Access with evidence development in the UK: past experience, current initiatives and future potential.

Access with evidence development (AED) describes the general approach of linking some form of access to the healthcare market with the generation of additional evidence relating to the value of the healthcare intervention under evaluation, with an explicit aim of aiding future decision making. A number of health systems around the world are interested in the potential for such schemes. This article looks in detail at the potential for some form of AED in the UK, focusing on the two major decision-making bodies: the Scottish Medicines Consortium in Scotland and the National Institute for Health and Clinical Excellence in England and Wales. We consider past experience with these approaches and current initiatives that are exploring their potential, and speculate as to how these schemes might develop in the future.