OBJECTIVES: We undertook a retrospective analysis of NICE technology appraisals in NSCLC, haematological malignancies; gastric and breast cancer and compared submission evidence with final NICE recommendation. METHODS: The analysis was based on a review of published appraisals on the NICE website from 2007-2010. RESULTS: Over the past 3 years, NICE completed 15 appraisals in the indications of NSCLC, haematological malignancies, gastric and breast cancer. Ten of these appraisals were of targeted-therapies.  A total of 5 out of 15 appraisals were not recommended mainly because weak clinical evidence surrounding efficacy.  One of these technologies, Lapatinib, was not recommended for breast cancer despite the manufacturer offering a patient-access scheme. Focusing on the 10 appraisals that received positive recommendation, 4 appraisals received unconditional reimbursement. Rituximab is the only targeted-therapy to receive unconditional reimbursement because it was cost effective (