Appendix 1: Mid and South Essex CCGs Collaboration Commissioners list of indications that may be commissioned for excluded drugs and devices 2021/2022 v1 High cost drugs excluded from the 2021/2022 National Tariff are not commissioned by Mid and South Essex Clinical Commissioning Groups (CCGs) unless the drugs and indications have approval through local processes. The table in Appendix 1 summarise the policy on the commissioning of drugs and devices. It is coded by a "traffic light" scheme as follows: Any drug and/or indication (licensed or unlicensed use) not listed In Appendix 1 is designated as NOT COMMISSIONED Not commissioned. Where provider Trusts prescribe this treatment the funding responsibility lies with the provider and not the commissioner. Approved for use in line with NICE Guidance or where NICE has been converted into a locally agreed protocol. Notification or individual or group prior approval required using proforma as per contract. Clinical evidence of outcomes may be requested by CCGs (in line with local contracts). Funding will not be authorised for patients who do not meet agreed criteria. Approved for use in line with locally agreed guidance only. Prior approval, notification proformas or electronic Blueteq® forms should be completed. Indications with other minimum dataset information must be provided on back up data to invoices. NHSE commissioning responsibility. CCGs should not consider funding requests for these drugs in these indications / group of patients. For drugs or indications where NHS England is the responsible commissioner the current version of the NHS England drug list should be refered to for the commissioning position, this is located at :- https://www.england.nhs.uk/commissioning/spec- services/key-docs/ Please note that the enclosed information reflects the current commissioning arrangements. These arrangements are subject to change in year if commissioning responsibility for particular drugs or services change between Mid and South Essex CCGs and the NHS England and / or new local drug policies are introduced or new NICE guidance is published. The main reference sources used to produce this document were: 1. National Tariff payment system 2020 2021 Annex A: The National Tariff and national prices workbook, High cost drugs and devices available at https://improvement.nhs.uk/resources/national‐tariff/ 2. East of England Priorities Advisory Commmittee (PAC) recommendations available at: http://www.prescqipp.info/ 3. National Institute for Health and Care Excellence (NICE) Guidance available at www.nice.org.uk. 4. UKMi Prescribing Outlook 2020 available from Specialist Pharmacy Services https://www.sps.nhs.uk/articles/prescribing‐outlook‐2020/ 5. UKMi New Drugs Online available from Specialist Pharmacy Services https://www.sps.nhs.uk/ 6. Indications for NHS England drugs list v15 published April 2020 available at https://www.england.nhs.uk/commissioning/spec‐services/key‐docs Version 1 April 2021 Appendix 1: Mid and South Essex CCGs Collaboration Commissioners' list of indications that may be commissioned for excluded drugs and devices 2021/2022 High cost drugs excluded from the 2021-22 National Tariff are not commissioned by Mid and South Essex Clinical Commissioning Groups (CCGs) unless the drugs and indications have approval through local processes. Please note that the enclosed information reflects the current commissioning arrangements. These arrangements are subject to change in year if commissioning responsibility for particular drugs or services change between Mid and South Essex CCGs and the NHS England and/or new local drug policies are introduced or new NICE guidance is published. Any drug and/or indication (licensed or unlicensed use) not listed In Appendix 1 is designated as NOT COMMISSIONED The table in Appendix 1 summarise the policy on the commissioning of drugs and devices. It is coded by a "traffic light" scheme as follows: Not commissioned. Where provider Trusts prescribe this treatment the funding responsibility lies with the provider and not the commissioner. Approved for use in line with NICE Guidance or where NICE has been converted into a locally agreed protocol or EoE CCG policy. Notification or individual or group prior approval required using proforma or electronic Blueteq® forms as per contract. Clinical evidence of outcomes may be requested by CCGs (in line with local contracts). Funding will not be authorised for patients who do not meet agreed criteria. Approved for use in line with locally agreed guidance only. Prior approval, notification proformas or electronic Blueteq® forms should be completed. Indications with other minimum dataset information must be provided on back up data to invoices. NHS England commissioning responsibility. CCGs should not consider funding requests for these drugs in these indications / group of patients. For drugs or indications where NHS England is the responsible commissioner the current version of the NHS England drug list should be refered to for the commissioning position, this is located at : https://www.england.nhs.uk/commissioning/spec-services/key-docs/ Version 1 April 2021 Page 2 of 50 Appendix 1: Mid and South Essex CCGs Collaboration Commissioners' list of indications that may be commissioned for excluded drugs and devices 2021/2022 Drug name BNF Category Licensed Indication/ NICE Guidance Indications agreed Is this commissioned? Notes section Indication for funding across What is required for EoE funding approval? Abatacept 10.1.3 Cytokine Rheumatoid arthritis NICE TA195, In line with NICE Complete proforma CCG commission adults modulators after failure of anti- August 2010 TA195. (using agreed local only. GP prescribing NOT expected. NHS England is TNF systems) responsible commissioner for paediatric use. Abatacept 10.1.3 Cytokine Rheumatoid Arthritis NICE TA375 In line with NICE Complete proforma CCG commission adults modulators not previously treated January 2016. TA375. (using agreed local only. GP prescribing NOT expected. NHS England is with DMARDs or after (partial review of systems) responsible commissioner conventional TA375, NICE for paediatric use. NICE DMARDs only have ID2710. TA375 replaced NICE failed In development TA280 [GID-TA10586] Abatacept 10.1.3 Cytokine Polyarticular juvenile NICE TA373 In line with NICE Complete proforma CCG commision adults only. modulators idiopathic arthritis December 2015 TA373. (using agreed local GP prescribing NOT expected. NHS England is (2nd line only). systems) responsible commissioner Unlicensed use in for paediatric use. adults. Abatacept 10.1.3 Cytokine Active psoriatic NICE TA568 NOT NOT COMMISSIONED modulators arthritis after March 2019 COMMISSIONED DMARDs Terminated appraisal. Abrocitinib JAK inhibitor Moderate to severe No NICE NOT NOT COMMISSIONED UK availability 2021 atopic dermatitis, in guidance COMMISSIONED adults anticipated. Actoxumab Monoclonal Prevention of No NICE NOT NOT COMMISSIONED Not licensed yet antibodies. No BNF recurrence guidance COMMISSIONED category of Clostridium anticipated. difficile infection Version 1 April 2021 Page 3 of 50 Appendix 1: Mid and South Essex CCGs Collaboration Commissioners' list of indications that may be commissioned for excluded drugs and devices 2021/2022 Drug name BNF Category Licensed Indication/ NICE Guidance Indications agreed Is this commissioned? Notes section Indication for funding across What is required for EoE funding approval? Adalimumab or 13.5.3 Cytokine Psoriasis NICE TA146 In line with NICE Complete proforma CCG commission Adults biosimilar modulators June 2008 TA146. (using agreed local only. GP prescribing NOT expected. NHS England is systems) responsible commissioner for plaque psoriasis in children NICE TA 455, paediatric use (of adult TAs), uveitis (NICE TA 460) and Hidradenitis Suppurativa (NICE TA 392) and Bechet's syndrome. Adalimumab or 1.5.3 Cytokine Crohn's Disease NICE TA187 May In line with NICE Complete proforma CCG commission Adults biosimilar modulators 2010 TA187 (using agreed local only. GP prescribing NOT expected. NHS England is systems) responsible commissioner for plaque psoriasis in children NICE TA 455, paediatric use (of adult TAs), uveitis (NICE TA 460) and Hidradenitis Suppurativa (NICE TA 392) and Bechet's syndrome. Adalimumab or 10.1.3 Cytokine Psoriatic Arthritis NICE TA199, In line with NICE Complete proforma CCG commission Adults biosimilar modulators August 2010 TA199. (using agreed local only. GP prescribing NOT expected. NHS England is systems) responsible commissioner for plaque psoriasis in children NICE TA 455, paediatric use (of adult TAs), uveitis (NICE TA 460) and Hidradenitis Suppurativa (NICE TA 392) and Bechet's syndrome. Version 1 April 2021 Page 4 of 50 Appendix 1: Mid and South Essex CCGs Collaboration Commissioners' list of indications that may be commissioned for excluded drugs and devices 2021/2022 Drug name BNF Category Licensed Indication/ NICE Guidance Indications agreed Is this commissioned? Notes section Indication for funding across What is required for EoE funding approval? Adalimumab or 1.5.3 Cytokine Moderate to severe NICE TA329 In line with NICE Complete proforma CCG commission Adults biosimilar modulators active ulcerative February 2015 criteria TA329 (using agreed local only. GP prescribing NOT expected. NHS England is colitis after the failure systems) responsible commissioner of conventional for plaque psoriasis in therapy children NICE TA 455, paediatric use (of adult TAs), uveitis (NICE TA 460) and Hidradenitis Suppurativa (NICE