NICE approves cost-comparison fast-track appraisal pilot

The UK’s National Institute for Health and Care Excellence (NICE) has approved the pilot programme for a new approach to the cost-comparison fast-track appraisals process. This novel approach arose in response to the COVID-19 pandemic, as NICE worked to identify new ways to develop and publish guidance affected by the work programme pause in 2020, as well as delivering the planned programme for 2021.

The pilot programme works by using a subset of the appraisal committee to assess low-risk treatments, comparing them to similar therapies that have already been appraised by NICE. This sub-committee is then able to make a recommendation without requiring a full committee meeting.

After an initial recommendation has been made, the guidance is then considered by the entire committee ahead of its release, and a full meeting can be scheduled if any concerns arise. According to NICE, the pilot process does not impact the standard governance or appeal processes.

NICE has already published draft guidance on the first treatment to have used the new process, recommending bimekizumab for treating severe plaque psoriasis. Clinical trial evidence shows bimekizumab to be more effective at treating the condition than three comparators, which were all previously approved by NICE. The cost-effectiveness estimates are also in line with what is considered to be an acceptable use of National Health Service (NHS) resources, so bimekizumab was recommended. Nearly 18,000 people will be eligible for the treatment.

The urgency of the pandemic led to necessary changes to the way NICE prioritised guidance production throughout 2020,” said Meindert Boysen at NICE. “As part of our 2021 review into the health technology evaluation process, we are taking this opportunity to introduce new measures to address the impact of the pandemic, including this pilot programme for a limited fast-tracked process. Although our review is still underway, we are pleased to have been able to pilot this new approach to committee decision making to recommend bimekizumab as a treatment option for severe plaque psoriasis.

“It is our hope that we will continue to be able to follow this new process for eligible low-risk appraisals, and release capacity within our committees and the technology evaluation team.”

“This new approach to ensure some NICE decisions are made in a more efficient way is good news, especially for the patients that stand to benefit. It is important that NICE and its committees have sufficient capacity to issue timely guidance to the NHS, and this is one way to help, given the success of the pilot exercise,” added Victoria Barrett at the Association of the British Pharmaceutical Industry (ABPI).