Chapter 4 64 Table 3: Pharmaceuticals that produced most and least incremental health benefit, ranked according to their added Quality-Adjusted Life Years (QALYs) extracted from NICE Technology Appraisals (TAs). TA Product Disease QALY SPECIFICS TOP-5 PHARMACEUTICALS WITH THE LARGEST INCREMENTAL HEALTH BENEFITS, COMPARED WITH THEIR NEXT-BEST ALTERNATIVE. TA538 dinutuximab beta neuroblastoma 5.22 Dinutuximab beta for treating high-risk neuroblastoma in people aged 12 months and over whose disease has at least partially responded to induction chemotherapy, followed by myeloablative therapy and stem cell transplant, only if they have not already had anti-GD2 immunotherapy. TA588 nusinersen spinal muscular atrophy 5.20 Nusinersen for treating 5q spinal muscular atrophy (SMA) only if people have pre-symptomatic SMA, or SMA types 1, 2 or 3. TA443 obeticholic primary biliary cholangitis 4.22 Obeticholic acid for treating primary biliary cholangitis in combination with ursodeoxycholic acid for people whose disease has responded inadequately to ursodeoxycholic acid or as monotherapy for people who cannot tolerate ursodeoxycholic acid. TA507 sofosbuvir–velpatasvir–voxilaprevir chronic hepatitis C 3.76 Sofosbuvir–velpatasvir–voxilaprevir for treating chronic hepatitis C in direct-acting antivirals experienced patients. TA589 blinatumomab acute lymphoblastic leukemia 2.96 Blinatumomab for treating Philadelphia-chromosome-negative CD19‑positive B‑precursor acute lymphoblastic leukemia in adults with minimal residual disease (MRD) of at least 0.1%, only if the disease is in first complete remission. TOP-5 PHARMACEUTICALS WITH THE SMALLEST INCREMENTAL HEALTH BENEFITS COMPARED WITH THEIR NEXT-BEST ALTERNATIVE. TA537 ixekizumab psoriatic arthritis -0.10 Ixekizumab (alone or with methotrexate) for treating active psoriatic arthritis in adults who have not responded to, or are ineligible for, a TNFalpha inhibitor. TA220 golimumab psoriatic arthritis -0.30 Golimumab for the treatment of active and progressive psoriatic arthritis. TA512 tivozanib renal cell carcinoma -0.38 Tivozanib for treating advanced renal cell carcinoma in adults, only if they have had no previous treatment. TA561 venetoclax chronic lymphocytic leukemia -0.39 Venetoclax (with rituximab) for treating chronic lymphocytic leukemia in adults who have had at least 1 previous therapy. TA543 tofacitinib psoriatic arthritis -0.49 Tofacitinib (with methotrexate) for treating active psoriatic arthritis in adults who have not responded to, or are ineligible for, a TNF-alpha inhibitor.
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