OBJECTIVES: The National Institute of Health and Care Excellence (NICE) appraises the clinical- and cost-effectiveness of health technologies upon which they issue recommendations on whether they should be adopted by the National Health Service in England and Wales. NICE issues review dates with each appraisal where they will assess whether the guidance needs updating, but will consider a review ahead of this deadline if significant new evidence comes to light that could change the recommendation. Additionally, a rapid review facility is available to consider new patient access schemes (PASs) subsequent to guidance publication. This research aims to determine how frequently NICE Single Technology Appraisal (STA) recommendations have changed subsequent to it being issued. METHODS: All STAs were screened up to 1^st December 2015 for any guidance that had been superseded. The date, decision, drug, indication and key rationale from both original and subsequent submissions were extracted.   RESULTS: CONCLUSIONS: Companies wanting to attain NICE recommendations need to focus their efforts on any appeals in the draft guidance review consultation processes. Once final guidance is issued, it is very difficult to change this, unless the company is willing to offer a new/alternative PAS.