Health inequalities - an update to NICE’s methods for health technology evaluation

Modular updates are a new way to make smaller, more frequent subject-specific updates to the methods and processes we follow when evaluating health technologies and developing guidelines.

We launched a framework for this process in 2024 to keep our methods and processes flexible and responsive to research advances and changes in the health and care system. As well as promoting consistency and prioritising updates in areas that matter most, importantly it allows stakeholders to contribute suggestions for updates, helping us to better meet the needs of our users.

Tackling health inequalities

Tackling health inequalities has long been a core part of NICE’s work and is enshrined in our principles.

This month we published a modular update to our health technology evaluations manual focusing on how we consider the effect of health technologies on health inequalities. The update is designed to ensure that NICE guidance continues to support initiatives that reduce health inequalities and help the most disadvantaged groups in society.

In recent years, new technical approaches have been developed to analyse health inequalities. One prominent approach, ‘distributional cost-effectiveness analysis’, models how health inequalities might change if a new health technology is recommended for use in the NHS.

The modular update is designed to equip pharmaceutical and healthtech companies and NICE’s independent external assessment groups with up-to-date guidance on how to use these approaches and produce better quality evidence on health inequality impacts. NICE committees can then use this improved evidence to consider health inequalities more consistently and fairly when making their recommendations.

You can view the updated health technology evaluations manual and more details on the modular update, including a summary of the public consultation, on our website.

What’s next?

Two new modular updates, suggested by internal and external stakeholders, were prioritised in the recently-concluded first round of the modular updates selection process.

• The EQ-5D-5L value set modular update will enable the adoption of the value set from the new UK valuation study for the EQ-5D-5L into NICE’s reference case.

• The surrogate endpoints modular update will provide updated guidance on how surrogate endpoints can be used in cost-effectiveness modelling.

NICE will begin work on these new modular updates in 2025/26, as the next round of the process begins.

Your opportunity to suggest a modular update

The next modular updates selection round begins in June 2025. Stakeholders are invited to submit suggestions for modular updates to NICE manuals through an online form which will be made available for two months from mid-June 2025 to mid-August 2025 on the NICE modular updates webpage.