Pemetrexed disodium for the treatment of malignant pleural mesothelioma: a systematic review and economic evaluation

Abstract

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as r...

Extrapolation of Survival Curves from Cancer Trials Using External Information

“…There are many examples of the use of external data on the general population 9 , 11 , 13 and also the use of registries, meta-analyses or prospective observational studies of cancer cohorts. 8 , 10 , 12 - 13 , 15 - 17 , 47 Many applications are tailored to specific circumstances and it is difficult to give an overall review. There are, however, marked differences in the way uncertainty is propagated.…”

“…In terms of uncertainty propagation, we therefore believe our general approach has some clear technical advantages over other ways of using external data. For example, the use of external data to choose a parametric model 8 - 9 fails to account for uncertainty in the model choice. Methods that “import” an estimate of the relative effect from the trial and overlay this on a model of the control arm, will misrepresent the uncertainty in the treatment effect estimate, because it was generated from a different model of the control arm.…”

“…One approach has been to use external data to inform the choice of parametric model to extrapolate the trial data. 8 - 11 Other investigators have replaced the control arm by external data, with 12 - 14 or without 15 - 17 adjustment, while maintaining the treatment effect from the trial. Most methods using data external to the trial require a process of matching the trial and external populations, 18 but investigators have differed in the relative weight given to each, and in how uncertainty in each source of information is reflected in the final model.…”

Almotriptan

“…sowie auf den Anteil der Personen, die sich eines Reservemedikamentes bedient hatten oder bei denen die Kopfschmerzen innerhalb von 24 Stunden zurückgekehrt waren. 7 In einer anderen placebokontrollierten Doppelblindstudie (n=668) wurde Almotriptan (12,5 oder 25 mg) ebenfalls Sumatriptan (100 mg) gegenübergestellt, wobei sich die beiden Substanzen als ebenbürtig erwiesen. 8 Jahrgang 29…”

“…Nummer Allerdings stellt die Cisplatin-Therapie nicht eine klar etablierte Standardbehandlung dar. 7 Bei der zweiten Indikation, der Rezidivbehandlung des nicht-kleinzelligen Bronchuskarzinoms, ist Pemetrexed eine fast doppelt so teure, offenbar aber etwas besser verträgliche Alternative zu Docetaxel. Dies darf aber nicht darüber hinwegtäuschen, dass Pemetrexed wie die meisten Zytostatika eine nebenwirkungsreiche Substanz ist; so muss man -umso mehr in Palliativsituationen, in denen Pemetrexed verschrieben würde -immer auch den möglichen Nutzen gegenüber der vermehrten Toxizität abwägen.…”