Will NICE approval no longer be enough to secure access in the NHS?

Reflections from NHS ConfedExpo on the Single National Formulary, pathway value, and real-world adoption

Hannah Palin (Local Value and Strategy Practice Lead at Petauri Evidence) and Ben Spurr (Partnerships Director at Petauri Evidence) attended NHS ConfedExpo to connect with colleagues and clients across the system and reflect on the evolving access landscape for life sciences. Here, Ben shares his takeaways from the event.

 What stood out at NHS ConfedExpo?

NHS ConfedExpo, held over June 10^th–11^th, was the ideal opportunity to gain new insights and spend time connecting with colleagues and clients across the system. A number of themes stood out, but one in particular stayed with me from Day 1: A panel discussion on medicines policy, the Single National Formulary (SNF), and the National Institute for Health and Care Excellence (NICE)’s cost-effectiveness threshold.

From approval to implementation

It’s clear that the direction of travel is no longer just focused on NICE approval. One could argue that this has been an open secret for many years, but how guidance is consistently implemented within pathways and prescribing practice has always been variable. How implementation of the SNF will be effectively implemented a the sub-national level is not fully understood.

From an access perspective, release of the 10-Year Plan has communicated the desire from the centre to shift:

• From local formulary variation → equitable and national consistency
• From singular cost focus → pathway and population value
• From single-product decisions → outcome-driven commissioning

However, in 2026, the NHS and life sciences find themselves balancing a tense trade-off across these factors due to the wider national and global environment, historical structures in the NHS, and expected speed of change.

What does this mean for the life sciences industry?

For life sciences, this further raises the bar with regard to expectations surrounding engagement, benefit, and value brought to the NHS. While there are clear shared goals around improving patient outcomes, there remains an inevitable (and appropriate) tension between NHS system priorities and industry objectives. Industry structures and ambitions focused on single-brand, single-indication performance may no longer best serve UK teams navigating the expectations centred around a pathway or therapy agnostic view.

Success will ultimately depend on answering three key questions:

• Where do you fit in the pathway?
• What do you aim to replace in practice, and is that feasible?
• What outcomes do you unlock at a system level?

In this context, access is moving beyond evidence submission to system navigation and real-world adoption.

Want to delve into these topics further? We’re keen to hear your perspectives!

At Petauri Evidence, we are leaders in supporting industry with market access strategy, enabling clients to navigate the complex and evolving NHS landscape, alongside value proposition development, budget impact modelling, and real‑world data solutions. Through robust evidence generation and communication, we support the successful adoption of life‑changing medicines within the NHS.

To start a conversation, reach out to the team at Petauri Evidence, email evidence@petauri.com.