OBJECTIVES: The range, complexity and number of National Institute for Health and Care Excellence (NICE) technology appraisal (TA) guidance is increasing each year and the total is expected to reach over 1,000 in 2024. A database was constructed to record key issues and decision-making assumptions from published NICE TAs to facilitate knowledge sharing across NICE, committee members and the wider HTA community. Renal cell carcinoma (RCC) was selected for initial extraction to support NICE’s pathway approach to technology appraisal, which aims to develop a core disease pathway model to improve consistency and reduce duplication.

METHODS: A database was designed and constructed in Microsoft Excel®. Manual searches of the NICE website were performed. NICE TA recommendations issued between March 2000 and December 2022 were reviewed. Data were extracted from RCC appraisal documents published before December 2022.

RESULTS: 15 of 854 published NICE TAs considered RCC. 11 of 15 were single technology appraisals, 2 managed access reviews, 1 multiple technology appraisal and 1 terminated. Clinical data was primarily informed by Phase 3 open-label studies and only the 3 most recent appraisals were supplemented with real-world data. Economic models were partitioned survival (72%) or state transition (28%). Differences across appraisals included model structure and health states, utility modelling and approaches to model long-term effects. The most common key issues related to generalisability, clinical evidence, long-term extrapolations and end-of-life criteria.

CONCLUSIONS: The database presents a summary of trends and themes that could be used to inform committee discussion in future RCC appraisals. Findings strengthen the rationale for the development of a pathway appraisal approach by highlighting key similarities and differences across RCC appraisals that could be improved on with a single pathway model. Following this initial extraction, further database development and extractions are planned for other conditions in the TA program.