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Since 2013, NICE appraise Highly Specialised Technologies (HST) ("for use in the provision of services for rare and very rare conditions") using a distinct appraisal framework. This research compares NICE HST appraisal outcomes with corresponding guidance by other European HTA bodies, stratified by archetype: cost-effectiveness versus clinical-effectiveness. Although NICE HST appraisals have more positive recommendations and have faster time to recommendations following European MA than other cost-effectiveness HTA bodies, time to positive recommendation is still substantially delayed compared to clinical-effectiveness HTA bodies. [Extracted from the article]

In the UK, medicines can be commissioned through Clinical Commissioning Groups (CCGs, which follow NICE appraisal guidance), or via national-level specialised services (those provided in a few hospitals and accessed by a few patients) where commissioning is governed by NHS England (NHSE). CCP documents only analysed data from literature searches and published cost-effectiveness studies, critically discussing the clinical, safety, and health economics impact to inform the commissioning decision. [Extracted from the article]