In 2022, the National Institute for Health and Care Excellence (NICE) undertook a detailed appraisal of whether it should broaden the perspective it uses in its economic evaluations, including consideration of wider societal impacts. NICE found that robust methods for quantifying wider societal effects are not yet sufficiently developed, and that evidence on the wider societal benefits of interventions, and of the services that might be displaced, is limited. NICE has also noted that expanding assessments to capture socio‑economic impacts could introduce ethical challenges, such as advantaging interventions for populations with higher workforce participation over those for children, older adults, or people unable to work.

Following this review, and after examining both international comparisons, and the significant methodological and ethical challenges involved, NICE’s Board concluded that it should retain its current approach of using a health-sector perspective routinely but with the flexibility to include wider societal benefits when they are especially relevant.