The Characteristics of Immunoncology Drugs Appraised by NICE and SMC: A Retrospective Analysis 2012-2023

Immunoncology has revolutionized cancer treatment by offering improved survival and quality of life. This study aimed to explore the characteristics of NICE and SMC's decisions for the reimbursement of immunoncology drugs, within the healthcare systems of the UK & Wales and Scotland respectively.

The classification of the Cancer Research Institute was used, to identify immunoncology drugs. A systematic search of publicly available HTA decisions on immunoncology drugs was performed, taking into account technology appraisals conducted from 2012 to 2023. Data on drug-indication pairs, recommendation status and ICER for both NICE and SMC appraisals, were extracted in standardized tables. A retrospective analysis of the reviewed decisions was conducted.

A total of 58 NICE and 57 SMC appraisals were analyzed, revealing that most decisions were positive or optimised/restricted (91.4 % and 87.7 %, respectively). Lung cancer and melanoma were the most frequently appraised indications. More than half of the appraisals (53.4 % for NICE and 61.4 % for SMC) reported ICERs above £ 30,000 per QALY. Patient group submissions were included in 89.7 % of NICE and all SMC decisions, reflecting the agencies' commitment to incorporating patient perspectives.

The number of immunoncology drugs assessed by NICE and SMC has increased significantly in the latest years, reflecting their expanding use across a broad range of cancer indications. This study highlights the high acceptance rates of immunoncology therapies appraised by both agencies, as well as the link between high ESMO-MCBS score (for both curative and non-curative settings) and positive or optimised/restricted coverage recommendations. By exploring the characteristics of immunoncology drugs appraisals, the analysis provides insights into the evolving landscape of this therapeutic area.