NICE Conference 2026 brought me to Manchester last month — and if I'm honest, the most technically charged discussion happened the night before the conference even opened.

AXIS Reimbursement hosted a pre-conference panel, chaired by Carl Prescott, with Allan Wailoo, Amanda Adler, and Fleur Chandler. We covered three topics that are quietly reshaping how evidence packages are built and evaluated: the new EQ-5D value set, the recent NICE cost-effectiveness threshold change, and VPAG.

The EQ-5D discussion matters more than it might appear — a revised value set can shift cost-effectiveness estimates significantly without a single clinical data point changing, with real implications for submissions already in the pipeline. The threshold debate is more politically charged: upward revision opens the door to approving more treatments, but raises hard questions about opportunity cost and what the NHS gives up elsewhere. VPAG added another layer. Afterall, it’s UK pharma’s least favourite acronym for a good reason. It was a technically rich evening, and a fitting warm-up for what followed.

New to some of the terminology? Check out The Pharma Glossary on my website.

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Professor Jonathan Benger CBE delivered his first major public address as NICE Chief Executive. The priorities were clear: faster access to medicines, less postcode lottery for high-impact health technology, and more value from every NHS pound already being spent. Ambitious framing — and the room was engaged, if cautiously so. The political climate makes delivery anything but straightforward, and several speakers acknowledged that gap openly.

A full morning session tackled the NHS's ambition to shift from treating sickness to keeping people well, as set out in the Government's 10 Year Health Plan. Speakers from Liverpool City Council, Public Health Wales, a North East ICB, and All About Obesity brought different perspectives to the same honest conclusion: "prevention is better than cure" is considerably easier to say than to operationalise at scale. The intent is genuine. The systems, incentives, and resources to back it up are still catching up.

One breakout offered a rare look at how NICE actually reaches its recommendations — how evidence is weighed, how patient voices are formally incorporated, and what good looks like in practice. For anyone working with NICE submissions professionally, it was a useful reminder that the process is more deliberative and nuanced than it can appear from the outside, and that lay members play a genuinely substantive role.

The session that generated the most discussion brought together Mark Sculpher (University of York), Daniel Ollendorf (ICER), and Nicole Mittmann (Canada's Drug Agency) to examine whether current HTA methods are keeping pace with modern decision-making demands.

The debate touched on distributional cost-effectiveness analysis, decision modifiers, and how much these should reflect broader societal preferences. No consensus was reached — which is probably the honest answer. The fact that NICE is actively exploring this in partnership with ICER and CDA-AMC through the new Health Economics Methods Advisory (HEMA) group signals that methodological evolution is firmly on the agenda.

The most consequential exchange of the day came when the chief executives of NICE and the MHRA shared the stage and committed to joint scientific advice and closely aligned timelines — with the explicit aim of getting safe, effective treatments to patients faster and making the UK a more compelling destination for life sciences investment. Whether this translates into meaningful change in practice remains to be seen. But having both organisations make that commitment publicly, in front of an industry audience, is not nothing. Hopefully?

Conferences are good for taking the temperature of an industry. They're less good for predicting what will actually change… And it's worth keeping that distinction in mind!

The NICE/MHRA commitment was the headline moment, and it felt meaningful. But commitments made on a stage and structural change in how two large organisations operate are different things.

The QALY and threshold debate isn't going away. VPAG remains the stone in pharma's shoe every time these discussions come up. The HEMA group gives that conversation a formal home — whether it leads anywhere useful is a question for the next few years, not the next few months.

I left cautiously engaged rather than optimistic. Good conversations, serious people, clear direction. Whether direction becomes momentum is something we'll be better placed to judge this time next year.

Were you there? I'd be curious how you found it.

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