233-z
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s40273-014-0233-z
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s40273-014-0233-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:33:y:2015:i:3:p:225-233. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.