The impact of rarity in NICE’s health technology appraisals
Abstract Background In the absence of a framework designed to evaluate medicines for rare diseases in the UK, most orphan medicines are appraised by the National Institute for Health and Care Excellence (NICE) through the Single Technology Appraisal (STA) process. Results An analysis of STA appraisa...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | Orphanet Journal of Rare Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13023-021-01845-x |
| _version_ | 1818453718529474560 |
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| author | Sophie Clarke Michelle Ellis Jack Brownrigg |
| author_facet | Sophie Clarke Michelle Ellis Jack Brownrigg |
| author_sort | Sophie Clarke |
| collection | DOAJ |
| description | Abstract Background In the absence of a framework designed to evaluate medicines for rare diseases in the UK, most orphan medicines are appraised by the National Institute for Health and Care Excellence (NICE) through the Single Technology Appraisal (STA) process. Results An analysis of STA appraisals of orphan and non-orphan medicines revealed that orphan medicines were subject to a significantly longer mean time in the NICE process than non-orphan medicines [370 days (n = 44) vs. 277 days (n = 118), p = < 0.0001]. A higher proportion of orphan STAs required more than one Appraisal Committee Meeting (ACM) versus non-orphan STAs, and orphan STAs were disadvantaged by worse outcomes with respect to positive recommendations than those orphan medicines assessed by Highly Specialised Technology evaluation (HST). Conclusions The uncertainties inherent to developing orphan medicines may contribute to these disadvantages. Improved understanding of the challenges in drug development for orphan medicines and clearer guidance for decision makers on navigating uncertainty in the HTA process may promote greater equity in access to medicines across rare and common conditions. |
| first_indexed | 2024-12-14T21:43:26Z |
| format | Article |
| id | doaj.art-ade76948592541639485025725739313 |
| institution | Directory Open Access Journal |
| issn | 1750-1172 |
| language | English |
| last_indexed | 2024-12-14T21:43:26Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Orphanet Journal of Rare Diseases |
| spelling | doaj.art-ade769485925416394850257257393132022-12-21T22:46:24ZengBMCOrphanet Journal of Rare Diseases1750-11722021-05-011611710.1186/s13023-021-01845-xThe impact of rarity in NICE’s health technology appraisalsSophie Clarke0Michelle Ellis1Jack Brownrigg2Pfizer LtdPfizer LtdPfizer LtdAbstract Background In the absence of a framework designed to evaluate medicines for rare diseases in the UK, most orphan medicines are appraised by the National Institute for Health and Care Excellence (NICE) through the Single Technology Appraisal (STA) process. Results An analysis of STA appraisals of orphan and non-orphan medicines revealed that orphan medicines were subject to a significantly longer mean time in the NICE process than non-orphan medicines [370 days (n = 44) vs. 277 days (n = 118), p = < 0.0001]. A higher proportion of orphan STAs required more than one Appraisal Committee Meeting (ACM) versus non-orphan STAs, and orphan STAs were disadvantaged by worse outcomes with respect to positive recommendations than those orphan medicines assessed by Highly Specialised Technology evaluation (HST). Conclusions The uncertainties inherent to developing orphan medicines may contribute to these disadvantages. Improved understanding of the challenges in drug development for orphan medicines and clearer guidance for decision makers on navigating uncertainty in the HTA process may promote greater equity in access to medicines across rare and common conditions.https://doi.org/10.1186/s13023-021-01845-xOrphan medicineRare diseasePopulation sizeNICEHSTSTA |
| spellingShingle | Sophie Clarke Michelle Ellis Jack Brownrigg The impact of rarity in NICE’s health technology appraisals Orphanet Journal of Rare Diseases Orphan medicine Rare disease Population size NICE HST STA |
| title | The impact of rarity in NICE’s health technology appraisals |
| title_full | The impact of rarity in NICE’s health technology appraisals |
| title_fullStr | The impact of rarity in NICE’s health technology appraisals |
| title_full_unstemmed | The impact of rarity in NICE’s health technology appraisals |
| title_short | The impact of rarity in NICE’s health technology appraisals |
| title_sort | impact of rarity in nice s health technology appraisals |
| topic | Orphan medicine Rare disease Population size NICE HST STA |
| url | https://doi.org/10.1186/s13023-021-01845-x |
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