NICE QALY thresholds will increase from £20,000–£30,000 to £25,000–£35,000 per quality-adjusted life year starting April 2026. The UK government announced this adjustment on 1 December 2025 to support pharmaceutical innovation and improve the NHS operating environment. Senior leaders in healthcare and pharma now face clear shifts in market access dynamics. This article analyses the background, key effects, and strategic steps forward.
Historical Context of NICE QALY Thresholds
NICE QALY thresholds have remained steady at £20,000–£30,000 since 1999. This range guides decisions on whether new medicines offer value for NHS money. Committees weigh QALYs, which measure life years gained and quality improvements against current care costs. Flexibilities exist for end-of-life treatments, health inequalities, and ultra-rare diseases – for instance, highly specialised technologies use £100,000–£300,000 per QALY.
Over time, these levels lost purchasing power due to inflation.
Effects of the Threshold Adjustment
The update targets new and ongoing technology appraisals. NICE projects 3–5 extra recommendations each year. Paused appraisals will resume under new NICE QALY thresholds if they might alter outcomes. No re-appraisals occur for past rejections unless new evidence emerges.
- NICE maintains 91% approval rates but gains capacity for borderline therapies.
- Pharma firms must submit evidence quickly and set fair prices.
- Ultra-rare disease thresholds stay the same.
Figure 1 compares the ranges:
| Metric | Current | New (2026) | Change |
|---|---|---|---|
| Per QALY | £20k–£30k | £25k–£35k | +£5k each end |
| Annual Approvals | ~70 | 73–75 | +3–5 |
Figure 1: NICE QALY Thresholds Comparison (NICE, 2025)
New Value Set for EQ-5D-5L
Alongside higher NICE QALY thresholds, a fresh value set arrives for EQ-5D-5L. This tool rates health across mobility, self-care, activities, pain, and anxiety. Public surveys will generate values that better reflect severe states, and experts anticipate 5–15% higher QALY scores for burdensome conditions. Thus, more treatments may pass cost-effectiveness tests.
Broader Consequences for Health Systems
This policy supports UK life sciences growth. It may add £500 million–£1 billion to NHS spending over five years, based on typical prices. Devolved regions might follow suit, though Scotland and Wales set their own paths.
Pharma executives should model submissions against new NICE QALY thresholds. The new thresholds now offer more room for innovation without upending fiscal controls. The change promises modest access gains and economic boosts. Stakeholders should prepare evidence and pricing now.
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