【正文】 l be identified from consultation with experts, primary data from relevant sources and the reviewed literature. Where possible, unit cost data will be extracted from the literature or obtained from other relevant sources (drug price lists, NHS reference costs and Chartered Institute of Public Finance and Accounting cost databases). Where appropriate costs will be discounted at % per annum, the rate remended in NICE guidance to manufacturers and sponsors of submissions. 37 b. Assessmentof benefitsA balance sheet will be constructed to list benefits and costs arising from alternative treatment options. LRiG anticipates that the main measures of benefit will be increased QALYs. Where appropriate, effectiveness and other measures of benefit will be discounted at %, the rate remended in NICE guidance to manufacturers and sponsors of submissions. 37 b. Modelling The ability of LRiG to construct an economic model will depend on the data available. Where modelling is appropriate, a summary description of the model and a critical appraisal of key structures, assumptions, resources, data and sensitivity analysis (see Section d) will be presented. In addition, LRiG will provide an assessment of the model’s strengths and weaknesses and discuss the implications of using different assumptions in the model. Reasons for any major discrepancies between the results obtained from assessment group model and the manufacturer model(s) will be explored. The time horizon will be a patient’s lifetime in order to reflect the chronic nature of the disease. A formal bination of costs and benefits will also be performed, although the type of economic evaluation will only be chosen in light of the variations in oute identified from the clinical effectiveness review evidence. If data are available, the results will be presented as incremental cost per QALY ratios for each alternative considered. If sufficient data are not available to construct these measures with reasonable precision, incremental costeffectiveness analysis or costminimisation analysis will be undertaken. Any failure to meet the reference case will be clearly specified and justified, and the likely implications will, as far as possible, be quantified. d. Sensitivity analysis If appropriate, sensitivity analysis will be applied to LRiG’s model in order to assess the robustness of the results to realistic variations in the levels of the underlying parameter values and key assumptions. Where the overall results are sensitive to a particular variable, the sensitivity analysis will explore the exact nature of the impact of variations. Imprecision inthe principal model costeffectiveness results with respect to key parameter values will be assessed by use of techniques patible with the modelling methodology deemed appropriate to the research question and to the potential impact on decision making for specific parisons (. multiway sensitivity analysis, costeffectiveness acceptability curves etc).7 HANDLING THE MANUFACTURER SUBMISSION(S) All data submitted by the drug manufacturers arriving before 22nd March 2011 and meeting the set inclusion criteria will be considered for inclusion in the review. Data arriving after this date will only be considered if time constraints allow. Any economic evaluations included in the manufacturer submission(s) will be assessed. This will include a detailed analysis of the appropriateness of the parametric and structural assumptions involved in any models in the submission and an assessment of how robust the models are to changes in key assumptions. Clarification on specific aspects of the model may be sought from the relevant manufacturer. Any 39。mercial in confidence39。 data taken from a manufacturer submission will be clearly marked in the NICE report according to established NICE policy and removed from the subsequent submission to the HTA 8 EXPERTISE IN THIS TAR TEAM AND COMPETING INTERESTS OF AUTHORS This TAR team will be made up of the following individuals:Team lead /clinical systematic reviewer Juliet Hockenhull Senior economic modeller Professor Adrian Bagust Systematic reviewer (clinical) Gemma Cherry Systematic reviewer (economics) Dr Angela Boland Economic modeller Dr Carlos Martin Saborido Information specialist Dr Yenal Dundar Medical statistician James Oyee Director Ms Rumona Dickson Clinical advisor A team of clinical experts will be established to address clinical questions related to the technology and to provide feedback on drafts of the final report 9 REFERENCES1. Freeman T. 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