About technology appraisals
Technology appraisals are recommendations on the use of new and existing medicines and treatments within the NHS, such as:
- medical devices (for example, hearing aids or inhalers)
- diagnostic techniques (tests used to identify diseases)
- surgical procedures (such as repairing hernias)
- health promotion activities (for example, ways of helping people with diabetes manage their condition).
We base our recommendations on a review of clinical and economic evidence.
- Clinical evidence measures how well the medicine or treatment works.
- Economic evidence measures how well the medicine or treatment works in relation to how much it costs the NHS - does it represent value for money?
Aim of technology appraisals
NICE is asked to look at particular drugs and devices when the availability of the drug or device 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.
The NHS is legally obliged to fund and resource medicines and treatments recommended by NICE's technology appraisals.
Technology appraisal decisions
Each technology appraisal may contain more than one recommendation. We classify our recommendations into four categories:
- only in research
- not recommended.
In addition to above four categories, an Appraisal Committee may issue a preliminary recommendation asking NICE 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 manufacturer 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. 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.
Further information about a 'minded no' recommendation can be found on our TA decisions FAQs page.
Versions of technology appraisals
NICE produces three versions of its technology appraisals: the full appraisal presents the recommendations from
- the full version in a format suited to implementation by health professionals and NHS bodies
- the quick reference guide presents recommendations in a suitable format for health professionals
- information for the public is written for using suitable language for people without specialist medical knowledge.
Recommended as an option
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.
This is reflected in the NHS Constitution, which 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.
The technology being appraised is listed in the scope of an appraisal under 'intervention'. NICE can only issue guidance/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. NICE cannot issue guidance or make recommendations about comparator technologies (unless also listed as an intervention in a multiple technology appraisal).
Read more about
- Developing NICE technology appraisals
- Published appraisals
- Appraisals in development
- Technology appraisal decisions
- Observing a meeting
This page was last updated: 12 March 2014