Approval to Access: The 90 Day Myth

A medicine being approved by a NICE Technology Appraisal doesn't mean that it automatically becomes available to or used by every eligible patient. This tool and the associated course intends to show the system as it really is, not how it is intended to be.

Scope. This flow covers medicines commissioned by ICBs following routine NICE technology appraisal. Specialised commissioning (NHS England direct) is out of scope. That pathway diverges at NICE publication and follows a separate route toward implementation.

About this tool

Independent and personal. This tool is produced independently through The Prescription. It reflects general patterns in the medicines access system in England and represents the personal views of the author. It does not represent the views, policies, or position of any NHS organisation, employer, or other body, and does not refer to any specific ICB, provider, or organisation. It is for education and discussion. It is not guidance, and should not be relied upon for clinical, commercial, or commissioning decisions.

A snapshot in time. This reflects the expected process based on national guidance and typical practice. Local variation exists, and NHS structures, policy, and priorities may change the detail or timelines shown here. Last reviewed June 2026.

Concurrent steps. Many of these steps run concurrently rather than sequentially. Durations reflect typical elapsed time for each step in isolation.

🤝 The course

Approval to Access: implementation intelligence for medicines

This free tool maps the barriers a medicine can meet on its way from approval to patients. The course goes further. It works through where a medicine is most likely to meet resistance, and where a genuine partnership with the NHS could ease that path so more eligible patients are treated.

Worked case studies, with the data behind expected versus actual uptake
Published NHS and industry collaborations behind each partnership opportunity, with sources
A structured way to explore the partnership potential for a medicine of your own

Explore the course →