flipper44 Member Level Re: None Monday, 02/23/2026 1:51:57 PM Reminder:
The QALY threshold raise is scheduled to take effect on April 1, 2026.
Under the updated NICE (National Institute for Health and Care Excellence) guidelines and the 2024 VPAG agreement framework:
The Base Threshold: The standard lower-bound is moving to £30,000 per QALY.
The Upper Range per QALY (£35,000): This is the crucial level for innovative or specialized medicines.
For treatment (indications) that demonstrate significant "severity" or treatments represent a major step forward in unmet needs, NICE will apply a more flexible upper threshold of £35,000. (The severity modifier also can increase this amount by 1.7 times.)
This shift to the £30k–£35k range is designed to provide greater headroom for advanced therapies to meet cost-effectiveness requirements during the reimbursement phase. This change goes live on the same day as the VPAG clawback tax reduction. (AKA: April 1, 2026)
You need to submit reimbursement evidence first. The fact that they haven’t 5.5 years post data lock suggests it ain’t happening in 2026. More carrots and excuses are en-route! ;)