All problems

For UK pharmaceutical and life sciences leaders

Your ICER sits above threshold and NICE has signalled rejection

A negative appraisal can lock you out of NHS market access for three to five years. Most products above NICE's £20,000 to £30,000 per QALY cost-effectiveness threshold are rejected unless a specific exception pathway is pursued, and few teams know how to build that case.

£20,000 to £30,000 per QALY cost-effectiveness threshold. Source: NICE

Two minutes. Solva follows up with specific exception and managed access pathway options.

  • Product launch delays in the UK market
  • Limited or no access to the NHS for innovative medicines
  • Requirement for significant price reductions to meet cost-effectiveness thresholds
  • Negative public perception and media coverage
  • Diversion of resources to manage appeals or alternative market access pathways
  • Morale impact on market access and medical affairs teams
  • Significant revenue loss from inability to access the NHS market
  • Increased R&D costs without corresponding return on investment
  • Delayed patient access to innovative treatments
  • Suboptimal patient outcomes due to lack of effective therapies
  • Damage to company's reputation as an innovator
  • Negative perception among healthcare professionals and patient groups

NICE has made positive recommendations (recommended, optimised, or recommended for the Cancer Drugs Fund) in 85% of its technology appraisals. (NICE, 2026)

Source: https://www.nice.org.uk/what-nice-does/our-guidance/about-technology-appraisal-guidance/technology-appraisal-data-appraisal-recommendations

Frequently asked questions

Why does this problem persist?

NICE applies a cost-effectiveness threshold of £20,000-£30,000 per QALY for most medicines. Products above this threshold face rejection unless they qualify for end-of-life, rare disease, or other special consideration pathways.

What is the cost of leaving it unaddressed?

A negative NICE appraisal can lead to significant revenue foregone due to delayed or denied market access to the NHS for 3-5 years. (Multiple sources, industry consensus)

This is exactly what I do with UK private practices. Answer the few questions above and I'll come back personally with where to start. Paul.

Solvable.Health© 2026

This information is for educational purposes only and does not constitute professional advice.