OBJECTIVES: The objective of this study was to identify factors related to acceptance of findings from matching-adjusted indirect comparisons (MAICs) in appraisals performed by the National Institute for Health and Care Excellence (NICE), Haute Autorité de Sante (HAS) and Gemeinsamer Bundesausschuss (G-BA).

METHODS: Products reviewed for MAICs were identified by searching NICE Single Technology Appraisal documents as of 31 December, 2019 to identify appraisals where MAICs were performed to provide clinical or economic data as part of the NICE submissions. Publicly available appraisal documents from the HAS and G-BA were then reviewed to identify MAIC methodological considerations. Perspectives on these methodological considerations from both the HAS and G-BA were evaluated to determine common themes related to acceptance of MAIC-based comparative effectiveness findings.

RESULTS: 16 STAs were identified and included as part of the analysis. Seven and five MAICs were appraised by HAS and G-BA, respectively. In only one case was a MAIC that was rejected by NICE submitted to one of the other bodies. None of the 12 MAICs was accepted by the HAS or G-BA due to: population characteristics across arms (N=6), differences in definition of primary outcome (N=3), differences in median follow-up time (N=2), and issues with data completeness/missing data (N=5). Key methodological criticisms of the analyses were largely consistent across the HAS and G-BA. Despite MAIC rejection, 86% of achieved an ASMR IV or better by HAS, but only 40% of products received non-quantifiable added benefit rating or better by the G-BA.

CONCLUSIONS: Submissions of MAICs appear to be less common in France and Germany as compared to the United Kingdom. No MAIC data were accepted by the HAS or G-BA in the appraisals reviewed, and reasons for rejection of data from MAICs were largely similar, suggesting significant resistance when submitting these data to these agencies.