LAUSR

Objectives: During the COVID-19 pandemic, the National Institute of Health and Care Excellence (NICE) in the UK have continued to meet virtually to conduct technology appraisals and publish recommendations. We sought to review the progress made during this time in the field of oncology. Methods: The NICE database of published technology appraisals was searched from 1st January 2020 to 22nd June 2021 to identify all published recommendations;proposed, in consultation, and in development appraisals were excluded. The identified publications were categorised by indication, with oncology appraisals selected for further review. Terminated appraisals were identified and the reason extracted. Data from full recommendations were extracted and analysed. Results: The search identified 96 publications, of which 57 (59%) related to an oncology indication. Of these oncology recommendations, 44 met the inclusion criteria: 18 (41%) were recommended in line with the marketing authorization, 13 (30%) were recommended with restrictions, 10 (23%) were limited to funding through the Cancer Drug Fund (CDF), and 3 (7%) were not recommended/not eligible for the CDF. Approximately half (24 [55%]) met NICE’s end of life criteria. Decisions to not recommended, limit to the CDF, or restrict to a sub-population were primarily the result of limited efficacy data creating uncertain cost-effectiveness likely to exceed the NICE willingness to pay threshold. This also applied to products meeting end-of-life criteria. Conclusions: Even with pandemic restrictions there have been advances in the treatments available to patients in the field of oncology, especially for advanced/metastatic cancers. However, more than half of submissions were restricted to the CDF or to sub-populations, confirming how vital it is to ensure all products have clear evidence and rationale within submissions to address limitations and ensure recommendations are made in line with the marketing authorization. Meeting end-of-life criteria is not sufficient to guarantee recommendation for use.