Presentation (CTI)

OBJECTIVES: The Commercial Liaison Team (CLT) at the National Institute for Health and Care Excellence (NICE) support pharmaceutical companies and NHS England with patient access schemes and pricing agreements for new interventions undergoing NICE appraisals. These interventions with pricing arrangements subsequently become comparators or subsequent treatments in future NICE appraisals. This means NICE cannot publish the committee’s decision-making incremental cost-effectiveness ratios (ICERs) or provide ICERs to the companies of new treatments entering the pathway. To assess how often this occurs, this study identified how many NICE Technology Appraisals (TAs) featured confidential prices.
METHODS: Published NICE TA guidance from April 2024 to March 2025 was identified. Terminated appraisals were excluded. Information was extracted from the identified guidance to assess if the intervention, comparator(s) or subsequent treatment(s) had a confidential price.
RESULTS: Sixty-nine pieces of guidance were identified. Of those, sixty-seven pieces of guidance (97.1%) had a confidential price for either the intervention or elsewhere in the pathway. Two appraisals (2.9%) contained no confidential prices. Sixty-one appraisals (88.4%) had a confidential price for the intervention. Fifty-five appraisals (79.7%) had a confidential price for another treatment in the pathway.
CONCLUSIONS: The CLT compared these results to a similar study completed in 2022 which found 94.7% of NICE TA guidance had a confidential price for either the intervention or elsewhere in the pathway. Confidential prices are increasingly included in NICE appraisals which poses challenges for the transparency of NICE decisions and for companies to understand where its true cost-effectiveness lies. NICE has taken steps to support companies by providing £10,000 ICER ranges including confidential comparator prices through the pre-appraisal committee meeting (pre-ACM) summary document. This gives companies an idea of the impact of other confidential prices in the treatment pathway on its ICER without revealing the confidential prices of other treatments in the pathway.