Does NICE think about real-world knowledge (RWD) for HTA evaluations? – Healthcare Economist


The reply is ‘sure’, however the query is in what method? A paper by Che et al. (2024) examines using real-world knowledge (RWD) throughout 2016-2023 HTA assessments. Over this time interval, 11% of HTA submissions included real-world knowledge. Additional, they discover that:

The primary sources of RWD thought of within the submissions have been illness registries and digital well being information. RWD have been primarily used to offer an exterior management arm to allow comparisons inside single-arm trials and to tell long-term therapy results when extrapolating survival knowledge past the trial follow-up. Changes for potential systematic variations between therapy teams have improved over time; nonetheless, roughly one-third of the submissions nonetheless relied on unadjusted therapy comparisons…Over one-third of the submissions relied on naïve and/or unadjusted therapy comparisons…

We see a pattern in direction of growing use of RWD as a part of NICE HTA submission.

Does NICE think about real-world knowledge (RWD) for HTA evaluations? – Healthcare Economist

Out of the 64 HTA submissions with RWD, two-thirds (n=44 ) thought of RWD for ECA evaluation solely within the base-case, 9 have been thought of in each the base-case and sensitivity evaluation, and 11 thought of RWD solely in sensitivity/state of affairs evaluation.

Confounding changes have been carried out within the majority of circumstances (30 of 44), with weighting (n=20), matching (n=7), regression (n=4), and simulated therapy comparability (n=2) the approaches used.

Why was RWD not used? For survival extrapolation, a variety of rationales have been supplied:

In 20 submissions, the real-world ECA [external control arm] was deemed inappropriate for extrapolation for varied causes, equivalent to (1) quick follow-up, (2) inclusion of therapies not noticed in UK scientific observe, and (3) key endpoints (e.g., progression-free survival) not collected.  

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