A Decade in Decision Making: Reviewing Trends in STAS by NICE in Different Disease Areas
Author(s)
Rachael Batteson, MSc, Simone Critchlow, MSc.
Petauri Evidence, Nottingham, United Kingdom.
Petauri Evidence, Nottingham, United Kingdom.
OBJECTIVES: The National Institute for Health and Care Excellence (NICE) have made 856 individual appraisal recommendations in the last decade. Research was conducted to examine any trends in decision-making by overarching disease area.
METHODS: A targeted review of the NICE website was conducted to identify single technology appraisals (STAs) published between January 2014 and December 2024. Data were extracted based on disease area, appraisal type, and NICE recommendation. 76 different categories of disease areas were defined. The 5 most common disease areas were considered in the results to examine trends in decision-making.
RESULTS: In total, 494 STAs were identified. The most common disease areas related to blood cancers (n=84, 17.0%), lung cancers (n=43, 8.7%), breast cancers (n=28, 5.7%), arthritis (n=26, 5.3%), and other haematological disorders (n=23, 4.7%). Breast cancers were considered to have the highest recommendation rate at 64.3% (rising to 89.3% when capturing Cancer Drugs Fund and optimised recommendations). For arthritis and haematological conditions, no negative recommendations were made, however arthritis had the lowest full recommendation rate (with a high number of optimised recommendations in both groups). In contrast, lung cancers had the largest non-recommendation rate, with a negative recommendation in 14% of instances.In total, the average recommendation rate across the 5 most common disease areas was 48.6% for full recommendation (rising to 88.9% when considering optimised recommendations) compared to 84% reported on the NICE website.
CONCLUSIONS: Overall, it is unclear whether the low full recommendation rate for arthritis is due to willingness-to-pay factors, such as lack of ability to meet a quality-adjusted life year weighting under the severity modifier, or linked to old end-of-life criteria, which arthritis would not be considered eligible for. Although NICE report high recommendation rates, there is a clear disparity across not just disease area but the type of recommendation achieved.
METHODS: A targeted review of the NICE website was conducted to identify single technology appraisals (STAs) published between January 2014 and December 2024. Data were extracted based on disease area, appraisal type, and NICE recommendation. 76 different categories of disease areas were defined. The 5 most common disease areas were considered in the results to examine trends in decision-making.
RESULTS: In total, 494 STAs were identified. The most common disease areas related to blood cancers (n=84, 17.0%), lung cancers (n=43, 8.7%), breast cancers (n=28, 5.7%), arthritis (n=26, 5.3%), and other haematological disorders (n=23, 4.7%). Breast cancers were considered to have the highest recommendation rate at 64.3% (rising to 89.3% when capturing Cancer Drugs Fund and optimised recommendations). For arthritis and haematological conditions, no negative recommendations were made, however arthritis had the lowest full recommendation rate (with a high number of optimised recommendations in both groups). In contrast, lung cancers had the largest non-recommendation rate, with a negative recommendation in 14% of instances.In total, the average recommendation rate across the 5 most common disease areas was 48.6% for full recommendation (rising to 88.9% when considering optimised recommendations) compared to 84% reported on the NICE website.
CONCLUSIONS: Overall, it is unclear whether the low full recommendation rate for arthritis is due to willingness-to-pay factors, such as lack of ability to meet a quality-adjusted life year weighting under the severity modifier, or linked to old end-of-life criteria, which arthritis would not be considered eligible for. Although NICE report high recommendation rates, there is a clear disparity across not just disease area but the type of recommendation achieved.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA6
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes