Lower usage of cancer medicines in the UK compared to other countries has created questions, including whether the current approach by NICE to assessing cancer medicines is an important factor in lower use in the UK. This Report is based on both a detailed literature review and interviews with key experts directly involved in the work of UK HTA bodies. It uncovers several important issues, including limitations in the use of QALYs for assessment of cancer therapies, the need for better integration of social value judgments in the deliberative process, and the important differences among licensing agencies, HTA bodies and companies about how best to measure effectiveness. Recommendations for addressing each issue are offered.