OBJECTIVES: The National Institute for Health and Care Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH) launched a parallel scientific advice (PSA) program in 2019. The aim of the present study was to compare past independent appraisals by NICE and CADTH to explore how the NICE-CADTH PSA program might be useful to manufacturers.

METHODS: Independent NICE and CADTH appraisals of specific technologies for hepatocellular carcinoma (HCC) or renal cell carcinoma (RCC) since 2016 were compared as an illustrative case study of appraisal committee judgements. For each appraisal, key data were extracted, including appraisal date, technology, indication, methodology for generating clinical and economic evidence, final recommendation, and important decision-drivers.

RESULTS: Four HCC or RCC technologies were independently appraised by NICE and CADTH. The approach and clinical inputs used in the economic modelling approach were similar across the NICE and CADTH submissions. Three of the technologies were recommended by both bodies and driven by the same conclusion that they addressed an unmet clinical need at an acceptable price. However, for one technology, there were conflicting recommendations—negative by CADTH and positive by NICE—despite both bodies expressing similar concerns about clinical and quality-of-life data in the pivotal phase II trial.

CONCLUSIONS: The NICE-CADTH PSA program might enable manufacturers to address concerns shared by both bodies early during evidence generation. Manufacturers would also have an opportunity to understand any areas of differences between the two bodies and to design a streamlined plan to simultaneously meet the requirements of both. However, despite future use of the PSA approach, NICE and CADTH may still make different appraisal decisions about a technology’s health economic benefits in the context of their respective countries. A systematic review covering NICE and CADTH appraisals in more disease areas is warranted to explore this possibility robustly.