Presentation (CTI)

OBJECTIVES: In 2022, NICE developed a new proportionate approach to HTA, aiming to apply a lighter touch, faster evaluation where appraisals are deemed as low risk, via a cost comparison route. The aim of this study was to determine whether NICE achieved their objective, by assessing the time taken from final scope to technology appraisal guidance via the cost comparison route compared to the standard single technology appraisal (STA) route.
METHODS: All 208 NICE appraisals published since the first cost comparison was published were analysed. Time to access was calculated based on time from the issuance of final scope to publication of the technology appraisal guidance. Terminated appraisals were excluded. Our analysis set included 132 STAs and 28 cost comparisons.
RESULTS: The average (mean) time to access via cost comparison was 294 days, compared to 439 days for STA. This results in an absolute difference of 145 days. The range for STAs (139 - 1,227 days) was also far wider than that observed for cost comparisons (154 - 747 days). Notably, only three cost comparison appraisals took longer than the average time for an STA, supporting the consistent efficiency delivered by the cost comparison process.
CONCLUSIONS: Based on a comprehensive analysis, technologies appraised via cost comparison are recommended 145 days quicker than those appraised via STA. In this sense, NICE’s proportionate approach is delivering on its stated aim, and NICE’s topic selection is appropriately determining eligibility for cost comparison.