Technology appraisal guidance

Technology appraisals are recommendations on the use of new and existing medicines and treatments within the NHS.

These can be:

  • medicines
  • medical devices
  • diagnostic techniques
  • surgical procedures
  • health promotion activities.

Charges for our appraisals came into effect on 1 April 2019.

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What we do

We base our recommendations on a review of clinical and economic evidence.

  • Clinical evidence shows how well the medicine or treatment works.
  • Economic evidence shows how well the medicine or treatment works in relation to how much it costs the NHS - does it represent value for money?

We are asked to look at particular drugs and devices when availability varies across the country. This may be because of different local prescribing or funding policies, or because there is confusion or uncertainty over its value. Our advice ends the uncertainty and helps to standardise access to healthcare across the country.

Technology appraisals take one of 3 forms:

  • A single technology appraisal (STA) which covers a single technology for a single indication.
  • A fast track appraisal (FTA) which also covers a single technology for a single indication but with a shorter process time to speed up access to the most cost-effective new treatments.
  • A multiple technology appraisal (MTA) which normally covers more than one technology, or one technology for more than one indication.

On 3 April 2018 we published an updated technology appraisals process guide which covers:

  • the single technology appraisal and fast track appraisal processes
  • processes for the Cancer Drugs Fund and assessing budget impact.

The process for multiple technology appraisals can be found in the process guide (PDF) published in September 2014.

Technology appraisals and the NHS Constitution

The NHS is legally obliged to fund and resource medicines and treatments recommended by NICE's technology appraisals.

The NHS Constitution states that patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if their doctor believes they are clinically appropriate.

When NICE recommends a treatment 'as an option', the NHS must make sure it is available within 3 months (unless otherwise specified) of its date of publication. This means that, if a patient has a disease or condition and the doctor responsible for their care thinks that the technology is the right treatment, it should be available for use, in line with NICE's recommendations.

Technology appraisal decisions

Each technology appraisal may contain more than one recommendation. We classify our recommendations into 5 categories:

  • recommended
  • optimised
  • only in research
  • not recommended
  • recommended for use in the Cancer Drugs Fund.

In addition to these types of technology appraisal recommendation, an appraisal committee may make a preliminary recommendation to seek clarification from the manufacturer or sponsor on the key evidence submitted for a technology. This will result in a recommendation which states that ‘the committee is minded not to recommend [the technology]…' and lists the requested information/clarification.

The company is then required to submit the requested clarification/evidence for consideration at the next planned discussion for the appraisal, at which the committee will develop a Final Appraisal Determination setting out its final recommendation(s).

The intention is that the further evidence or analyses could lead to a positive recommendation. However, after consideration of the requested evidence, the committee may decide not to change their preliminary recommendation. If the requested evidence is not provided, the committee will issue a final recommendation which does not recommend the technology, based on the on the original evidence submitted.

Information on the recommendations made by our technology appraisal guidance

Developing technology appraisal guidance

An overview of the development process.

Intervention/comparator technologies

The technology being appraised is listed in the scope of an appraisal under 'intervention'. We can only make recommendations about the intervention being appraised.

A comparator technology is one that is currently used in the NHS and could be replaced by the intervention, if recommended. We cannot issue guidance or make recommendations about comparator technologies, unless also listed as an intervention in a multiple technology appraisal.

Changes to health technology evaluation

We're reviewing and, where necessary, updating the methods and processes we use to produce guidance around health technologies.

Interim data collection agreement with Vertex Pharmaceuticals

The interim data collection agreement for Vertex’s cystic fibrosis modulator therapies has been updated to include elexacaftor, tezacaftor and ivacaftor following the announcement of a 4-year deal agreed by NHS England and NHS Improvement and Vertex Pharmaceuticals in June 2020.

EU exit transition period

Health technology evaluation: what happens after the transition period?

Decision Support Unit and technical support documents

We commissioned the Decision Support Unit (DSU) to:

  • provide a research and training resource to support the technology appraisal programme.
  • develop a series of technical support documents with further information about how to implement the approaches described in the current guide to the methods for technology appraisals.

More information

Technology appraisal submission templates

Company submission templates

Company cost comparison submission templates

Other consultee templates

Early Access to Medicines Scheme (EAMS)

Position statements

Participation in clinical trials and subsequent access to drugs appraised by NICE: a statement on the applicability of technology appraisal guidance

Patients taking part in clinical trials may receive drugs which have been evaluated by NICE technology appraisal guidance. Queries have been raised regarding the applicability of NICE technology appraisals for patients who have previously received the same medication as part of a clinical trial.

Research is a core function of the NHS. Use of NICE appraised medicines within the clinical trial context should be viewed as use in new and experimental circumstances. It should be noted that in these circumstances the drug is not being prescribed as part of routine clinical practice.

Arrangements for the supply and funding of the technology provided in clinical trials after the trial ends should be agreed with appropriate commissioners before the trial commences. Once the clinical trial ends, the patient will need to discuss with their doctor whether it is clinically appropriate to continue receiving the medication.

For the avoidance of any doubt, if a patient's clinical condition falls within the recommendation of a NICE technology appraisal, they should be prescribed the medication as recommended in the guidance, regardless of any previous participation in a clinical trial in which they may have received medicines for their condition.

On occasion, NICE will make a recommendation that a drug should not be prescribed, but that patients who are currently receiving it as part of their routine clinical care should continue to do so. It is important to note that this recommendation does not cover situations where patients are receiving the medication as part of a clinical trial.

Technology appraisal process and methods guides

Information about how we select and produce our technology appraisal guidance, and the principles and methods used in our appraisals.