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.