Do Health Technology Assessment Decisions in England and Scotland Align or Differ?
Author(s)
ABSTRACT WITHDRAWN
Objectives: To compare recommendations published by the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC) and determine to what extent they align. Data source and Methods: The Office of Health Economic (OHE) database on Health Technology Assessment (HTA) decision outcomes was the main data source used. Information on centrally authorised medicinal products listed by the European Medicines Agency (EMA), and outcomes and dates of HTA guidance by NICE and SMC since January 2015 were considered. We matched 154 medicine indications appraised by the two agencies between January 2015 and December 2019 and grouped the decision outcomes of the agencies to make them comparable. We conducted a descriptive analysis of the pairwise distribution of the decision groups identified. We performed kappa tests of statistical differences between decision outcomes from the agencies. Finally, we conducted descriptive statistics on time elapsed between EMA licence and HTA decisions by NICE and SMC. Results: There is an alignment between NICE and SMC decision outcomes in 63% of cases. In more than 10% of cases, NICE provided some level of access to an intervention (either via full or conditional recommendation) which was not recommended by SMC, whilst, in nearly 20% of cases, SMC fully recommended a medicine for which NICE made a conditional recommendation. Both cancer and orphan indications showed similar levels of alignment compared to all indications. Overall, differences in decision outcomes between NICE and SMC were not statistically significant. There are, however, numerical differences that are potentially important and that we consider require further investigation. On average, publication of SMC decisions appears later than NICE decisions across indications. Conclusions: There is alignment between NICE and SMC decision outcomes in the majority of cases. Reasons behind the differences observed can be driven by different factors that merit further investigation.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PMU36
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Approval & Labeling, Decision & Deliberative Processes
Disease
No Specific Disease