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Medicines Not Reimbursed Through National Prices and Directly Commissioned by Nhs England MEDICINES NOT REIMBURSED THROUGH NATIONAL PRICES AND DIRECTLY COMMISSIONED BY NHS ENGLAND VERSION 11 PUBLISHED DECEMBER 2016 SUITABLE FOR SUITABLE FOR SHARED CARE SPECIALIST SHARED CARE BETWEEN PRIOR CENTRE ONLY WITH PRIMARY SPECIALIST MONITORING/AUDIT APPROVAL (includng outreach CARE (IF DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA AND REQUIREMENTS PROFORMA when delivered as SUPPORTED BY SECONDARY REQUIRED part of a provider LOCAL CARE VIA network) PRESCRIBING NETWORK COMMITTEE) MODEL HIV IN COMBINATION WITH OTHER ANTI- ABACAVIR NHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √ RETROVIRAL DRUGS NHS ENGLAND CLINICAL HIV IN COMBINATION WITH OTHER ANTI- NHS ENGLAND AIDS/HIV ANTIRETROVIRALS COMMISSIONING POLICY: BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √ ABACAVIR + LAMIVUDINE + RETROVIRAL DRUGS DOLUTEGRAVIR (TRIUMEQ®) B06/P/b/AGREED REGIONAL GUIDELINES HIV IN COMBINATION WITH OTHER ANTI- ABACAVIR + LAMIVUDINE NHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √ RETROVIRAL DRUGS ABALOPARATIDE DRUGS AFFECTING BONE MALE AND JUVENILE OSTEOPOROSIS NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ METABOLISM NHS ENGLAND CLINICAL ABATACEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS COMMISSIONING POLICY: E03/P/d; TA NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ 373 PAEDIATRIC INDICATIONS (WHERE ABATACEPT NHS ENGLAND CYTOKINE MODULATORS AS PER ADULT TA'S (TA195, TA280) NICE NICE NICE √ ADULT TA AVAILABLE) TA259, 387 (SEE ALSO SSC1438) NICE/NHS ENGLAND POLICY NICE ABIRATERONE CANCER NHS ENGLAND HORMONE ANTAGONISTS ONLY IN ENZALUTAMIDE NAÏVE SACT √ √ PATIENTS NHS ENGLAND CLINICAL ADALIMUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS COMMISSIONING POLICY: E03/P/d; TA NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ 373 NHS ENGLAND CLINICAL ADALIMUMAB UVEITIS - PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ COMMISSIONING POLICY:D12X02 NOT ROUTINELY COMMISSIONED ADALIMUMAB UVEITIS - ADULTS NHS ENGLAND CYTOKINE MODULATORS (NHS ENGLAND CLINICAL AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ COMMISSIONING POLICY: D12/P/a) HIGHLY SPECIALISED HIGHLY SPECIALISED ADALIMUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA √ CRITERIA ONLY CRITERIA ONLY PAEDIATRIC INDICATIONS (WHERE AS PER ADULT TA'S (TA130, TA143, ADALIMUMAB NHS ENGLAND CYTOKINE MODULATORS NICE NICE NICE AUDIT √ ADULT TA AVAILABLE) TA146, TA187, TA199) ADALIMUMAB HIDRADENITIS SUPPURATIVA NHS ENGLAND CYTOKINE MODULATORS NICE TA 392 NICE NICE NICE AUDIT √ √ VIRAL HEPATITIS (B&C) & NOT ROUTINELY COMMISSIONED ADEFOVIR HEPATITIS B NHS ENGLAND AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RESPIRATORY SYNCYTIAL VIRUS (CG165) AFATINIB CANCER NHS ENGLAND CANCER EXCLUSION TA310 NICE NICE SACT √ NOT ROUTINELY COMMISSIONED AFLIBERCEPT CANCER NHS ENGLAND CANCER EXCLUSION AS PER CDIFR APPROVAL AS PER CDIFR APPROVAL SACT √ (TA307) DRUGS USED IN METABOLIC HIGHLY SPECIALISED HIGHLY SPECIALISED AGALSIDASE ALFA FABRY'S DISEASE NHS ENGLAND NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED DATABASE √ DISORDERS CRITERIA ONLY CRITERIA ONLY DRUGS USED IN METABOLIC HIGHLY SPECIALISED HIGHLY SPECIALISED AGALSIDASE BETA FABRY'S DISEASE NHS ENGLAND NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED DATABASE √ DISORDERS CRITERIA ONLY CRITERIA ONLY ALBUTREPENONACOG ALFA HAEMOPHILIA B NHS ENGLAND BLOOD-RELATED PRODUCTS SSC 1652 SSC 1652 SSC 1652 PRODUCTS ON CMU FRAMEWORK √ ALBUTROPIN ADULT ONSET GROWTH HORMONE GROWTH HORMONE & GROWTH DEFICIENCY NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ HORMONE RECEPTOR ANTAGONIST ALDESLEUKIN CANCER NHS ENGLAND IMMUNOMODULATING DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL SACT √ DRUGS AFFECTING THE IMMUNE ALEMTUZUMAB MULTIPLE SCLEROSIS NHS ENGLAND TA312 NICE NICE NICE AUDIT √ √**** RESPONSE TRUST GUIDELINES: ISLET PRE-TRANSPLANT DRUGS AFFECTING THE IMMUNE ALEMTUZUMAB NHS ENGLAND TRANSPLANTATION (ONLY IF PROVIDED TRUST GUIDELINES TRUST GUIDELINES √ IMMUNOSUPPRESSION RESPONSE AT ZERO DRUG COST) DRUGS AFFECTING THE IMMUNE TRUST GUIDELINES: (ONLY IF ALEMTUZUMAB CLL NHS ENGLAND TRUST GUIDELINES TRUST GUIDELINES SACT √ RESPONSE PROVIDED AT ZERO DRUG COST) HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED HIGHLY SPECIALISED ALEMTUZUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS (ONLY IF PROVIDED AT ZERO DRUG HIGHLY SPECIALISED CRITERIA √ CRITERIA ONLY CRITERIA ONLY COST) DRUGS USED IN METABOLIC HIGHLY SPECIALISED HIGHLY SPECIALISED ALGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLAND NHS ENGLAND SERVICE SPECIFICATION HIGHLY SPECIALISED DATABASE √ DISORDERS CRITERIA ONLY CRITERIA ONLY DRUGS USED IN METABOLIC ALIPOGENE TIPARVOVEC LIPOPROTEIN LIPASE DEFICIENCY NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ DISORDERS VIRAL HEPATITIS (B&C) & ALISPORIVIR HEPATITIS C NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RESPIRATORY SYNCYTIAL VIRUS DRUGS USED IN METABOLIC ALPHA-1 ANTITRYPSIN ALPHA-1 ANTITRYPSIN DEFICIENCY NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ DISORDERS ALPHA MANNOSIDASE DRUGS USED IN METABOLIC ALPHA MANNOSIDASE DEFICIENCY NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RECOMBINANT HUMAN DISORDERS VASODILATOR ANTIHYPERTENSIVE PULMONARY ARTERIAL NHS ENGLAND CLINICAL AMBRISENTAN NHS ENGLAND DRUGS/PULMANORY ARTERIAL NHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √ HYPERTENSION COMMISSIONING POLICY: A11/P/c HYPERTENSION NOT ROUTINELY COMMISSIONED AMIFAMPRIDINE PHOSPHATE LEMS NHS ENGLAND NEUROMUSCULAR DISORDERS AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ NHS ENGLAND POLICY: 16009/P AMIKACIN INHALATION CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ CYSTIC FIBROSIS AMIKACIN LIPOSOMAL NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ NUMBER OF PATIENTS TREATED AMPHOTERICIN LIPOSOMAL FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES PROPORTION GIVEN FOR SPC √ INDICATIONS WITHIN POLICY NHS ENGLAND CLINICAL ANAKINRA JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ COMMISSIONING POLICY: E03/P/d SPECIALIST AUTOINFLAMMATORY ANAKINRA NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ DISEASE ANAKINRA PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ CRYOPYRIN ASSOCIATED PERIODIC CRYOPYRIN ASSOCIATED PERIODIC HIGHLY SPECIALISED HIGHLY SPECIALISED ANAKINRA NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED DATABASE √ SYNDROME SYNDROME SERVICE SPECIFICATION CRITERIA ONLY CRITERIA ONLY NHS England drugs-list v11 v4 NHSE Commissioned PbRE Drugv11 1 22/12/2016 SUITABLE FOR SUITABLE FOR SHARED CARE SPECIALIST SHARED CARE BETWEEN PRIOR CENTRE ONLY WITH PRIMARY SPECIALIST MONITORING/AUDIT APPROVAL (includng outreach CARE (IF DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA AND REQUIREMENTS PROFORMA when delivered as SUPPORTED BY SECONDARY REQUIRED part of a provider LOCAL CARE VIA network) PRESCRIBING NETWORK COMMITTEE) MODEL NUMBER OF PATIENTS TREATED ANIDULAFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES PROPORTION GIVEN FOR SPC √ INDICATIONS WITHIN POLICY ANTIHAEMOPHILIC FACTOR/VON AS PER BCSH GUIDELINES FOR NHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES PRODUCTS ON CMU FRAMEWORK √ WILLEBRAND FACTOR COMPLEX SPECIALISED INDICATIONS APLASTIC ANAEMIA DRUGS USED IN HYPOPLASTIC, ANTILYMPHOCYTE GLOBULIN NHS ENGLAND BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √ ORGAN TRANSPLANT HAEMOLYTIC, AND RENAL ANAEMIAS ANTIPSEUDOMONAS AERUGINOSA CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ IgY AS PER BCSH GUIDELINES FOR ANTITHROMBIN III NHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √ SPECIALISED INDICATIONS ANTITHYMOCYTE APLASTIC ANAEMIA DRUGS USED IN HYPOPLASTIC, NHS ENGLAND BCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √ IMMUNOGLOBULIN ORGAN TRANSPLANT HAEMOLYTIC, AND RENAL ANAEMIAS APREMILAST PAEDIATRIC INDICATIONS NHS ENGLAND CYTOKINE MODULATORS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ CLINICAL GUIDELINES FOR INTRAVENOUS/SUBCUTANEOUS ARAGAM AS PER NATIONAL DMP NHS ENGLAND IMMUNOGLOBULIN USE, SECOND NATIONAL GUIDELINES NATIONAL GUIDELINES QUALITY DASHBOARD √ HUMAN NORMAL IMMUNOGLOBULINS EDITION UPDATE (JULY 2011) DRUGS USED IN METABOLIC ASFOTASE ALFA HYPOPHOSPHATASIA NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ DISORDERS
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