OBJECTIVES: In January 2009, the National Institute for Health and Clinical Excellence (NICE) adopted an evaluation process for life-extending end-of-life treatments. For eligible drugs, QALYs are weighted to favour the incremental cost-utility ratios (ICUR). Also, patient access scheme (PAS, pricing agreements) are sometimes established between the NHS and drug manufacturers to lower the economic impact of costly drugs. The purpose of this study was to document the effects of the end-of-life evaluation process (EOL) on anticancer drugs listing recommendations. METHODS: NICE website was searched to identify published technology appraisal guidances of anticancer drugs issued between January 2009 and May 2011. We documented EOL and PAS status, the listing recommendation and the supporting ICURs. Positive and negative recommendations were stratified by EOL and PAS status. RESULTS: We retrieved 32 recommendations among which 50% were approvals. The proportion of accepted drugs tends to be higher among those evaluated with the EOL (9/16; 56%, p=0,8). The ICURs of positive recommendations associated with drugs not eligible or not considered for the EOL were mostly comprised between 20,000£/QALY and 30,000£/QALY gained. On the other hand, ratios of positive recommendations for drugs eligible to the EOL were higher and varied from 30,350£/QALY to 54,366£/QALY gained. Among drugs evaluated with the EOL, the proportion of accepted drugs analysed with PAS (6/9; 67%, p=0,51) tends to be higher than for drugs accepted without PAS. CONCLUSIONS: Despite the small number of evaluations since its implementation, we observed with the EOL a higher ICUR threshold that may have led NICE to recommend to list more anticancer drugs that it would have been without the EOL. When the EOL was considered, PAS also seems to have contributed to a higher rate of positive listing. These findings have raised questions about the economic evaluation of anticancer drugs in Canada.