Background: The Medical Technologies Evaluation Programme (MTEP) of NICE in England aims to evaluate medical devices that are deemed to be cost-saving or cost-neutral and produce Medical Technology Guidance (MTG) to encourage their adoption.
Objective: To review the MTGs since MTEP's inception in 2009 until February 2017.
Methods: One researcher assessed all published MTGs and extracted data on the clinical and economic evidence supporting each technology. The NICE Committee's decision outcome for each assessment was also recorded. A qualitative analysis was performed on technologies that were not supported for adoption to identify the main drivers of the decision.
Results: Thirty-one MTGs were reviewed. The committee fully supported the medical devices in 14 MTGs, 11 were partially supported and six were not supported. Of the MTGs, 58% had no RCT data available and the main source of evidence came from non-experimental studies. There was no statistically significant difference in the average number of RCTs and non-experimental studies between the fully-supported, partially-supported, and not-supported technologies. Whilst all the fully-supported MTGs demonstrated cost-saving results, only 50% of the not-supported MTGs did. The sponsor estimated a higher average cost-saving than the EAC in most of the cases (20/31). The qualitative evaluation suggests that the main drivers for negative decisions were the quantity or quality of studies, and costs incurred in the economic evaluation results.
Conclusions: The main drivers of the decision-making process are the quality and quantity of the submitted evidence supporting the technologies, as well as the economic evaluation results.