Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the report published by Breast Cancer Now, entitled Setting the Bar too High, what assessment his Department has made of the impact of the opportunity cost‑neutrality requirement within NICE’s severity modifier on access to treatments for secondary breast cancer.

The severity modifier was introduced by the National Institute for Health and Care Excellence (NICE) in January 2022 as part of a number of changes intended to make its methods fairer, faster, and more consistent. The severity modifier was designed on the principle of opportunity cost neutrality to ensure that introducing additional weighting for severe conditions did not increase overall National Health Service spending or displace more care than the previous end-of-life modifier.

NICE has been monitoring how the severity modifier is being applied and found that it has resulted in a greater proportion of medicines recommended than under NICE’s previous methods. The latest figures indicate 87.0% of decisions taken since the severity modifier was implemented have recommended use of the treatment, compared with 82.5% when the end-of-life modifier was being used. For advanced cancer treatments specifically, 84.8% of decisions have been positive since the introduction of the severity modifier, compared to 69.1% under NICE’s previous methods.