OBJECTIVES: To characterize final NICE recommendations for anti-cancer agents indicated for 15 selected cancers, over time. METHODS: The analysis was based on a review of 58 drug-indication assessments, representing solid tumor and hematological cancers, published on NICE’s website (January 2001–March 2012).  From each assessment, we extracted the manufacturer’s initial submission base case incremental cost-effectiveness ratio (ICER), inclusion of a patient access scheme (PAS), application of end-of-life (EOL) consideration, and final NICE decision. RESULTS: Average manufacturer base case ICER increased over time, and the percentage of drugs not recommended increased from 0% in 2001 to 54% in 2011.  Across all years, NICE recommended 62% (36/58) drug-indication combinations.  Among these, 14% (5/36) included a PAS only, 11% (4/36) satisfied EOL criteria only, and 22% (8/36) included both a PAS and satisfied EOL criteria.  Seventy-two percent (26/36) had a manufacturer base case ICER ≤ ₤30,000, of which 27% (7/26) included a PAS with the initial submission, resulting in a base case ICER ≤ ₤30,000.  Of the 10 recommended drug-indication combinations with a manufacturer base case ICER > ₤30,000, 5 included a PAS with the initial manufacturer submission and another 3 satisfied EOL criteria only.  Additionally, 11 drug-indication combinations included a PAS with initial manufacturer submission, of which 4 satisfied EOL criteria, but none were recommended. CONCLUSIONS: Over time, manufacturer base case ICERs > ₤30,000 have become more common, although NICE is more likely to recommend cancer drugs if the base case ICER is < ₤30,000. Drugs with a base case ICER > ₤30,000 are recommended, typically, when the manufacturer and NICE reach an agreement to reduce cost of treatment through a PAS or when the cancer drug satisfies EOL criteria. Nevertheless, inclusion of a PAS with the initial manufacturer submission does not guarantee a positive recommendation.