Presentation (CTI)

OBJECTIVES: The February 2022 update to the NICE technology-appraisal (TA) manual formally invited companies to present benefits not captured by the quality adjusted life year calculation (QALY). This analysis aims to assess in, oncology TAs, the frequency and nature of such arguments, the supporting evidence submitted, and committee receptivity to benefits beyond the QALY arguments.METHODS: All oncology single technology appraisals
METHODS: All oncology single technology appraisals with final guidance published between January 2023 and June 2025 were reviewed. Final draft guidance and evidence submitted by the company were included in analysis. Data extraction comprised of indication details, uncaptured benefits arguments, supporting evidence types, committee responses. Receptivity was defined as explicit acknowledgement
RESULTS: A total of 86 oncology technology appraisals (TAs) published between January 2023 and June 2025 were reviewed. Companies presented beyond the QALY benefit arguments in 51 (59%) of these submissions, with a year-on-year increase from 12/33 (36 %) in 2023 to 21/33 (63 %) in 2024 and 18/21 (85 %) in the first half of 2025. Over this time frame, committees acknowledged uncaptured benefits in 19/51 instances (37%). The trend for acknowledgement of uncaptured benefits in TAs has been positive over time, increasing from 3/33 (9%) TAs in 2023, to 8/33 (24%) in 2024, and 8/21 (38%) in 2025. The most common uncaptured benefit arguments related to patient quality of life aspects not captured by EQ-5D, caregiver burden, and healthcare system capacity benefits.
CONCLUSIONS: While the inclusion of benefits beyond the QALY arguments in oncology TAs is increasing, committee acceptance remains low. Companies are increasingly including such arguments in their submissions; however, there is significant variation in the approaches deployed and evidence quality. Of particular importance, whilst acknowledgement of these benefits appears to be increasing, the impact on reimbursement decisions remains unclear due to limited transparency on the decision-making process.