As an example, based on the 2008 central estimate of the cost per QALY threshold (£12,936), the approval of ranibizumab (Lucentis®, Roche) for the treatment of diabetic macular oedema (prior to the Patient Access Scheme agreement) would have imposed additional annual costs of up to £80M on the NHS each year and been likely to displace 6184 QALYs elsewhere in the NHS. This forgone health is likely to be made up of 411 additional deaths and 1864 life-years forgone, most of which are likely to occur in circulatory, respiratory, gastrointestinal and cancer PBCs. However, much of the total health effect of these additional costs (4987 QALYs) is associated with QoL forgone during disease which is most likely to occur in respiratory, neurological, circulatory and mental health PBCs.