National Institute for Health and Care Excellence

Established in 1999, NICE appraises new medicines for the NHS in England (and by adoption Wales and Northern Ireland) and issues clinical guidelines and quality standards. Its technology appraisals judge cost-effectiveness against a threshold of £25,000 to £35,000 per QALY, raised from £20,000 to £30,000 by a government direction that took effect on 2 April 2026, with a higher weight for severe conditions, and its decisions determine whether patients in England can access new cancer drugs on the NHS. The Cancer Drugs Fund, reformed in 2016, provides managed access to promising drugs while further evidence is collected, and NICE has pioneered the use of real-world data from the fund in re-appraisal. NICE guidance is influential in HTA globally, and it partners with the MHRA on the Innovative Licensing and Access Pathway.