OBJECTIVES: Overall survival (OS) is a key driver in health-economic evaluation in oncology. Less mature OS results in higher uncertainty for long-term survival extrapolation in health-economic evaluations. Mature OS helps with more accurate extrapolation of long-term benefit and therefore can be favorable from reimbursement perspective. This research aims at describing the relationship between the level of OS maturity with related NICE recommendation status.

METHODS: The oncology NICE technology appraisals (TA) published from January 2022 until March 2023 were identified, excluding terminated TA, not single technology appraisal and non-oncology indications. The range of OS (i.e, percentage surviving at the end of follow-up) was collected (per 10% increment) from the company submission and clinical trial publication if the information was redacted from the TA. The recommendation status was collected from the NICE website.

RESULTS: 47 oncology TA were reviewed among 119 TA published in the defined period. OS and the associated median follow-up for OS were publicly available for 24 TA that received positive recommendation. Reported OS at maximum follow-up ranged anywhere from 0-10 to 90-100%. Of those recommended for routine commissioning (n=21/24), 9 reported OS between 20% and 40% and 5 reported OS over 80%. Those TA receiving recommendation for routing commissioning following Cancer Drugs Fund (CDF) review (n=7/21) reported OS from 10 to 70% indicating immaturity of OS may be acceptable at the time of review following CDF exit. The average median follow-up (n=24) is 31 months (from 7.4 to 85). Among those submitting without OS (n=6/47), only one was not recommended while others received positive recommendation.

CONCLUSIONS: In recent NICE oncology TA, OS could be immature for different reasons, including good prognosis during the trial follow-up. OS immaturity did not preclude from receiving a positive recommendation. OS availability was not a required condition to receive a positive recommendation.