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Draft guidance consultation

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1 Recommendations

1.1

Palopegteriparatide should not be used to treat chronic hypoparathyroidism in adults.

1.2

This recommendation is not intended to affect treatment with palopegteriparatide that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

What this means in practice

Palopegteriparatide is not required to be funded and should not be used routinely in the NHS in England for the condition and population in the recommendations.

This is because there is not enough evidence to determine whether palopegteriparatide is value for money in this population.

Why the committee made these recommendations

Usual treatment for chronic hypoparathyroidism is calcium and vitamin D supplements. Some people also have thiazide diuretics.

Results from a clinical trial comparing palopegteriparatide plus usual treatment with placebo plus usual treatment are uncertain. This is because the trial design may not allow a fair comparison, for reasons including:

  • usual treatment in the trial may not be the same as usual treatment in the NHS

  • the way that the trial measured how well the treatments work may not show whether palopegteriparatide plus usual treatment works better than usual treatment alone.

There are also uncertainties with the economic model including its design and the evidence used to inform it.

Because of the uncertainties in the clinical evidence and the economic model, it is not possible to determine the most likely cost-effectiveness estimates for palopegteriparatide. Further analyses are needed. So, palopegteriparatide should not be used.