OBJECTIVES: In March, the National Institute for Health and Care Excellence (NICE) revealed their plans to implement Value Based Assessment (VBA) in their Technology Appraisal process: VBA will replace NICE’s end-of-life criteria. Instead wider societal impact (WSI) and burden of illness (BOI) will be systematically included in the assessment through absolute and proportional Quality Adjusted Life Year (QALY) shortfall. However, it is unclear whether these elements will impact NICE’s recommendations.  METHODS: The BOI and WSI for the 26 examples provided by NICE was compared with an average displaced treatment in the NHS. Assuming that both elements were weighted equally, an average QALY shortfall rating was calculated. This was then transformed into a hypothetical willingness to pay (WTP) threshold ranging from £20,000 for the drug with the lowest rating to £50,000 per QALY for the drug with the highest rating. The hypothetical WTP was compared with the most plausible ICER and recommendation from NICE.  RESULTS: Multiple Sclerosis, rheumatoid and psoriatic arthritis, as well as oncology indications were associated with a high BOI/WSI. Six of the 26 examples had higher most plausible ICERs than the estimated threshold. Two of these six were still recommended using end-of-life criteria (metastatic melanoma and mCRPC), whereas the remainder were not recommended by NICE. Three of the 26 examples had ICERs below the estimated WTP threshold but higher than £30,000, and were still recommended. All of these recommendations mentioned additional value elements such as innovation, end-of-life criteria or even QoL impact on family.   CONCLUSIONS: This analysis presented a possible scenario for the implementation of VBA. None of the drugs with a negative recommendation would get a positive recommendation under this scenario. The products at most risk are those currently accepted using end-of-life criteria. However, how the new value elements will be weighted has yet to be determined.