Time Trends in NICE HTA Decisions

According to the 1999 UK Department of Health consultation document, the fundamental purpose of the National Institute for Health and Clinical Excellence (NICE) was to reduce inequalities in access to innovative care and ensure more rapid access to medicines identified as being of value to the NHS. Since NICE’s debut in April 1999, several analyses have examined the uptake of technologies that have been considered by NICE, but no evidence has yet been published on whether and how NICE’s health technology appraisal (HTA) processes may have affected the speed of access to new treatments. This report examines two aspects of the impact of the HTA process on access. First, it examines the elapsed time between launch of a medicine to publication of a technology appraisal. If availability is delayed until NICE has published its appraisal, then this interval is an important determinant of speed of access. Second, the report analyses elapsed time between the start and completion of the technology appraisal process itself. The clear timelines established for NICE allow benchmarking of performance. Included also are changes in elapsed time for the process over the years; how elapsed time has been affected by the introduction of the single technology appraisal (STA) process; and any specific factors that may account for different elapsed times across decisions.