NICE reviews number crunching methods as advanced technologies hit market


NICE is to review how it develops guidance on drugs, focusing on issues such as modifiers used in decision making and dealing with uncertainties in evidence.

Following approval at its last board meeting NICE said that it had drawn up a shortlist of topics for the upcoming review of its health technology assessments.

The review follows commitments made in the 2019 Voluntary Scheme for Branded Medicines Pricing and Access and reflect the challenges assessing new technologies such as cancer drugs targeting tumours based on their genetic characteristics, and expensive but effective cell and gene therapies.

This agreement on pricing was drawn up in conjunction with industry, the government and the NHS and aims to control drug spend while ensuring that manufacturers get a fair return on their investment in R&D.

It also aims to ensure patients get quick access to the latest novel medicines, one of industry's main complaints about the health service.


NICE has drawn up a shortlist of topics to review: these include dealing with uncertainty in evidence and how to reduce it.

This will include deliberations on how data analytics and real-world evidence can be used.

Other topics will include modifiers used in decision making to costs used in health technology assessments and equality considerations in guidance development.

NICE will also look at how quality of life is incorporated into economic analyses and considered by the cost-effectiveness body’s committees conducting their independent reviews of drugs.

There will also be a focus on technology-specific issues such as evaluation of drugs targeting tumours according to their genetic make-up rather than where they originate in the body.

Methods assessing clinical and cost effectiveness of the position of technologies in the care pathway will also be under review, NICE said.

The review will cover NICE’s technology appraisals (TA), highly specialised technologies (HST), medical technologies, and diagnostics assessment programmes.

For each topic NICE will explore the case for change, and proposals presented for public consultation in summer next year.

Details of further review topics that will be completed after 2020 have also been announced.

These include looking at the best ways to evaluate new and emerging genomic technologies and testing strategies, and reviewing and, where necessary, updating the methodology for producing guidance on medical devices and diagnostics that address antimicrobial resistance.

NICE said it also plans to review the methods used to assess digital health technologies and future needs in this area.

NICE chief executive Sir Andrew Dillon said: “This update is part of the regular review and refresh of our methods to ensure that they are robust and up-to-date.

“NICE is undertaking this review at a time of unprecedented change in the healthcare system, where developments such as personalised medicine, digitalisation of health, and use of cell and gene therapy, mean products are becoming ever more challenging to evaluate.”