Chapter 4 62 which can occur at the company’s request, leaving 184 appraisals associated with 129 drugs for inclusion in our data set (different appraisals can review the same drug for different indications). Of the 184 drug-indication pairs, the median incremental QALY gain relative to the best alternative therapy was 0.27 QALY (interquartile range [IQR]: 0.07-0.73) (Figure 4). The highest median benefits were associated with drugs developed for medical disciplines such as hematology (0.70, IQR: 0.55-1.22), oncology (0.46, IQR: 0.20-0.88), and neurology (0.45, IQR: 0.13-1.15), and the lowest for drugs associated with medical disciplines such as vascular medicine (0.11, IQR: 0.010.19), ophthalmology (0.09, IQR: 0.04-0.22) and endocrinology (0.02, IQR: 0.01-0.06). Of note, QALY estimates were redacted in 26.7% of neurology, 28.6% of ophthalmology, 37.2% of oncology and 44.9% of hematology appraisals, whereas for vascular medicine and endocrinology, QALY estimates were available in all appraisals (also see Supplementary Material). Endocrinology Other Ophthalmology Vascular medicine Cardiology Gastroenterology Rheumatology Neurology Oncology Haematology blinatumomab dinutuximab nusinersen ustekinumab sofosbuvir-velpatasvir-voxilaprevir obe cholic sacubitril tocilizumab ranibizumab ruxoli nib dapagliflozin Infec ous diseases Incremental Quality−Adjusted Life Year (QALY) 0 1 2 3 4 5 Figure 4: The added value of novel pharmaceuticals approved by NICE from 2010 to 2020. Display of the distribution (boxplot) of added value in Quality-Adjusted Life Years (QALYs) of novel pharmaceuticals per medical discipline that have received a positive coverage decision of NICE between January 1, 2010 and December 31, 2020, compared with their next-best alternative. Medical disciplines with fewer than eight appraisals were classified as ‘Other’.
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