PNS264 AN ASSESSMENT OF THE RECOMMENDATIONS MADE BY NICE'S MEDICAL TECHNOLOGIES EVALUATION PROGRAMME, AND WHETHER THE RECOMMENDATIONS SUPPORT MTEP'S STATED AIMS.

Abstract

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. All topics reviewed by MTEP between 2010 and January 2019 were identified through the published topics on NICE’s website. These topics were then analysed and categorised by their recommendation status, which was one of the following results: not recommended, partially recommended or recommended. The topics that received a negative recommendation were then further analysed to assess the factors that contributed to the recommendation, and whether or not the justification is aligned with MTEP’s stated aims. Of the 40 topics assessed, 28 had a positive recommendation, 8 had a negative recommendation and 4 had a partial recommendation. The rationale for either giving a limited recommendation or a negative recommendation often cited strength of the evidence base, either in the total or selected patients, or the uncertainty of the benefit in the NHS patient population. Uncertainty of the patient and system benefits of a treatment was a significant contributing factor to most negative recommendations, as stated in the summary recommendations in 6 of the 8 non-recommended topics. 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.