medicines not reimbursed through …...ataluren duchenne muscular dystrophy nhs england...

12
DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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) ABACAVIR HIV IN COMBINATION WITH OTHER ANTI- RETROVIRAL DRUGS NHS 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 DRUGS NHS ENGLAND AIDS/HIV ANTIRETROVIRALS NHS ENGLAND CLINICAL COMMISSIONING POLICY: B06/P/b/AGREED REGIONAL GUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET ABACAVIR + LAMIVUDINE HIV IN COMBINATION WITH OTHER ANTI- RETROVIRAL DRUGS NHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET ABALOPARATIDE MALE AND JUVENILE OSTEOPOROSIS NHS ENGLAND DRUGS AFFECTING BONE METABOLISM NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ABATACEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND CLINICAL COMMISSIONING POLICY: E03/P/d; TA 373 NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY ABIRATERONE CANCER NHS ENGLAND HORMONE ANTAGONISTS TA259, 387 (SEE ALSO SSC1438) ONLY IN ENZALUTAMIDE NAÏVE PATIENTS NICE/NHS ENGLAND POLICY NICE SACT ADALIMUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND CLINICAL COMMISSIONING POLICY: E03/P/d; TA 373 NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY ADALIMUMAB UVEITIS - ADULTS NHS ENGLAND CYTOKINE MODULATORS TA460 NICE NICE NICE AUDIT ADALIMUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ADALIMUMAB HIDRADENITIS SUPPURATIVA NHS ENGLAND CYTOKINE MODULATORS NICE TA 392 NICE NICE NICE AUDIT ADALIMUMAB PLAQUE PSORIASIS IN CHILDREN NHS ENGLAND CYTOKINE MODULATORS NICE TA 455 NICE NICE NICE AUDIT ADEFOVIR HEPATITIS B NHS ENGLAND VIRAL HEPATITIS (B&C) & RESPIRATORY SYNCYTIAL VIRUS NOT ROUTINELY COMMISSIONED (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 EXCLUSION NOT ROUTINELY COMMISSIONED (TA307) AS PER IFR APPROVAL AS PER IFR APPROVAL SACT AGALSIDASE ALFA FABRY'S DISEASE NHS ENGLAND DRUGS USED IN METABOLIC DISORDERS NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED DATABASE AGALSIDASE BETA FABRY'S DISEASE NHS ENGLAND DRUGS USED IN METABOLIC DISORDERS NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED DATABASE ALBUTROPIN ADULT ONSET GROWTH HORMONE DEFICIENCY NHS ENGLAND GROWTH HORMONE & GROWTH HORMONE RECEPTOR ANTAGONIST NOT 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 ENGLAND DRUGS AFFECTING THE IMMUNE RESPONSE TA312 AND NHS ENGLAND POLICY STATEMENT 170075P NICE NICE NICE AUDIT √**** ALEMTUZUMAB PRE-TRANSPLANT IMMUNOSUPPRESSION NHS ENGLAND DRUGS AFFECTING THE IMMUNE RESPONSE TRUST GUIDELINES: ISLET TRANSPLANTATION (ONLY IF PROVIDED AT ZERO DRUG COST) TRUST GUIDELINES TRUST GUIDELINES ALEMTUZUMAB CLL NHS ENGLAND DRUGS 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 CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ALGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLAND DRUGS USED IN METABOLIC DISORDERS NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED DATABASE ALIPOGENE TIPARVOVEC LIPOPROTEIN LIPASE DEFICIENCY NHS ENGLAND DRUGS USED IN METABOLIC DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ALISPORIVIR HEPATITIS C NHS ENGLAND VIRAL HEPATITIS (B&C) & RESPIRATORY SYNCYTIAL VIRUS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ALPHA MANNOSIDASE RECOMBINANT HUMAN ALPHA MANNOSIDASE DEFICIENCY NHS ENGLAND DRUGS USED IN METABOLIC DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL AMBRISENTAN PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND VASODILATOR ANTIHYPERTENSIVE DRUGS/PULMANORY ARTERIAL HYPERTENSION NHS ENGLAND CLINICAL COMMISSIONING POLICY: A11/P/c NHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY AMIFAMPRIDINE PHOSPHATE LEMS NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED NHS ENGLAND POLICY: 16009/P AS 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 LIPOSOMAL CYSTIC 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 ANABASUM SCLERODERMA NHS ENGLAND DRUGS AFFECTING THE IMMUNE RESPONSE NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ANAKINRA JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND CLINICAL COMMISSIONING POLICY: E03/P/d NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY ANAKINRA PERIODIC FEVERS AND AUTOINFLAMMATORY CONDITIONS NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND CLINICAL COMMISSIONING POLICY: 170062P NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY ANAKINRA CRYOPYRIN ASSOCIATED PERIODIC SYNDROME NHS ENGLAND CYTOKINE MODULATORS CRYOPYRIN ASSOCIATED PERIODIC SYNDROME SERVICE SPECIFICATION HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED DATABASE ANAKINRA ADULT ONSET STILLS DISEASE NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND CLINICAL COMMISSIONING POLICY: 170056P NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY ANIDULAFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES NUMBER OF PATIENTS TREATED PROPORTION GIVEN FOR SPC INDICATIONS WITHIN POLICY ANIFROLUMAB SLE NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ANTILYMPHOCYTE GLOBULIN APLASTIC ANAEMIA ORGAN TRANSPLANT NHS ENGLAND DRUGS USED IN HYPOPLASTIC, HAEMOLYTIC, AND RENAL ANAEMIAS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES ANTIPSEUDOMONAS AERUGINOSA IgY CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL ANTITHROMBIN III AS PER BCSH GUIDELINES FOR SPECIALISED INDICATIONS NHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES ANTITHYMOCYTE IMMUNOGLOBULIN APLASTIC ANAEMIA ORGAN TRANSPLANT NHS ENGLAND DRUGS USED IN HYPOPLASTIC, HAEMOLYTIC, AND RENAL ANAEMIAS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES ARIMOCLOMOL NIEMANN-PICK DISEASE NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES AND DIRECTLY COMMISSIONED BY NHS ENGLAND VERSION 15 PUBLISHED APRIL 2020 NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 1 31/03/2020

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Page 1: MEDICINES NOT REIMBURSED THROUGH …...ATALUREN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NICE HST3 NICE NICE NORTHSTAR DATABASE √ ATAZANAVIR HIV IN COMBINATION

DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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-

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

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 MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/P/d; TA 373NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

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 MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/P/d; TA 373NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ADALIMUMAB UVEITIS - ADULTS NHS ENGLAND CYTOKINE MODULATORS TA460 NICE NICE NICE AUDIT √ √

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

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED CRITERIA √

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

ADALIMUMAB PLAQUE PSORIASIS IN CHILDREN NHS ENGLAND CYTOKINE MODULATORS NICE TA 455 NICE NICE NICE AUDIT √ √

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

RESPIRATORY SYNCYTIAL VIRUS

NOT ROUTINELY COMMISSIONED

(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 IFR APPROVAL AS PER IFR 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

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

RESPONSE

TA312 AND NHS ENGLAND POLICY

STATEMENT 170075PNICE 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

CRITERIA ONLYHIGHLY SPECIALISED CRITERIA √

ALGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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 MANNOSIDASE

RECOMBINANT HUMANALPHA MANNOSIDASE DEFICIENCY NHS ENGLAND

DRUGS USED IN METABOLIC

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

AMBRISENTAN PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

ANABASUM SCLERODERMA NHS ENGLANDDRUGS AFFECTING THE IMMUNE

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

ANAKINRA JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

ANAKINRAPERIODIC FEVERS AND

AUTOINFLAMMATORY CONDITIONSNHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170062PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ANAKINRACRYOPYRIN ASSOCIATED PERIODIC

SYNDROMENHS ENGLAND CYTOKINE MODULATORS

CRYOPYRIN ASSOCIATED PERIODIC

SYNDROME SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

ANAKINRA ADULT ONSET STILLS DISEASE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170056PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

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

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

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIASBCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

ARIMOCLOMOL NIEMANN-PICK DISEASE NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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

VERSION 15 PUBLISHED APRIL 2020

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 1 31/03/2020

Page 2: MEDICINES NOT REIMBURSED THROUGH …...ATALUREN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NICE HST3 NICE NICE NORTHSTAR DATABASE √ ATAZANAVIR HIV IN COMBINATION

DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

ASFOTASE ALFA HYPOPHOSPHATASIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSHST6 NICE NICE AS PER MAA √ √

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

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

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-

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

ATAZANAVIR + COBICISTAT

(EVOTAZ®)

HIV IN COMBINATION WITH OTHER ANTI-

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

AUTOLOGOUS SERUM EYE DROPS DRY EYE NHS ENGLAND BLOOD-RELATED PRODUCTSAS PER NHS ENGLAND

LETTER/CIRCULARNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

AVACOPAN ANCA-POSITIVE VASCULITIS NHS ENGLAND CYTOKINE MODULATORS 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 LYSINECYSTIC FIBROSIS (CONTINUOUS

TREATMENT)NHS ENGLAND ANTIBACTERIAL DRUGS

NOT ROUTINELY COMMISSIONED

NHS ENGLAND CLINCAL

COMMISSIONING POLICY: 16001/P

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

BARDOXOLONE METHYL PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

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) &

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

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

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

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 NICE TA 565 NICE NICE NICE AUDIT √ √

BEPERMINOGENE PERPLASMID PERIPHERAL VASCULAR DISEASE NHS ENGLAND GENE THERAPY NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

BETAINE HOMOCYSTINURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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 √

BICTECRAVIR (IN COMINATION

WITH EMTRICITABINE AND

TENOFOVIR ALAFENAMIDE)

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINCAL

COMMISSIONING POLICY: 170131PNHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

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 √

BORTEZOMIBORGAN REJECTION POST KIDNEY

TRANSPLANTNHS ENGLAND ANTINEOPLASTIC DRUGS

NOT ROUTINELY COMMISSIONED

(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: A07/P/c)

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

BORTEZOMIB CANCERNHS ENGLAND/

CDFANTINEOPLASTIC DRUGS

TA129, TA228, TA311, TA378, TA573

CDF POLICY

NOT ROUTINELY COMMISSIONED

(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170035P,

170074P)

NICE

CDF

NICE

CDFSACT √ √

BOSENTAN DIGITAL ULCERS NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

BOSENTAN PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

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 √

BRIMAPITIDEACUTE SENSORINEURAL HEARING

LOSSNHS ENGLAND PROTEIN KINASE INHIBITORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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

BUROSUMAB X LINKED HYPOPHOSPHATAEMIA NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSEHST 8 NICE NICE NICE AUDIT √ √

C1 ESTERASE INHIBITORSHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT NHS ENGLAND ALLERGIC EMERGENCIES

NHS ENGLAND CLINICAL

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

C1 ESTERASE INHIBITORSHEREDITARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES

NHS ENGLAND CLINICAL

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

C1 ESTERASE INHIBITORS

HEREDITARY ANGIOEDEMA -

PROPHYLACTIC TREATMENT IN

CHILDREN (CINRYZE ONLY)

NHS ENGLAND ALLERGIC EMERGENCIESAS PER NHS ENGLAND CLINICAL

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

CABOTEGRAVIRHIV 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 √

CALCIFIDIOLINBORN ERRORS IN PRIMARY BILE ACID

SYNTHESISNHS ENGLAND OTHER ENDOCRINE DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CANAKINUMABCRYOPYRIN ASSOCIATED PERIODIC

FEVER SYNDROMENHS ENGLAND IMMUNOMODULATING DRUGS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 200209PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

CANAKINUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND IMMUNOMODULATING DRUGSNOT ROUTINELY COMMISSIONED

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

CANNABIDIOL (AS EPIDIOLEX) DRAVET/LENNOX GESTAUT SYNDROME NHS ENGLAND CANNABINOIDS TA615 & TA614 NICE NICE NICE AUDIT √ √

CAPLACIZUMABTHROMBOTIC THROMBOCYTOPENIC

PUPURA NHS ENGLAND PLATELET DISORDER DRUGS

NOT ROUTINELY COMMISSIONED

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

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

CARGLUMIC ACID UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

CARNITINE CARNITINE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

CENEGERMIN NEUROTROPHIC KERATITIS NHS ENGLAND ATMPNOT ROUTINELY COMMISSIONED

(TA 532)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

DRUGSHST12 NICE NICE NICE AUDIT √ √

CETUXIMAB CANCER NHS ENGLAND ANTINEOPLASTIC DRUGS TA145, TA176 (replaced by TA439), TA473 NICE NICE SACT √ (not TA145) √

CHENODEOXYCHOLIC ACIDCEREBROTENDINOUS

XANTHOMATOSIS (CTX) NHS ENGLAND

DRUGS USED IN METABOLIC

DISORDERS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 170127PNHS ENGLAND POLICY NHS ENGLAND POLICY √ √

CHENODEOXYCHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 170127PNHS ENGLAND POLICY NHS ENGLAND POLICY √ √

CHOLIC ACIDINBORN ERRORS IN PRIMARY BILE ACID

SYNTHESISNHS ENGLAND

DRUGS USED IN METABOLIC

DISORDERS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 170127PNHS ENGLAND POLICY NHS ENGLAND POLICY √ √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

CINACALCETPRIMARY AND SECONDARY

HYPERPARATHYROIDISM NHS ENGLAND

DRUGS FOR MINERAL BONE

DISORDERS

TA117

NHS ENGLAND POLICY 16034/P

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY√

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 TA492, TA616 (Replaces TA492) NICE NICE NICE AUDIT √ √****

CLADRIBINEPULMONARY LANGERHANS

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

CLAZAKIZUMAB ANTIBODY MEDICATED REJECTION NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

COBICISTATHIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:

F03/P/b/AGREED REGIONAL GUIDELINES

NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

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

NHS ENGLAND CLINICAL

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

NHS ENGLAND CLINICAL

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

CRIZANLIZUMAB SICKLE CELL DISEASE NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

CRIZOTINIB CANCER NHS ENGLAND/CDF PROTEIN KINASE INHIBITORSNICE TA 406, 422

CDF (TA 529)

NICE

CDF

NICE

CDFSACT √ √

CYCLIC PYRANOPTERIN

MONOPHOSPHATEMOLYBDENUM COFACTOR DEFICIENCY NHS ENGLAND

DRUGS USED IN METABOLIC

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

CYSTEAMINE (MERCAPTAMINE) NEPHROPATHIC CYSTINOSIS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

DABRAFENIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA321, TA396 & TA 544 NICE NICE SACT √ (not TA321) √

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

DARBOPOETIN ALPHA DIALYSIS-INDUCED ANAEMIA NHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD

RENAL DIALYSIS ONLY, INCLUDING VIA

OUTPATIENTS, AND ONLY AS PER NICE

CG114

TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√

DARUNAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

DARUNAVIR + COBICISTAT HIV IN COMBINATION WITH OTHER ANTI-

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

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

RESPIRATORY SYNCYTIAL VIRUSTA 365 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

DASATINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS NICE TA 425, 426 NICE NICE 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

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 16070/PNHS ENGLAND POLICY NHS ENGLAND POLICY

QUALITY DASHBOARD/ NATIONAL

HAEMOGLOBINOPATHY REGISTRY√

DEFERIPRONE**IRON CHELATION IN THALASSAEMIA

AND SICKLE CELLNHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 16070/PNHS ENGLAND POLICY NHS ENGLAND POLICY

QUALITY DASHBOARD/ NATIONAL

HAEMOGLOBINOPATHY REGISTRY√

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

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

DELAMANID MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL

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

DESFERRIOXAMINE**IRON CHELATION IN THALASSAEMIA

AND SICKLE CELLNHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 16070/PNHS ENGLAND POLICY NHS ENGLAND POLICY

QUALITY DASHBOARD/ NATIONAL

HAEMOGLOBINOPATHY REGISTRY√

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

DEXRAZOXANE ANTHRACYCLINE CARDIOTOXICITY NHS ENGLAND IMMUNOMODULATING DRUGSNHS ENGLAND CLINICAL

COMMISSIONING POLICY 200204PNHS ENGLAND POLICY NHS ENGLAND POLICY 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 √

DICHLORPHENAMIDEPRIMARY HYPO AND HYPERKALAEMIC

PERIODIC PARALYSISNHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

DIDANOSINEHIV IN COMBINATION WITH OTHER ANTI-

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

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

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

DOLUTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: B06/P/a/

AGREED REGIONAL GUIDELINES

NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

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

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

DORAVIRINEHIV iN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINCAL

COMMISSIONING POLICY: 190137PNHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

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

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

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

NOT ROUTINELY COMMISSIONED

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

ECULIZUMABC3 GLOMERULOPATHY (POST

TRANSPLANT)NHS ENGLAND

PAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 16054/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ECULIZUMAB AHUS NHS ENGLANDPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/PS(HSS)/A

NICE HST1

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE√ √

ECULIZUMABPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIANHS ENGLAND

PAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA

NHS NATIONAL SPECIALISED

COMMISSIONING TEAM SERVICE

SPECIFICATION

NSCT SERVICE SPEC NSCT SERVICE SPEC NSCT SERVICE SPEC √

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

EDRATIDE SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE

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

EFAVIRENZHIV IN COMBINATION WITH OTHER ANTI-

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

EFRALOCTOCOG ALFA /

EFMOROCTOCOG ALFA / FACTOR

VIII FC FUSION PROTEIN (Elocta®)

HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS SSC 1652, see also SSC 1818 SSC 1652 SSC 1652 PRODUCTS ON CMU FRAMEWORK √

EFTRENONACOG ALFA 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) &

RESPIRATORY SYNCYTIAL VIRUSTA 413 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

ELIGLUSTAT GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSHST5 NICE NICE HIGHLY SPECIALISED DATABASE √

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-

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

EMAPALUMABHAEMOPHAGOCYTIC

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

EMICIZUMABAS PER BCSH GUIDELINES FOR

SPECIALISED INDICATIONSNHS ENGLAND BLOOD-RELATED PRODUCTS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170067/P AND

170134P

NHS ENGLAND POLICY NHS ENGLAND POLICY PRODUCTS ON CMU FRAMEWORK √

EMRICASANNON-ALCOHOLIC STEATOHEPATITIS

(NASH) FIBROSISNHS ENGLAND

DRUGS USED IN METABOLIC

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

EMTRICITABINEHIV IN COMBINATION WITH OTHER ANTI-

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

EMTRICITABINE +TENOFOVIR +

DARUNAVIR + COBICISTAT

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: F03/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

EMTRICITABINE +TENOFOVIR +

ELVITEGRAVIR + COBICISTAT

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: F03/P/aNHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

EMTRICITABINE +TENOFOVIRHIV IN COMBINATION WITH OTHER ANTI-

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

EMTRICITABINE + TENOFOVIR

ALAFENAMIDE

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

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

EMTRICITABINE + RILPIVIRINE +

TENOFOVIR ALAFENAMIDE

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

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

ENFUVIRTIDEHIV IN COMBINATION WITH OTHER ANTI-

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

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 √

EPOETIN ALPHA, BETA, THETA AND

ZETADIALYSIS-INDUCED ANAEMIA NHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD

RENAL DIALYSIS ONLY, INCLUDING VIA

OUTPATIENTS, AND ONLY AS PER NICE

CG114

TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√

EPOPROSTENOL (5) PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

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 MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/P/d; TA 373NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ETANERCEPT PLAQUE PSORIASIS IN CHILDREN NHS ENGLAND CYTOKINE MODULATORS TA455 NICE NICE NICE AUDIT √ √

ETELCALCETIDEHYPERPARATHYROIDISM - DIALYSIS

PATIENTS ONLYNHS ENGLAND

DRUGS FOR MINERAL BONE

DISORDERSTA448 NICE NICE √ √

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-

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

EVEROLIMUS (AFINITOR®) CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA421, TA432, TA449, TA498 NICE NICE SACT √ √

EVEROLIMUS (CERTICAN®)PREVENTING ORGAN REJECTION IN

LIVER TRANSPLANTATIONNHS ENGLAND PROTEIN KINASE INHIBITORS

NOT ROUTINELY COMMISSIONED

(TA348)AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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 √

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 √ √

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 4 31/03/2020

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

EVEROLIMUS (VOTUBIA®)

SEIZURES ASSOCIATED WITH

SUBEPENDYMAL GIANT CELL

ASTROCYTOMA (SEGA) ASSOCIATED

WITH TUBULAR SCLEROSIS

NHS ENGLAND PROTEIN KINASE INHIBITORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170093PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

EVEROLIMUS (VOTUBIA®)RENAL ANGIOMYOLIPOMA ASSOCIATED

WITH TUBULAR SCLEROSISNHS ENGLAND PROTEIN KINASE INHIBITORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY STATEMENT

B14X09L

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

EVINACUMABHOMOZYGOUS FAMILIAL

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

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

(HOLOCLAR)

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 ATMP TA 467 NICE NICE NICE AUDIT √ √

FACTOR IXAS PER BCSH GUIDELINES FOR

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

FACTOR VIIAS PER BCSH GUIDELINES FOR

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

FACTOR VIIAAS PER BCSH GUIDELINES FOR

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

FACTOR VIIIAS PER BCSH GUIDELINES FOR

SPECIALISED INDICATIONSNHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES, see also SSC 1818 BCSH GUIDELINES BCSH GUIDELINES PRODUCTS ON CMU FRAMEWORK √

FACTOR VIII INHIBITOR BYPASSING

FACTOR (FEIBA)

AS PER BCSH GUIDELINES FOR

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

FACTOR XIIIAS PER BCSH GUIDELINES FOR

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

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 √****

FEDRATINIB MYELOFIBROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE

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

FENFLURAMINE DRAVET DISEASE NHS ENGLAND CENTRAL NERVOUS SYSTEM NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

FIBRINOGENAS PER BCSH GUIDELINES FOR

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

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 √

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

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

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-

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

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

FOSTEMSAVIRHIV 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 √

GALUNISERTIB CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROME NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

GALSULFASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

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 √

GIVOSIRAN HEPATIC PORPHYRIA NHS ENGLANDDRUGS USED IN METABOLIC

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

GLATIRAMER MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS TA527 & NHS ENGLAND POLICY: D04/P/b NHS ENGLAND POLICY NHS ENGLAND POLICY AS PER NHSE POLICY √ √****

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

RESPIRATORY SYNCYTIAL VIRUSNICE TA 499 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

GLUCARPIDASEMETHOTREXATE INDUCED RENAL

DYSFUNCTIONNHS ENGLAND POISONING

NHS ENGLAND CLINICAL

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

GLYCEROL PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS

AS PER NHS ENGLAND CIRCULAR SSC

1881 AND LETTERNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

GOSURANEMAB SUPRANUCLEAR PALSY NHS ENGLAND CENTRAL NERVOUS SYSTEM NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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 √

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

RESPIRATORY SYNCYTIAL VIRUSTA 413 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

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 √

HAEM ARGINATE HEPATIC PORPHYRIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

HUMAN ALPHA-1 PROTEINASE

INHIBITOREMPHYSEMA NHS ENGLAND DRUGS USED FOR EMPHYSEMA NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

HUMAN COAGULATION FACTOR X FACTOR X DEFICIENCY NHS ENGLAND BLOOD-RELATED PRODUCTSNHS ENGLAND CLINICAL

COMMISSIONING POLICY:200208PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

HUMAN HETEROLOGOUS LIVER

CELLSUREA CYCLE DISORDERS NHS ENGLAND

DRUGS USED IN METABOLIC

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

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 √

IBALIZUMABHIV 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 √

ICATIBANTHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES

NHS ENGLAND CLINICAL

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

ICATIBANTHEREDUTARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES

NHS ENGLAND CLINICAL

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

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

ILOPROST (5) PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

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

IMATINIBCHRONIC GRAFT VERSUS HOST

DISEASENHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:16069/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

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

IMIGLUCERASE GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

IMLIFIDASETRANSPLANT REJECTION PREVENTION

IN HLA-SENSITISED PATIENTSNHS ENGLAND NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INDINAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

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

INFLIXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

INFLIXIMAB UVEITIS NHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED

(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: D12/P/a &

D12/P/a)

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

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 PULMONARY SARCOIDOSIS NHS ENGLAND CYTOKINE MODULATORSNOT ROUTINELY COMMISSIONED

NHS ENGAND POLICY 170088PAS 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

CRITERIA ONLYHIGHLY SPECIALISED CRITERIA √

INOTERSEN AMYLOIDOSIS NHS ENGLAND UNCLASSIFIED HST9 NICE NICE NICE AUDIT √ √

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

INTERFERON ALFA N3MIDDLE EAST RESPIRATORY

SYNDROMEIMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

INTERFERON BETA MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA 527, TA624

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

INTRAVENOUS NORMAL HUMAN

IMMUNOGLOBULINSMULTIPLE INDICATIONS NHS ENGLAND

INTRAVENOUS NORMAL HUMAN

IMMUNOGLOBULINS

CLINICAL GUIDELINES FOR

IMMUNOGLOBULIN USE, SECOND

EDITION UPDATE (JULY 2011)

IMMUNOGLOBULIN GUIDELINES

PUBLISHED 2019 ON MDSAS WEBSITE

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 190136P

NATIONAL GUIDELINES NATIONAL GUIDELINES

QUALITY DASHBOARD

NATIONAL IMMUNOGLOBULIN DATA

BASE

ISAVUCONAZOLEFUNGAL INFECTION (LICENSED

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

√ √

IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: A01/P/c,

16049/P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

IXAZOMIB AMYLOIDOSIS NHS ENGLAND CANCER EXCLUSION NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

IXAZOMIB MULTIPLE MYELOMA CDF CANCER EXCLUSION CDF (TA 505) CDF CDF SACT √ √

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

RESPIRATORY SYNCYTIAL VIRUSCG165 NICE NICE NICE AUDIT √

LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-

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

LANADELUMAB HEREDITARY ANGIOEDEMA NHS ENGLAND ALLERGIC EMERGENCIES TA606 NICE NICE NICE AUDIT √ √

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√ √

LANTHANUM CARBONATE ADULT RENAL DIALYSIS ONLY NHS ENGLAND PHOSPHATE BINDING AGENTS TRUST GUIDELINES TRUST GUIDELINES √

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

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

LENALIDOMIDE CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA171, TA322, TA587, TA586 NICE NICE SACT √ √

LENALIDOMIDE POEMS NHS ENGLAND IMMUNOMODULATING DRUGS HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

LERONLIMABHIV 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 √

LETERMOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION TA 591 NICE NICE NICE AUDIT √ √

LEVOFLOXACIN (INHALED) CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NHS ENGLAND POLICY 170078P NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

LEVOKETOCONAZOLE CUSHING'S DISEASE NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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 NHS ENGLAND POLICY 170059P NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

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-

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

LUMACAFTOR AND IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNHS ENGLAND URGENT POLICY

STATEMENT 190137PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

LUSPATERCEPT CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROME NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MACIMORELIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH

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

MACITENTAN PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

MANNITOL CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: A01/P/b

TA266

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√

MARALIXIBAT ALAGILLE SYNDROME NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

MARAVIROCHIV IN COMBINATION WITH OTHER ANTI-

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

MARAVIROC NATALIZUMAB INDUCED PML NHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY STATEMENT

170040P

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

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

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

MECASERMIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH

HORMONE RECEPTOR ANTAGONIST

NHS ENGLAND CLINICAL

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

MEPOLIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPYTA431

NICE NICE NICE AUDIT √ √

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

METRELEPTIN  CONGENITAL LEPTIN DEFICIENCY NHS ENGLAND OTHER ENDOCRINE DRUGSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170095PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

MEXILETINE NON DYSTROPHIC MYOTONIA NHS ENGLAND NEUROMUSCULAR DISORDERSAS PER NHS ENGLAND CIRCULAR SSC

2001 AND LETTERAS PER BLUETEQ FORM AS PER BLUETEQ FORM AS PER BLUETEQ FORM √ √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

MIGALASTAT FABRY'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNICE HST4 NICE NICE HIGHLY SPECIALISED DATABASE √

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

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

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-

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

NEVIRAPINEHIV IN COMBINATION WITH OTHER ANTI-

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

NILOTINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA241, TA251, TA426 NICE NICE SACT √ √

NINTEDANIB OVARIAN CANCER NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL 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) &

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

NITISINONE ALKAPTONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

NITISINONE TYROSINAEMIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

NITRIC OXIDE PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

NUSINERSEN SPINAL MUSCULAR ATROPHY NHS ENGLAND NEURODEGENERATIVE CONDITIONS TA588 NICE NICE NICE AUDIT √ √

OBETICHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSTA443 NICE NICE NICE AUDIT √ √

OCRELIZUMAB MULTIPLE SCLEROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSETA 533, TA 585 NICE NICE NICE AUDIT √ √****

OCTOCOG ALFA HAEMOPHILIA A NHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES: See also SSC 1818 AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

OCTREOLIN ACROMEGALY NHS ENGLANDGROWTH HORMONE & GROWTH

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

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

PROCUREMENT COST TO BE USED√

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

PROCUREMENT COST TO BE USED√

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

OLIPUDASE ALFA ACID SPHINGOMYELINASE DEFICIENCY NHS ENGLANDLYSOSOMAL STORAGE DISORDER

DRUGSNOT 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

VIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA 365 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

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 √

PALOVAROTENEFYBRODYSPLASIA OSSIFICANS

PROGRESSIVANHS ENGLAND

DRUGS AFFECTING BONE

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

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

RESPIRATORY SYNCYTIAL VIRUS

JCVI GUIDELINES

PHE SPECIFICATIONAS PER SPECIFICATION AS PER SPECIFICATION √ √

PARA-AMINOSALICYLIC ACIDMULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGS

NHS ENGLAND CLINICAL

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

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 √

PARICALCITOL HYPERPARATHYROIDISM NHS ENGLAND OTHER ENDOCRINE DRUGS AS PER CINACALCET AS PER CINACALCET AS PER CINACALCET AS PER CINACALCET √

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

RESPIRATORY SYNCYTIAL VIRUSNICE TA 499 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √

PASIREOTIDE ACROMEGALY NHS ENGLAND SOMATOSTATIN ANALOGUESNOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY 16003/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PASIREOTIDE CUSHING'S DISEASE NHS ENGLAND SOMATOSTATIN ANALOGUESNHS ENGLAND CLINICAL

COMMISSIONING POLICY: A03X03/01NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

PATISIRAN AMYLOIDOSIS NHS ENGLAND NOVEL - NO GROUP NAME AGREED HST10 NICE NICE NICE AUDIT √ √

PAZOPANIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS

TA215

NOT ROUTINELY COMMISSIONED NHS

ENGLAND POLICY STATEMENT 170117P

NICE NICE SACT √

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

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

RESPIRATORY SYNCYTIAL VIRUS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: B07/P/a; TA75,

TA96, TA106, TA200, TA 300

CG165

NICE NICE NICE AUDIT √

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 √ √****

PEGUNIGALSIDASE ALFA FABRY'S DISEASE NHS ENGLANDLYSOSOMAL STORAGE DISORDER

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

PEGVALIASE PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

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

PEGVISOMANT ACROMEGALY NHS ENGLANDHYPOTHALMIC & ANTERIOR PITUITARY

HORMONES & ANTI-OESTROGENS

NHS ENGLAND CLINICAL

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

PEMBROLIZUMAB CANCER INDICATIONS NHS ENGLAND/CDF CANCER EXCLUSION

TA 357, TA366, TA428, TA531

CDF POLICY (TA 447 (replaced by TA531),

TA 519, TA522 TA540, TA553, TA557 &

TA600)

NICE

CDF

NICE

CDFSACT √ √

PEMBROLIZUMABDRUG RESISTANT GESTATIONAL

TROPHOBLASTIC NEOPLASIANHS ENGLAND CANCER EXCLUSION

NHS ENGLAND CLINICAL

COMMISSIONING POLICY STATEMENT:

170027P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

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

RESPIRATORY SYNCYTIAL VIRUSTA499 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √

PIRFENIDONE IDIOPATHIC PULMONARY FIBROSIS NHS ENGLAND PULMONARY FIBROSIS TA 504 (SPECIALIST CENTRE ONLY) NICE NICE NICE AUDIT √ √

PLERIXAFOR STEM CELL MOBILISATION NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: B04/P/b,

16064/P

NHS ENGLAND POLICY NHS ENGLAND POLICY

NUMBER OF PATIENTS TREATED

NUMBER OF PATIENTS

SUCCESSFULLY TRANSPLANTED

STAGE DRUG UTILISED

√ √

POMALIDOMIDE CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA427 NICE NICE SACT √ √

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

PONATINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA451 NICE NICE SACT √ √

PONESIMOD MULTIPLE SCLEROSIS NHS ENGLANDDRUGS USED FOR NEUROMUSCULAR

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

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

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

PROTEIN CAS PER BCSH GUIDELINES FOR

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

PROTHROMBIN COMPLEXAS PER BCSH GUIDELINES FOR

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

RALTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

RASBURICASE HYPERURICAEMIA NHS ENGLANDGOUT AND CYTOTOXIC-INDUCED

HYPERURICAEMIAAGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

RAVULIZUMABPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIANHS ENGLAND

PAROXYSMAL NOCTURNAL

HAEMOGLOBINURIANOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RAXIBACUMAB INHALED ANTHRAX NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

REFANALINPREVENTION OF DELAYED GRAFT

FUNCTIONNHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

REGORAFENIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA488 & TA555 NICE NICE SACT √ √

REPARIXINPREVENTION OF DELAYED GRAFT

FUNCTIONNHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RESLIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPY TA479 NICE NICE NICE AUDIT √ √

REVEGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLANDLYSOSOMAL STORAGE DISORDER

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

RISDIPLAM SPINAL MUSCULAR ATROPHY NHS ENGLAND NEURODEGENERATIVE CONDITIONS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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

RILPIVIRINEHIV IN COMBINATION WITH OTHER ANTI-

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

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

RIOCIGUATPULMONARY ARTERIAL HYPERTENSION

(CTEPH)NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

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

RIOCIGUAT PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 16055/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITONAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

RITUXIMABSTEROID SENSITIVE NEPHROTIC

SYNDROMENHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

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

RITUXIMABSTEROID RESISTANT NEPHROTIC

SYNDROMENHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

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

NHS ENGLAND POLICY 16048/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMABCHRONIC INFLAMMATORY

DEMYELINATING POLYNEUROPATHYNHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY 170026/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

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 √ √

RITUXIMABANTI-NMDAR AUTOIMMUNE

ENCEPHALITISNHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:16036/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

RITUXIMABCONNECTIVE TISSUE DISEASE -

INTERSTITIAL LUNG DISEASENHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY 170015/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMABCYTOPENIA COMPLICATING PRIMARY

IMMUNODEFICIENCYNHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

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

RITUXIMABCHRONIC GRAFT VERSUS HOST

DISEASENHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:16069/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB SLE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

RITUXIMAB MEMBRANOUS NEPHROPATHY NHS ENGLAND CYTOKINE MODULATORSNOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY 16047/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RITUXIMABDERMATOMYOSITIS AND POLYMYOSITIS

(ADULTS)NHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:16036/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

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

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 8 31/03/2020

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

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

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:16035/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB IMMUNOGLOBIN G4 RELATED DISEASE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY:16057/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

RITUXIMAB MYASTHENIA GRAVIS NHS ENGLAND CYTOKINE MODULATORS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY STATEMENT

170084P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

RITUXIMABFOCAL SEGMENTAL

GLOMERULOSCLEROSISNHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY STATEMENT 1818AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

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 √

RIVIPANSEL SODIUM HEPATIC VENO-OCCLUSIVE DISEASE NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

RIVIPANSEL SODIUM SICKLE CELL DISEASE NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ROMIPLOSTIM ITP IN CHILDREN NHS ENGLAND PLATELET DISORDER DRUGS AS PER ADULT TA 221 NICE NICE NICE AUDIT √ √

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

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

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 √

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

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

RESPIRATORY SYNCYTIAL VIRUSNOT 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 √

SACROSIDASECONGENITAL SUCRASE ISOMALTASE

DEFICIENCYNHS ENGLAND

DRUGS USED IN METABOLIC

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

SAPROPTERINADULTS AND CHILDREN WITH

PHENYLKETONURIANHS ENGLAND

DRUGS USED IN METABOLIC

DISORDERS

NOT ROUTINELY COMMISSIONED

(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170103P)

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

SAPROPTERIN MATERNAL PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS

NHS ENGLAND CLINICAL

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

SAQUINAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

SATRALIZUMAB NEUROMYELITIS OPTICA 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

NOT ROUTINELY COMMISSIONED

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

SELEXIPAG PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: 170104PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

SETRUSUMAB OSTEOGENESIS IMPERFECTA NHS ENGLANDDRUGS AFFECTING BONE

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

SEVELAMER ADULT RENAL DIALYSIS ONLY NHS ENGLAND PHOSPHATE BINDING AGENTS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

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

SIROLIMUS (RAPAMUNE)TRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

DRUGS AFFECTING THE IMMUNE

RESPONSE

TA481, TA482

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREED

NICE NICEPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

SODIUM OXYBATENARCOLEPSY - PEADIATRIC SERVICES

ONLYNHS ENGLAND HYPNOTICS & ANXIOLYTICS

NHS ENGLAND CLINICAL

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

SODIUM PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

SOFOSBUVIR/LEDIPASVIR +/-

RIBAVIRINHEPATITIS C NHS ENGLAND

VIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA 363 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

SOFOSBUVIR/PEGINTERFERON+

RIBAVIRINHEPATITIS C NHS ENGLAND

VIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA 330 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

SOFOSBUVIR/VELPATASVIR HEPATITIS C NHS ENGLANDVIRAL HEPATITIS (B&C) &

RESPIRATORY SYNCYTIAL VIRUSTA 430 AS PER RUN RATE CARD AS PER RUN RATE CARD HEPATITIS C MDS √ √

SORAFENIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA 474 & TA 535 NICE NICE SACT √ √

STAVUDINEHIV IN COMBINATION WITH OTHER ANTI-

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

SUBCUTANEOUS HUMAN NORMAL

IMMUNOGLOBULINSMULTIPLE INDICATIONS NHS ENGLAND

INTRAVENOUS/SUBCUTANEOUS

HUMAN NORMAL IMMUNOGLOBULINS

CLINICAL GUIDELINES FOR

IMMUNOGLOBULIN USE, SECOND

EDITION UPDATE (JULY 2011)

IMMUNOGLOBULIN GUIDELINES

PUBLISHED 2019 ON MDSAS WEBSITE

NATIONAL GUIDELINES NATIONAL GUIDELINES

QUALITY DASHBOARD

NATIONAL IMMUNOGLOBULIN DATA

BASE

SUCROFERRIC OXYHDROXIDE ADULT RENAL DIALYSIS ONLY NHS ENGLAND PHOSPHATE BINDING AGENTS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

SUNITINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA169, TA179, TA449 NICE NICE SACT √ (Only TA449) √

SUTIMLIMAB PRIMARY COLD AGGLUTININ DISEASE 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 √

TAFAMIDIS AMYLOIDOSIS NHS ENGLAND NEURODEGENERATIVE CONDITIONS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TALIGLUCERASE ALFA GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

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

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

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

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

RESPIRATORY SYNCYTIAL VIRUS

NOT ROUTINELY COMMISSIONED

(TA154)AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TEMSIROLIMUS CANCER NHS ENGLAND PROTEIN KINASE INHIBITORSNOT ROUTINELY COMMISSIONED

(TA178)IFR IFR SACT √

TENOFOVIR

HIV IN COMBINATION WITH OTHER ANTI-

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-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

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

TENOFOVIR ALAFENAMIDE +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

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

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 9 31/03/2020

Page 10: MEDICINES NOT REIMBURSED THROUGH …...ATALUREN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NICE HST3 NICE NICE NORTHSTAR DATABASE √ ATAZANAVIR HIV IN COMBINATION

DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

TENOFOVIR DISOPROXIL +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:

F03/P/b/AGREED REGIONAL GUIDELINES

NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

TENOFOVIR + EMTRICITABINE +

EFAVIRENZ

HIV IN COMBINATION WITH OTHER ANTI-

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

TENOFOVIR + EMTRICITABINE +

RILPIVIRINE

HIV IN COMBINATION WITH OTHER ANTI-

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

TEPRASIRANPREVENTION OF DELAYED GRAFT

FUNCTIONNHS ENGLAND RENAL TRANSPLANTATION NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TEPROTUMUMAB GRAVES ORBITOPATHY NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TERIFLUNOMIDE MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA303

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

TERIPARATIDE OSTEOGENESIS IMPERFECTA NHS ENGLANDDRUGS AFFECTING BONE

METABOLISM

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY: 16002/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TERIPARATIDE MALE AND JUVENILE OSTEOPOROSIS NHS ENGLANDDRUGS AFFECTING BONE

METABOLISM

NHS ENGLAND CLINICAL

COMMISSIONING POLICY STATEMENT

170064P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

TETRAHYDROBIOPTERIN PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

TEZACAFTOR WITH IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNHS ENGLAND URGENT POLICY

STATEMENT 190137PNHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √

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

THALIDOMIDE CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA228 NICE NICE SACT √

THROMBOMODULIN,

RECOMBINANT HUMANPSEUDOANEURYSM NHS ENGLAND BLOOD-RELATED PRODUCTS IPG060 IPG060 NICE √

TIPRANAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

TOBRAMYCIN CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY: A01/P/b

TA276

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√* √*

TOCILIZUMAB ADULT ONSET STILLS DISEASE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY 170056PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

TOCILIZUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY: E03/P/d; TA 373NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

TOCILIZUMAB TAKAYASU ARTERITIS NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

COMMISSIONING POLICY 16056/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

TOCILIZUMAB GIANT CELL ARTERITIS NHS ENGLAND CYTOKINE MODULATORS TA 518 NICE NICE NICE AUDIT √ √

TOCILIZUMAB CYTOKINE RELEASE SYNDROME NHS ENGLAND CYTOKINE MODULATORS AS PER BLUETEQ FORM AS PER BLUETEQ FORM AS PER BLUETEQ FORM BLUETEQ AUDIT √ √

TOLVAPTAN HYPONATRAEMIA IN CANCER NHS ENGLANDPOSTERIOR PITUITARY HORMONES

AND ANTAGONISTS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 16051/PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

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

TRENONACOG ALPHA HAEMOPHILIA B NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TRIENTENE WILSONS DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY 170094PNHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

TRIHEPTANOIN PYRUVATE CARBOXYLASE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

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

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

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

USTEKINUMAB PLAQUE PSORIASIS IN CHILDREN NHS ENGLAND CYTOKINE MODULATORS TA455 NICE NICE NICE AUDIT √ √

VADADUSTAT 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 √

VALGANCICLOVIR CYTOMEGALOVIRUS NHS ENGLAND CYTOMEGALOVIRUS INFECTION AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

VANDETANIB THYROID CANCER NHS ENGLAND PROTEIN KINASE INHIBITORSNOT ROUTINELY COMMISSIONED

(TA550)IFR IFR SACT √

VATIQUINONE FRIEDREICHS ATAXIA NHS ENGLAND NEURODEGENERATIVE CONDITIONS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

VELAGLUCERASE ALFA GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNHS ENGLAND SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLYHIGHLY SPECIALISED DATABASE √

VELCALCETIDE HYPERPARATHYROIDISM NHS ENGLANDDRUGS AFFECTING BONE

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

VELMANASE ALFA ALPHA MANNOSIDASE DEFICIENCY NHS ENGLANDDRUGS USED TO TREAT ALPHA

MANNOSIDOSISNOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

VEMURAFENIB MELANOMA NHS ENGLAND PROTEIN KINASE INHIBITORS TA269 NICE NICE NICE AUDIT √

VESTRONIDASE ALFA MUCOPOLYSACCHARIDOSIS VII NHS ENGLANDLYSOSOMAL STORAGE DISORDER

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

VOLANESORSENFAMILIAL CHYLOMICRONEMIA

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

VONICOG ALFA VON WILLEBRAND DEFICIENCY NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

VON WILLEBRAND FACTOR,

RECOMBINANTVON WILLEBRAND DEFICIENCY NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

VORETIGENE NEPARVOVEC INHERITED RETINAL DYSTROPHIES NHS ENGLANDRETINAL DISORDERS/INTRAOCULAR

LENS REPLACEMENT SURGERYHST11 NICE NICE NICE AUDIT √ √

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

VORICONAZOLE CHRONIC PULMONARY ASPERGILLOSIS NHS ENGLAND ANTIFUNGALS HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

VOXELOTOR SICKLE CELL DISEASE NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

VX-210 SPINAL CORD INJURY NHS ENGLAND NOVEL - NO GROUP NAME AGREED NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ZICONOTIDE INTRATHECAL ANALGESIA NHS ENGLAND NON-OPIOID ANALGESICSNOT ROUTINELY COMMISSIONED - NHS

ENGLAND POLICY 16011/PAS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

ZIDOVUDINEHIV IN COMBINATION WITH OTHER ANTI-

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

ZIDOVUDINE + LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-

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

ZIDOVUDINE + LAMIVUDINE +

ABACAVIR

HIV IN COMBINATION WITH OTHER ANTI-

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

OTHER DRUGS NOT LISTED

UNDER PBR EXCLUSIONS

3,4 DIAMINOPYRIDINELAMBERT EATON MYASTHENIC

SYNDROMENHS ENGLAND AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 10 31/03/2020

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

ABEMACICLIB CANCER CDF CANCER EXCLUSIONTA563

CDF TA579

NICE

CDF

NICE

CDF SACT √ √

ALBUMIN BOUND PACLITAXEL CANCER NHS ENGLAND CANCER EXCLUSION TA 476 NICE NICE SACT √ √

ALECTINIB CANCER NHS ENGLAND CANCER EXCLUSION TA 536 NICE NICE SACT √ √

ARSENIC TRIOXIDE CANCER NHS ENGLAND CANCER EXCLUSION

TA 526

NOT ROUTINELY COMMISSIONED

NHS ENGLAND POLICY STATEMENT

170072P

NICE NICE SACT √ √

ATEZOLIZUMAB CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

TA520, TA525, TA584

CDF (TA 492)

NICE

CDF

NICE

CDF SACT √ √

AUTOLOGOUS CHONDROCYTE

IMPLANTATIONARTICULAR CARTILAGE DEFECT NHS ENGLAND TA 477 & TA 508 NICE NICE NICE AUDIT √ √

AVELUMAB CANCER NHS ENGLAND CANCER EXCLUSIONTA 517

CDF

NICE

CDF

NICE

CDFSACT √ √

AXICABTAGENE CILOLEUCEL CANCER CDF ATMP TA 559 CDF CDF SACT √ √

AZATHIOPRINETRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREEDTRUST GUIDELINES TRUST GUIDELINES √* √*

BENDAMUSTINE CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

TA216

CDF POLICY

NHS ENGLAND POLICY (WITH

RITUXIMAB) 170055P, 17088P & 170054P

NICE

CDF

NHS ENGLAND POLICY

NICE

CDF

NHS ENGLAND POLICY

SACT√ (Not for all

policies)√

BINIMETINIB CANCER NHS ENGLAND CANCER EXCLUSION TA562 NICE NICE SACT √ √

BLINATUMOMAB CANCER NHS ENGLAND CANCER EXCLUSION TA450, TA589 NICE NICE SACT √ √

BRENTUXIMAB CANCER NHS ENGLAND CANCER EXCLUSIONTA446 (replaced by TA524), TA478, TA524,

TA577NICE NICE SACT √ √

BRIGATINIB CANCER NHS ENGLAND CANCER EXCLUSION TA571 NICE NICE SACT √ √

CABAZITAXEL CANCER NHS ENGLAND CANCER EXCLUSION TA 391 NICE NICE SACT √ √

CABOZANTINIB CANCER NHS ENGLAND/CDF CANCER EXCLUSION TA 463, TA516 & TA 542 NICE NICE SACT √ √

CARFILZOMIB CANCER NHS ENGLAND CANCER EXCLUSION TA 457 NICE NICE SACT √ √

CEMIPLIMAB CANCER CDF CANCER EXCLUSION TA 592 (CDF) CDF CDF SACT √ √

CERITINIB CANCER NHS ENGLAND CANCER EXCLUSION TA 395, TA 500 NICE NICE SACT √ √

CHEMOTHERAPY CANCER - (NOT SPECIFICALLY LISTED)NHS ENGLAND/

CDFCANCER EXCLUSION TRUST GUIDELINES/ NICE/ CDF POLICY

TRUST GUIDELINES/ NICE/

CDF POLICY

TRUST GUIDELINES/ NICE/

CDF POLICYSACT √

CICLOSPORINTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREEDTRUST GUIDELINES TRUST GUIDELINES

PRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

CLOFARABINE CANCER CDF CANCER EXCLUSION

CDF POLICY

NOT ROUTINELY COMMISSIONED - NHS

ENGLAND POLICY 170080P

CDF CDF SACT √

COLESTILAN ADULT RENAL DIALYSIS ONLY NHS ENGLANDDRUGS FOR MINERAL BONE

DISORDERSTRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

DACOMITINIB CANCER NHS ENGLAND CANCER EXCLUSION TA595 NICE NICE SACT √ √

DARATUMUMAB CANCER CDF CANCER EXCLUSION CDF (TA 510, TA 573) CDF CDF SACT √ √

DINUTUXIMAB CANCER NHS ENGLAND CANCER EXCLUSION TA 538 NICE NICE SACT √ √

DOCETAXEL CANCER NHS ENGLAND CANCER EXCLUSION

NHS ENGLAND CLINICAL

COMMISSIONING POLICY STATEMENT

B15/PS/a

NHS ENGLAND POLICY NHS ENGLAND POLICY SACT √

DURVALUMAB CANCER CDF CANCER EXCLUSION CDF TA578 CDF CDF SACT √ √

ENCORAFENIB CANCER NHS ENGLAND CANCER EXCLUSION TA562 NICE NICE SACT √ √

ERIBULIN CANCER NHS ENGLAND CANCER EXCLUSION NICE TA 423 NICE NICE SACT √ √

FACTOR X (COAGADEX) HEREDITARY FACTOR X DEFICIENCY NHS ENGLAND BLOOD-RELATED PRODUCTS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

GEMCITABINE (WITH

CAPECITABINE)CANCER NHS ENGLAND CANCER EXCLUSION NHS ENGLAND POLICY 170101P NHS ENGLAND POLICY NHS ENGLAND POLICY SACT √ √

GEMTUZUMAB OZOGAMICIN CANCER NHS ENGLAND CANCER EXCLUSION TA 545 NICE NICE SACT √ √

IBRUTINIB CANCER NHS ENGLAND/CDF PROTEIN KINASE INHIBITORSTA429, TA502

CDF (TA491)

NICE

CDF

NICE

CDF SACT √ √

IDELALISIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS NICE TA 359 NICE NICE SACT √

INOTUZUMAB OZOGAMICIN CANCER NHS ENGLAND CANCER EXCLUSION TA 541 NICE NICE SACT √ √

IPILIMUMAB CANCER NHS ENGLAND/CDF CANCER EXCLUSION TA268, TA319, TA400, CDF TA581NICE

CDF

NICE

CDFSACT √ √

LENVATINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA498, TA 535 & TA 551 NICE NICE SACT √ √

LIPOSOMAL CYTARABINE-

DAUNORUBICIN CANCER NHS ENGLAND CANCER EXCLUSION TA 522 NICE NICE SACT √ √

LUTETIUM (177Lu)

OXODOTREOTIDE CANCER NHS ENGLAND CANCER EXCLUSION TA 539 NICE NICE SACT √ √

MESENCHYMAL STEM CELLS (E.G.

PROCHYMAL®)

ACUTE GVHD AND OTHER INDICATIONS

(BCSH)NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

MIDOSTAURIN CANCER NHS ENGLAND CANCER EXCLUSION TA 523 NICE NICE SACT √ √

MYCOPHENOLATE MOFETILTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREED

NICE NICEPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

MYCOPHENOLIC ACIDTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREED

NICE NICEPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

NELARABINE CANCER CDF CANCER EXCLUSION CDF POLICY CDF CDF SACT √

NERATINIB CANCER NHS ENGLAND CANCER EXCLUSION TA612 NICE NICE SACT √ √

NIRAPARIB CANCER CDF CANCER EXCLUSION CDF (TA 528) CDF CDF SACT √ √

NIVOLUMAB CANCER NHS ENGLAND/CDF CANCER EXCLUSION

TA 384, 400, 417, 462, 530

CDF (TA 483, TA 484, TA 490, TA 558, TA

581)

NICE

CDF

NICE

CDF SACT √ √

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 11 31/03/2020

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DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/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)

OBINUTUZUMAB CANCER NHS ENGLAND/CDF CANCER EXCLUSIONTA343 & 513

CDF (TA472)

NICE

CDF

NICE

CDFSACT √ √

OLAPARIB CANCER NHS ENGLAND/CDF CANCER EXCLUSION TA 381, CDF TA598, TA620NICE

CDF

NICE

CDFSACT √ √

OSIMERTINIB CANCER CDF CANCER EXCLUSION CDF (TA 416) CDF CDF SACT √ √

PALBOCICLIB CANCER NHS ENGLAND/CDF CANCER EXCLUSION TA 495 & TA 619 (CDF)NICE

CDF

NICE

CDFSACT √ √

PANITUMUMAB CANCER NHS ENGLAND CANCER EXCLUSION TA439 NICE NICE SACT √ √

PANOBINOSTAT CANCER NHS ENGLAND CANCER EXCLUSION TA 380 NICE NICE SACT √

PEGASPARGASE CANCER NHS ENGLAND CANCER EXCLUSION TA 408 NICE NICE SACT √

PEGYLATED LIPOSOMAL

DOXORUBICINCANCER

NHS ENGLAND/

CDFCANCER EXCLUSION

TA91

CDF POLICY

NICE

CDF

NICE

CDFSACT √

PEMETREXED CANCER NHS ENGLAND CANCER EXCLUSIONTA135, TA181, TA190, TA 402

NICE NICE SACT √

PEPTIDE RECEPTOR

RADIONUCLEOTIDE THERAPYCANCER CDF NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PERTUZUMAB CANCER NHS ENGLAND CANCER EXCLUSION NICE TA 424, TA 509 and TA 569 NICE NICE SACT √ √

PIXANTRONE CANCER NHS ENGLAND CANCER EXCLUSION TA306 NICE NICE SACT √

PROTEIN KINASE INHIBITORSENDOCRINOLOGY; NON-MALIGNANT

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

RADIUM-223 DICHLORIDE CANCER NHS ENGLAND CANCER EXCLUSION NICE TA 376 replaced by TA 412 NICE NICE SACT √ √

RAMUCIRUMAB CANCER NHS ENGLAND CANCER EXCLUSIONNOT ROUTINELY COMMISSIONED -

TA 378AS PER IFR APPROVAL AS PER IFR APPROVAL SACT √

RIBOCICLIB CANCER NHS ENGLAND/CDF CANCER EXCLUSION TA 496, CDF TA593NICE

CDF

NICE

CDFSACT √ √

RUCAPARIB CANCER NHS ENGLAND/CDF CANCER EXCLUSION CDF TA611 CDF CDF SACT √ √

STRIMVELIS

ADENOSINE DEAMINASE DEFICIENCY-

SEVERE COMBINED

IMMUNODEFICIENCY

NHS ENGLAND ATMP HST7 NICE NICE NICE AUDIT √

TACROLIMUSTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREED

NICE NICEPRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

TALIMOGENE LAHERPAREPVEC CANCER NHS ENGLAND CANCER EXCLUSION TA 410 NICE NICE SACT √ √

TEMOZOLOMIDE CANCER NHS ENGLAND CANCER EXCLUSIONTA23 & TA121

NHS ENGLAND POLICY 200203P

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICYSACT √ √

TEMOZOLOMIDEENDOCRINOLOGY; NON-MALIGNANT

CONDITIONSNHS ENGLAND CANCER EXCLUSION NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

TISAGENLECLEUCEL CANCER CDF ATMP CDF (TA 554, TA 567)NICE

CDF

NICE

CDF SACT √ √

TIVOZANIB CANCER NHS ENGLAND CANCER EXCLUSION TA 512 NICE NICE SACT √ √

TRABECTEDIN CANCER NHS ENGLAND ANTINEOPLASTIC DRUGS TA185 NICE NICE SACT √

TRAMETINIB CANCER NHS ENGLAND CANCER EXCLUSION TA 396 & TA 544 NICE NICE SACT √ √

TRASTUZUMAB CANCER NHSE ENGLAND CANCER EXCLUSION TA 34, 107, 208 NICE NICE SACT √

TRASTUZUMAB EMTANSINE CANCER NHS ENGLAND CANCER EXCLUSION TA 458 NICE NICE SACT √ √

TRIFLURIDINE–TIPIRACIL CANCER NHS ENGLAND CANCER EXCLUSION TA 405 NICE NICE SACT √ √

URIDINE TRIACETATETREATMENT OF TOXIXITY WITH 5-FU

AND CAPECITABINENHS ENGLAND CANCER EXCLUSION

NHS ENGLAND URGENT POLICY

STATEMENT 1929NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

VENETOCLAX CANCER NHS ENGLAND/CDF CANCER EXCLUSIONTA 487

CDF

NICE

CDF

NICE

CDFSACT √ √

* DRUG IS BEING REPATRIATED FROM PRIMARY TO SECONDARY CARE THEREFORE SUPPLY ROUTE MAY VARY AT PRESENT

NEW LINES ADDED TO V15 LIST

CHANGES TO V14 19/20 LIST

ADDITIONAL NOTES:

10. Products that are currently available via the Early Access to Medicines Scheme are not covered by this list but all require registration via the Blueteq system

9. PLEASE NOTE THIS IS A NOT LIVE LIST AND THE COMMISSIONING POSITION MAY CHANGE PRIOR TO A NEW LIST BEING PUBLISHED IN MARCH OF EACH YEAR - REFER TO THE NICE POLICY PROGRAMME ON THE NICE WEBSITE AND/OR THE NHS ENGLAND POLICY PROGRAMME PUBLSIHED AT

https://www.england.nhs.uk/publication/clinical-commissioning-policy-work-programme/

1. WHERE THE FUNDED INDICATION IS FOR PAEDIATRIC USE THE CCG WILL BECOME THE RESPONSIBLE COMMISSIONER WHEN THE PATIENT IS TRANSFERRED TO THE ADULT SERVICE

2. CCGS ARE THE RESPONSIBLE COMMISSIONER FOR RITUXIMAB IN ADULT NON CANCEROUS HAEMOTOLOGICAL CONDITIONS (EG ITP) AND NON SPECIALIST AUTO-INFLAMMATORY CONDITIONS (EG RA)

6. NHS ENGLAND IS THE RESPONSIBLE COMMISSIONER WHEN SOMATROPIN ANALOGUES (GROWTH HORMONE) ARE PRESCRIBED IN SPECIALIST CENTRES FOR INDICATIONS FALLING OUTSIDE NICE GUIDANCE

8.DRUGS APPROVED BY NICE FOR ADULT CONDITIONS WILL BE COMMISSIONED IN CHILDREN AT SPECIALISED PAEDIATRIC CENTRES IF THE PATIENT MEETS THE NICE CRITERIA AND THERE IS EVIDENCE TO SUGGEST THAT THE DRUG IS SAFE AND CLINICALLY APPROPRIATE TO USE IN CHILDREN AS PER THE NHS ENGLAND MEDICINES FOR

CHILDREN POLICY FOUND AT https://www.england.nhs.uk/publication/commissioning-medicines-for-children-specialised-services/ AND A BLUETEQ FORM IS AVAILABLE. THIS INCLUDES FOR DRUGS NORMALLY COMMISISONED BY CCG'S IN ADULTS EG ADALIMUMAB, ETANERCEPT, INFLIXIMAB ETC PLEASE NOTE THAT MEDICINES FUNDED UNDER THE NHS

ENGLAND MEDICINES FOR CHILDREN POLICY MAY HAVE ADDITIONAL CRITERIA WITH RESPECT TO ACCESS

7. NHS ENGLAND COMMISSIONS ARVS AS PER PUBLISHED POLICIES, FOR THE TREATMENT OF PEOPLE WITH DIAGNOSED HIV INFECTION AND FOR THOSE THOUGHT TO BE HIV POSITIVE (POST EXPOSURE PROPHYLAXIS). NHS ENGLAND DOES NOT ROUTINELY COMMISSION PRE-EXPOSURE PROPHYLAXIS AND THIS IS ONLY AVAILABLE TO THOSE

ENROLLED IN CLINICAL STUDIES OR OTHER NHS ENGLAND AGREED SCHEMES

3. ELTROMBOPAG AND ROMIPLOSTIM ARE THE RESPONSIBILTY OF CCGS REGARDLESS OF THE CAUSE OF THE THROMBOCYTOPENIA IN ADULTS (PAEDIATRICS ARE NHS

ENGLAND RESPONSIBILITY)

5. USE IN VASCULAR DISEASE IS COMMISSIONED BY NHS ENGLAND WITHIN SPECIALIST CENTRES - CCG's ARE RESPONSIBLE FOR ALL OTHER INDICATIONS

4. IT IS A MANDATED REQUIREMENT THAT ALL USE OF CHEMOTHERAPY IS RECORDED IN THE SACT DATABASE INCLUDING THOSE TREATMENTS FUNDED THROUGH THE CDF

** ROUTINELY COMMISSIONED IN COMBINATION WHEN DUAL THERAPY REQUIRED

*** ONLY WHEN PRESCRIBED IN AN ADULT SPECIALIST CENTRE

**** ONLY WHERE IT IS A RECOGNISED MS CENTRE WITH SPECIALIST NURSE SUPPORT

NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 12 31/03/2020