Identification of Cost-Effectiveness Evidence in UK NICE Single Technology Assessment Company Submissions: Databases, Sources and Currency of Searching
Kate Misso , Akvile Stoniute, Rhiannon Green, James Kenworthy.
Poster Session: 1. May 6th 2024. Poster Session Time: 10:30-13:30. Discussion Period: 12:30-13:30.
Abstract
Objectives
Comprehensive systematic reviews of clinical and cost-effectiveness evidence underpin company submissions to the UK National Institute for Health and Care Excellence (NICE) Single Technology Assessment (STA) process for drug reimbursement. NICE mandate up-to-date, well-conducted and robust methods, however STA approaches vary between submissions. The objective of this study was to survey the sources searched and currency of economic evidence identification in UK NICE Single Technology Assessment submissions
Methods
We conducted a survey of 50 randomly selected STA submissions included in committee papers for NICE STA submissions published between 10.1.18 and 6.12.23. As NICE limit the content of committee papers in the public domain, data were extracted from company submissions, clarification responses and Evidence Assessment Group reports. An initial pilot sample of 10 STAs was data extracted and assessed.
Results
The pilot sample (n=10) included indications in oncology (7), cardiovascular (2) and gynaecology (1). The mean number of databases searched per topic was five (range: 2-11). Resources searched included Embase (n=5), Medline (n=4), Embase/Medline combined (n=4). Only half of submissions included conferences or grey literature. The most frequently searched database was NHS Economic Evaluation Database (NHS EED) (n=6). Although NHS EED is an important archival source of economic evaluations, it ceased in March 2015 and is no longer current. Currency of searching was an issue; the mean time elapsed between search date and STA submission was 9 months (range: 54-482 days).
Conclusion
Due to the lack of completeness in STA committee papers in the public domain, many of the SR and cost-effectiveness methods informing NICE reimbursement decisions lack detail, reproducibility and transparency. Currency of evidence searches could be improved. NHS EED's continued inclusion demonstrates a clear need for an alternative, specialist source of up-to-date, pre-screened and ready filtered economic studies to inform regulatory evidence submissions and dossiers.