OBJECTIVES: Since April 2018, the National Institute for Health and Care Excellence’s (NICE) process for technology appraisals has included a technical engagement phase, with the aim of resolving important issues with stakeholders before the appraisal committee meeting (ACM). This research reviews how successful technical engagement has been in resolving issues before ACMs.

METHODS: NICE technology appraisals published from January 2019 to December 2021 were identified from the NICE website. For each appraisal, the number of issues before and outstanding after technical engagement were extracted using publicly available information. Details on the nature of the issues were also collected.

RESULTS: 148 completed technology appraisals were identified, of which 98 had a technical engagement phase. 61 of these were for cancer drugs. On average there were 8 issues at technical engagement, and 25% of these were resolved during technical engagement. In 27% of the appraisals no issues were successfully resolved during technical engagement. There were no statistically significant differences between cancer and non-cancer drugs for the total number of issues or the proportion resolved during technical engagement. There was a statistically significant trend towards fewer issues being resolved during technical engagement over time. The most common issues resolved during technical engagement were those relating to cost/resource inputs in the economic model and utilities. The most common issues remaining after technical engagement were those relating to survival modelling and indirect treatment comparisons.

CONCLUSIONS: Technical engagement has been successful in resolving some issues before ACMs, saving committees discussion time. However, progressively fewer issues are being resolved over time. Technical engagement has also not resolved any issues for several topics. Issues relating to survival modelling are likely to be important drivers of cost-effectiveness and are not often resolved during technical engagement.