Helping improve patient outcomes and access to new medicines

If the budget impact of a new drug exceeds NICE's threshold of £20 million, in any of the first three years, NHS England may engage in commercial discussions with the company. These discussions are designed to mitigate the impact that funding the technology would have on the rest of the NHS.

HST are recommendations by NICE on the use of new and existing highly specialised medicines and treatments within the NHS in England. These medicines are often very high cost, low volume treatments where NHS England needs to enter into confidential commercial arrangements with the company in order to be able to make the treatments available to patients whilst delivering value for money to the NHS.

The voluntary scheme for branded medicines pricing, access and growth (VPAG) is the overarching agreement on pricing for branded medicines supplied to NHS hospitals across the UK. We have advised NHS England’s Medicines Procurement and Supply Chain team on the terms of VPAG and the preceding 2019 agreement. The deal reached means that VPAG will secure twice the level of savings of the scheme which it replaces, amounting to some £14bn in savings against list prices of medicines.