Rationale for implementation approach
NICE's standard approach for implementing updates to its manuals is to only apply changes to new evaluations that are started after the manual has been updated. However, the increase to NICE's cost-effectiveness thresholds will be made following a direction by Department of Health and Social Care (DHSC) ministers and therefore is not a typical methods change.
Furthermore, because the threshold increase can impact the price of a technology being evaluated, some companies with technologies in ongoing evaluations which are due to publish final guidance before the manuals are anticipated to change in April 2026 might want to delay the evaluation until the new threshold can be applied.
NICE considers that following its usual approach will result in significant delays in and terminations of ongoing evaluations of new medicines. This risks creating a substantial backlog in NICE's technology appraisal work programme, leading to delays in patient access to new medicines and NICE's ability to publish timely guidance.
Therefore, NICE considers that an alternative transitional approach to implementing the increase to its cost-effectiveness threshold is required. The approach outlined aims to give NICE users clarity to mitigate risk.