Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the potential merits of NICE modifying its Single Technology Appraisal ICER thresholds to recognise the value of treatments for severe and rare conditions that are not put through NICE’s Highly Specialised Technology pathway.

The National Institute for Health and Care Excellence (NICE) is currently reviewing its technology appraisal and highly specialised technology evaluation methods. The methods review will include a review of a wide range of methods, including those relevant to severe and rare conditions.

The Voluntary Scheme for Branded Medicines Pricing and Access 2019 - an agreement between the Government and the Association of the British Pharmaceutical Industry - states that the standard cost effectiveness threshold used by NICE will be retained at the current range (£20,000 - £30,000 per Quality Adjusted Life Year).

In the current Single Technology Appraisal process there are several factors that may currently be considered by NICE committees when deliberating, including some that may affect the value of a treatment. NICE’s methods review will explore if these factors are still relevant for patients and the National Health Service, whether there is a need to modify the approach and whether any additional factors should be taken into account when making a recommendation on a technology.

The review will also consider other methods that are important for rare and severe conditions, including methods for measuring and valuing the health-related quality of life for people with rare diseases, dealing with uncertainty and sourcing different types of evidence. Proposals will be presented for six weeks of public consultation in the summer of 2020.

Furthermore, in parallel with the methods review, NICE is reviewing its highly specialised technologies topic selection criteria – to make them clearer, more specific, and more transparent and predictable.