Understanding NICE Decision-Making Committees: A Qualitative Exploration

OBJECTIVES: This study aimed to understand the needs and perspectives of National Institute for Health and Care Excellence (NICE) committee members to enhance the clarity and usability of our submissions. These experts, including practitioners, professionals, providers, commissioners, researchers, and lay members, are critical in assessing innovations related to patient care. By exploring how effective communication can be used in submission dossiers through one-on-one interviews we sought to uncover common overarching themes to improve committee members’ understanding and engagement.

METHODS: We adopted a “Listening and Appreciation” approach, prioritizing non-technical elements over product specific or health economic methodologies and data analytics. Through anonymized virtual one-on-one interviews with five individuals representative of typical committee members with current or recent committee experience, we explored effective communication, storytelling, submission structure, emphasis, and writing style.

RESULTS: The respondents indicated NICE operates within a unique context spanning the UK’s political landscape, NHS and Department of Health. Consequently, approaches by manufacturers that aren’t tailored for the UK raise concerns and invite closer scrutiny. A degree of scepticism toward the pharmaceutical industry exists, with tension between perceived profit-focused motives and the need to deliver value for money to taxpayers. The NICE approval process is perceived as robust, but in reality, it is challenging and includes documentation that may be underutilized or poorly understood. The end-to-end process significantly impacts the outcome, with key moments of truth and specific audiences playing crucial roles at different times. Submissions should be easy to read, and manufacturers are urged to focus on clarity, objectivity and to be accommodating and honest. Ultimately though, value underpinned by evidence drives decision-making.

CONCLUSIONS: All stakeholders, NICE and industry alike are aligned to bring innovative medicines to patients to improve outcomes for everybody, but manufactures could do more to enhance their submissions to help committee members in their deliberations.