OBJECTIVES: This study is to call attention to the problems resulting from the National Institute for Health and Care Excellence’s (NICE) recent revision to their methods guidance on discounting, which recommends applying a lower discount rate than the reference case rate in selected cases. BACKGROUND: NICE’s reference case discount rate for costs and health effects is 3.5%. In 2011 NICE amended their economic appraisal guidelines recommending differential discounting of costs and health effects at 3.5% and 1.5% respectively in selected cases. A recently published article in Value in Health criticised this amendment on a number of grounds, including ambiguity over what are the eligible selected cases; the lack of rationale for selective application of differential discounting; the apparent inconsistencies that unjustified selective application give rise to; and, the size of the differential between the two discount rates. In April 2013 NICE published a comprehensive revision of their methods guidelines, in which equal discounting of costs and effects at 1.5% in selected cases is now recommended. ANALYSIS: While NICE’s new 2013 guidance no longer includes an unjustified differential between the discount rate on costs and health effects, it still recommends the application of lower discount rates in selected cases. The revised guidance still offers no rationale for such selective application of lower discount rates. This means that many of problems described in the recently published critique of the 2011 amendment still apply to the new 2013 guidance, including a particularly worrying potential for age discrimination. CONCLUSIONS: NICE’s selective application of lower discount rates in certain cases is not justified and leads to inconsistencies in the appraisal of different interventions. NICE is urged to again revise their discounting guidance, this time ensuring all interventions are treated equally and are subject to the same discount rates.