Review of HTA Decisions for Oncology Treatments by NICE and NCPE

OBJECTIVES: Understanding the decision-making processes of health technology assessment (HTA) agencies is essential to ensuring optimal submission strategies for new technologies. This study compares recent HTA decisions for oncology treatments by the National Institute for Health and Care Excellence (NICE) in England and the National Centre for Pharmacoeconomics (NCPE) in Ireland. The objective is to identify trends or differences in the recommendations provided by these agencies, which can inform future submissions and strategic planning for market access.

METHODS: The guidance for 29 oncology-specific HTA submissions to the NCPE from 2022 to date was reviewed. Each HTA's criteria, evidence, recommendations, and justifications were examined. These were then compared to outcomes for the 29 equivalent NICE appraisals. The key differences and similarities between NICE and NCPE HTA outcomes were identified, analysed and summarised.

RESULTS: Of the 29 oncology-specific HTA submissions to have completed the NCPE assessment process, 16 are reimbursed. Comparing these with equivalent NICE appraisals, 11 HTAs recommended in Ireland received a ‘recommended’ status from NICE, with five through the Cancer Drug Fund (CDF). Four HTAs in Ireland received an 'optimised' status at NICE, with only one HTA receiving such status when including those assessed through the CDF. One HTA was recommended by the NCPE but not by NICE due to a termination by the company. For interventions reimbursed by both NCPE and NICE, the NCPE outcome was, on average, 1.88 years after NICE.

CONCLUSIONS: Our study reveals significant differences in HTA decisions for oncology treatments between NICE and NCPE. NICE often uses 'recommended' and 'optimised' statuses, supported by the CDF, to reduce uncertainty. In contrast, NCPE aligns more closely with final reimbursement outcomes but is slower. These findings help stakeholders tailor their submission strategies. Further research is needed to see if these trends apply to other therapeutic areas and how methodological differences affect recommendations.