The Threshold Is Going Up by 25%
NICE currently assesses whether a new treatment delivers enough health benefit to justify its cost: the quality-adjusted life year (QALY). A QALY combines how much longer a treatment helps someone live with the quality of that extra life. Until now, NICE has applied a cost-effectiveness range of £20,000–£30,000 per QALY gained. If a medicine costs more than that for each year of good-quality life it delivers, it typically won’t be recommended.
From April 2026, that range rises to £25,000–£35,000 per QALY. In practice, it means the NHS is willing to pay more for new medicines – treatments that were previously rejected on cost grounds may now get approved.
3–5 More Medicines Approved Each Year
NICE currently recommends around 91% of the medicines it evaluates – roughly 70 per year. Their own analysis suggests the new threshold could add an additional 3–5 approved medicines or indications annually.
For some appraisals already underway, NICE has paused decisions where the new threshold might change the outcome – meaning a batch of recommendations could land shortly after April.
This Is Part of a Bigger Deal
The threshold change didn’t happen in isolation. It’s part of the UK–US Economic Prosperity Agreement, which committed the UK government to investing around 25% more in innovative treatments. The pharmaceutical industry’s rebate rate under the VPAG scheme is also dropping from 22.9% to 14.5%, making the UK a more attractive market for drug launches.
The government estimates this will increase medicines spending by around £1.5 billion over three years. The NHS will not receive additional funding to cover this – the savings are expected to come from the rebate changes and broader efficiency gains.
It’s worth noting the counterargument: some health economists have argued that NICE’s existing threshold was already too high relative to the real opportunity cost of NHS spending, and that raising it could displace more health than it creates. A PharmacoEconomics analysis published in December 2025 estimated that medicines approved by NICE between 2000 and 2020 resulted in a net loss of approximately 1.25 million QALYs when displacement effects are factored in.
Either way, the practical effect is clear: the medicines pipeline to the NHS is widening, and primary care will be where many of these treatments land.
Source: NICE. Changes to NICE’s cost-effectiveness thresholds confirmed.
These articles report on published research. It does not constitute medical advice.
