Presentation (CTI)

OBJECTIVES: As healthcare systems aim to promote fair and inclusive access to health gains, equity is growing priority in health technology assessment. Updated National Institute for Health and Care Excellence (NICE) guidance emphasises the importance of incorporating health inequalities into technology appraisal (TA) methods, given the growing need to consider equity in healthcare decision-making. We identify and describe methods used to consider health equity in published NICE TA reports from the past year.
METHODS: A Scoping Review was conducted. All completed TAs and Highly Specialised TAs published from 28 May 2024 to 6th June 2025 were eligible for this scoping review. Data were extracted by a single reviewer using a pre-specified form, this was independently check by a second reviewer. Findings were narratively summarised.
RESULTS: Just twenty of the 90 technology appraisal reports published discussed equity. Two reports1,2 (Exa-cel therapy for sickle cell and beta thalassemia) outlined the conduct of a distributional cost-effectiveness analysis (DCEA) which stratified patient populations using the Index of Multiple Deprivation. This allowed estimation of equity weighted Quality-Adjusted-Life-Year (QALY) gains and opportunity costs across socioeconomic groups, highlighting how the intervention could reduce health inequity benefitting those from more deprived backgrounds most. Eighteen reports indicated equity considerations were addressed by assuming an additional QALY would have the same weight regardless of the characteristics of individuals receiving health benefit.
CONCLUSIONS: Less than a quarter of TA reports published over the past year mention equity and only two apply quantitative methods to assess its impact. Recent NICE guidance signals a commitment to addressing health inequalities, however equity-focused analysis remains sparse relying on established rather than innovative methods. Broader use of methods, could be supported through clearer methodological guidance helping to embed equity more consistently in health technology assessments.