REVIEW OF EVIDENCE UNDERPINNING RECOMMENDATIONS IN PAST NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE HEALTHTECH GUIDANCE
Author(s)
Tom Macmillan, BA, MSc1, Emma Carr, BA1, Thomas Walker2.
1York Health Economics Consortium, York, United Kingdom, 2NICE, Manchester, United Kingdom.
1York Health Economics Consortium, York, United Kingdom, 2NICE, Manchester, United Kingdom.
OBJECTIVES: To evaluate the evidence used to support recommendations in the National Institute for Health and Care Excellence’s (NICE) health technology guidance (HTG) programme.
METHODS: A total of 50 HTG entries were reviewed from the medical technologies evaluation programme (MTEP) and the diagnostics assessment programme (DAP), published between 2019 and 2026. Data were extracted for CE class of the technologies, recommendation type, study design and sample size, study applicability and generalisability, quality and risk of bias assessment, clinical, safety and cost outcomes, and the results and evidence used to inform the economic models. The extracted information was then evaluated to determine if there were any notable patterns or connections between the characteristics of the evidence available to the committee and the recommendations that were made.
RESULTS: We evaluated 37 individual recommendations for MTEP (18 fully recommended, 4 evidence-generation, 14 research-only and 1 not recommended) and 26 for DAP (9 full, 2 evidence-generation, 13 research-only and 2 not recommended). As expected, technologies deemed to be cost-effective generally received full recommendations (17/18 MTEP, 9/9 DAP). Devices or diagnostics that received full recommendations tended to be supported by larger studies in both MTEP (median sample size in full recommendations: 543; evidence generation: 97.5; research recommendations: 356; no recommendation: 332) and DAP (median sample size in full recommendations: 2962; evidence generation: 592; research recommendations: 510; no recommendation: 628). However, technologies that received other types of recommendation were not characterised by especially small sample sizes. For DAP technologies (though not MTEP), the identification of RCT evidence, evidence with no applicability/generalisability concerns and significant findings in favour of the technology were indicative of positive recommendations.
CONCLUSIONS: As expected, a finding of cost-effectiveness was most consistently aligned with positive recommendations, as was the use of RCT evidence for diagnostic technologies. Patterns between other evidence characteristics and recommendation types were less clear.
METHODS: A total of 50 HTG entries were reviewed from the medical technologies evaluation programme (MTEP) and the diagnostics assessment programme (DAP), published between 2019 and 2026. Data were extracted for CE class of the technologies, recommendation type, study design and sample size, study applicability and generalisability, quality and risk of bias assessment, clinical, safety and cost outcomes, and the results and evidence used to inform the economic models. The extracted information was then evaluated to determine if there were any notable patterns or connections between the characteristics of the evidence available to the committee and the recommendations that were made.
RESULTS: We evaluated 37 individual recommendations for MTEP (18 fully recommended, 4 evidence-generation, 14 research-only and 1 not recommended) and 26 for DAP (9 full, 2 evidence-generation, 13 research-only and 2 not recommended). As expected, technologies deemed to be cost-effective generally received full recommendations (17/18 MTEP, 9/9 DAP). Devices or diagnostics that received full recommendations tended to be supported by larger studies in both MTEP (median sample size in full recommendations: 543; evidence generation: 97.5; research recommendations: 356; no recommendation: 332) and DAP (median sample size in full recommendations: 2962; evidence generation: 592; research recommendations: 510; no recommendation: 628). However, technologies that received other types of recommendation were not characterised by especially small sample sizes. For DAP technologies (though not MTEP), the identification of RCT evidence, evidence with no applicability/generalisability concerns and significant findings in favour of the technology were indicative of positive recommendations.
CONCLUSIONS: As expected, a finding of cost-effectiveness was most consistently aligned with positive recommendations, as was the use of RCT evidence for diagnostic technologies. Patterns between other evidence characteristics and recommendation types were less clear.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA133
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas