OBJECTIVES: Several technology appraisals (TAs) submitted to the National Institute for Health and Care Excellence (NICE) included indirect comparison techniques, such as matching-adjusted indirect comparisons (MAICs) and simulated treatment comparisons (STCs). Decision Support Unit (DSU) 18 brought formal submission guidelines on MAICs and STCs. The objective of this study is to assess the responsiveness of NICE to MAICs and STCs before/after the formal guidelines were released, and the most common recommendations by NICE for future submissions.

METHODS: All NICE TAs that dealt with any stages of cancer and had been completed as of December 2001 were reviewed. We included reports published on the NICE website by the Independent Assessment Group or Evidence Review Group on TAs including MAICs/STCs. The following information was extracted: whether used anchored/unanchored MAIC/STC, whether conducted systematic error quantification, acceptance by NICE of the MAIC/STC results, and overall criticism/recommendations.

RESULTS: Nine submissions were identified, with eight including MAICs and one including STC. Among them, seven TAs (using MAIC) were submitted after the release of the NICE guidelines. Seven submissions used unanchored MAIC/STC. For two MAICs it was not clear whether they were anchored/unanchored. No submissions specifically conducted the systematic error quantification suggested by the NICE guidelines. MAICs were accepted in six submissions. The most common limitation noticed was bias induced by unobserved factors. Other limitations included lacking external data validation and statistical details. The STC, which was from before the NICE DSU 18 guidelines, was not accepted.

CONCLUSIONS: MAICs seem to be an accepted approach by NICE. Omitting prognostic variables and effect modifiers was the main concern of NICE towards MAIC/STC. This needs to be considered in future TAs.