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Mixture and Non-mixture Cure Models for Health Technology Assessment: What You Need to Know

Author

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  • Nicholas R. Latimer

    (University of Sheffield
    Delta Hat)

  • Mark J. Rutherford

    (University of Leicester)

Abstract

There is increasing interest in the use of cure modelling to inform health technology assessment (HTA) due to the development of new treatments that appear to offer the potential for cure in some patients. However, cure models are often not included in evidence dossiers submitted to HTA agencies, and they are relatively rarely relied upon to inform decision-making. This is likely due to a lack of understanding of how cure models work, what they assume, and how reliable they are. In this tutorial we explain why and when cure models may be useful for HTA, describe the key characteristics of mixture and non-mixture cure models, and demonstrate their use in a range of scenarios, providing Stata code. We highlight key issues that must be taken into account by analysts when fitting these models and by reviewers and decision-makers when interpreting their predictions. In particular, we note that flexible parametric non-mixture cure models have not been used in HTA, but they offer advantages that make them well suited to an HTA context when a cure assumption is valid but follow-up is limited.

Suggested Citation

  • Nicholas R. Latimer & Mark J. Rutherford, 2024. "Mixture and Non-mixture Cure Models for Health Technology Assessment: What You Need to Know," PharmacoEconomics, Springer, vol. 42(10), pages 1073-1090, October.
  • Handle: RePEc:spr:pharme:v:42:y:2024:i:10:d:10.1007_s40273-024-01406-7
    DOI: 10.1007/s40273-024-01406-7
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    References listed on IDEAS

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    1. Helen Bell Gorrod & Ben Kearns & John Stevens & Praveen Thokala & Alexander Labeit & Nicholas Latimer & David Tyas & Ahmed Sowdani, 2019. "A Review of Survival Analysis Methods Used in NICE Technology Appraisals of Cancer Treatments: Consistency, Limitations, and Areas for Improvement," Medical Decision Making, , vol. 39(8), pages 899-909, November.
    2. John Paul Gosling, 2018. "SHELF: The Sheffield Elicitation Framework," International Series in Operations Research & Management Science, in: Luis C. Dias & Alec Morton & John Quigley (ed.), Elicitation, chapter 0, pages 61-93, Springer.
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