Session (CTI)

PURPOSE: Both the National Institute for Health and Care Excellence (NICE) HTA reviewers and European Union Joint Clinical Assessment (JCA) guidelines require time-varying NMA methods to more precisely compare survival benefits when the proportional hazards assumption is violated. However, detailed guidance including implementation into a CEM is limited. This workshop demonstrates the advantages, limitations and sensitivity of the CEM results when using different NMA methods. A recent NICE oncology technical appraisal (TA858) serves as the motivating example. DESCRIPTION: Workshop attendees will acquire practical knowledge of several time-varying NMA methods, considering multivariate parametric, fractional polynomial, restricted cubic spline, M-splines and piecewise modelling within the context of building a CEM for HTA review. Topics include a) technical critique of different time-varying NMAs from the user perspective, b) application and interpretation of subsequent NMA results within the CEM and c) the differential impact of these advanced methods against the need for pragmatism with implications for HTA bodies. Ms. Westley will chair the session, providing a brief introduction (5 min.). Dr. Liu will explain nuances of data preparation and how to compare different time-varying NMA approaches (10 min.). Dr. Kearns will demonstrate applications and limitations for the CEM including results uncertainty (15 min.). Dr. Pedder will discuss considerations and challenges encountered when employing these methods within HTA systems such as NICE and the JCA (15 min.). Through structured voting plus open discussion led by Ms. Westley (15 min.), audience participation will include choosing what they think is the most appropriate NMA model, observing consequences of their method selection during CEM implementation and discussing the broader informativeness towards HTA submission. This interactive workshop will be valuable to research analysts, clinicians and industry leaders interested in the call for robust but interpretable modelling approaches to inform HTA decision-making for both NICE and the JCA.