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The NHS does not “universally” provide medicines within the mandated 90 days from the National Institute for Health and Care Excellence (NICE) recommendation, Jonathan Benger, chief executive of NICE, has said.
Giving evidence at a House of Lords Science and Technology Committee session on 24 June 2026, Benger said this means new medicines approved by NICE “are not necessarily returning on investment in the way that the companies that have supported through them through the [research and development] process have been hoping”.
During the evidence session on personalised medicine and AI, committee member Lord Paul Rudd Drayson put to Benger: “If you look at the relative decline of the UK pharmaceutical industry over the time that NICE has been in existence, some argue that that is due to the UK being seen increasingly as a market which is not an early adopter of new innovative medicines, and that really hurts UK-based life sciences companies who are operating at the forefront.”
“I reject the idea that investment decisions that are being made by pharmaceutical companies are directly related to NICE methods or NICE approval,” Benger responded.
Instead, he suggested: “We still aren’t adequately joined up in terms of making sure that the medicines that we do approve at NICE and the technologies that we approve at NICE reach patients in the NHS.”
This particularly affected preventative medicines where the return on investment was difficult to quantify, Benger noted.
He continued: “We can make the recommendations, but implementation in the NHS often requires a business case that requires quite rapid return on investment, and it can be difficult to argue for investments today that will achieve benefits in 10 or 20 years’ time. I think that’s difficult at a political level, I think it’s difficult at a local systems level as well.
“There is a funding mandate that says that those medicines should be provided within 90 days of a positive NICE recommendation, and we know that that doesn’t happen universally.
“What that tells us is that mandation, as it were, doesn’t really have the impact that we were hoping it would in a system that is as stretched, as complex and as challenged as the NHS.
“There’s a lot of fragmentation, and it’s about creating pathways and systems that will enable and support people to implement our guidance effectively … the National HealthTech Access Pathway that we have advocated for for many years, and which we were delighted to see adopted in the ten-year plan, is exactly that.”
The National HealthTech Access Pathway is a collaboration between NICE, the Department of Health and Social Care, NHS England, Medicines and Healthcare products Regulatory Agency and the Office for Life Sciences to expand access to health technologies in the UK.
In response to Benger’s comments, a spokesperson for the NHS told The Pharmaceutical Journal on 25 June 2026: “NHS patients in England routinely benefit from innovative medicines that can be life-changing or even lifesaving, often ahead of the rest of Europe, as was the case with personalised CAR-T cancer therapy.
“However, we know there is still variation in patients’ access to approved medicines across the country, which is why we are developing a single national formulary for medicines that will establish a single evidence-base source of prescribing guidance to deliver fairer access to, and faster uptake of, all medicines — providing better outcomes for patients across England.”
Victoria Jordan, executive director of patient access at the Association of the British Pharmaceutical Industry, said: “The publication of NICE guidance and the obligation for the NHS to fund NICE-recommended medicines within 90 days should enable rapid and equitable adoption across the NHS, but this is often not the case.
“The UK lags behind comparator countries, with the average uptake of new medicines per capita around half of that in comparator countries, and only 27% of local formularies are updated to include new medicines within 90 days of NICE guidance being published.
“The reasons for this are multifaceted and complex, with layers of process and local decision-making coupled with significant financial and practical barriers. Overcoming these barriers will require a coordinated approach to improve visibility and planning for delivering new medicines within care pathways, as well as the NHS embracing an innovation seeking mindset and the government ensuring budget holders have sufficient allocations to do this.”
