Presentation (CTI)

OBJECTIVES: With stakeholders such as payers and patient organisations increasingly seeking to integrate the patient voice into reimbursement decisions, interest in patient preference (PP) is growing. Previous research has suggested that the inclusion of PP studies in NICE technology appraisals (TAs) frequently led to Committee consideration of intervention attributes in final appraisal documents, but few TAs incorporated PP quantitively in their modelling. This research investigated the incorporation of utility adjustments to reflect PP in economic modelling in past NICE TAs and the extent to which such adjustments were accepted by Committees.
METHODS: The NICE website was searched on 02 June 2025 for completed TAs. Information regarding the approach to utility adjustment for PP and subsequent critique was extracted from the 10 most recent appraisals in which PP had been quantitatively included in the economic model.
RESULTS: Ten appraisals explicitly incorporating utility adjustment for PP were identified after searching the 148 most recent NICE appraisals. All 10 appraisals incorporated a utility increment or decrement based on administration route, all favouring oral administration. Utility adjustment was included in the base case in 9/10 of the appraisals. Incorporation of utility adjustment for PP was accepted with no critique from the Committee or assessors in four appraisals, accepted with critique in three appraisals, and rejected in three appraisals. Lack of evidence supporting inclusion and limitations of the sources informing utility adjustment (e.g. vignette studies) were cited as key areas of uncertainty.
CONCLUSIONS: PP regarding treatment administration route appears to be increasingly incorporated into economic models via utility adjustment in NICE appraisals. Despite a lack of guidance and uncertainty about methodological approaches to quantitively incorporating PP, Committees have accepted the incorporation of adjustment for PP in the final decision-making modelling approach.