OBJECTIVES: In 2022, the National Institute for Health and Care Excellence (NICE) introduced its proportionate approach to technology appraisals (PATT) to increase capacity and allow more rapid guidance development. We sought to evaluate initial scheme success by comparing PATT assessments with other reimbursement or regulatory agencies.

METHODS: Drugs that had undergone PATT were identified via the NICE website. Appraisal timings and reimbursement restrictions were compared with Haute Autorité de santé, Institute for Quality and Efficiency in Health Care (IQWiG), Federal Joint Committee (G-BA), Food and Drug Administration (FDA), Pharmaceutical Benefits Advisory Committee (PBAC) and Canada’s Drug and Health Technology Agency (CADTH). Appraisal timings were estimated from published documentation.

RESULTS: As of June 2023, five drugs had undergone PATT, and 31 published HTA or regulatory assessments were available (n=7 for somatrogon, nintedanib and eptinezumab, n=6 for vutrisiran and n=4 for nivolumab).

For three drugs, NICE had neither the shortest appraisal time, nor the longest; appraisal lengths typically fell towards the shorter end of the range vs. peers: somatrogon (23 weeks [range: 12-37 weeks]), vutrisiran (18 weeks [range: 12-60 weeks]) and eptinezumab (31 weeks [range: 12-57 weeks]). PATT took 31 weeks for nivolumab, slower than the other two assessing agencies: FDA (11 weeks) and CADTH (26 weeks). Nintedanib assessment was also slower than international peers (35 weeks [range: 13-26 weeks]).

NICE completed its assessment of somatrogon ahead of the FDA, of eptinezumab ahead of G-BA, vutrisiran ahead of G-BA and CADTH and nivolumab ahead of PBAC and CADTH. Nintedanib had already been approved by all other agencies prior to NICE assessment.

CONCLUSIONS: While only five drugs have been assessed under PATT, early analysis shows a positive impact on appraisal length compared with NICE’s standard route. However, while review times have been shortened, calendar approval dates are mixed compared with international peers.