OBJECTIVES: With new innovative treatments such as advanced therapies, value definitions in healthcare are evolving. A 2022 systematic review of value assessment frameworks in healthcare identified 9 categories of VAs. Based on overlap with the ISPOR Value Flower (2018), two categories are of interest: “societal impact” and “ethics and equity”. This study aimed to investigate consideration of societal and equity-based VAs within the decision-making process for a subset of technologies deemed innovative by NICE.

METHODS: Products deemed innovative and with additional benefits not captured in cost-effectiveness modelling (CEM) were identified by screening technology appraisals (TAs) and highly-specialized technology (HST) appraisals conducted in 2023. Included final appraisal documents (FAD) were examined for mention of societal and equity-based VAs by key stakeholders. VAs were categorized as decision-drivers where the FAD specifically stated that the committee had considered the VA during decision-making.

RESULTS: Of 97 TA and HST evaluations conducted by NICE in 2023, 15 technologies (16%) were deemed innovative with additional benefits not captured by CEM. On average, more VA were mentioned where the technology was recommended (2.3) compared with restricted (1.6) or not recommended (1.7). The VA mentioned most frequently by patient experts was “improved productivity” (27%), whereas “reduced caregiver or family burden” and “impact on equity and patient accessibility” most frequently cited by manufacturers (20% each) and “impact on equity and patient accessibility” by clinical experts (27%). Societal or equity-based VAs were considered in decision-making in 5 FADs (33%; 3 recommended;1 restricted indication recommendation;1 not recommended).

CONCLUSIONS: Existing methods used to evaluate innovative therapies often discuss additional benefits not captured by CEM, however these attributes are less frequently cited as decision-drivers. Despite this, a higher number of VA discussed in FADs was generally associated with positive NICE recommendation, illustrating the potential of these attributes to support the value of technologies during reimbursement negotiations.