Publications
News: Early and Advanced Breast Cancer guidelines published 25th February
As part of our remit to provide the National Collaborating Centre for Cancer with economics support, we have contributed to the two NICE clinical guidelines on the diagnosis and treatment of breast cancer published today.
Two de novo economic models we conducted influenced some of the key priority recommendations which will have the most significant impact on the NHS:
A cost-effectiveness analysis informed the guideline recommendation to offer pre-treatment ultrasound for the staging of the axilla in early breast cancer patients. Due to the paucity of quality of life data, we estimated the necessary QALY gain that would be required in order for ultrasound-guided needle biopsy to be considered cost-effective from an NHS perspective by doing a threshold analysis. The guideline development group considered the quality of life for patients given this procedure would at least meet this threshold since they would avoid the more invasive alternative procedure, sentinel lymph node biopsy.
An economic evaluation of sequences of chemotherapy for advanced breast cancer was conducted for the advanced breast cancer guideline to update three NICE technology appraisals. This involved synthesizing data from clinical trials investigating different chemotherapy regimens using indirect treatment comparison techniques, in collaboration with statisticians from the University of Bristol. Using this data, along with assumptions from the guideline development group, we were able to populate a decision tree model and interpret the results which led to a recommendation on the preferred sequence of chemotherapy offered to these patients.
