IntroductionThe National Institute for Health Research (NIHR) Innovation Observatory (NIHRIO) is the national Horizon Scanning (HS) organization in England, and the National Institute for Health and Care Excellence (NICE) is its key health technology assessment (HTA) stakeholder. NIHRIO has a remit to notify NICE of innovative technologies with a time horizon of three years prior to regulatory approval in the European Union (EU)/United Kingdom (UK). The notification process produces an initial ‘filtration form’ followed by a ‘technology briefing’ produced 17–20 months prior to licence for those technologies that NICE will consider for appraisal. Since April 2017, NIHRIO has produced ~400 technology briefings. We present an analysis of how this has fed into the NICE HTA process so far.MethodsThe analysis mapped NIHRIO's technology briefings (April 2017 – June 2020) with relevant NICE technology appraisal/highly specialized technologies (TA/HST) guidance during the time period. The analysis followed the timeline of technologies from identification during the horizon scanning process to filtration to briefing submission to NICE and entering the TA/HST process to outcome/recommendation given by NICE.ResultsUntil June 2020, 496 technology briefings entered the NICE TA/HST scoping process. Forty per cent are in progress, four per cent have had a TA/HST recommendation and three per cent that entered the NICE TA/HST scoping process did not complete it. On average it took less time from briefing submission to NICE recommendation for cancer indications. The time from discovery to NICE recommendation ranged from 115 months to 22 months.ConclusionsHS for TA/HST is a lengthy process from identification to final recommendation and there is considerable variation in time duration from identification to briefing submission to NICE recommendation. Average time taken from briefing submission to NICE recommendation is shorter for cancer indications and repurposed medicines. A full TA/HST may not be recommended for all technology briefings, rather they may update existing guidance or find different routes of evaluation. Technologies that enter the TA/HST scoping process might be terminated, suspended or discontinued for several reasons which may include lack of company engagement, change in development or regulatory plans by the company. Timely notification is key in achieving TA/HST recommendation at the time of market authorization but not the only influencing factor.
Does it Matter Whether Canada’s Separate Health Technology Assessment Process for Cancer Drugs has an Economic Rationale?
