OBJECTIVES: Early in 2017, NICE consulted on a number of changes to their Single Technology Appraisal (STA) process. One proposal was for a separate Fast-Track Appraisal (FTA) process for technologies whose company submitted base case ICER was <£10,000 per QALY gained. We explored the viability of a <£10,000 per QALY gained threshold based on evidence from previously conducted STAs.

METHODS: Members of Evidence Review Group teams from Sheffield and Liverpool undertook a content analysis of documents relating to all STAs conducted by NICE between 2009 and 2016. We extracted relevant data using Excel and used narrative text and tables to present and discuss key themes.

RESULTS: Over the period assessed, 15% (26/171) of STAs had base case ICERs <£10,000 and 73% (19/26) of this group received a positive recommendation after consideration at a single Appraisal Committee (AC) meeting. The remaining seven STAs were ultimately given a positive recommendation after a ‘Minded No’ decision at the first AC meeting. For these seven STAs, uncertainty in the submitted analyses meant that an additional AC meeting was required before a decision was made. We also noted that 28/171 STAs had multiple base case ICERs which were both less than and more than the threshold and 5/171 STAS had ICERs between £10,000 and £15,000 per QALY gained.

CONCLUSIONS: Evidence generated by this work is generally in support of the FTA process being implemented at NICE. However, findings highlight that some technologies with ICERs <£10,000 per QALY gained might not be able to be handled within the reduced timeframe imposed by the FTA process. At the time of abstract submission, the outcome of the first submission through this process has not been established, nor has the finer detail of what constitutes a move from the FTA process to the standard STA process.