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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 15 PUBLISHED APRIL 2020 SUITABLE FOR SUITABLE FOR SPECIALIST SHARED CARE SHARED CARE CENTRE ONLY BETWEEN PRIOR WITH PRIMARY (includng SPECIALIST APPROVAL CARE (IF DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/AUDIT REQUIREMENTS outreach when AND PROFORMA SUPPORTED BY delivered as part SECONDARY REQUIRED LOCAL of a provider CARE VIA PRESCRIBING network) 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 B06/P/b/AGREED REGIONAL GUIDELINES DOLUTEGRAVIR (TRIUMEQ®) 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 NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ COMMISSIONING POLICY: E03/P/d; TA 373 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 NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ COMMISSIONING POLICY: E03/P/d; TA 373 ADALIMUMAB UVEITIS - ADULTS NHS ENGLAND CYTOKINE MODULATORS TA460 NICE NICE NICE AUDIT √ √ HIGHLY SPECIALISED HIGHLY SPECIALISED ADALIMUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS HIGHLY SPECIALISED CRITERIA ONLY HIGHLY SPECIALISED CRITERIA √ CRITERIA ONLY CRITERIA ONLY 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 √ √ 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 IFR APPROVAL AS PER IFR 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 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 TA312 AND NHS ENGLAND POLICY ALEMTUZUMAB MULTIPLE SCLEROSIS NHS ENGLAND NICE NICE NICE AUDIT √ √**** RESPONSE STATEMENT 170075P 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 PROVIDED ALEMTUZUMAB CLL NHS ENGLAND TRUST GUIDELINES TRUST GUIDELINES SACT √ RESPONSE 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 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 NHS ENGLAND CLINICAL AMBRISENTAN PULMONARY ARTERIAL HYPERTENSION NHS ENGLAND DRUGS/PULMANORY ARTERIAL NHS ENGLAND POLICY NHS ENGLAND POLICY AS PER POLICY √ 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 DRUGS AFFECTING THE IMMUNE ANABASUM SCLERODERMA NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RESPONSE 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 PERIODIC FEVERS AND NHS ENGLAND CLINICAL ANAKINRA NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ AUTOINFLAMMATORY CONDITIONS COMMISSIONING POLICY: 170062P 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 CLINICAL ANAKINRA ADULT ONSET STILLS DISEASE NHS ENGLAND CYTOKINE MODULATORS NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √ COMMISSIONING POLICY: 170056P NUMBER OF PATIENTS TREATED ANIDULAFUNGIN FUNGAL INFECTION NHS ENGLAND ANTIFUNGALS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES 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 √ 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 ARIMOCLOMOL NIEMANN-PICK DISEASE NHS ENGLAND NEUROMUSCULAR DISORDERS NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ NHS England drugs-list v15 2020-2021.xlsx NHSE Commissioned PbRE Drugv15 1 31/03/2020 SUITABLE FOR SUITABLE FOR SPECIALIST SHARED CARE SHARED CARE CENTRE ONLY BETWEEN PRIOR WITH PRIMARY (includng SPECIALIST APPROVAL CARE (IF DRUG NAME INDICATION COMMISSIONER PBR CATEGORY TA/POLICY STARTING CRITERIA STOPPING CRITERIA MONITORING/AUDIT REQUIREMENTS outreach when AND PROFORMA SUPPORTED BY delivered as part SECONDARY REQUIRED LOCAL of a provider CARE VIA PRESCRIBING network) NETWORK COMMITTEE) MODEL DRUGS USED IN METABOLIC ASFOTASE ALFA HYPOPHOSPHATASIA NHS ENGLAND HST6 NICE NICE AS PER MAA √ √ DISORDERS VIRAL HEPATITIS (B&C) & ASUNAPREVIR HEPATITIS C NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RESPIRATORY SYNCYTIAL VIRUS DRUGS AFFECTING THE IMMUNE ATACICEPT SLE NHS ENGLAND NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √ RESPONSE ATALUREN DUCHENNE MUSCULAR DYSTROPHY NHS ENGLAND NEUROMUSCULAR DISORDERS NICE HST3 NICE NICE NORTHSTAR DATABASE √ √ HIV IN COMBINATION WITH OTHER ANTI- ATAZANAVIR NHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √ RETROVIRAL DRUGS ATAZANAVIR + COBICISTAT HIV IN COMBINATION WITH OTHER ANTI- NHS ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES BHIVA GUIDELINES (8) BHIVA GUIDELINES (8) HARS DATASET √ (EVOTAZ®) RETROVIRAL DRUGS AS PER NHS ENGLAND AUTOLOGOUS SERUM EYE DROPS DRY EYE NHS ENGLAND
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