OBJECTIVES: NICE updated the scoping criteria for the highly specialised technology (HST) programme in 2022 following consultation with stakeholders. The seven previous criteria were streamlined to four, with the aim to make the “routing decision clearer, consistent, more transparent and precise to provide greater clarity, precision and predictability for the routing of topics". This study analysed products that were accepted to HST previously, against the new criteria, to test the hypothesis that the new criteria enable greater predictability for the routing of topics.

METHODS: Drugs assessed via HST prior to the change in scoping criteria were assessed against the previous and new criteria to assess whether any would fare differently within the new routing system. Two approaches were used; one applying a stringent interpretation of criteria and one applying a less stringent interpretation, to account for subjectivity in the application of each of the criteria.

RESULTS: Twenty HST appraisals have been completed for 19 unique products. When applying each set of criteria stringently, only 9 of 20 (45%) appraisals met all old criteria, vs 17 of 20 (85%) meeting new criteria. When applied less stringently, this changes to 16 of 20 (80%) meeting old criteria, vs 19 of 20 (95%) meeting new criteria.

CONCLUSIONS: The new HST routing criteria reflect actual decision making from NICE more consistently than the old criteria. Therefore, the new criteria which will be used going forward are a more accurate reflection of routing for HST.