NICE has developed a medtech innovation briefing (MIB) on the Alair bronchial thermoplasty system for adults with severe, difficult to control asthma.

The Alair bronchial thermoplasty system is designed to reduce the amount of smooth muscle in the airway walls, with the aim of improving symptoms in people with severe, difficult to control asthma. Evidence from 3 systematic reviews (reporting on 3 randomised controlled trials of mixed quality) suggests that use of the Alair system is associated with some patient benefits (such as improved quality of life, and morning peak expiratory flow), but not all benefits were considered to be clinically significant. There is mixed evidence in relation to other outcomes (including asthma exacerbations, hospitalisations and emergency department visits).

The procedure must be done 3 times, once every 3 weeks. The device cost for 3 procedures is up to £6,930 (for 3 single-use catheters), with a capital cost of up to £31,500 for the radiofrequency controller. Additional costs include more detailed pre-bronchoscopy assessments, increased patient monitoring and treating short-term adverse events.

MIBs provide a description of the medical technology, including its likely place in therapy, the costs of using the technology and a critical review of the strengths and weaknesses of the relevant published evidence.

Their purpose is to provide objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals. By making this information available, NICE helps to avoid the need for NHS organisations to produce similar information for local use.

MIBs are not NICE guidance. They differ in format, contain no judgement on the value of the technology and do not constitute a guidance recommendation.

MIBs are commissioned by NHS England and produced in support of the NHS 5 Year Forward View, specifically as one of a number of steps which will accelerate innovation in new treatments and diagnostics.