OBJECTIVES :

Historically, the National Institute of Health and Care Excellence (NICE) appraisal process has been resource intensive, with most drugs requiring two committee meetings prior to receiving a positive NICE outcome. To address this, in April 2018, NICE began the roll-out of a new single technology appraisal (STA) process, incorporating a technical engagement phase to resolve any issues within submissions prior to committee meetings. This study aimed to assess whether the new process has resulted in changes to outcomes of STAs.

METHODS :

STAs published by NICE between January 2017 and June 2020 were identified. For each appraisal, data were extracted on outcomes of ACDs (if relevant) and FADs.

RESULTS :

Of the 148 appraisals identified, 12% were assessed by the new and 88% by the old STA process. Both processes resulted in similar proportions of recommended (R), optimized (O) and not recommend (NR) outcomes (R: 61% vs. 51%, O: 33% vs. 37%, NR: 6% vs. 11% in the new and old processes, respectively). In terms of number of committee meetings, a greater proportion of drugs undergoing the new process required only one committee meeting compared to the old process (53% vs. 35%). The remaining 47% of new process drugs receiving a positive outcome required two committee meetings to achieve this, however for drugs undergoing the old process, 50% required two committee meetings and a further 15% required three committee meetings, before achieving a positive NICE outcome.

CONCLUSIONS

Introduction of the new process does not appear to have changed the proportion of drugs achieving a recommended, optimized or not recommended NICE outcome. However, the new process has reduced the number of appraisal committee meetings required before achieving a final positive NICE outcome, aiding faster patient access. Nevertheless, nearly half of appraisals undergoing the new process still require two meetings, suggesting a potential need for further improvement.