The National Institute for Health and Care Excellence (NICE) technology appraisal guidance process was introduced in 1999. We have interpreted this question as referring to individual medicines distinguished by their generic names. It should be noted that the number of medicines is not the same as the number of products. The figures given also differ from volumes of prescriptions or spending.
Out of 2,538 medicines used in the National Health Service in 2018/19, including medicines prescribed by general practitioners and used in hospitals, 1,799 (71%) had a best estimate launch date in the United Kingdom pre-dating the NICE appraisal process.
The NHS does not have unlimited resources and NHS commissioners have to make difficult decisions about commissioning care. In the absence of a positive technology appraisal or highly specialised technology recommendation by NICE, NHS commissioners should make funding decisions on individual treatments based on an assessment of the available evidence. This is reflected in the NHS Constitution as a right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence.