Presentation (CTI)

OBJECTIVES: Disease-specific reference models should be based on the best available evidence, and may enable more robust decisions to be made when recommending technologies, by encouraging consistency of assumptions and approaches to modelling. They may allow for a more efficient decision-making process, by making better use of time spent evaluating, developing or interpreting new economic models. They could help to bring existing NICE guidance together and provide a tool for readily updating guidance where incorporation of technology appraisals into clinical guidelines is challenging. This project aimed to inform development of a NICE position statement.
METHODS: A review of the academic literature was undertaken to understand the benefits and challenges with reference models. Experience of the development, adoption and maintenance of disease-specific reference models were captured from discussions across NICE’s programmes (e.g. guidelines, technology appraisals, and science, evidence and analytics), and other HTA bodies. Insights were gathered from the previous NICE pilot on Pathways approach to technology appraisals.
RESULTS: Few HTA organisations reported currently developing disease-specific reference models. Substantial resourcing is needed for the development and maintenance of models. Experience from within NICE has shown that early and consistent stakeholder involvement in the development process is imperative for their success.
CONCLUSIONS: There are significant barriers to the routine implementation of reference models, as they are more challenging to integrate into existing NICE processes. Disease-specific extensions to the NICE reference case could outline the characteristics a model should have for a specific disease or condition and can be considered an intermediate step to reference models. They could potentially lead to a reduction in unnecessary variation between models within a disease area. Lessons are being taken forward into the development of a NICE obesity reference case extension to support the pipeline of new interventions in this area.