MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES …€¦ · adalimumab uveitis - adults nhs...

DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIAMONITORING/AUDIT

REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

ABACAVIRHIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √

ABACAVIR + LAMIVUDINE +

DOLUTEGRAVIR (TRIUMEQ®)

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:

B06/P/b/AGREED REGIONAL GUIDELINES

BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √

ABACAVIR + LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-


ABALOPARATIDEMALE AND JUVENILE OSTEOPOROSIS NHS ENGLAND

DRUGS AFFECTING BONE

METABOLISMNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ABATACEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS


COMMISSIONING POLICY: E03/P/d; TA

373

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ABATACEPTPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS AS PER ADULT TA'S (TA195, TA280) NICE NICE NICE √

ABIRATERONE CANCER NHS ENGLAND HORMONE ANTAGONISTS

TA259, 387 (SEE ALSO SSC1438)

ONLY IN ENZALUTAMIDE NAÏVE

PATIENTS

NICE/NHS ENGLAND POLICY NICESACT √ √

ADALIMUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS



373


ADALIMUMAB UVEITIS - PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY:D12X02NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ADALIMUMAB UVEITIS - ADULTS NHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED

(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: D12/P/a)

AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ADALIMUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED CRITERIA √

ADALIMUMABPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS

AS PER ADULT TA'S (TA130, TA143,

TA146, TA187, TA199)NICE NICE NICE AUDIT √

ADALIMUMAB HIDRADENITIS SUPPURATIVA NHS ENGLAND CYTOKINE MODULATORS NICE TA 392 NICE NICE NICE AUDIT √ √

ADEFOVIR HEPATITIS B NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUS


(CG165)AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

AFATINIB CANCER NHS ENGLAND CANCER EXCLUSION TA310 NICE NICE SACT √

AFLIBERCEPT CANCER NHS ENGLAND CANCER EXCLUSIONNOT ROUTINELY COMMISSIONED

(TA307)AS PER CDIFR APPROVAL AS PER CDIFR APPROVAL SACT √

AGALSIDASE ALFA FABRY'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

AGALSIDASE BETA FABRY'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ALBUTREPENONACOG ALFA HAEMOPHILIA BNHS ENGLAND BLOOD-RELATED PRODUCTS SSC 1652 SSC 1652 SSC 1652 PRODUCTS ON CMU FRAMEWORK √

ALBUTROPIN ADULT ONSET GROWTH HORMONE

DEFICIENCY NHS ENGLANDGROWTH HORMONE & GROWTH

HORMONE RECEPTOR ANTAGONISTNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ALDESLEUKIN CANCER NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL SACT √

ALEMTUZUMAB MULTIPLE SCLEROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSETA312 NICE NICE NICE AUDIT √ √****

ALEMTUZUMABPRE-TRANSPLANT

IMMUNOSUPPRESSIONNHS ENGLAND

DRUGS AFFECTING THE IMMUNE

RESPONSE

TRUST GUIDELINES: ISLET

TRANSPLANTATION (ONLY IF PROVIDED

AT ZERO DRUG COST)

TRUST GUIDELINES TRUST GUIDELINES √

ALEMTUZUMAB CLL NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE

TRUST GUIDELINES: (ONLY IF

PROVIDED AT ZERO DRUG COST)TRUST GUIDELINES TRUST GUIDELINES SACT √

ALEMTUZUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS

HIGHLY SPECIALISED CRITERIA ONLY

(ONLY IF PROVIDED AT ZERO DRUG

COST)

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ALGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ALIPOGENE TIPARVOVEC LIPOPROTEIN LIPASE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ALISPORIVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ALPHA-1 ANTITRYPSIN ALPHA-1 ANTITRYPSIN DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC


ALPHA MANNOSIDASE

RECOMBINANT HUMANALPHA MANNOSIDASE DEFICIENCY NHS ENGLAND

DRUGS USED IN METABOLIC


AMBRISENTANPULMONARY ARTERIAL

HYPERTENSIONNHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION


COMMISSIONING POLICY: A11/P/cNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

AMIFAMPRIDINE PHOSPHATE LEMS NHS ENGLAND NEUROMUSCULAR DISORDERSNOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY: 16009/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

AMIKACIN INHALATION CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

AMIKACIN LIPOSOMALCYSTIC FIBROSIS

NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

AMPHOTERICIN LIPOSOMAL FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

√

ANAKINRA JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/P/dNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ANAKINRASPECIALIST AUTOINFLAMMATORY

DISEASENHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ANAKINRA PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ANAKINRACRYOPYRIN ASSOCIATED PERIODIC

SYNDROMENHS ENGLAND CYTOKINE MODULATORS

CRYOPYRIN ASSOCIATED PERIODIC

SYNDROME SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES AND DIRECTLY COMMISSIONED BY NHS ENGLAND

VERSION 11 PUBLISHED DECEMBER 2016

NHS England drugs-list v11 v4 NHSE Commissioned PbRE Drugv11 1 22/12/2016


REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

ANIDULAFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

ANTIHAEMOPHILIC FACTOR/VON

WILLEBRAND FACTOR COMPLEX

AS PER BCSH GUIDELINES FOR

SPECIALISED INDICATIONSNHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES PRODUCTS ON CMU FRAMEWORK √

ANTILYMPHOCYTE GLOBULIN APLASTIC ANAEMIA

ORGAN TRANSPLANTNHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIASBCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

ANTIPSEUDOMONAS AERUGINOSA

IgYCYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ANTITHROMBIN IIIAS PER BCSH GUIDELINES FOR

SPECIALISED INDICATIONSNHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

ANTITHYMOCYTE

IMMUNOGLOBULIN

APLASTIC ANAEMIA

ORGAN TRANSPLANTNHS ENGLAND


HAEMOLYTIC, AND RENAL ANAEMIASBCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

APREMILAST PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ARAGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS

HUMAN NORMAL IMMUNOGLOBULINS

CLINICAL GUIDELINES FOR

IMMUNOGLOBULIN USE, SECOND

EDITION UPDATE (JULY 2011)

NATIONAL GUIDELINES NATIONAL GUIDELINES QUALITY DASHBOARD √

ASFOTASE ALFA HYPOPHOSPHATASIA NHS ENGLANDDRUGS USED IN METABOLIC


ASUNAPREVIR + DACLATASVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


ATACICEPT SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSENOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ATALUREN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NICE HST3 NICE NICE NORTHSTAR DATABASE √ √

ATAZANAVIRHIV IN COMBINATION WITH OTHER ANTI-


ATAZANAVIR + COBICISTAT

(EVOTAZ®)



AVORALSTAT HEREDITARY ANGIOEDEMA NHS ENGLAND ALLERGIC EMERGENCIES NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

AXITINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA333 (also refer to circular SSC1508) NICE NICE SACT √

AZACITIDINE CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROME TA218 NICE NICE SACT √

AZTREONAM LYSINE CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGSNHS ENGLAND CLINCAL

COMMISSIONING POLICY: A01/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √* √*

AZTREONAM LYSINE CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS


NHS ENGLAND CLINCAL

COMMISSIONING POLICY: 16001/P


BARICITINIBPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BASILIXIMAB RENAL TRANSPLANT NHS ENGLANDCORTICOSTEROIDS AND OTHER

IMMUNOSUPPRESSANTSTA85 & TA99 NICE NICE √

BECLABUVIR HEPATITIS CNHS ENGLAND

VIRAL HEPATITIS (B&C) &


BEDAQUILINE EXTENSIVELY DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: F04/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

BEDAQUILINE MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


BEGELOMAB GRAFT VERSUS HOST DISEASE NHS ENGLANDMALIGNANT DISEASE AND

IMMUNOSUPPRESSIONNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BELATACEPT RENAL TRANSPLANT NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE

NOT ROUTINELY COMMISSIONED - NICE

TA IN PROGRESSNICE TA IN PROGRESS NICE TA IN PROGRESS NICE TA IN PROGRESS √

BELIMUMAB SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSENICE TA 397 NICE NICE NICE AUDIT √ √

BENRALIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPY NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BERACTANT RESPIRATORY DISTRESS SYNDROME NHS ENGLAND PULMONARY SURFACTANTS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

BETAINE HOMOCYSTINURIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


BEVACIZUMAB CANCER CDF ANTINEOPLASTIC DRUGS CDF POLICY CDF CDF SACT √

BEVACIZUMAB NEUROFIBROMATOSIS NHS ENGLAND ANTINEOPLASTIC DRUGSAS PER NATIONAL PROTOCOL (SEE NF2

SERVICE SPEC)

AS PER NATIONAL

PROTOCOL

AS PER NATIONAL

PROTOCOLAS PER NATIONAL PROTOCOL √

BIMAGRUMAB INCLUSION BODY MYOSITIS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BIOTIN MULTIPLE SCLEROSIS NHS ENGLAND VITAMINS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BLISIBIMODSYSTEMIC LUPUS ERYTHEMATOSUS

(SLE)NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BOCEPREVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA253 NICE NICE HEPATITIS C MDS √ √

BORTEZOMIBORGAN REJECTION POST KIDNEY

TRANSPLANTNHS ENGLAND ANTINEOPLASTIC DRUGS



COMMISSIONING POLICY: A07/P/c)


BORTEZOMIB CANCERNHS ENGLAND/

CDFANTINEOPLASTIC DRUGS

TA129, TA228, TA311, TA 378

CDF POLICY

NICE

CDF

NICE

CDFSACT √

BOSENTAN DIGITAL ULCERS NHS ENGLAND



HYPERTENSION


COMMISSIONING POLICY: A13/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

BOSENTANPULMONARY ARTERIAL




HYPERTENSION



BOSUTINIB CANCER NHS ENGLAND CANCER EXCLUSION TA 401 NICE NICE SACT √

BOTULINUM TOXIN FOCAL SPASTICITY IN CHILDREN NHS ENGLANDTORSION DYSTONIAS AND OTHER

INVOLUNTARY MOVEMENTSAGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES AS PER POLICY √

BOTULINUM TOXIN**** INTRAVESICAL USE IN SPINAL CORD

INJURYNHS ENGLAND

TORSION DYSTONIAS AND OTHER

INVOLUNTARY MOVEMENTSAGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES AS PER POLICY √

BRINCIDOFOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BRODALIMUMABPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

C1 ESTERASE INHIBITORSHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT NHS ENGLAND ALLERGIC EMERGENCIES


COMMISSIONING POLICY: B09/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

C1 ESTERASE INHIBITORSHEREDUTARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES


COMMISSIONING POLICY: 16045/PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √ √



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

CANAKINUMABCRYOPYRIN ASSOCIATED PERIODIC

SYNDROMENHS ENGLAND IMMUNOMODULATING DRUGS

CRYOPYRIN ASSOCIATED PERIODIC

SYNDROME SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


CANAKINUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND IMMUNOMODULATING DRUGSNOT ROUTINELY COMMISSIONED

(TA302)AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CARGLUMIC ACID UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


CARNITINE CARNITINE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


CASPOFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

CATRIDECACOGCONGENITAL FACTOR XIII A-SUBUNIT

DEFICIENCYNHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CERALIFIMOD MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CERLIPONASE ALFA NEURONAL CEROID LIPOFUSCINOSIS NHS ENGLANDLYSOSOMAL STORAGE DISORDER

DRUGSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CERTOLIZUMAB PEGOL PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CETUXIMAB CANCERNHS ENGLAND/

CDFANTINEOPLASTIC DRUGS

TA145, TA176

CDF POLICY

NICE

CDF

NICE

CDFSACT √

CHENODEOXYCHOLIC ACIDCEREBROTENDINOUS

XANTHOMATOSIS (CTX) NHS ENGLAND



CHENODEOXYCHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC


CHOLIC ACIDINBORN ERRORS IN PRIMARY BILE

ACID SYNTHESISNHS ENGLAND



CIDOFOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

CIPROFLOXACIN INHALATION CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CIPROFLOXACIN LIPOSOMAL

(INHALED)

CYSTIC FIBROSISNHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CLADRIBINE MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √****

CLADRIBINEPULMONARY LANGERHANS

HISTIOCYTOSISNHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

COBICISTATHIV IN COMBINATION WITH OTHER ANTI-




F03/P/b/AGREED REGIONAL GUIDELINES

NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

COBITOLIMODPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND



CO-CARELDOPA INTESTINAL GEL PARKINSON'S DISEASE NHS ENGLAND NEURODEGENERATIVE CONDITIONSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: D04/P/eNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

COLISTIMETHATE SODIUM CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS


COMMISSIONING POLICY: A01/P/b

TA276

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√* √*

CONESTAT ALFAHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES



CRIZOTINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS NICE TA 406, 422 NICE NICE SACT √

CYSTEAMINE (MERCAPTAMINE) NEPHROPATHIC CYSTINOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


DABRAFENIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA321, 396 NICE NICE SACT √ (TA396) √

DACLATASIVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA 364 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

DACLIZUMAB MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DARUNAVIRHIV IN COMBINATION WITH OTHER ANTI-


DARUNAVIR +

COBICISTAT (REZOLSTA®)



DASABUVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


DASATINIB CANCERNHS ENGLAND/

CDFPROTEIN KINASE INHIBITORS

NICE TA 425, 426

CDF POLICY

NICE

CDF

NICE

CDF SACT √

DECITABINE CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROMENOT ROUTINELY COMMISSIONED

(TA270)AS PER IFR APPROVAL AS PER IFR APPROVAL SACT √

DEFERASIROXIRON CHELATION IN THALASSAEMIA

AND SICKLE CELLNHS ENGLAND


HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD


COMMISSIONING POLICY 16070/PNHS ENGLAND POLICY NHS ENGLAND POLICY

QUALITY DASHBOARD/ NATIONAL

HAEMOGLOBINOPATHY REGISTRY√

DEFERIPRONE**IRON CHELATION IN THALASSAEMIA




IRON OVERLOAD





DEFIBROTIDE HEPATIC VENO-OCCLUSIVE DISEASE NHS ENGLAND BLOOD-RELATED PRODUCTSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: B04/P/cNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

DELAMANID EXTENSIVELY DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


DELAMANID MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


DESFERRIOXAMINE**IRON CHELATION IN THALASSAEMIA




IRON OVERLOAD





DEXRAZOXANE ANTHRACYCLINE EXTRAVASATION NHS ENGLAND IMMUNOMODULATING DRUGS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

DEXRAZOXANE ANTHRACYCLINE CARDIOTOXICITY NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DIBOTERMIN ALFA COMPLEX SPINAL SURGERY NHS ENGLAND BONE MORPHOGENETIC PROTEINNHS ENGLAND CLINICAL

COMMISSIONING POLICY 16063/PNHS ENGLAND POLICY NHS ENGLAND POLICY AUDIT, BSR REGISTRY √

DIDANOSINEHIV IN COMBINATION WITH OTHER ANTI-


DIMETHYL FUMARATE MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS TA320 NICE NICE NICE AUDIT √ √****



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

DOLUTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-




B06/P/b/AGREED REGIONAL GUIDELINES


DORAVIRINEHIV iN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DORNASE ALFA PRIMARY CILIARY DYSKINESIA NHS ENGLAND MUCOLYTICSNOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY 16029/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DORNASE ALFA CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: A01/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √* √*

DRISAPERSEN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DUPILUMAB ASTHMA NHS ENGLANDDRUGS AFFECTING THE IMMUNE


ECALLANTIDEHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ECULIZUMABORGAN REJECTION POST KIDNEY

TRANSPLANTNHS ENGLAND

PAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA


NHS ENGLAND POLICY: A07/P/bAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ECULIZUMABC3 GLOMERULOPATHY (POST

TRANSPLANT)NHS ENGLAND


HAEMOGLOBINURIA



ECULIZUMAB AHUS NHS ENGLANDPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA


COMMISSIONING POLICY: E03/PS(HSS)/A

NICE HST1

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE√

ECULIZUMABPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIANHS ENGLAND


HAEMOGLOBINURIA

NHS NATIONAL SPECIALISED

COMMISSIONING TEAM SERVICE

SPECIFICATION

NSCT SERVICE SPEC NSCT SERVICE SPEC NSCT SERVICE SPEC √

EDRATIDE SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE


EFAVIRENZHIV IN COMBINATION WITH OTHER ANTI-


EFRALOCTOCOG ALFA /

EFMOROCTOCOG ALFA / FACTOR

VIII FC FUSION PROTEIN (Elocta®)

HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS SSC 1652 SSC 1652 SSC 1652 PRODUCTS ON CMU FRAMEWORK √

EFTRENONACOG ALFA (Alprolix®) HAEMOPHILIA B NHS ENGLAND BLOOD-RELATED PRODUCTS SSC 1652 SSC 1652 SSC 1652 PRODUCTS ON CMU FRAMEWORK √

ELBASVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


ELIGLUSTAT GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


ELOSULFASE ALFA MUCOPOLYSACCHARIDOSIS IV TYPE A NHS ENGLANDLYSOSOMAL STORAGE DISORDER

DRUGSNICE HST2

MANAGED ACCESS

AGREEMENT

MANAGED ACCESS

AGREEMENTMANAGED ACCESS AGREEMENT √ √

ELTROMBOPAG ITP IN CHILDREN NHS ENGLAND PLATELET DISORDER DRUGS AS PER ADULT TA 293 NICE NICE NICE AUDIT √

ELVITEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

ELVUCITABINEHIV IN COMBINATION WITH OTHER ANTI-


EMRICASANNON-ALCOHOLIC STEATOHEPATITIS

(NASH) FIBROSISNHS ENGLAND



EMTRICITABINEHIV IN COMBINATION WITH OTHER ANTI-


EMTRICITABINE +TENOFOVIRHIV IN COMBINATION WITH OTHER ANTI-


EMTRICITABINE + TENOFOVIR

ALAFENAMIDE DESCOVY®HIV IN COMBINATION WITH OTHER ANTI-



COMMISSIONING POLICY: 16043/PNHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

EMTRICITABINE + RILPIVIRINE +

TENOFOVIR ALAFENAMIDE

(ODEFSEY®)





ENFUVIRTIDEHIV IN COMBINATION WITH OTHER ANTI-


ENTECAVIR HEPATITIS B NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA153 & IN PROGRESS NICE NICE NICE AUDIT √

ENZALUTAMIDE CANCER NHS ENGLAND HORMONE ANTAGONISTS

TA316, TA 377 (SEE ALSO SSC1439)

BOTH: ONLY IN ABIRATERONE NAÏVE

PATIENTS

NICE/NHS ENGLAND POLICY NICESACT √

EPOPROSTENOL (5)PULMONARY ARTERIAL




HYPERTENSION



EPRATUZUMAB SLE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

EPRODISATE AMYLOIDOSIS NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

EPTOTERMIN ALFA COMPLEX SPINAL SURGERY NHS ENGLAND BONE MORPHOGENETIC PROTEIN NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ERLOTINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORSTA162, TA227, TA 374& IN PROGRESS

NHSE LETTERNICE NICE SACT √

ETANERCEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS



373


ETANERCEPTPAEDIATRIC INDICATIONS (WHERE



TA143, TA199)NICE NICE NICE AUDIT √

ETEPLIRSEN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ETRAVIRINEHIV IN COMBINATION WITH OTHER ANTI-


ETROLIZUMABPAEDIATRIC INDICATIONS (WHERE




EVEROLIMUS (AFINITOR®) CANCERNHS ENGLAND/


TA421

CDF POLICY

NICE

CDF

NICE

CDF SACT √

EVEROLIMUS (CERTICAN®)PREVENTING ORGAN REJECTION IN

LIVER TRANSPLANTATIONNHS ENGLAND PROTEIN KINASE INHIBITORS



EVEROLIMUS (CERTICAN®)PREVENTING ORGAN REJECTION IN

HEART TRANSPLANTATIONNHS ENGLAND PROTEIN KINASE INHIBITORS

NOT ROUTINELY COMMISSIONED NHS

ENGLAND POLICY 16016/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

EVEROLIMUS (VOTUBIA®)

SUBEPENDYMAL GIANT CELL

ASTROCYTOMA (SEGA) ASSOCIATED

WITH TUBULAR SCLEROSIS

NHS ENGLAND PROTEIN KINASE INHIBITORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: 16066/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

EVEROLIMUS (VOTUBIA®)

RENAL ANGIOMYOLIPOMA

ASSOCIATED WITH TUBULAR

SCLEROSIS

NHS ENGLAND PROTEIN KINASE INHIBITORS


COMMISSIONING POLICY STATEMENT

B14X09L


EVOLOCUMABHOMOZYGOUS FAMILIAL

HYPERCHOLESTEROLAEMIANHS ENGLAND LIPID-REGULATING DRUGS

AS NICE TA 394

(FOLLOW GUIDANCE FOR

HETEROZYGOUS FH)

NICE NICE NICE AUDIT √

EX-VIVO EXPANDED AUTOLOGOUS

HUMAN CORNEAL EPITHELIAL

CELLS CONTAINING STEM CELLS

TREATMENT OF ADULT PATIENTS WITH

MODERATE TO SEVERE LIMBAL STEM

CELL DEFICIENCY (LSCD), UNILATERAL

OR BILATERAL, DUE TO PHYSICAL OR

CHEMICAL OCULAR BURNS

NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

FACTOR IXAS PER BCSH GUIDELINES FOR


FACTOR VIIAS PER BCSH GUIDELINES FOR


FACTOR VIIAAS PER BCSH GUIDELINES FOR


FACTOR VIIIAS PER BCSH GUIDELINES FOR


FACTOR VIII INHIBITOR BYPASSING

FACTOR (FEIBA)

AS PER BCSH GUIDELINES FOR


FACTOR XIIIAS PER BCSH GUIDELINES FOR


FAMPRIDINE MULTIPLE SCLEROSIS NHS ENGLAND NEUROMUSCULAR DISORDERSNOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY: 16010/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √****

FIBRINOGENAS PER BCSH GUIDELINES FOR


FIBROBLAST GROWTH FACTOR 1

GENE THERAPYSOMATOSTATIN ANALOGUE NHS ENGLAND SOMATOSTATIN ANALOGUES NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

FILGOTINIBPAEDIATRIC INDICATIONS (WHERE




FILGRASTIM BARTH SYNDROME NHS ENGLAND DRUGS USED IN NEUTROPENIA HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

FILGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIA SPC TRUST GUIDELINES TRUST GUIDELINES




PRODUCT WITH LOWEST

ACQUISITION COST TO BE USED

√

FILIBUVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


FINGOLIMOD MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA254

NHS ENGLAND POLICY: D04/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NICE AUDIT √ √****

FITUSIRAN HAEMOPHILIA A AND B NHS ENGLANDANAEMIAS AND SOME OTHER BLOOD


FLEBOGAMMA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






FLEBOGAMMADIF AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






FORIGERIMOD ACETATE SLE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

FOSAMPRENAVIRHIV IN COMBINATION WITH OTHER ANTI-


FOSCARNET CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

FOSTEMSAVIRHIV iN COMBINATION WITH OTHER ANTI-


GALSULFASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


GAMMAGARD AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMMANORM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMMAPLEX AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMUNEX AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GANCICLOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

GANETESPIB CANCER NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSENOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL SACT √

GEFITINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA192 NICE NICE SACT √

GEVOKIZUMAB UVEITIS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

GLATIRAMER MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS TA32 & NHS ENGLAND POLICY: D04/P/b NHS ENGLAND POLICY NHS ENGLAND POLICY AS PER NHSE POLICY √ √****

GLECAPREVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


GLUCARPIDASEMETHOTREXATE INDUCED RENAL

DYSFUNCTIONNHS ENGLAND POISONING


COMMISSIONING POLICY: B15/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

GLYCEROL PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


GLYCOPEGYLATED FACTOR IX HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

GOLIMUMAB PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS AS PER ADULTS TA'S (TA220, TA233) NICE NICE NICE AUDIT √



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

GRANULOCYTE-MACROPHAGE

COLONY-STIMULATING FACTOR

(LEUKINE® - IMPORT)

ANTIBODY-POSITIVE PULMONARY

ALVEOLAR PROTEINOSISNHS ENGLAND DRUGS USED IN NEUTROPENIA NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

GRAZOPREVIRHEPATITIS C NHS ENGLAND



HIV VACCINE HIV INFECTION PROPHYLAXIS NHS ENGLAND VACCINES AND ANTISERA NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

HIZENTRA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






HUMAN (HAEM) ARGINATE HEPATIC PORPHYRIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


HUMAN HETEROLOGOUS LIVER

CELLSUREA CYCLE DISORDERS NHS ENGLAND



HUMAN PARATHYROID HORMONE-

RELATED PROTEIN ANALOGUE

MALE AND JUVENILE OSTEOPOROSIS

HYPOPARATHYROIDISMNHS ENGLAND

DRUGS AFFECTING BONE

METABOLISMNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

HYQVIA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS

HUMAN NORMAL IMMUNOGLOBULINSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

IBALIZUMABHIV iN COMBINATION WITH OTHER ANTI-


ICATIBANTHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES



ICATIBANTHEREDUTARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES


COMMISSIONING POLICY: 16045/PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √ √

IDEBENONE DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

IDURSULFASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ILOPROST (5)PULMONARY ARTERIAL




HYPERTENSION



IMATINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA70, TA86, TA251, TA326 NICE NICE SACT √

IMATINIB GRAFT VERSUS HOST DISEASE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

IMIGLUCERASE GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


INDINAVIRHIV IN COMBINATION WITH OTHER ANTI-


INFLIXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


INFLIXIMAB UVEITIS NHS ENGLAND CYTOKINE MODULATORS



COMMISSIONING POLICY: D12/P/a &

D12/P/a)


INFLIXIMABPAEDIATRIC INDICATIONS (WHERE



TA140, TA143, TA163, TA199)NICE NICE NICE AUDIT √

INFLIXIMABCONNECTIVE TISSUE DISEASE -

INTERSTITAL LUNG DISEASENHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED -

POLICY IN PROGRESSAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INFLIXIMAB CROHN'S DISEASE IN CHILDREN NHS ENGLAND CYTOKINE MODULATORS TA187 NICE NICE NICE AUDIT √

INFLIXIMAB GRAFT VERSUS HOST DISEASE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INFLIXIMAB RENAL NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INFLIXIMAB SARCOIDOSIS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INFLIXIMAB HIDRADENITIS SUPPURATIVA NHS ENGLAND CYTOKINE MODULATORSNOT ROUTINELY COMMISSIONED - NHS

ENGLAND POLICY 16018/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INFLIXIMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


INTERFERON ALFA HEPATITIS B AND C NHS ENGLAND IMMUNOMODULATING DRUGS TA75 NICE NICE NICE AUDIT √

INTERFERON BETA MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA32

NHS ENGLAND POLICY: D04/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER NHSE POLICY √ √****

INTRATECT AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






ISAVUCONAZOLEFUNGAL INFECTION (LICENSED

INDICATIONS)NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS


COMMISSIONING POLICY: A01/P/c,

16049/P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

IXAZOMIB AMYLOIDOSIS/ MULTIPLE MYELOMA NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

KIOVIG AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






LAMIVUDINE HEPATITIS B NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSCG165 NICE NICE NICE AUDIT √

LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-


LANREOTIDE CANCER NHS ENGLAND SOMATOSTATIN ANALOGUES AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√

LANREOTIDE CONGENITAL HYPERINSULINISM NHS ENGLAND SOMATOSTATIN ANALOGUES HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

LANREOTIDE*** ACROMEGALY NHS ENGLAND SOMATOSTATIN ANALOGUES AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√ √

LAPATINIB CANCER CDF PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED CDIFR CDIFR SACT √

LAQUINIMOD MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √****

LARONIDASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


LEBRIKIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPY NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LENALIDOMIDE CANCERNHS ENGLAND/

CDFIMMUNOMODULATING DRUGS

TA171, TA322

CDF POLICY

NICE

CDF

NICE

CDFSACT √



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

LENOGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIA SPC TRUST GUIDELINES TRUST GUIDELINES




PRODUCT WITH LOWEST

ACQUISITION COST TO BE USED

√

LENOGRASTIM BARTH SYNDROME NHS ENGLAND DRUGS USED IN NEUTROPENIA HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

LETERMOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LEVOFLOXACIN (INHALED) CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LIPEGFILGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIANOT ROUTINELY COMMISSIONED -


LIXIVAPTANHYPONATRAEMIA AND OTHER

ENDOCRINE USESNHS ENGLAND

POSTERIOR PITUITARY HORMONES

AND ANTAGONISTSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LOMITAPIDEHOMOZYGOUS FAMILIAL

HYPERCHOLESTEROLEMIA NHS ENGLAND LIPID-REGULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LONAFARNIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

LOPINAVIR + RITONAVIRHIV IN COMBINATION WITH OTHER ANTI-


LUMACAFTOR AND IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNOT ROUTINELY COMMISSIONED

TA IN PROGRESSAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MACIMORELIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH


MACITENTANPULMONARY ARTERIAL




HYPERTENSION


COMMISSIONING POLICY: A11/P/cAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MANNITOL CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS


COMMISSIONING POLICY: A01/P/b

TA266

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√

MARAVIROCHIV IN COMBINATION WITH OTHER ANTI-


MASITINIB PANCREATIC CANCER/GIST NHS ENGLAND PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MAVRILIMUMABPAEDIATRIC INDICATIONS (WHERE




MECASERMIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH

HORMONE RECEPTOR ANTAGONIST


COMMISSIONING POLICY: EO3/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

MEPOLIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPYNOT ROUTINELY COMMISSIONED

TA IN PROGRESSAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

METRELEPTIN DYSLIPIDAEMIA NHS ENGLAND OTHER ENDOCRINE DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MICAFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

MIGALASTAT FABRY'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


MIGLUSTAT GAUCHER'S DISEASE/ NIEMANN-PICK NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


MOMELOTINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MOTAVIZUMAB RSV PROPHYLAXIS NHS ENGLANDVIRAL HEPATITIS (B&C) &


NATALIZUMAB MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA127

NHS ENGLAND POLICY: D04/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NICE AUDIT √ √****

NELFINAVIRHIV IN COMBINATION WITH OTHER ANTI-


NEVIRAPINEHIV IN COMBINATION WITH OTHER ANTI-


NILOTINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA241, TA251 NICE NICE SACT √

NINTEDANIB OVARIAN CANCER NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED CDIFR CDIFR SACT √

NINTEDANIB (OFEV®) IDIOPATHIC PULMONARY FIBROSIS NHS ENGLAND IMMUNOMODULATING DRUGS TA 379 NICE NICE NICE AUDIT √ √

NINTEDANIB (VARGATEF®) NON-SMALL-CELL LUNG CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA347 NICE NICE SACT √

NITAZOXANIDE HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


NITISINONE ALKAPTONURIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


NITISINONE TYROSINAEMIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


NITRIC OXIDEPULMONARY ARTERIAL




HYPERTENSION

AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

NONACOG ALPHA (BeneFIX) HAEMOPHILIA B NHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

NONACOG BETA PEGOL HAEMOPHILIA B NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

NORMAL IMMUNOGLOBULIN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






OBETICHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC


OCRELIZUMAB MULTIPLE SCLEROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE


OCTAGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






OCTOCOG ALFA HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

OCTREOLIN ACROMEGALY NHS ENGLANDGROWTH HORMONE & GROWTH


OCTREOTIDE CANCER NHS ENGLAND SOMATOSTATIN ANALOGUES AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST


OCTREOTIDE CONGENITAL HYPERINSULINISM NHS ENGLAND SOMATOSTATIN ANALOGUES HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

OCTREOTIDE*** ACROMEGALY NHS ENGLAND SOMATOSTATIN ANALOGUES AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST




REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

OFATUMUMAB CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA344 NICE NICE SACT √

OFATUMUMAB PEMPHIGUS VULGARIS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

OLESOXIME SPINAL MUSCULAR ATROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

OMALIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPY TA278 NICE NICE NICE AUDIT √ √

OMBITASVIR/PARITAPREVIR/RITON

AVIR + DASABUVIR + RIBAVIRINHEPATITIS C NHS ENGLAND



OSILODROSTAT CUSHING'S DISEASE NHS ENGLAND OTHER ENDOCRINE DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

OZANIMOD MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PACRITINIB MYELOFIBROSIS NHS ENGLAND PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PALIVIZUMAB RSV PROPHYLAXIS NHS ENGLANDVIRAL HEPATITIS (B&C) &


JCVI GUIDELINES

PHE SPECIFICATIONAS PER SPECIFICATION AS PER SPECIFICATION √ √

PARA-AMINOSALICYLIC ACID TB NHS ENGLAND ANTITUBERCULOSIS DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PARATHYROID HORMONESPECIALIST ENDOCRINOLOGY

CONDITIONSNHS ENGLAND PARATHYROID HORMONE AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

PARENTERAL NUTRITION (HOME

USE)INTESTINAL FAILURE NHS ENGLAND PARENTERAL NUTRITION AS PER BLUETEQ FORM AS PER BLUETEQ FORM AS PER BLUETEQ FORM AUDIT √ √

PARENTERAL NUTRITION

(INPATIENT USE)

INTESTINAL FAILURE; INADEQUATE/

UNSAFE ENTERAL FEEDINGNHS ENGLAND PARENTERAL NUTRITION

ONLY WHEN DURATION OF PN IS > 14

DAYS OR INITIATED PRIOR TO

ADMISSION. ADULTS; SEE ALSO CG32.

SEE ALSO 'MANUAL FOR PRESCRIBED

SPECIALISED SERVICES'

TRUST GUIDELINES TRUST GUIDELINES √

PARITAPREVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


PASIREOTIDE ACROMEGALY NHS ENGLAND SOMATOSTATIN ANALOGUESNOT ROUTINELY COMMISSIONED


PASIREOTIDE CUSHING'S DISEASE NHS ENGLAND SOMATOSTATIN ANALOGUESNHS ENGLAND CLINICAL

COMMISSIONING POLICY: 16052/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

PAZOPANIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA215 NICE NICE SACT √

PEG INTERFERON ALFA HEPATITIS B AND C NHS ENGLANDVIRAL HEPATITIS (B&C) &



COMMISSIONING POLICY: B07/P/a; TA75,

TA96, TA106, TA200, TA 300

CG165

NICE NICE NICE AUDIT √

PEGFILGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIANOT ROUTINELY COMMISSIONED -


PEGINTERFERON BETA-1A MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS

ROUTINELY COMMISSIONED AS PER

SSC1534: MULTIPLE SCLEROSIS FIRST

LINE DISEASE MODIFYING AGENTS

NHS ENGLAND POLICY NHS ENGLAND POLICY NICE AUDIT √ √****

PEGINTERFERON LAMBDA-1A HEPATITIS C NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PEGVISOMANT ACROMEGALY NHS ENGLAND

HYPOTHALMIC & ANTERIOR

PITUITARY HORMONES & ANTI-

OESTROGENS


COMMISSIONING POLICY: 16050/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

PEMBROLIZUMABMELANOMA (UNRESECTABLE,

METASTATIC)NHS ENGLAND CANCER EXCLUSION TA 357 NICE NICE SACT √

PEMBROLIZUMABTREATMENT NAÏVE MELANOMA

(UNRESECTABLE, METASTATIC)NHS ENGLAND CANCER EXCLUSION TA 366 NICE NICE SACT √

PIRFENIDONE IDIOPATHIC PULMONARY FIBROSIS NHS ENGLAND PULMONARY FIBROSIS TA282 (SPECIALIST CENTRE ONLY) NICE NICE NICE AUDIT √ √

PLERIXAFOR STEM CELL MOBILISATION NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE


COMMISSIONING POLICY: B04/P/b,

16064/P

NHS ENGLAND POLICY NHS ENGLAND POLICY


NUMBER OF PATIENTS

SUCCESSFULLY TRANSPLANTED

STAGE DRUG UTILISED

√ √

POMALIDOMIDE CANCER CDF IMMUNOMODULATING DRUGS CDF POLICY CDF CDF SACT √

POMALIDOMIDE MYELOFIBROSIS NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PONATINIB CANCER CDF PROTEIN KINASE INHIBITORS CDF POLICY CDF CDF SACT √

PONESIMOD MULTIPLE SCLEROSIS NHS ENGLANDDRUGS USED FOR NEUROMUSCULAR


PORACTANT ALFA RESPIRATORY DISTRESS SYNDROME NHS ENGLAND PULMONARY SURFACTANTS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST


POSACONAZOLE FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES




√

PRETOMANID MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PRIVIGEN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






PROTEIN CAS PER BCSH GUIDELINES FOR


PROTHROMBIN COMPLEXAS PER BCSH GUIDELINES FOR


RALTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-


RASBURICASE HYPERURICAEMIA NHS ENGLANDGOUT AND CYTOTOXIC-INDUCED

HYPERURICAEMIAAGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

REGORAFENIB CANCER CDF PROTEIN KINASE INHIBITORS CDF POLICY CDF CDF SACT √

RESLIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPY NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

REVEGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLANDLYSOSOMAL STORAGE DISORDER

DRUGSNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RIBAVIRIN HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &



COMMISSIONING POLICY: B07/P/a; TA75,

TA106, TA200

NICE NICE

NICE AUDIT

PRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED

√

RIGOSERTIB MDS/PANCREATIC CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROME NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RILONACEPTCRYOPYRIN-ASSOCIATED PERIODIC

SYNDROMESNHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RILPIVIRINEHIV IN COMBINATION WITH OTHER ANTI-


RIOCIGUATPULMONARY ARTERIAL

HYPERTENSION (CTEPH)NHS ENGLAND



HYPERTENSION


COMMISSIONING POLICY: A11/P/cNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RIOCIGUATPULMONARY ARTERIAL




HYPERTENSION





REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

RITONAVIRHIV IN COMBINATION WITH OTHER ANTI-


RITUXIMABSTEROID SENSITIVE NEPHROTIC



COMMISSIONING POLICY: E03/P/bNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMABSTEROID RESISTANT NEPHROTIC



COMMISSIONING POLICY: E03/P/cNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB PRIMARY SJOGREN'S SYNDROME (PSS) NHS ENGLAND CYTOKINE MODULATORSNOT ROUTINELY COMMISSIONED -


RITUXIMABCHRONIC INFLAMMATORY

DEMYELINATING POLYNEUROPATHYNHS ENGLAND CYTOKINE MODULATORS



RITUXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


RITUXIMAB ACQUIRED HAEMOPHILIA NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: F02/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB ANCA-POSITIVE VASCULITIS NHS ENGLAND CYTOKINE MODULATORSTA308

NHS ENGLAND POLICY: A13/P/a

NICE/ NHS ENGLAND

POLICY

NICE/ NHS ENGLAND

POLICYNICE/ NHS ENGLAND POLICY √

RITUXIMABCONNECTIVE TISSUE DISEASE -

INTERSTITIAL LUNG DISEASENHS ENGLAND CYTOKINE MODULATORS



RITUXIMABCYTOPENIA COMPLICATING PRIMARY

IMMUNODEFICIENCYNHS ENGLAND CYTOKINE MODULATORS


COMMISSIONING POLICY:16044/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB GRAFT VERSUS HOST DISEASE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMAB SLE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: A13/PS/aNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB MYOSITIS NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


RITUXIMAB NEPHRITIS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMAB NEUROMYELITIS OPTICA NHS ENGLAND CYTOKINE MODULATORS AS PER SPECIFICATION AS PER SPECIFICATION AS PER SPECIFICATION AS PER SPECIFICATION √

RITUXIMABABO-INCOMPATIBLE KIDNEY

TRANSPLANTSNHS ENGLAND CYTOKINE MODULATORS AS PER SPECIFICATION AS PER SPECIFICATION AS PER SPECIFICATION AS PER SPECIFICATION √

RITUXIMABPEMPHIGUS VULGARIS AND

PEMPHIGOID DISEASENHS ENGLAND CYTOKINE MODULATORS



RITUXIMAB IMMUNOGLOBIN G4 RELATED DISEASE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


RITUXIMAB IV CANCER NHS ENGLAND CYTOKINE MODULATORSTA65, TA137, TA174, TA193, TA226, TA243

NHS ENGLAND CDF LETTER

TA65, TA137, TA174, TA193,

TA226, TA243

NHS ENGLAND CDF LETTER

TA65, TA137, TA174, TA193,

TA226, TA243

NHS ENGLAND CDF

LETTER

SACT √

RITUXIMAB SUBCUTANEOUS

FORMULATIONCANCER NHS ENGLAND CYTOKINE MODULATORS

AS PER CIRCULAR IE ONLY

COMMISSIONED FOR FOLLICULAR

LYMPHOMA MAINTENANCE TREATMENT

AS PER CIRCULAR AS PER CIRCULAR SACT √

ROPEGINTERFERON ALFA-2b HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


ROXADUSTAT DIALYSIS-INDUCED ANAEMIA NHS ENGLANDDRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIASNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RUXOLITINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA 386 NICE NICE SACT √

SANDOGLOBULIN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






SAPROPTERIN CHILDREN WITH PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS



COMMISSIONING POLICY: E06/P/a)


SAPROPTERIN MATERNAL PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS


COMMISSIONING POLICY: E12/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY HIGHLY SPECIALISED DATABASE √

SAQUINAVIRHIV IN COMBINATION WITH OTHER ANTI-


SARILUMABPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

SEBELIPASE ALFA LYSOSOMAL ACID LIPASE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS


NICE HST IN PROGRESSAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

SECUKINUMAB PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

SELEXIPAGPULMONARY ARTERIAL




HYPERTENSION



SETROBUVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


SIALIC ACID MYOPATHY NHS ENGLANDDRUGS USED IN METABOLIC


SILDENAFILPULMONARY ARTERIAL




HYPERTENSION


COMMISSIONING POLICY: A11/P/cNHS ENGLAND POLICY NHS ENGLAND POLICY

AS PER POLICY

PRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED

√

SIMEPREVIR/PEGINTERFERON +

RIBAVIRINHEPATITIS C NHS ENGLAND


RESPIRATORY SYNCYTIAL VIRUSTA 331 NICE NICE HEPATITIS C MDS √ √

SIRUKUMABPAEDIATRIC INDICATIONS (WHERE




SODIUM BENZOATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


SODIUM OXYBATENARCOLEPSY - PEADIATRIC SERVICES

ONLYNHS ENGLAND HYPNOTICS & ANXIOLYTICS


COMMISSIONING POLICY: 16065/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

SODIUM PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


SOFOSBUVIR/DACLATASVIR +




SOFOSBUVIR/LEDIPASVIR +/-




SOFOSBUVIR/PEGINTERFERON+




SORAFENIB CANCER CDF PROTEIN KINASE INHIBITORS CDF POLICY CDF CDF SACT √



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

STAVUDINEHIV IN COMBINATION WITH OTHER ANTI-


SUBCUVIA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






SUBGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






SUNITINIB CANCERNHS ENGLAND/


TA169, TA179

CDF POLICY

NICE

CDF

NICE

CDFSACT √

SUSOCTOCOG ALFA (OBIZUR) HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TABALUMAB SLE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TADALAFILPULMONARY ARTERIAL




HYPERTENSION



TALIGLUCERASE ALFA GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


TARIBAVIRIN HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &


TEDUGLUTIDE SHORT BOWEL SYNDROME NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TELAPREVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA252 NICE NICE HEPATITIS C MDS √ √

TELBIVUDINE HEPATITIS B NHS ENGLANDVIRAL HEPATITIS (B&C) &




TEMSIROLIMUS CANCER CDF PROTEIN KINASE INHIBITORS CDF POLICY CDF CDF SACT √

TENOFOVIR


RETROVIRAL DRUGS

HEPATITIS B +/- OTHER ANTI-

RETROVIRAL DRUGS

NHS ENGLAND AIDS/HIV ANTIRETROVIRALSTA173 (FOR HEPATITIS B)/AGREED

REGIONAL GUIDELINES FOR HIV

BHIVA GUIDELINES (8)

NICE

BHIVA GUIDELINES (8)

NICEHARS DATASET √

TENOFOVIR ALAFENAMIDE HEPATITIS B NHS ENGLAND AIDS/HIV ANTIRETROVIRALS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TENOFOVIR ALAFENAMIDEHIV IN COMBINATION WITH OTHER ANTI-




TENOFOVIR ALAFENAMIDE +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE (GENVOYA®)





TENOFOVIR DISOPROXIL +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE (STRIBILD®)





F03/P/b/AGREED REGIONAL GUIDELINES


TENOFOVIR + EMTRICITABINE +

EFAVIRENZ



TENOFOVIR + EMTRICITABINE +

RILPIVIRINE



MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES …€¦ · adalimumab uveitis - adults nhs...

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Transcript of MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES …€¦ · adalimumab uveitis - adults nhs...