Chronic Illnesses

The National Institute for Health and Care Excellence (NICE) introduced the severity modifier in 2022 to replace the existing end of life modifier, based on evidence of societal preferences and as part of a comprehensive review of NICE’s methods and processes. The modifier was designed through extensive public and stakeholder engagement and in line with the principle of opportunity cost neutrality. NICE’s updated methods, including the severity modifier, have enabled it to recommend a number of treatments for conditions such as hepatitis D and cystic fibrosis, that it may not otherwise have been able to recommend for use on the National Health Service. Under these new methods, the proportion of positive recommendations is higher, at 86.5%, than with the end-of-life modifier, at 82.5%.

NICE has commissioned research to gather further evidence on societal preferences that will inform future methods reviews.