NICE medical technologies guidance addresses specific technologies notified to NICE by sponsors. The 'case for adoption' is based on the claimed advantages of introducing the specific technology compared with current management of the condition. This case is reviewed against the evidence submitted and expert advice. If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages.
1.1 The case for adopting the geko device is supported for use in people who have a high risk of venous thromboembolism and for whom other mechanical and pharmacological methods of prophylaxis are impractical or contraindicated. Although clinical evidence is limited, the case is supported because of the plausibility that the geko device may reduce the high risk of venous thromboembolism in patients who cannot use other forms of prophylaxis, and the low risk of the device causing harm.
1.2 In patients at high risk of venous thromboembolism who would otherwise receive no prophylaxis, using the geko device is estimated to be cost saving. The amount saved depends on the level of reduction in relative risk of deep vein thrombosis associated with geko treatment compared with no treatment. There is no direct evidence on the size of this reduction, but when values obtained with other mechanical methods of prophylaxis were used in cost modelling, the estimated cost saving for the geko device in patients at high risk of venous thromboembolism compared with no prophylaxis was £197 per patient.