| Reasons | Illustrative examples |
| Cost effectiveness | A drug treatment gives a good return on the money it costs in terms of health outcome |
| An independent expert on health economics recommends the drug treatment | |
| Equality | A drug treatment helps to break down barriers to healthcare |
| Funding a drug treatment helps rectify disparities in health status among members of the population | |
| Funding a drug treatment helps rectify disparities in the level of healthcare provision across regions | |
| Funding a drug treatment helps rectify disparities in resources available in different clinical specialties | |
| Clinical effectiveness | There is a net health benefit to those treated with a drug, either as prolonged life or improved quality of life |
| A drug treatment increases patients’ chances for an independent life | |
| A drug treatment is lifesaving | |
| An independent scientific expert recommends a drug treatment | |
| Gross cost | The amount of money that it costs to offer a drug treatment |
| The total cost to the organisation, as a percentage of resources available, of offering a drug treatment | |
| The net cost to society of offering/not offering a drug treatment | |
| Political directive | Funding a drug treatment will help the organisation meet a performance target or comply with NICE guidelines |
| Appropriateness | A drug treats a condition that the general public considers an illness or disease |
| Patients cannot be expected to pay for a drug treatment themselves | |
| Patient choice | A drug treatment is a high priority within a clinical specialty for patients and patient representatives |
| Funding a drug treatment will offer patients a choice of when, where and how health services are provided | |
| Patients should be allowed to refuse treatment | |
| A drug treatment that delivers the best health improvement, based on patient-centred outcome measures, should have high priority for funding | |
| Delayed effects | A drug treatment has immediate effect |
| The service is a preventive measure that will save health resources in the long term | |
| Fear of litigation | It is likely that not funding a drug treatment will lead to a legal challenge |
| Internal and external pressures | Internal pressure from clinicians can lead to the legitimacy of decision-makers setting priorities being questioned |
| External pressure from patient interest groups and the media can lead to the legitimacy of decision-makers setting priorities being questioned | |
| Age | There is a special responsibility to treat young children because they have their lives in front of them |
| There is a special responsibility to treat the elderly because they have contributed to society | |
| No alternative | Denying services will take away the last hope |
| The health service owes patients at least to do something | |
| Responsibility | People who take risks with their health are not eligible for the same treatment as people who do not |
| Value to medical research | Funding this drug would enable research that will benefit people in the future |
NICE, National Institute for Health and Clinical Excellence.