OBJECTIVES: In the UK, the National Institute for Health and Care Excellence (NICE) requires that “relevant” cost-effectiveness studies and health-related quality-of-life (HRQoL) data are identified using “systematic” and “transparent” searches and cost and healthcare resource use (CHRU) data are “identified systematically”. Systematic literature reviews (SLRs) can be resource intensive and time consuming and this study aims to help determine whether the SLR approach is an efficient use of limited resources.

METHODS: We reviewed what methods companies submitting to NICE claimed to use (systematic versus other), whether their methodologies reflected this, what effect this had on how Technology Appraisals (TAs) were appraised, and what this may mean for acceptability of future methods. A sample of company submission documents for NICE TAs (1 March to 18 June 2024) were retrieved.

RESULTS: 22 TAs were identified. 20 single TAs (STAs) described using SLRs to identify EEs and HRQoL. 19 of these STAs described using SLRs for CHRU data. 1 STA submission did not describe a CHRU SLR, instead using reference costs and a pragmatic review of similar models. The Evidence Assessment Group (EAG) did not comment on this approach in its critique. 2 TAs were rapid assessments, meaning SLRs were not feasible. Instead, a pragmatic approach used evidence from 2 living reviews.

CONCLUSIONS: Economics reviews in NICE TAs continue to mostly be SLRs despite no explicit requirement for this. We identified no explicit criticism from the EAG where a pragmatic approach was taken. Because SLRs expend large resources, this research suggests that a carefully considered pragmatic approach could be sufficient to identify relevant data using transparent and replicable methods. Advances in reviewing – for example the integration of artificial intelligence in record selection or data extraction – may help to bridge the gap and make companies more comfortable in using pragmatic reviews for highly valuable TA submissions.