Should cost effectiveness analyses for NICE always consider future unrelated medical costs?

When developing guidance on the use of new technologies within the NHS, NICE recommends the use of cost effectiveness. Specifically, an intervention is deemed cost effective by NICE if ‘its health benefits are greater than the opportunity costs of programmes displaced to fund the new technology, in the context of a fixed NHS budget. In other words, the general consequences for the wider group of patients in the NHS are considered alongside the effects for those patients who may directly benefit from the technology.’ We argue that the technical guidelines for health technology assessment used by NICE should change given this definition of cost effectiveness. The point at issue is the handling of “unrelated future medical costs”.