The National Institute of Health and Care Excellence (NICE) in England makes recommendations about medicines and treatments based on how well they work and their cost. Most of their recommendations are positive, but some are 'optimised', meaning they have restrictions. A study looked at optimised recommendations from 2015 to 2019 and found that in 65% of cases, NICE recommended the treatment for less than half of the patients who could benefit from it. This shows that while NICE's decisions are usually positive, they often limit patient access to certain treatments.