Single Technology Appraisal (STA) for one technology in a defined population. Multiple Technology Appraisal (MTA) when several technologies are evaluated together. Highly Specialised Technologies (HST) for very rare conditions with specific evaluation frameworks. We work across all three.

United Kingdom

NICE submissions, to the reference case.

Q: What is the NICE reference case?

The NICE Manual sets the methodological reference case: NHS / Personal Social Services perspective, cost-utility analysis with QALYs as the outcome, 3.5% annual discount rate, lifetime horizon for chronic conditions, full probabilistic sensitivity analysis. The reference case is the default; deviations need explicit justification.

Q: What's the QALY threshold?

NICE's standard threshold range is £25,000 to £35,000 per QALY. End-of-life criteria and severity modifiers can extend this; the 2022 NICE Manual moved from end-of-life to a severity-based weighting that can raise the effective threshold for conditions with substantial absolute shortfall in QALYs.

Q: How do you handle indirect comparisons?

NICE expects systematic indirect treatment comparison or network meta-analysis when head-to-head trials are absent. We build the indirect comparison into the model's parameter sourcing, with the same audit trail as direct-evidence parameters, and document the comparator network in the dossier.

Cost-utility models built to NICE's methodology. We work across Single Technology Appraisals (STA), Multiple Technology Appraisals (MTA), and Highly Specialised Technologies (HST).

What NICE actually evaluates.

NICE appraises medicines, devices, diagnostics, and procedures for the NHS in England. Scotland runs through the Scottish Medicines Consortium; Wales and Northern Ireland follow NICE through their own adoption pathways.

The threshold runs from £25,000 to £35,000 per QALY, with modifiers that lift it for high-severity or rare-condition technologies. The 2022 NICE Manual replaced end-of-life criteria with severity-based weighting tied to QALY shortfall.

The appraisal process moves through scope consultation, evidence submission from the company, an Evidence Review Group (ERG) critique, the committee meeting, and one or more appraisal consultation documents before the Final Appraisal Document. Each step has its own working window and its own kind of question to expect.

Where HEC fits in the pathway.

Pre-scope strategy

Comparator network mapping, indirect treatment comparison (ITC) or network meta-analysis (NMA) feasibility, choice of model structure (partitioned survival, Markov, decision tree), severity-modifier framing.

Reference-case model build

NHS/PSS perspective, QALYs, 3.5% discount, lifetime horizon. Survival extrapolation with formal comparison across distributions (Weibull, Gompertz, log-normal, generalised gamma). PSA, deterministic sensitivity analysis (DSA), and scenario analyses.

Company submission

The document NICE actually evaluates: narrative + tables + model + Excel workbook. Every claim sourced; every assumption defended in the appendices.

ERG critique response

The ERG report is the moment most models earn or lose. We turn around revised analyses within the committee timeline and prepare hearing briefings.

Severity modifier analysis

Absolute and proportional QALY shortfall analyses for technologies that might qualify for severity weighting. Built into the same model.

Confidential commercial access

Patient access schemes and confidential discounts modelled into the price-sensitive part of the analysis without leaking into the public-facing dossier.

Common questions on NICE.

What is the NICE reference case?

The methodological default in the NICE Manual: NHS / PSS perspective, CUA with QALYs, 3.5% discount, lifetime horizon where appropriate, full PSA. Deviations are allowed but need to be defended explicitly.

STA, MTA, or HST?

STA for a single technology in a defined population; MTA when several technologies are evaluated together; HST for very rare conditions. We work across all three.

What's the QALY threshold?

Standard £25,000 to £35,000 per QALY. Severity-based weighting can raise the effective threshold for high-severity or rare conditions; the structure changed in 2022 from end-of-life to severity.

How do you handle indirect comparisons?

When head-to-head trials are absent we build the ITC or NMA into the model's parameter sourcing, with full audit trail. The comparator network is documented in the dossier.

Planning a NICE appraisal?

30 minutes to scope the appraisal class, comparator network, and where an agreement adds value.

Book a 30-minute call