OBJECTIVES: NICE states 82% of its appraisal recommendations are positive. This study reviews 20 years of NICE data, to assess the likelihood that a topic will be approved through NICE’s STA process for the full patient population indicated at marketing authorisation.

METHODS: NICE publicly available technology appraisals were reviewed. All Multiple Technology Appraisals were removed from this study. Of the 419 remaining STAs, 42 were withdrawn, leaving 377 completed STAs in total. 313 STA recommendations were positively recommended. The study analysed individual STAs to distinguish the type of recommendation that each was awarded and to assess whether a recommendation was made for a sub-group. Where individual STAs included recommendations for numerous indications, this study considers each indication as a separate STA.

RESULTS: The research found 83.02% of the 377 completed STAs were granted a positive recommendation. 1.33% of the total number of appraised STAs were recommended only in research; 28.12% received an optimised recommendation; 53.58%, received a full recommendation. Roughly half of technology appraisals (53.58%), receive a recommendation which is indicated to treat the full patient population, as set out in the technology’s marketing authorisation. The remaining positively recommended technologies received a recommendation for a patient population smaller than the one indicated at the time of marketing authorisation (29.45%).

CONCLUSIONS: A large proportion of the positively recommended NICE STAs (29.45%) were not recommended in line with their full patient population. 28.12% being technologies that received an optimised recommendation i.e. recommended for a smaller group of patients than originally stated by the marketing authorisation. This data suggests it’s likely NICE will recommend a technology for a patient population smaller than the company originally set out. This may be because data for a particular group of patients was stronger. Further research on this area would be beneficial.