MARA rated nivolumab (Opdivo) A (Strong) before NICE published TA1127 on 4 February 2026, recommending the drug for neoadjuvant plus adjuvant treatment of resectable NSCLC without EGFR or ALK alterations. The MARA NICE signal placed rejection at 3% against a 19% baseline — confirmed: NICE recommended access and found costs comparable to or lower than pembrolizumab. The two amber domains in the scorecard — HRQoL (Moderate, medium sensitivity) and Uncertainty (Moderate) — both surfaced in the NICE evaluation, where utility values were questioned and the indirect comparison with pembrolizumab was judged highly uncertain, though neither blocked the recommendation. NICE used a cost-comparison methodology rather than a standard incremental cost-effectiveness analysis, but the direction of the CE domain assessment (costs within acceptable range) held.