NICE approves first treatment in pilot of new approach to cost-comparison fast track appraisals

As part of the recovery from the COVID-19 pandemic, NICE has been working hard to find new ways to develop and publish guidance affected by the work programme pause in 2020, while also delivering the planned programme for 2021.

To address this, a new approach to the cost comparison fast track appraisal process is being piloted this summer for the review of selected low-risk appraisals.

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. The pilot process does not impact the standard governance or appeal processes.

Today (2 August) NICE has published draft guidance on the first treatment to have used the new process, recommending bimekizumab (by UCB Pharma) for treating severe plaque psoriasis.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 NHS resources, so bimekizumab is recommended. Nearly 18,000 people will be eligible for the treatment.

Meindert Boysen, director of the Centre for Health and Technology Evaluation at NICE, said: “The urgency of the pandemic led to necessary changes to the way NICE prioritised guidance production throughout 2020. 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.”

Victoria Barrett, Head of HTA & Market Access Policy, the Association of the British Pharmaceutical Industry, said: “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.”

The draft guidance on bimekizumab can be read here.