The North East Treatment Advisory Group (NETAG) has produced an appraisal of tolvaptan within its licensed indication for the treatment of hyponatraemia due to SIADH and concluded that tolvaptan is not recommended for use within NHS North East for this indication. The Group considered that tolvaptan is unlikely to be cost-effective compared with existing treatment options. In addition, the group was concerned about the potential for unrestricted long-term treatment. Individual patients in exceptional circumstances may be suitable for treatment. Such cases must be referred via local individual funding request mechanisms.