MedTech-related health technology assessments from UK NIHR in March 2021

01

Apr 2021

The National Institute for Health Research (NIHR) funds valuable independent research for health and social care decision-makers in England. Reports from the Health Technology Assessment (HTA) Programme are published in the NIHR HTA Journal and inform NICE guidance.

In March 2021, six MedTech-related assessments were published in the NIHR HTA Journal:

  • Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis. It was concluded that screening all pregnant women with an ultrasound scan in late pregnancy may be justified for identifying breech presentation but not for identifying fetal growth problems
  • Patch augmentation surgery for rotator cuff repair, based on the mixed-methods feasibility study (Patch Augmented Rotator Cuff Surgery, PARCS) of a randomized controlled trial. It was concluded that the need for further clinical studies is clear, particularly given the range and number of different patches available. Randomized comparisons of on-lay patch use for completed rotator cuff repairs and bridging patch use for partial rotator cuff repairs were identified as further research areas. The value of an observational study to assess safety concerns of patch use was also highlighted. These elements are included in the trial designs proposed in this study
  • Assistive technology and telecare to maintain independent living at home for people with dementia, based on the ATTILA randomized controlled trial. It was concluded that a full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community and participants' health and social care or societal costs, nor did it decrease caregiver burden
  • Sacral nerve stimulation versus the magnetic sphincter augmentation device for adult faecal incontinence: the SaFaRI RCT. An assessment of sacral nerve stimulation (SNS) versus the magnetic sphincter augmentation device (FENIX) for adults suffering from moderate to severe faecal incontinence was based on the multicenter, parallel-group, unblinded, randomized trial (SaFaRI). The SaFaRI study was terminated in 2017, having recruited 99 participants of the target sample size of 350, therefore, substantially underpowered to detect differences between the treatment groups, with significant uncertainty in the cost-effectiveness analysis. Both FENIX and SNS's success was low (on average 12.5%), with no statistically significant difference between the two groups. A higher rate of postoperative complications was in the FENIX group (73.3%) than in the SNS group (22.5%). A total of 15 out of 50 (30%) participants in the FENIX group ultimately had to have their device explanted. Slightly higher costs and quality-adjusted life-years were observed in the FENIX group. However, this was reversed over the lifetime horizon, when SNS was the optimal option, with only a 45% chance of FENIX being cost-effective. Further research is needed to clarify the treatment pathways for SNS and determine its actual clinical and cost-effectiveness
  • Modelling of hypothetical SARS-CoV-2 point-of-care tests on admission to hospital from A&E: rapid cost-effectiveness analysis. This study described the likely impact of "acceptable" and "desirable" SARS-CoV-2 point-of-care tests within a hospital in terms of A&E waiting for bay occupancy, diagnostic accuracy, and cost-effectiveness. If a SARS-CoV-2 point-of-care test with the desired target product profile becomes available, this looks promising. Future work is needed to obtain more data on the diagnostic accuracy of SARS-CoV-2 point-of-care tests and the impact of these tests on the occupancy of waiting bays and isolation bays. These parameters are currently uncertain
  • Prognostic tools for identification of high risk in people with Crohn's disease: a systematic review and cost-effectiveness study. The aim was to assess the prognostic test accuracy, clinical impact, and cost-effectiveness of IBDX® and PredictSURE-IBD™ (serological biomarkers panels) in identifying those at high risk of following a severe course of Crohn's disease. Although the model indicates that standard care dominates the tests, the lack of evidence of prognostic accuracy of the two tests and the uncertainty around the benefits of the top-down and step-up treatment approaches mean that the results should be interpreted as indicative rather than definitive

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks).

The latest related news

13

Apr 2021

On March 23, 2021, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system and associated tariffs for state and private laboratories to be implemented not later than May 01, 2021. NLK system is used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018.Thirty-four new codes were added in medical biochemistry and medical microbiology areas.

Read more

12

Apr 2021

On March 17, 2021, NHS Digital released HRG4+ 2021/22 Local Payment Grouper. In general, there were no significant changes in the HRG logic for 2021/22, and no new HRGs were introduced. Two new ICD-10 codes for COVID-19 were incorporated into the grouping logic in addition to three codes already included in the consultation grouper. Furthermore, three new Main Speciality Codes (MSC) and 25 new Treatment Function Codes (TFC), which were introduced in April 2020, became mandatory to use in Grouper from April 2021. These codes concern a wide specter of areas of care.

Read more

08

Apr 2021

On March 22, 2021, NHS England and NHS Improvement released 2021/22 National Tariff Payment System consultation documents and launched an online feedback survey that closes on April 30, 2021. The main proposed change is introducing an "Aligned Payment and Incentive" (API) approach, comprising fixed and variable elements, for almost all services in the scope of the tariff and limiting national prices to unbundled diagnostic imaging services.

Read more

06

Apr 2021

On March 22, 2021, NHS England published the final version of the 2021/22 NHS Standard Contract and associated documents, which took effect from April 01, 2021. NHS England mandates the NHS Standard Contract for use by commissioners for all healthcare services contracts other than primary care. Changes mainly concerned introducing new "Aligned Payment and Incentive" (API) rules proposed by the 2021/22 National Tariff Payment System.

Read more

31

Mar 2021

To give researchers more tools to assess healthcare innovations' efficiency and demonstrate the effectiveness of novel technologies, the Dutch Organization for Health Research and Development (ZonMw), in collaboration with the National Health Care Institute (ZIN), initiated the new HTA Methodology Program for 2021-2024.

Read more