Comparing methods for full versus single technology appraisal: a case study of docetaxel and paclitaxel for early breast cancer.
OBJECTIVE
The aim of this study is to compare and contrast the reports of the rapid National Institute for Health and Clinical Excellence (NICE) single technology (STA) process with the full Health Technology Assessment Report (TAR) for the same technologies (docetaxel and paclitaxel for the adjuvant treatment of early breast cancer).


METHODS
Documentary analysis was used to compare three reports. A data extraction form was developed to record information on the decision problem addressed in each report, literature searching methods, the clinical effectiveness review, cost-effectiveness analysis, conclusions and issues of concern.


RESULTS
The decision problems and search strategies for the STAs differed from those reported in the TAR. Not all trials of clinical effectiveness included in the TAR were reported by manufacturers. The methods and assumptions used to assess the cost-effectiveness of the technologies were generally similar between reports, although only one common health economic comparison was presented across the three reports. The TAR supports the STA results for docetaxel but suggested that the manufacturer's cost-effectiveness estimates for paclitaxel were highly optimistic.


CONCLUSIONS
Although the STA process provides the opportunity for rapid appraisal of new technologies, there remains uncertainty concerning the extent to which STAs adequately address the specific decision problem under consideration.
Kaltenthaler
Eva
E
School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. e.kaltenthaler@sheffield.ac.uk
Tappenden
Paul
P
Booth
Andrew
A
Akehurst
Ron
R
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003362:Cost-Benefit Analysis; D003657:Decision Making; D000077143:Docetaxel; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000191:economics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D043823:Taxoids / Q000191:economics / Q000627:therapeutic use*; D013673:Technology Assessment, Biomedical / Q000379:methods*; D035501:Uncertainty
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel