OBJECTIVES: Health technology appraisal (HTA) recommendations from the UK National Institute of Health and Clinical Excellence (NICE) are intended to standardise health care throughout the NHS, and hasten the uptake of new, more effective medicines that are cost-effective. Several studies have investigated whether NICE guidance influences UK drug uptake as intended, mostly using sales data. However, this approach does not reveal which indication, line of therapy, nor patient sub-group a drug has been used to treat. This study aims to avoid these limitations by using IMS Health’s Oncology AnalyzerTM as the primary data source. Oncology AnalyzerTM contains detailed records for a representative patient sample, allowing analyses to be focussed on the particular indication and treatment criteria specified in NICE HTAs. METHODS: HTAs for breast cancer drugs appraised by NICE from 2005 to 2008 were analysed. For each HTA, the proportion of the eligible patient sub-group that received the recommended (or not recommended) drugs from Q1 2005 to Q1 2009 was determined. Changes in drug uptake in the relevant patient populations were assessed for the UK, and were also compared to uptake in similar European countries. RESULTS: NICE produced 6 HTAs for breast cancer, encompassing 8 drugs, during the period assessed. In 5 out of 6 cases, the publication of an HTA was followed by the recommended change in UK drug uptake. However, when UK uptake of drugs recommended by NICE was compared to uptake of the same drugs in four other European countries (France, Germany, Italy and Spain), the UK ranked at the bottom of the group. CONCLUSIONS: The NICE HTAs assessed were mostly followed by the intended changes in drug uptake, suggesting they were implemented, at least by some PCTs. Despite this, international comparisons of uptake for these drugs revealed that the UK performed poorly compared to similar European countries.