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Decideum’s Will Greenhill presented three posters at ISPOR Europe 2019 conference this week:

Assessing the likelihood of receiving a positive recommendation within the indicated patient population at marketing authorisation through NICE’s STA process [pdf-1]

NICE states 82% of its appraisal recommendations are positive. This study reviews 20 years of NICE data, to assess the likelihood that a topic will be approved through NICE’s STA process for the full patient population indicated at marketing authorisation.

Our findings demonstrated that a large proportion of the positively recommended NICE STAs (29.45%) were not recommended in line with their full patient population. 28.12% being technologies that received an optimised recommendation i.e. recommended for a smaller group of patients than originally stated by the marketing authorisation. This data suggests it’s likely NICE will recommend a technology for a patient population smaller than the company originally set out. This may be because data for a particular group of patients was stronger. Further research on this area would be beneficial.

Assessing the likelihood of receiving a positive recommendation without a PAS or CAA, through NICE’s STA process [pdf-2]

NICE states that 82% of its appraisal recommendations are positive. This study reviews 20 years of NICE data, to investigate the proportion of recommendations which took account of either a Patient Access Scheme (PAS) or a Commercial Access Agreement (CAA). We concluded it is likely companies submitting to NICE will have to include a PAS or a CAA before or during their appraisal, in order to gain a positive recommendation. Roughly a quarter (23.87%) of NICE STA submissions gain a full recommendation in line with its marketing authorisation.

An assessment of whether the recommendations made by NICE’s Medical Technologies Evaluation Programme support MTEP’s stated aims [pdf-3]

This study seeks to examine the approval rates of technologies assessed by NICE’s MTEP process, and the reasons for the outcome of MTEP’s evaluations. It will also consider whether MTEP can be said to fulfil its stated aims on the basis of these findings. We determined MTEP takes a risk averse approach to assessment of medical technologies with potential benefits to patients and the NHS, as demonstrated by the fact that lack of certainty of extent of benefit of the technology was a significant factor in most negative recommendations. NICE may wish to revisit this approach if it seeks to promote uptake of innovative and beneficial technologies, perhaps incorporating conditional approval as a recommendation that would encourage access and further data collection.

For further information about our research and services please contact: will.greenhill@decideum.com

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