The National Institute for Health and Care Excellence (NICE) has adopted the new UK EQ-5D-5L value set for valuing health-related quality of life in adults. The change replaces the EQ-5D-3L value set used in NICE evaluations since 2012 and moves the methods update consulted on earlier this year into implementation.
The value set converts reported health states into utility values used to calculate quality-adjusted life years (QALYs). Changing those values can therefore alter incremental cost-effectiveness ratios, with NICE’s impact work showing that the effect varies according to whether treatment benefits principally extend survival or improve quality of life.
In NICE’s sample of 37 technology appraisals, cancer medicines became more cost effective, with median incremental cost-effectiveness ratios falling by 12%. Non-cancer medicines that improved quality of life without extending survival became less cost effective, with a median increase of 59%. Results were mixed for non-cancer treatments that extended survival. NICE’s equality assessment acknowledged that the less favourable effects included treatments for chronic conditions classed as disabilities.
The Association of the British Pharmaceutical Industry (ABPI) subsequently assessed 71 technology appraisals and reported a similar pattern. It warned that reduced cost effectiveness under the new value set could restrict access to some medicines and called for the effects to be monitored.
The change also forms part of the UK–US pharmaceutical arrangement. The agreement specifically committed the UK to adopt EQ-5D-5L alongside the higher NICE cost-effectiveness threshold as measures supporting a 25% increase in net NHS prices for prospective new medicines.
The distributional effect of the new method may therefore be as consequential as the higher threshold. Survival-extending treatments may gain headroom, while medicines whose value lies mainly in improving life with chronic disease may face greater pressure on evidence, price and cost effectiveness.
Source: National Institute for Health and Care Excellence
Link: Interim methods statement – implementing the EQ-5D-5L value set PMG51
Date: 27 August 2026
Source: Association of the British Pharmaceutical Industry, ABPI
Link: NICE has updated how it values quality of life – the move from 3L to 5L
Date: 28 August 2026
