Expert Elicitation
Two National Institute for Health and Care Excellence (NICE) appraisal committee meetings (ACMs) were held to discuss NICE single technology appraisal (TA) ID1441, tebentafusp for advanced uveal melanoma1. The draft final appraisal decision was that tebentafusp was not deemed to be cost-effective and would not be recommended for the Cancer Drugs Fund1.
An appeal hearing was held on 20 October 2023, which was upheld on several points. The upheld points related to the appeal panel’s expectation that, faced with significant uncertainty, the input of experts should be particularly important in informing the committee’s judgements. The upheld appeal points related specifically to “the most appropriate choice, and interpretation of survival curve models to interrogate the available data, and the most appropriate means of allocating supportive care costs in the model”1.
To address the two upheld appeal points, the NICE DSU was instructed by NICE to
1. Use a structured approach to elicit expert estimates of the expected survival of people with uveal melanoma treated with pembrolizumab and those treated with tebentafusp and the uncertainty around these estimates.
2. Consult expert opinion on the resources used in the provision of best supportive care (BSC) for people with uveal melanoma over the course of their disease after progression.
A structured expert elicitation approach was used for point 1, for which two workshops were conducted, one online and one face-to-face. An online survey was used to obtain expert opinion for point 2.
1. National Institute for H, Care E. Tebentafusp for treating advanced (unresectable or metastatic) uveal melanoma. Technology Appraisal ID1441. Available at https://www.nice.org.uk/guidance/indevelopment/gid-ta10428 [Last accessed 17th May 2024] 2024
The DSU Report:
This report provides a brief commentary on the expert elicitation workshops and surveys conducted, in conjunction with the online and face-to-face expert elicitation workshop reports.
DSU Report
Expert elicitation exercise in response to an upheld appeal (NICE technology appraisal ID1441, tebentafusp for advanced uveal melanoma)