Abstract
In May 2019 the Accelerated Access Collaborative (AAC) selected 12 products for “rapid uptake” within the National Health Service (NHS) England, and extra budget has been made available for the utilisation of these products. This research explores whether products achieving this status need to be cost-saving versus current standard of care (SoC). This research analysed the National Institute of Health and Care Excellence (NICE) guidance of each rapid uptake product, with a focus on cost evidence, to identify whether all products were lower cost than the respective SoC in that therapy area. 9 of the rapid uptake products were found to be lower cost than their respective SoC. However, three quantitative faecal immunochemical tests for colorectal cancer were more expensive than the current SoC (guaiac-based Faecal Occult Blood Tests (FOBTs)); The average cost per test for each of the OC Sensor assay (£4.53), the HM-JACKarc assay (£6.04) and the FOB Gold (£1.96) assay was greater than for a guaiac-based FOBT (£0.78). But additional analysis shows that the OC Sensor and HM-JACKarc assay tests are more sensitive than the guaiac-based FOBTs, detecting 100%, 92% and 50% of colorectal cancers respectively; Therefore, these new tests can provide long-term cost savings for the NHS, due to allowing earlier diagnosis of patients’ colorectal cancer. The FOB Gold assay was not included in this analysis but was shown to have an Incremental Cost-Effectiveness Ratio of £4, 725 per Quality Adjusted Life Year (QALY) gained compared with guaiac-based FOBTs. Products do not have to be lower cost than current SoC in order to gain AAC rapid uptake status in NHS England. Instead other characteristics, such as improvement in treatment pathways, are considered by the AAC.
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