ABSTRACT
This chapter reflects on the changing pressures on NICE’s HTA activities. Should NICE prioritise patients’ access to new medicines, along with encouragement for innovation in the life sciences industries, as government advocates? Is this consistent with its role in promoting cost-effectiveness? NICE is moving from a ‘yes/no’ algorithm to an attitude that asks ‘how can we reach yes, and for which patients?’ The Cancer Drugs Fund interlude of 2010–13 illustrates this, NICE capturing what started as a rogue policy invented on the hoof by an electioneering David Cameron. The episode illustrates the complexity of NICE’s policy environment and its uncertainties, and the growing importance of NICE’s interaction with NHS England, especially about affordability.
