In this BMJ Analysis article, the authors note that the funding of new, expensive medicines relies increasingly on releasing funds by displacing other treatments, but NICE does not specify which, and thus in addition to the inequitable geographical variation in the availability of new medicines, inconsistent decisions on which treatments to abandon will also lead to geographical variation. They discuss how to establish which medicines should be discontinued, focusing on the following topics:

• Identifying medicines for disinvestment

• Prime candidates

• Grey areas

• Options for NICE

• Implementation