UK confirms NICE methods shift at heart of US pharma deal
In a letter to the House of Commons Science, Innovation and Technology Committee, Minister for Science, Innovation, Research and Nuclear Lord Patrick Vallance explains that the National Institute for Health and Care Excellence (NICE) will, from April 2026, apply higher core cost‑effectiveness thresholds of £25,000 to £35,000 per quality‑adjusted life‑year, up from the previous £20,000 to £30,000 range. The letter also confirms that NICE will implement this shift by updating its methods and manual so that ongoing and future technology appraisals use the new thresholds, with flexibility to pause or re‑run cases that would otherwise have been rejected under current rules.
Alongside this, the minister reiterates that the voluntary scheme for branded medicines pricing, access and growth (VPAG) will cap repayments at 15% of eligible sales, significantly below recent clawback rates, in order to support investment linked to the tariff‑free export offer in the US deal. DHSC, NHS England and NICE have jointly modelled that the combination of higher thresholds and lower rebates will add around £1 billion in medicines spend over the current Spending Review period, with the cost absorbed centrally by DHSC rather than through cuts to day‑to‑day NHS services.
The package integrates a less restrictive cost‑effectiveness test into NICE’s methods while locking in a more generous branded medicines envelope, shifting long‑term opportunity costs onto other centrally funded programmes. Access advocates are now focused on whether DHSC publishes a full impact assessment that weighs these foregone benefits against any health gains and industrial returns generated by the deal.
Source: House of Commons Science, Innovation and Technology Committee
Link: DHSC, NHS England and NICE produced a joint analysis to estimate the cost impact
Date: 30 January 2026
