OBJECTIVES: As an outcome of an Appeal Panel decision, NICE technology appraisals (TA) and highly specialised technology (HST) committees were required to express explicit considerations and conclusions when children had been covered in the evaluation alongside adults. The Appeal Panel for sebelipase alfa for treating lysosomal acid lipase deficiency expressed that an explicit consideration and conclusion should have been added on what extra or different accommodation, if any, is necessary because the population included children, to reflect that the condition did not only affect the child, but had a major impact on their families and carers in all aspects of life. This research aims to outline possible solutions and how this has been handled in previous NICE TA or HST evaluations.

METHODS: Review of case studies, published and ongoing TA and HST evaluations, where children were considered alongside adults.

RESULTS: As a results of the appeal decision, an additional section was added to recent guidance, which explained the committee’s consideration on this issue. It explained that potentially some health-related benefits, either for children or carers, were not accounted for in the modelling, however it concluded that the fact that children were affected by the condition was reflected in the clinical evidence and were considered by the committee and therefore no additional considerations were needed in its decision-making.

CONCLUSIONS: NICE is committed to eliminating discrimination, advancing equality of opportunity, and fostering good relations, as required by the Equality Act 2010, therefore considering a subgroup based on age would not be in line with its policies. When children are considered alongside adults, NICE TA and HST committees are already taking into consideration that the condition does not only affect the child, but also their family and carers, however an additional section in the guidance, explicitly explaining these considerations could be considered in the future.