In England, the National Institute of Health and Care Excellence (NICE) uses the cost of treatment per quality-adjusted life-year as the basis for its’ decision making. In general, technologies will only receive a positive NICE recommendation if their estimated cost per QALY is below the 20 000 to 30 000 incremental cost-effectiveness ratio threshold. In order to demonstrate cost-effectiveness, manufacturers must often agree financial agreements (such as confidential discounts) with NHS England. In this study, we compared the use of financial agreements for oncology and non-oncology drugs assessed by NICE between 2017 and 2019
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