OBJECTIVES: NICE states that 82% of its appraisal recommendations are positive. This study reviews 20 years of NICE data, to investigate the proportion of recommendations which took account of either a Patient Access Scheme (PAS) or a Commercial Access Agreement (CAA).

METHODS: NICE’s publicly available technology appraisal (TA) recommendations were reviewed. Of the 877 TA recommendations, all Multiple Technology Appraisals were removed from this study. Of the 419 remaining STAs, 42 were withdrawn, leaving 377 completed STAs in total. This study investigates the 313 STA recommendations that were positively recommended. Where individual STAs included recommendations for numerous indications, this study considers each indication as a separate STA. Also reviewed was NICE data on technologies recommended for use in the NHS with patient access schemes and other commercial access arrangements.

RESULTS: The research found that 83.02% of the STA’s in this study were granted a positive recommendation. 1.33% of the STAs were recommended only in research; 28.12% received an optimised recommendation; 53.58% received a full recommendation. 29.71% of all appraisals received what NICE would deem as a full positive recommendation, but with either a PAS or CAA attached to it (4.51% were recommended through the CDF). Finally, 23.87% of all appraisals achieved a full recommendation without a PAS or a CAA, in line with the technology’s marketing authorisation.

CONCLUSIONS: It is likely companies submitting to NICE will have to include a PAS or a CAA before or during their appraisal, in order to gain a positive recommendation. Roughly a quarter (23.87%) of NICE STA submissions gain a full recommendation in line with its marketing authorisation.