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Nicholson to end NHS black listing of drugs

pharmafile | August 9, 2012 | News story | Sales and Marketing IHW, NHS, NICE, Sir David Nicholson, formulary 

The chief executive of the NHS is looking to stamp out black listing of NICE-approved medicines.

In a letter to NHS managers, Sir David Nicholson said that he would be changing NHS contracts to ensure that all NHS bodies who use drug formularies will not be able to block new medicines approved by NICE.

Formularies are drawn up by PCTs and SHAs and list the drugs they will fund. But increasingly these formularies have been used to block new treatments from NICE, or delay their use to help cut costs. 

Sir David wrote: “Formularies have an important role in underpinning safe and effective use of medicines. However, they should not duplicate NICE assessments or challenge an appraisal recommendation. Once on formularies, there should be no further barriers to the use or prescription of technologies or medicines. 

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“Some good progress has been made, but there is much more to do to reduce variation. With that in mind, I want to see all NHS organisations publish information which sets out which NICE technology appraisals are included in their local formularies.”

He said that these publications should be clear and posted online so that patients, the public and stakeholders can easily understand them – currently, not all NHS bodies do promulgate their formulary lists.

From 1 April next year, Sir David said he intends to make this a standard term and condition in NHS contracts. In addition, Keith Ridge, chief pharmaceutical officer, will be writing to NHS chief pharmacists asking them to review local formulary processes.

Financial pressure 

NHS bodies have been blocking drugs in an effort to save costs – the NHS is under considerable financial pressure and must save £5 billion a year from 2009 to 2015.

Many PCTs and SHAs have used formularies to block new and expensive drugs so that the cost does not come out of its budget. 

But pharma, NICE and the government have criticised these decisions. To remedy this so-called black listing of drugs, UK prime minister David Cameron announced the creation of a ‘NICE Compliance Regime for Technology Appraisals’.

This came out from the Innovation Health and Wealth Report, published in December, and is designed to support patient access to NICE-approved drugs by ensuring all medicines are available to patients three months after an appraisal.

Sir David’s letter is looking to build on the Compliance Regime by ensuring that these PCT and SHA Clusters commit to this new policy, and that it will be continued by clinical commissioning groups, which will become the new commissioners from April next year. 

This has been coming to a head in the last few months, and comes in the same week that the chair of NICE, Sir Michael Rawlins, suggested that charity groups should sue the NHS if they think it is blocking access to NICE-approved drugs. 

Ben Adams 

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