Background: Quality assurance (QA) of health technology assessment (HTA) models is essential to ensure that decisions made by the National Institute for Health and Care Excellence (NICE) are robust, transparent and credible. In 2015/2016, NICE’s Decision Support Unit (DSU) undertook unpublished work to examine QA practices across External Assessment Groups (EAGs) and to develop consensus principles. Since then, NICE appraisal processes, timelines and methodological expectations have evolved substantially.
Objectives: To examine how QA practices used by EAGs have changed between 2015 and 2025, and to develop an updated consensus framework and checklist for proportionate QA of economic models used in NICE technology appraisals.
Methods: Surveys of all EAGs were conducted in 2015 and 2025 to capture QA practices for company-submitted and de novo EAG-built models. Findings were discussed at a consensus workshop in January 2016 and refined through a two-round survey of EAG representatives in 2025. Consensus statements were finalised and translated into a QA checklist.
Results: QA practices have evolved considerably, with increased use of formal model testing and verification activities and greater involvement of clinical experts in QA of company models. The proportion of EAGs producing explicit QA statements increased markedly, although variability in approaches remains. Timelines and resource constraints limit the feasibility of some QA activities, particularly for exploratory analyses and de novo models developed under accelerated processes.
Conclusions: This study provides an updated, consensus-based framework for proportionate QA of HTA models used by EAGs. The resulting checklist supports transparency, consistency and reproducibility while allowing flexibility to reflect appraisal context and resource constraints, aligning with the principles of the AQuA book and NICE’s proportionate approach to appraisal.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)