NICE QALY threshold increase — in effect from April 2026
From April 2026, NICE's cost-effectiveness threshold has risen from £20,000–£30,000 to £25,000–£35,000 per quality-adjusted life year (QALY) gained. This is the first increase in the threshold since NICE was established. The change was linked to the UK-US Economic Prosperity Deal and forms part of a broader commitment to invest around 25% more in innovative medicines. Government modelling suggests the increase could enable three to five additional medicines or indications to be recommended for NHS use each year.
For high-cost drug commissioners and Blueteq users, this means: more medicines are likely to receive positive NICE recommendations in the coming months, increasing the volume of new treatment-specific forms required; and some appraisals that were previously paused at the old threshold will now proceed to publication. The governance infrastructure needed to implement these new medicines — eligibility checking, prior approval, audit trail — becomes more rather than less important as the pipeline expands.
