A Systematic Review and Economic Model

Health Technology Assessment 2009; Vol. 13: No. 38 The effectiveness and cost-effectiveness of methods of storing donated kidneys from deceased donors: a systematic review and economic model M Bond, M Pitt, J Akoh, T Moxham, M Hoyle and R Anderson August 2009 DOI: 10.3310/hta13380 Health Technology Assessment NIHR HTA programme www.hta.ac.uk HTA How to obtain copies of this and other HTA programme reports An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below). Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents. Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph. 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Abstract ........................................................... iii Glossary and list of abbreviations .................... vii The effectiveness and cost-effectiveness Executive summary .......................................... xi of methods of storing donated kidneys Chapter 1 Acknowledgements .......................... 91 Background ............................................... 1 from deceased donors: a systematic Description of the problem ....................... 1 References ........................................ 93 Current service provision ........................... 7 review and economic model Description of technology under assessment 9 Appendix 1 Literature searching strategies . 99 Chapter 2 Definition of the decision problem ........... 13 1* 1 2 1 Appendix 2 Decision problem ....................................... 13 M Bond, M Pitt, J Akoh, T Moxham, Study identification .................... 105 Overall aims and objectives ....................... 13 1 1 M Hoyle and R Anderson Appendix 3 Chapter 3 Data extraction tables ............... 107 1 Assessment of clinical effectiveness .......... 15 Peninsula Technology Assessment Group (PenTAG), Peninsula Medical Methods for reviewing effectiveness .......... 15 School, Universities of Exeter and Plymouth, UK Appendix 4 Results ........................................................ 17 2Derriford Hospital, Plymouth Hospitals NHS Trust, UK Excluded studies ......................... 133 Assessment of effectiveness ........................ 18 Safety ......................................................... 30 *Corresponding author Appendix 5 Subgroups .................................................. 31 Flow of kidneys in the Machine Preservation Summary of clinical effectiveness .............. 31 Trial ............................................. 139 Declared competing interests of authors: J Akoh is part of the investigating research Chapter 4 Appendix 6 Assessment of cost-effectiveness .............. 35 team for one of the sites of the PPART trial. CHEC list assessment of economic evaluations Some economic aspects of kidney preservation methods ................................................ 141 ............................................................. 35 Systematic review of existing cost-effectiveness evidence Appendix 7 ............................................................. 35 PenTAG model transitions ......... 143 Assessment of industry submissions to NICE 38 The PenTAG cost–utility assessment ......... 38 Appendix 8 Model parameters – the standard data set 42 Base-case outputs from the PenTAG model by age Results of PenTAG cost–utility analysis ...... 55 group .......................................... 145 One-way sensitivity analysis ....................... 66 Probabilistic sensitivity analysis ................. 71 Appendix 9 Summary of cost-effectiveness ................... 78 Hazard ratios for graft survival .. 149 Chapter 5 Appendix 10 Assessment of factors relevant to the NHS and other Published August 2009 Probabilistic sensitivity analyses 151 parties ........................................................ 79 DOI: 10.3310/hta13380 The use of machine perfusion to predict the viability of Health Technology Assessment reports published to kidneys ................................................... 79 date ............................................ 157 Safety and ease of use of machine perfusion and cold This report should be referenced as follows: storage ................................................... 80 Health Technology Assessment Systems and regulations for organ retrieval and transport Bond M, Pitt M, Akoh J, Moxham T, Hoyle M, Anderson R. The effectiveness and cost- programme ................................ 177 ............................................................. 80 effectiveness of methods of storing donated kidneys from deceased donors: a systematic Impact of dialysis versus transplantation on employment review and economic model. Health Technol Assess 2009;13(38). status ...................................................... 80 Health Technology Assessment is indexed and abstracted in Index Medicus/MEDLINE, Excerpta Chapter 6 Medica/EMBASE, Science Citation Expanded (SciSearch) and Current Contents/Clinical Discussion .................................................. 83 Principal findings ...................................... 83 Medicine. Strengths and limitations of the systematic review of clinical effectiveness ........................................... 85 Strengths and limitations of the cost–utility analysis 85 Other relevant factors ................................ 88 Chapter 7 Conclusions ................................................ 89 Implications for service provision ............. 89 Suggested research priorities ..................... 89 NIHR Health Technology Assessment programme he Health Technology Assessment (HTA) programme, part of the National Institute for Health TResearch (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. ‘Health technologies’ are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. 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