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The Memokath-051 Stent for the Treatment of Ureteric Obstruction: A NICE Medical Technology Guidance

Lookup NU author(s): Dr Christopher Marshall, Dr Andrew SimsORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

© 2018 The Author(s) Memokath-051 is a thermo-expandable, nickel-titanium alloy spiral stent used to treat ureteric obstruction resulting from malignant or benign strictures. The National Institute for Health and Care Excellence (NICE) selected Memokath-051 for evaluation. The company, PNN Medical, claimed Memokath-051 has clinical superiority and cost savings compared with double-J stents. It identified five studies reporting clinical evidence on Memokath-051 and constructed a de novo cost model comparing Memokath-051 to double-J stents. Results indicated that Memokath-051 generated cost savings of £4156 per patient over 2.5 years. The External Assessment Centre (EAC) critiqued the company’s submission and completed substantial additional work. Sixteen studies were identified assessing Memokath-051 and all listed comparators in the scope (double-J stents, reconstructive surgery and metallic and alloy stents) except nephrostomy. Similar success rates were reported for Memokath-051 compared with double-J and Resonance stents and worse outcomes compared with other options with evidence available. The EAC updated the company’s cost model structure and modified several inputs. The EAC’s model estimated that Memokath-051 generated savings of at least £1619 per patient over 5 years compared with double-J stents, was cost neutral compared with other metallic stents and was cost saving compared with surgery up to month 55. Overall, Memokath-051 is likely to be cost saving in patients not indicated for reconstructive surgery and those expected to require a ureteral stent for at least 30 months. The Medical Technologies Advisory Committee (MTAC) reviewed the evidence and supported the case for adoption, issuing partially supportive recommendations published after public consultation as Medical Technologies Guidance 35.


Publication metadata

Author(s): Eaton Turner E, Jenks M, McCool R, Marshall C, Millar L, Wood H, Peel A, Craig J, Sims AJ

Publication type: Article

Publication status: Published

Journal: Applied Health Economics and Health Policy

Year: 2018

Volume: 16

Issue: 4

Pages: 445-464

Print publication date: 01/08/2018

Online publication date: 03/04/2018

Acceptance date: 02/04/2016

Date deposited: 16/04/2018

ISSN (print): 1175-5652

ISSN (electronic): 1179-1896

Publisher: Adis International Ltd

URL: https://doi.org/10.1007/s40258-018-0389-3

DOI: 10.1007/s40258-018-0389-3


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