Immuno-oncology (I-O) therapies have emerged as an alternative approach to chemotherapy and other cancer treatments over the last decade. However, their reimbursement can be hindered by biological complexity and higher costs than other cancer therapies. We attempted to quantify the success rate of I-O treatments vs other cancer treatments appraised by the National Institute for Health and Care Excellence (NICE) in the UK.

We identified oncology technology appraisals published by NICE between 2011-2020 and categorised I-O treatments based on the Cancer Research Institute classification. We defined success as the treatment being reimbursed by the National Health Service (NHS) or by the Cancer Drugs Fund (CDF).

Of 400 NICE appraisals, 95/400 (23.7%) assessed I-O treatments (75 completed, 20 terminated), and 126/400 (31.5%) assessed other oncology treatments, including chemotherapy and targeted therapies (109 completed, 17 terminated). The number of appraisals per year increased from 4 (2011) to 18 (2020) for I-O, and from 6 to 14 for other oncology treatments. Recommended I-O therapies were less likely to be reimbursed within the NHS (47/75, 62.6% vs 82/109, 75.2%) and twice as likely to be reimbursed within the CDF (17/75, 22.7% vs 12/109, 11.0%) compared to other cancer therapies, possibly indicating a higher uncertainty of I-O effectiveness. The most appraised I-O treatments were checkpoint inhibitors, recommended in 30/32 appraisals (93.7%; 19 NHS, 11 CDF). Most non-I-O therapies were tyrosine kinase inhibitors, which received positive recommendations in 41/53 appraisals (77.4%; 37 NHS, 4 CDF). The rate of negative recommendations was similar for I-O and other cancer treatments (11/75, 14.7% vs 15/109, 13.8%, respectively).

I-O treatments had a similar success rate as other cancer treatments (85.3% vs 86.2%, pooling NHS and CDF recommendations); however, a greater proportion of I-O treatments were funded under the CDF, potentially due to effectiveness uncertainties.

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