OBJECTIVES: The National Institute for Health and Care Excellence (NICE) is known for its rigour in reviewing novel treatments and its cost-effectiveness driven methodologies for determining a treatment’s benefit to the healthcare system. Value for money is also a key concern for non-UK governments, however not all jurisdictions have the same health technology assessment (HTA) processes in place to evaluate novel treatments entering the market. With increased pharmaceutical spending and subsequent increase of importance of HTA to inform funding decisions, these non-UK governments potentially look elsewhere to assist in developing HTA methodologies and funding decisions. This study investigated NICE’s impact on HTA methodologies and decision-making in ex-UK health care systems. METHODS: Review and comparison of guidelines from NICE and 13 HTA bodies in 12 countries across the world. Review and comparison of NICE recommendations and subsequent decisions from 13 agencies between January 1^st