Statement of intent on NICE’s approach to ongoing evaluations ahead of proposed changes to NICE’s standard cost-effectiveness thresholds

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Implementation across NICE work programmes

Approach for TAs for medicines and HealthTech products

We anticipate that NICE will be directed to implement a new threshold by the Department of Health and Social Care (DHSC) from April 2026, subject to ongoing DHSC processes. For technology appraisals (TAs) that are currently in development but for which the first committee meeting will take place from April 2026, TA processes will continue as usual. Committees will be able to apply the new standard threshold in their decision making from the point of the DHSC directing NICE to do so. This is likely to be from April 2026. We will communicate with NICE stakeholders should timelines change, reflecting ongoing DHSC processes.

For TAs for which the final committee meeting has already taken place or will take place before NICE receives a direction (likely April 2026), but NICE has not yet issued final draft guidance, NICE will apply cost-effectiveness thresholds as follows:

  • 1. Committee meetings will proceed as scheduled in the period prior to NICE receiving a direction, using the current standard cost-effectiveness threshold of £20,000 to £30,000 during this period.

  • 2. If a technology is found to be cost effective using the current standard threshold of £20,000 to £30,000, NICE will proceed to release final draft guidance as usual.

  • 3. If a technology is not found to be cost effective using the current standard threshold of £20,000 to £30,000 but the company indicates that applying the new threshold of £25,000 to £35,000 could result in a positive recommendation:

    • a. Release of final draft guidance will be paused until NICE can apply the new threshold, following a DHSC direction. This will likely be from April 2026.

    • b. Once the new threshold is applied, NICE will automatically increase the maximum acceptable incremental cost-effectiveness ratio (ICER) that the committee has decided on under the current NICE thresholds by £5,000. This will not require further committee discussion.

    • c. Publication processes and commercial processes will then continue as usual.

  • 4. If a technology is not found to be cost effective using the current thresholds of £20,000 to £30,000 and it would not be recommended even when the threshold would increase by £5,000, NICE will proceed to releasing negative final draft guidance as usual.

This approach applies to all technologies undergoing evaluation through NICE's TA programme. These are primarily medicines, however, we anticipate a small number of HealthTech topics to be evaluated through this programme.

Approach for HealthTech and guidelines programmes

It is for the DHSC to decide which NICE guidance programmes a threshold change will apply to. The DHSC has confirmed only that the proposed changes will apply to NICE's TA guidance.

NICE has proposed that the increase in threshold is applied across all NICE guidance as appropriate. We await a government decision on application to the HealthTech and guideline programmes. If a change to thresholds were to be agreed for HealthTech and guidelines, NICE would follow a similar, pragmatic implementation approach to that set out for TA, taking into account appropriate adjustments to reflect the different characteristics of the programmes. This would support implementation across all NICE guidance.

Decisions would apply to ongoing evaluations from the point of a manual change.