Impact of Patient and Clinician Engagement (PACE) Meetings on Scottish Medicines Consortium Recommendations

OBJECTIVES: For medicines used to treat end of life and/or rare conditions, the Scottish Medicines Consortium (SMC) offers the submitting company the opportunity to request a Patient and Clinician Engagement (PACE) meeting to broaden the decision-making framework beyond the standard assessment process. This meeting can be requested if the initial advice for the standard submission is “not recommended” for use within NHS Scotland. The following study aims to investigate the outcome and impact of PACE meetings on SMC recommendations.

METHODS: Health Technology Assessment (HTA) reports from January 2020 to June 2024 were downloaded from the SMC website. Reports with submission type “Abbreviated”, “Collaboration”, “Non-submissions” and “Ultra-orphan initial assessment” were excluded from our analysis. Two additional reports with the status “withdrawn/revoked” were also excluded. For the selected reports, eligibility for a PACE meeting, request by the manufacturer to convene a PACE meeting and the final SMC decision were assessed.

RESULTS: Out of the 222 studied reports, 144 were [eligible] for PACE meeting, and thus included in analysis. A PACE meeting was requested by the manufacturer in 117 cases. Of the remaining 27 cases for which a PACE meeting was not requested by the manufacturer, 26 received an SMC recommendation of “accepted” or “restricted” while 1 was not “recommended” by the SMC. Of the 117 re-assessments with PACE meetings, results showed that 70 submissions were accepted for use in the NHS, 5 were subject to coverage with evidence development (interim acceptance), 26 were accepted for restricted use in the NHS and 16 were not recommended.

CONCLUSIONS: A noticeable change was observed in the SMC recommendations after a PACE meeting was held showing the impact of patient and clinicians voice on SMC decision making.