Drug Evaluation Committee Introduction to the NICE TSD Evidence Synthesis Series: Focusing on Network Meta-Analysis
Data Science Subcommittee
December 2020
In April 2019, cost-effectiveness evaluation was institutionalized as a system to complement the existing drug price standard system. Under this institutionalization, in examining cost-effectiveness, the presence or absence of additional usefulness of the technology under evaluation relative to the comparator technology must be evaluated by means of a systematic review. However, in the case of new medical technologies (e.g., new drugs), there is often insufficient evidence for comparison with control technologies in cost-effectiveness evaluations, and indirect comparisons may be necessary. In such cases, simple indirect comparisons are not recommended, and the use of adjusted indirect comparisons is necessary. NMA is expected to reduce bias and improve estimation accuracy compared to simple indirect comparisons by comprehensively utilizing evidence and adjusting for confounding factors that may exist between studies.
On the other hand, NMA has a number of assumptions that must be met to ensure the validity of its results, and there are a number of issues to keep in mind when using it. Therefore, understanding the methodology and evaluating the validity of the NMA model (examining heterogeneity and inconsistency) are essential, and careful interpretation of the results is important.
As there are very few practical materials on NMA for cost-effectiveness assessment in Japan, the DS Subcommittee Continuation T5 in 2019 will focus on the Evidence Synthesis series (TSD1-7) of the Technical Support Document (TSD) published by NICE in the UK. The report summarizes the methodologies and points to be noted for evidence synthesis with a focus on NMA, and explains how to use WinBUGS in the appendix of each TSD, as well as examples of analysis.
The statements in this report that cite/refer to each TSD are the interpretation of this Task Force, and NICE is not responsible for any of them. Not all of the TSDs are introduced in this report, but some of them are excerpted. In introducing them, the Task Force has added its interpretation and additional explanations. Please note that this is the Task Force's own compilation and does not represent the views of NICE.
Data Science Subcommittee, Committee on Drug Evaluation, Japan Pharmaceutical Manufacturers Association
2019 Ongoing Task Force 5
NICE TSD1-7 ESG deliverables (2019KT5) (2.3MB)
Deliverables of the Drug Evaluation Committee Return to list of all deliverables