NICE proposed approaches for the economic evaluation of multi-indication health technologies

NICE introduced the HTA Innovation Laboratory (HTA Lab) in 2022, which aimed to develop creative solutions to complex problems in health technology assessment. HTA Lab is conducting a few projects, including “Methods for the evaluation of diagnostics used in multiple care pathways”. 

In July 2024, the first stage of this project was accomplished, and a report was published on proposed approaches to the economic evaluation of multi-indication health technologies. 

Multi-indication health technologies (MIHTs) can be used across multiple disease areas or multiple indications. MIHTs include diagnostic technologies such as circulating tumor DNA (ctDNA) tests, polygenic risk scores (PRS), and digital health technologies such as virtual ward platform technologies. For example, ctDNA tests can be used to detect various types of cancer, and a PRS may be used to identify people with an increased risk of cardiovascular disease or different cancers.

The report focuses on diagnostic technologies because these are the most common MIHTs. However, the recommendations apply to any health technology that would require multiple economic analyses to obtain a complete picture of its value for money.

The following key conclusions and recommendations were made in the report:

• Using currently available approaches, economic evaluation of MIHTs requires multiple separate decision models in each disease area or indication to estimate their value for money. This increases the complexity of the analysis and the time required;
• The complexities of evaluating multi-indication diagnostics are yet to be reflected in modeling conducted within NICE assessments. The inclusion of multiple indications in published economic evaluations is limited;
• This report proposes pragmatic approaches that NICE could adopt for future economic evaluations of MIHTs and provides recommendations for implementing the approaches on pilot topics;
• Method-related recommendations include prioritizing use cases for modeling with input from experts using structured expert elicitation methods (the main criterion for prioritization should be the expected value to the NHS) and identifying the most informative and pragmatic modeling strategy;
• Process-related recommendations include the following: to establish an expert working group to support the evaluation; to allow flexible time and resources for economic modeling; to improve the efficiency of modeling other use cases; to allow company-submitted models.

See the full details here.

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