Alitretinoin for Severe Chronic Hand Eczema A NICE Single Technology Appraisal Mark Rodgers, 1 Susan Griffin, 2 Mike Paulden, 2 Russell Slack, 1 Steven Duffy, 1 John R. Ingram, 3 Nerys Woolacott 1 and Mark Sculpher 2 1 Centre for Reviews and Dissemination, University of York, Heslington, York, UK 2 Centre for Health Economics, University of York, Heslington, York, UK 3 University Hospital of Wales, Cardiff, Heath Park Way, Heath, Cardiff,UK Contents Abstract ................................................................................. 351 1. The Decision Problem................................................................... 353 2. The Independent Evidence Review Group (ERG) Review .................................... 353 2.1 Clinical Evidence .................................................................. 354 2.1.1 Critique and Interpretation..................................................... 355 2.2 Cost-Effectiveness Evidence ......................................................... 356 2.2.1 Critique and Interpretation..................................................... 357 2.3 Conclusions of the ERG Report ....................................................... 358 3. Key Methodological Issues .............................................................. 358 4. National Institute for Health and Clinical Excellence Guidance ............................... 359 4.1 Preliminary Guidance .............................................................. 359 4.2 Response to Preliminary Guidance ................................................... 359 4.3 Final Guidance .................................................................... 360 5. Interpretation of Guidance.............................................................. 360 Abstract The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of alitretinoin (Basilea Pharmaceuticals Ltd, Basel, Switzerland) to submit evidence for the clinical and cost effectiveness of this drug for the treatment of patients with severe chronic hand eczema (CHE), as part of the Institute’s single technology appraisal (STA) process. The Centre for Reviews and Dissemination and the Centre for Health Economics at the University of York were commissioned to act as the Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and NICE’s subsequent decisions. The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology based upon the manufacturer’s submis- sion to NICE. The ERG also independently searched for relevant evidence and modified the manufacturer’s decision analytic model to examine the impact of altering some of the key assumptions. REVIEW ARTICLE Pharmacoeconomics 2010; 28 (5): 351-362 1170-7690/10/0005-0351/$49.95/0 ª 2010 Adis Data Information BV. All rights reserved.