Presentation (CTI)

OBJECTIVES: NICE is transitioning to a whole lifecycle approach to guidance development and maintenance, requiring more consistent, robust and efficient health economic methods across disease areas. This study aimed to develop and apply a transparent selection framework for disease-specific reference case extensions, and to assess advanced cancer as a potential topic for development.
METHODS: A two-stage selection framework was developed with input from NICE teams responsible for health economics, decision modelling, surveillance and prioritisation. Stage 1 assessed candidate areas against operational concepts for whole lifecycle guidance, including alignment with system-wide priorities, impact on patient outcomes, budgetary impact and need to bring together NICE guidance. Stage 2 assessed the expected added value of a reference case extension for health economic modelling and committee decision-making, considering current modelling challenges, future innovation pipelines, and operational feasibility.
RESULTS: Thirteen cancer topics met key operational criteria, including alignment with national cancer priorities, high drug expenditure and challenges incorporating technology appraisal recommendations into guidelines. Advanced cancer was identified as a strong candidate for a disease-specific reference case extension because no single validated, usable health economic model exists across the area and existing submissions show recurring methodological inconsistencies, particularly around structural uncertainty and resource-use estimation. The topic also has continuing relevance because of a sustained pipeline of innovative therapies and biosimilar opportunities with potential implications for value-based decision-making and guidance updates.
CONCLUSIONS: A structured, transparent framework can support selection of disease-specific reference case extensions under a whole lifecycle approach. Applying the framework supported advanced cancer as a high-priority topic where consistent modelling guidance could improve efficiency, methodological consistency and the maintainability of NICE guidance.