OBJECTIVES

To identify and describe NICE technology appraisals (TAs) completed via the fast track appraisal (FTA) route introduced in April 2017.

METHODS

NICE’s website was searched, in June 2019, using the term “fast track appraisal”. Search results were limited to TA guidance. TAs published after April 2017 were examined to identify those considered via the FTA route. The appraised technologies’ characteristics and the clinical and economic evidence bases were examined.

RESULTS

Twenty-nine records were retrieved. Of these, four were published TAs developed through the FTA process (TA486, TA497, TA521 and TA572) and one was in development (ID1398). Completed appraisals were published between November 2017 and March 2019. These were for diabetes (n=1), psoriasis (n=1), eye condition (n=1) and spondyloarthristis (n=1). All were new indications for drugs previously recommended by NICE in other indications.

In the four published appraisals, indirect treatment comparison (n=1) and network meta-analysis (n= 3) were used to demonstrate equivalence in health benefits. All used cost comparison to demonstrate cost neutrality or saving. None of the recommended technologies made a “low ICER” case (ICER < £10,000/QALY gained). The number of accepted comparators in the cost comparison ranged from one to three per appraisal. Only drug acquisition cost was included in the analysis, with all submissions assuming that other costs are equivalent. In two out of the four appraisals, patient access scheme discounts were available for the interventions. In three of the appraisals the comparators also had confidential commercial arrangements, so the magnitude of cost saving was reported for only one technology.

CONCLUSIONS

The new NICE FTA process appears to be underutilised as few technologies have been considered via this route over the first two years since its introduction. Completed appraisals give useful insights into the characteristics of the technologies recommended via this route and their associated evidence bases.