Are NICE processes fit for the evaluation of new interventional procedures?

The recent changes in the guidance issued by the National Institute for Health and Care Excellence (NICE) regarding the use of endovascular aneurysm repair highlight many of the difficulties faced in the evaluation and introduction of new interventional procedures. This paper questions whether the current processes for evaluation, largely based upon cost-utility analysis, are adequate to address the issues raised by such technologies. In particular, it considers the implications of rapidly evolving technologies, time preferences and process utilities for the evaluation and introduction of new procedures and devices.