The National Institute for Health and Care Excellence (NICE) published its updated manual for health technology evaluations in January 2022 and has introduced a number of changes to make its methods and processes fairer, faster and more consistent. This includes the introduction of a broader severity modifier in place of the end-of-life modifier. Analysis carried out by NICE in the development of the modifier indicates that the vast majority of cancer medicines that would be eligible for the end-of-life modifier would also be eligible for a weighting under the severity modifier.