OBJECTIVES: To identify decisions by the SMC using the PACE process since the scheme was introduced and identify issues that influence a successful outcome. METHODS: Assessments that used the PACE process were identified from SMC briefing notes between May 2014 and June 2015. Key points expressed were classified into clinical issues or added value to the patient or carers. RESULTS: Twenty assessments were identified that used the PACE process: 17 in oncology indications and one each in hypertension, infection in cystic fibrosis, and myelofibrosis/splenomegaly. Ten were accepted (seven with a patient access scheme [PAS]) – three that met orphan criteria, one that met end-of-life criteria, and six that met both.  Five products were accepted with restrictions (four with a PAS) and five were rejected (one with a PAS). All assessments discussed clinical issues, including health-related benefits (17/20), health-related quality of life (HRQL) benefit related to symptoms (13/20), and reduction in adverse events (11/20). Sixteen provided data on the severity of the condition (impact on patients, carers and families, and/or assessment of severity); 9 characterized the unmet need; 13 considered the most appropriate position for the medicine in the pathway of care and/or identified specific patient groups. Seven assessments argued for added value to patients (convenience of treatment) and value to patient’s family and carers in terms of impact on family life (6), requirements for carers (2), and carers’ ability to work (1). CONCLUSIONS: PACE assessments to date have largely focused on clinical issues and patient’s quality of life, with limited attention as yet to the benefit to patients’ families/carers. PACE appears to be meeting the SMC’s objective of providing a forum for patients and clinicians to present arguments regarding the wider benefits of a drug that may not be easily captured in the standard assessment process.