MEDICINES NOT REIMBURSED THROUGH … ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES...

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

REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

ABACAVIRHIV IN COMBINATION WITH OTHER ANTI-

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

ABACAVIR + LAMIVUDINE +

DOLUTEGRAVIR (TRIUMEQ®)

HIV IN COMBINATION WITH OTHER ANTI-

RETROVIRAL DRUGSNHS ENGLAND AIDS/HIV ANTIRETROVIRALS

NHS ENGLAND CLINICAL

COMMISSIONING POLICY:

B06/P/b/AGREED REGIONAL GUIDELINES

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

ABACAVIR + LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-


ABALOPARATIDEMALE AND JUVENILE OSTEOPOROSIS NHS ENGLAND

DRUGS AFFECTING BONE

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

ABATACEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS


COMMISSIONING POLICY: E03/P/d; TA

373

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √ √

ABATACEPTPAEDIATRIC INDICATIONS (WHERE

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

ABIRATERONE CANCER NHS ENGLAND HORMONE ANTAGONISTS

TA259, 387 (SEE ALSO SSC1438)

ONLY IN ENZALUTAMIDE NAÏVE

PATIENTS

NICE/NHS ENGLAND POLICY NICESACT √ √

ADALIMUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS



373


ADALIMUMAB UVEITIS - 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 √

ADALIMUMABPAEDIATRIC INDICATIONS (OR WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS

AS PER TA455 OR ADULT TA'S (TA130,

TA143, TA146, TA187, TA199, TA329,

TA392, TA460)

NICE NICE NICE AUDIT √ √

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

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

RESPIRATORY SYNCYTIAL VIRUS

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


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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

ALBUTROPIN ADULT ONSET GROWTH HORMONE

DEFICIENCY NHS ENGLANDGROWTH HORMONE & GROWTH

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

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

ALEMTUZUMAB MULTIPLE SCLEROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSETA312 NICE NICE NICE AUDIT √ √****

ALEMTUZUMABPRE-TRANSPLANT

IMMUNOSUPPRESSIONNHS ENGLAND

DRUGS AFFECTING THE IMMUNE

RESPONSE

TRUST GUIDELINES: ISLET

TRANSPLANTATION (ONLY IF PROVIDED

AT ZERO DRUG COST)

TRUST GUIDELINES TRUST GUIDELINES √

ALEMTUZUMAB CLL NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE

TRUST GUIDELINES: (ONLY IF

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

ALEMTUZUMAB BEHCETS SYNDROME NHS ENGLAND CYTOKINE MODULATORS

HIGHLY SPECIALISED CRITERIA ONLY

(ONLY IF PROVIDED AT ZERO DRUG

COST)

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ALGLUCOSIDASE ALFA POMPE DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ALIPOGENE TIPARVOVEC LIPOPROTEIN LIPASE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

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

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

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

ALPHA MANNOSIDASE

RECOMBINANT HUMANALPHA MANNOSIDASE DEFICIENCY NHS ENGLAND

DRUGS USED IN METABOLIC


AMBRISENTANPULMONARY ARTERIAL

HYPERTENSIONNHS ENGLAND

VASODILATOR ANTIHYPERTENSIVE

DRUGS/PULMANORY ARTERIAL

HYPERTENSION


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

AMIFAMPRIDINE PHOSPHATE LEMS NHS ENGLAND NEUROMUSCULAR DISORDERSNOT ROUTINELY COMMISSIONED

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

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

AMIKACIN LIPOSOMALCYSTIC FIBROSIS

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

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

NUMBER OF PATIENTS TREATED

PROPORTION GIVEN FOR SPC

INDICATIONS WITHIN POLICY

√

ANAKINRA JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

ANAKINRASPECIALIST AUTOINFLAMMATORY

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

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

ANAKINRACRYOPYRIN ASSOCIATED PERIODIC

SYNDROMENHS ENGLAND CYTOKINE MODULATORS

CRYOPYRIN ASSOCIATED PERIODIC

SYNDROME SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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




√

ANTIHAEMOPHILIC FACTOR/VON

WILLEBRAND FACTOR COMPLEX

AS PER BCSH GUIDELINES FOR

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

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

VERSION 13 PUBLISHED APRIL 2018

NHS England drugs-list v13 NHSE Commissioned PbRE Drugv13 1 23/03/2018


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)

ANTILYMPHOCYTE GLOBULIN APLASTIC ANAEMIA

ORGAN TRANSPLANTNHS ENGLAND

DRUGS USED IN HYPOPLASTIC,

HAEMOLYTIC, AND RENAL ANAEMIASBCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

ANTIPSEUDOMONAS AERUGINOSA

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

ANTITHROMBIN IIIAS PER BCSH GUIDELINES FOR

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

ANTITHYMOCYTE

IMMUNOGLOBULIN

APLASTIC ANAEMIA

ORGAN TRANSPLANTNHS ENGLAND


HAEMOLYTIC, AND RENAL ANAEMIASBCSH GUIDELINES BCSH GUIDELINES BCSH GUIDELINES √

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

ARAGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS

HUMAN NORMAL IMMUNOGLOBULINS

CLINICAL GUIDELINES FOR

IMMUNOGLOBULIN USE, SECOND

EDITION UPDATE (JULY 2011)

NATIONAL GUIDELINES NATIONAL GUIDELINES QUALITY DASHBOARD √

ASFOTASE ALFA HYPOPHOSPHATASIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSHST6 NICE NICE AS PER MAA √ √

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


ATACICEPT SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE

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

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

ATAZANAVIRHIV IN COMBINATION WITH OTHER ANTI-


ATAZANAVIR + COBICISTAT

(EVOTAZ®)



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

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

AZACITIDINE CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROME TA218 NICE NICE SACT √

AZTREONAM LYSINE CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGSNHS ENGLAND CLINCAL

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

AZTREONAM LYSINECYSTIC FIBROSIS (CONTIUOUS

TREATMENT)NHS ENGLAND ANTIBACTERIAL DRUGS


NHS ENGLAND CLINCAL

COMMISSIONING POLICY: 16001/P

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

BARICITINIBPAEDIATRIC INDICATIONS (WHERE

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

BASILIXIMAB RENAL TRANSPLANT NHS ENGLANDCORTICOSTEROIDS AND OTHER

IMMUNOSUPPRESSANTSTA85 & TA99 NICE NICE √

BECLABUVIR HEPATITIS CNHS ENGLAND

VIRAL HEPATITIS (B&C) &


BEDAQUILINE EXTENSIVELY DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL

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

BEDAQUILINE MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


BEGELOMAB GRAFT VERSUS HOST DISEASE NHS ENGLANDMALIGNANT DISEASE AND

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

BELATACEPT RENAL TRANSPLANT NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSE

NOT ROUTINELY COMMISSIONED - NICE

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

BELIMUMAB SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE

RESPONSENICE TA 397 NICE NICE NICE AUDIT √ √

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

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

BETAINE HOMOCYSTINURIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


BEVACIZUMAB CANCER CDF ANTINEOPLASTIC DRUGS CDF POLICY CDF CDF SACT √

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

SERVICE SPEC)

AS PER NATIONAL

PROTOCOL

AS PER NATIONAL

PROTOCOLAS PER NATIONAL PROTOCOL √

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

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

BLISIBIMODSYSTEMIC LUPUS ERYTHEMATOSUS

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

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

RESPIRATORY SYNCYTIAL VIRUSTA253 NICE NICE HEPATITIS C MDS √ √

BORTEZOMIBORGAN REJECTION POST KIDNEY

TRANSPLANTNHS ENGLAND ANTINEOPLASTIC DRUGS


(NHS ENGLAND CLINICAL

COMMISSIONING POLICY: A07/P/c)


BORTEZOMIB CANCERNHS ENGLAND/

CDFANTINEOPLASTIC DRUGS

TA129, TA228, TA311, TA 378

CDF POLICY

NICE

CDF

NICE

CDFSACT √

BOSENTAN DIGITAL ULCERS NHS ENGLAND



HYPERTENSION


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

BOSENTANPULMONARY ARTERIAL




HYPERTENSION



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

BOTULINUM TOXIN FOCAL SPASTICITY IN CHILDREN NHS ENGLANDTORSION DYSTONIAS AND OTHER

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

BOTULINUM TOXIN**** INTRAVESICAL USE IN SPINAL CORD

INJURYNHS ENGLAND

TORSION DYSTONIAS AND OTHER

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

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

BRODALIMUMABPAEDIATRIC INDICATIONS (WHERE

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

C1 ESTERASE INHIBITORSHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT NHS ENGLAND ALLERGIC EMERGENCIES


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

C1 ESTERASE INHIBITORSHEREDITARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES


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


CANAKINUMABCRYOPYRIN ASSOCIATED PERIODIC

SYNDROMENHS ENGLAND IMMUNOMODULATING DRUGS

CRYOPYRIN ASSOCIATED PERIODIC

SYNDROME SERVICE SPECIFICATION

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED




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)

CANAKINUMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND IMMUNOMODULATING DRUGSNOT ROUTINELY COMMISSIONED

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

CARGLUMIC ACID UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


CARNITINE CARNITINE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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




√

CATRIDECACOGCONGENITAL FACTOR XIII A-SUBUNIT

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

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

CERLIPONASE ALFA NEURONAL CEROID LIPOFUSCINOSIS NHS ENGLANDLYSOSOMAL STORAGE DISORDER

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

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

CETUXIMAB CANCER NHS ENGLAND ANTINEOPLASTIC DRUGS TA145, TA176, TA439, TA473 NICE NICE SACT √ √

CHENODEOXYCHOLIC ACIDCEREBROTENDINOUS

XANTHOMATOSIS (CTX) NHS ENGLAND



CHENODEOXYCHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC


CHOLIC ACIDINBORN ERRORS IN PRIMARY BILE

ACID SYNTHESISNHS ENGLAND



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




√

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

CIPROFLOXACIN LIPOSOMAL

(INHALED)

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

CLADRIBINE MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS 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 √

COBICISTATHIV IN COMBINATION WITH OTHER ANTI-




F03/P/b/AGREED REGIONAL GUIDELINES

NHS ENGLAND POLICY NHS ENGLAND POLICY HARS DATASET √

COBITOLIMODPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND



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

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

COLISTIMETHATE SODIUM CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS


COMMISSIONING POLICY: A01/P/b

TA276

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√* √*

CONESTAT ALFAHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES



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

CYSTEAMINE (MERCAPTAMINE) NEPHROPATHIC CYSTINOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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

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

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

DACLIZUMAB MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS TA441 NICE NICE NICE AUDIT √ √

DARUNAVIRHIV IN COMBINATION WITH OTHER ANTI-


DARUNAVIR +

COBICISTAT (REZOLSTA®)



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


DASATINIB CANCERNHS ENGLAND/

CDFPROTEIN KINASE INHIBITORS

NICE TA 425, 426

CDF POLICY

NICE

CDF

NICE

CDF SACT √

DECITABINE CANCER NHS ENGLAND MYELODYSPLASTIC SYNDROMENOT ROUTINELY COMMISSIONED

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

DEFERASIROXIRON CHELATION IN THALASSAEMIA

AND SICKLE CELLNHS ENGLAND


HAEMOLYTIC, AND RENAL ANAEMIAS -

IRON OVERLOAD


COMMISSIONING POLICY 16070/PNHS ENGLAND POLICY NHS ENGLAND POLICY

QUALITY DASHBOARD/ NATIONAL

HAEMOGLOBINOPATHY REGISTRY√

DEFERIPRONE**IRON CHELATION IN THALASSAEMIA




IRON OVERLOAD





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

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

DELAMANID EXTENSIVELY DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


DELAMANID MULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGSNHS ENGLAND CLINICAL


DESFERRIOXAMINE**IRON CHELATION IN THALASSAEMIA




IRON OVERLOAD





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

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

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

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

DIDANOSINEHIV IN COMBINATION WITH OTHER ANTI-


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

DOLUTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-




B06/P/b/AGREED REGIONAL GUIDELINES




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

DORNASE ALFA PRIMARY CILIARY DYSKINESIA NHS ENGLAND MUCOLYTICSNOT ROUTINELY COMMISSIONED

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

DORNASE ALFA CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNHS ENGLAND CLINICAL

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

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

DUPILUMAB ASTHMA NHS ENGLANDDRUGS AFFECTING THE IMMUNE


ECALLANTIDEHEREDITARY ANGIOEDEMA - ACUTE

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

ECULIZUMABORGAN REJECTION POST KIDNEY

TRANSPLANTNHS ENGLAND

PAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA


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

ECULIZUMABC3 GLOMERULOPATHY (POST

TRANSPLANT)NHS ENGLAND


HAEMOGLOBINURIA


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

ECULIZUMAB AHUS NHS ENGLANDPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIA


COMMISSIONING POLICY: E03/PS(HSS)/A

NICE HST1

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE√

ECULIZUMABPAROXYSMAL NOCTURNAL

HAEMOGLOBINURIANHS ENGLAND


HAEMOGLOBINURIA

NHS NATIONAL SPECIALISED

COMMISSIONING TEAM SERVICE

SPECIFICATION

NSCT SERVICE SPEC NSCT SERVICE SPEC NSCT SERVICE SPEC √

EDRATIDE SLE NHS ENGLANDDRUGS AFFECTING THE IMMUNE


EFAVIRENZHIV IN COMBINATION WITH OTHER ANTI-


EFRALOCTOCOG ALFA /

EFMOROCTOCOG ALFA / FACTOR

VIII FC FUSION PROTEIN (Elocta®)

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

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

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


ELIGLUSTAT GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

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-


EMRICASANNON-ALCOHOLIC STEATOHEPATITIS

(NASH) FIBROSISNHS ENGLAND



EMTRICITABINEHIV IN COMBINATION WITH OTHER ANTI-


EMTRICITABINE +TENOFOVIRHIV IN COMBINATION WITH OTHER ANTI-


EMTRICITABINE + TENOFOVIR

ALAFENAMIDE DESCOVY®HIV IN COMBINATION WITH OTHER ANTI-



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

EMTRICITABINE + RILPIVIRINE +

TENOFOVIR ALAFENAMIDE

(ODEFSEY®)





ENFUVIRTIDEHIV IN COMBINATION WITH OTHER ANTI-


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

RESPIRATORY SYNCYTIAL VIRUSTA153 & IN PROGRESS NICE NICE NICE AUDIT √

ENZALUTAMIDE CANCER NHS ENGLAND HORMONE ANTAGONISTS

TA316, TA 377 (SEE ALSO SSC1439)

BOTH: ONLY IN ABIRATERONE NAÏVE

PATIENTS

NICE/NHS ENGLAND POLICY NICESACT √

EPOPROSTENOL (5)PULMONARY ARTERIAL




HYPERTENSION



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

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

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

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

NHSE LETTERNICE NICE SACT √

ETANERCEPT JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS



373


ETANERCEPTPAEDIATRIC INDICATIONS OR (WHERE


AS PER TA455 OR ADULT TA'S (TA103,

TA130, TA143, TA199)NICE NICE NICE AUDIT √ √

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

ETRAVIRINEHIV IN COMBINATION WITH OTHER ANTI-


ETROLIZUMABPAEDIATRIC INDICATIONS (WHERE




EVEROLIMUS (AFINITOR®) 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



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 √ √

EVEROLIMUS (VOTUBIA®)

RENAL ANGIOMYOLIPOMA

ASSOCIATED WITH TUBULAR

SCLEROSIS

NHS ENGLAND PROTEIN KINASE INHIBITORS


COMMISSIONING POLICY STATEMENT

B14X09L




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)

EVOLOCUMABHOMOZYGOUS FAMILIAL

HYPERCHOLESTEROLAEMIANHS ENGLAND LIPID-REGULATING DRUGS

AS NICE TA 394

(FOLLOW GUIDANCE FOR

HETEROZYGOUS FH)

NICE NICE NICE AUDIT √

EX-VIVO EXPANDED AUTOLOGOUS

HUMAN CORNEAL EPITHELIAL

CELLS CONTAINING STEM CELLS

TREATMENT OF ADULT PATIENTS WITH

MODERATE TO SEVERE LIMBAL STEM

CELL DEFICIENCY (LSCD), UNILATERAL

OR BILATERAL, DUE TO PHYSICAL OR

CHEMICAL OCULAR BURNS

NHS ENGLAND ATMP TA 467 NICE NICE NICE AUDIT √ √

FACTOR IXAS PER BCSH GUIDELINES FOR


FACTOR VIIAS PER BCSH GUIDELINES FOR


FACTOR VIIAAS PER BCSH GUIDELINES FOR


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


FACTOR XIIIAS PER BCSH GUIDELINES FOR


FAMPRIDINE MULTIPLE SCLEROSIS NHS ENGLAND NEUROMUSCULAR DISORDERSNOT ROUTINELY COMMISSIONED

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

FIBRINOGENAS PER BCSH GUIDELINES FOR


FIBROBLAST GROWTH FACTOR 1

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

FILGOTINIBPAEDIATRIC INDICATIONS (WHERE




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

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

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




PRODUCT WITH LOWEST

ACQUISITION COST TO BE USED

√

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


FINGOLIMOD MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA254

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

FITUSIRAN HAEMOPHILIA A AND B NHS ENGLANDANAEMIAS AND SOME OTHER BLOOD


FLEBOGAMMA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






FLEBOGAMMADIF AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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

FOSAMPRENAVIRHIV IN COMBINATION WITH OTHER ANTI-


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




√

FOSTEMSAVIRHIV iN COMBINATION WITH OTHER ANTI-


GALSULFASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


GAMMAGARD AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMMANORM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMMAPLEX AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






GAMUNEX AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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




√

GANETESPIB CANCER NHS ENGLANDDRUGS AFFECTING THE IMMUNE

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

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

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

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

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

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

GLUCARPIDASEMETHOTREXATE INDUCED RENAL

DYSFUNCTIONNHS ENGLAND POISONING


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

GLYCEROL PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


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

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

GRANULOCYTE-MACROPHAGE

COLONY-STIMULATING FACTOR

(LEUKINE® - IMPORT)

ANTIBODY-POSITIVE PULMONARY

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

GRAZOPREVIRHEPATITIS C NHS ENGLAND



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



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)

HIZENTRA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


HUMAN HETEROLOGOUS LIVER

CELLSUREA CYCLE DISORDERS NHS ENGLAND



HUMAN PARATHYROID HORMONE-

RELATED PROTEIN ANALOGUE

MALE AND JUVENILE OSTEOPOROSIS

HYPOPARATHYROIDISMNHS ENGLAND

DRUGS AFFECTING BONE


HYQVIA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS

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

IBALIZUMABHIV iN COMBINATION WITH OTHER ANTI-


ICATIBANTHEREDITARY ANGIOEDEMA - ACUTE

TREATMENT ONLYNHS ENGLAND ALLERGIC EMERGENCIES



ICATIBANTHEREDUTARY ANGIOEDEMA -

PROPHYLACTIC TREATMENTNHS ENGLAND ALLERGIC EMERGENCIES



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

IDURSULFASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


ILOPROST (5)PULMONARY ARTERIAL




HYPERTENSION



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

IMATINIBCHRONIC GRAFT VERSUS HOST

DISEASENHS ENGLAND CYTOKINE MODULATORS


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

IMIGLUCERASE GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


INDINAVIRHIV IN COMBINATION WITH OTHER ANTI-


INFLIXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


INFLIXIMAB UVEITIS NHS ENGLAND CYTOKINE MODULATORS



COMMISSIONING POLICY: D12/P/a &

D12/P/a)


INFLIXIMABPAEDIATRIC INDICATIONS (WHERE


AS PER ADULT TA'S (TA130, TA134,

TA140, TA143, TA163, TA187, TA199,

TA329)


INFLIXIMABCONNECTIVE TISSUE DISEASE -

INTERSTITAL LUNG DISEASENHS ENGLAND CYTOKINE MODULATORS

NOT ROUTINELY COMMISSIONED -

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

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

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

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

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

INFLIXIMAB HIDRADENITIS SUPPURATIVA NHS ENGLAND CYTOKINE MODULATORSNOT ROUTINELY COMMISSIONED - NHS


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

CRITERIA ONLY

HIGHLY SPECIALISED


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

INTERFERON BETA MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA32

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

INTRATECT AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






ISAVUCONAZOLEFUNGAL INFECTION (LICENSED

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




√

IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS


COMMISSIONING POLICY: A01/P/c,

16049/P

NHS ENGLAND POLICY NHS ENGLAND POLICY NHS ENGLAND POLICY √

IXAZOMIB AMYLOIDOSIS 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 √ √

KIOVIG AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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

RESPIRATORY SYNCYTIAL VIRUSCG165 NICE NICE NICE AUDIT √

LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-


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

PROCUREMENT COST TO BE USED√

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

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

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

PROCUREMENT COST TO BE USED√ √

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

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

LARONIDASE MUCOPOLYSACCHARIDOSIS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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

LENALIDOMIDE CANCERNHS ENGLAND/

CDFIMMUNOMODULATING DRUGS

TA171, TA322

CDF POLICY

NICE

CDF

NICE

CDFSACT √

LENALIDOMIDE POEMS NHS ENGLAND IMMUNOMODULATING DRUGS HIGHLY SPECIALISED CRITERIA ONLYHIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

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




PRODUCT WITH LOWEST

ACQUISITION COST TO BE USED

√

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

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

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

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

LIPEGFILGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIANOT ROUTINELY COMMISSIONED -


LIXIVAPTANHYPONATRAEMIA AND OTHER

ENDOCRINE USESNHS ENGLAND

POSTERIOR PITUITARY HORMONES

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

LOMITAPIDEHOMOZYGOUS FAMILIAL

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

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

LOPINAVIR + RITONAVIRHIV IN COMBINATION WITH OTHER ANTI-


LUMACAFTOR AND IVACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICSNOT ROUTINELY COMMISSIONED

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

MACIMORELIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH


MACITENTANPULMONARY ARTERIAL




HYPERTENSION


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

MANNITOL CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS



TA266

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√

MARAVIROCHIV IN COMBINATION WITH OTHER ANTI-


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

MAVRILIMUMABPAEDIATRIC INDICATIONS (WHERE




MECASERMIN GROWTH FAILURE NHS ENGLANDGROWTH HORMONE & GROWTH

HORMONE RECEPTOR ANTAGONIST


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

MEPOLIZUMAB ASTHMA NHS ENGLAND ALLERGEN IMMUNOTHERAPYTA431


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

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




√

MIGALASTAT FABRY'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSNICE HST4 NICE NICE HIGHLY SPECIALISED DATABASE √

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


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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

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


NATALIZUMAB MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA127

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

NELFINAVIRHIV IN COMBINATION WITH OTHER ANTI-


NEVIRAPINEHIV IN COMBINATION WITH OTHER ANTI-


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

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

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

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

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


NITISINONE ALKAPTONURIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


NITISINONE TYROSINAEMIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


NITRIC OXIDEPULMONARY ARTERIAL




HYPERTENSION

AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

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

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

NORMAL IMMUNOGLOBULIN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






OBETICHOLIC ACID PRIMARY BILIARY CIRRHOSIS NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERSTA443 NICE NICE NICE AUDIT √ √

OCRELIZUMAB MULTIPLE SCLEROSIS NHS ENGLANDDRUGS AFFECTING THE IMMUNE


OCTAGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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

OCTREOLIN ACROMEGALY NHS ENGLANDGROWTH HORMONE & GROWTH


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


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

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

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




REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

OFATUMUMAB CANCER NHS ENGLAND IMMUNOMODULATING DRUGS TA344 NICE NICE SACT √

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

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

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

OMBITASVIR/PARITAPREVIR/RITON

AVIR + DASABUVIR + RIBAVIRINHEPATITIS C NHS ENGLAND



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

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

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

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


JCVI GUIDELINES

PHE SPECIFICATIONAS PER SPECIFICATION AS PER SPECIFICATION √ √

PARA-AMINOSALICYLIC ACIDMULTI DRUG RESITANT TB NHS ENGLAND ANTITUBERCULOSIS DRUGS



PARATHYROID HORMONESPECIALIST ENDOCRINOLOGY

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

PARENTERAL NUTRITION (HOME

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

PARENTERAL NUTRITION

(INPATIENT USE)

INTESTINAL FAILURE; INADEQUATE/

UNSAFE ENTERAL FEEDINGNHS ENGLAND PARENTERAL NUTRITION

ONLY WHEN DURATION OF PN IS > 14

DAYS OR INITIATED PRIOR TO

ADMISSION. ADULTS; SEE ALSO CG32.

SEE ALSO 'MANUAL FOR PRESCRIBED

SPECIALISED SERVICES'

TRUST GUIDELINES TRUST GUIDELINES √

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

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


PASIREOTIDE CUSHING'S DISEASE NHS ENGLAND SOMATOSTATIN ANALOGUESNHS ENGLAND CLINICAL


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

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



COMMISSIONING POLICY: B07/P/a; TA75,

TA96, TA106, TA200, TA 300

CG165

NICE NICE NICE AUDIT √

PEGFILGRASTIM NEUTROPENIA NHS ENGLAND DRUGS USED IN NEUTROPENIA NOT ROUTINELY COMMISSIONED AS PER IFR APPROVAL AS PER IFR APPROVAL AS PER IFR APPROVAL √

PEGINTERFERON BETA-1A MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGS

ROUTINELY COMMISSIONED AS PER

SSC1534: MULTIPLE SCLEROSIS FIRST

LINE DISEASE MODIFYING AGENTS

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

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

PEGVISOMANT ACROMEGALY NHS ENGLAND

HYPOTHALMIC & ANTERIOR

PITUITARY HORMONES & ANTI-

OESTROGENS



PEMBROLIZUMAB CANCER INDICATIONS NHS ENGLAND/CDF CANCER EXCLUSIONTA 357, TA366, TA428

CDF POLICY (TA 447)

NICE

CDF

NICE

CDFSACT √ √

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


COMMISSIONING POLICY: B04/P/b,

16064/P

NHS ENGLAND POLICY NHS ENGLAND POLICY


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


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


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




√

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

PRIVIGEN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






PROTEIN CAS PER BCSH GUIDELINES FOR


PROTHROMBIN COMPLEXAS PER BCSH GUIDELINES FOR


RALTEGRAVIRHIV IN COMBINATION WITH OTHER ANTI-


RASBURICASE HYPERURICAEMIA NHS ENGLANDGOUT AND CYTOTOXIC-INDUCED

HYPERURICAEMIAAGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

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

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 √

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



COMMISSIONING POLICY: B07/P/a; TA75,

TA106, TA200

NICE NICE

NICE AUDIT

PRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED

√

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

RILONACEPTCRYOPYRIN-ASSOCIATED PERIODIC

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

RILPIVIRINEHIV IN COMBINATION WITH OTHER ANTI-


RIOCIGUATPULMONARY ARTERIAL

HYPERTENSION (CTEPH)NHS ENGLAND



HYPERTENSION


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

RIOCIGUATPULMONARY ARTERIAL




HYPERTENSION



RITONAVIRHIV IN COMBINATION WITH OTHER ANTI-




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)

RITUXIMABSTEROID SENSITIVE NEPHROTIC



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

RITUXIMABSTEROID RESISTANT NEPHROTIC



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

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


RITUXIMABCHRONIC INFLAMMATORY

DEMYELINATING POLYNEUROPATHYNHS ENGLAND CYTOKINE MODULATORS



RITUXIMAB JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


RITUXIMAB ACQUIRED HAEMOPHILIA NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

RITUXIMAB ANCA-POSITIVE VASCULITIS NHS ENGLAND CYTOKINE MODULATORSTA308

NHS ENGLAND POLICY: A13/P/a

NICE/ NHS ENGLAND

POLICY

NICE/ NHS ENGLAND

POLICYNICE/ NHS ENGLAND POLICY √

RITUXIMABCONNECTIVE TISSUE DISEASE -

INTERSTITIAL LUNG DISEASENHS ENGLAND CYTOKINE MODULATORS



RITUXIMABCYTOPENIA COMPLICATING PRIMARY

IMMUNODEFICIENCYNHS ENGLAND CYTOKINE MODULATORS



RITUXIMABCHRONIC GRAFT VERSUS HOST

DISEASENHS ENGLAND CYTOKINE MODULATORS



RITUXIMAB SLE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL

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

RITUXIMAB MYOSITIS NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


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

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

RITUXIMABABO-INCOMPATIBLE KIDNEY

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

RITUXIMABPEMPHIGUS VULGARIS AND

PEMPHIGOID DISEASENHS ENGLAND CYTOKINE MODULATORS



RITUXIMAB IMMUNOGLOBIN G4 RELATED DISEASE NHS ENGLAND CYTOKINE MODULATORSNHS ENGLAND CLINICAL


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

NHS ENGLAND CDF LETTER

TA65, TA137, TA174, TA193,

TA226, TA243

NHS ENGLAND CDF LETTER

TA65, TA137, TA174, TA193,

TA226, TA243

NHS ENGLAND CDF

LETTER

SACT √

RITUXIMAB SUBCUTANEOUS

FORMULATIONCANCER NHS ENGLAND CYTOKINE MODULATORS

AS PER CIRCULAR IE ONLY

COMMISSIONED FOR FOLLICULAR

LYMPHOMA MAINTENANCE TREATMENT

AS PER CIRCULAR AS PER CIRCULAR SACT √

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) &


ROXADUSTAT DIALYSIS-INDUCED ANAEMIA NHS ENGLANDDRUGS USED IN HYPOPLASTIC,

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

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

SANDOGLOBULIN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






SAPROPTERIN CHILDREN WITH PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS



COMMISSIONING POLICY: E06/P/a)


SAPROPTERIN MATERNAL PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS


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

SAQUINAVIRHIV IN COMBINATION WITH OTHER ANTI-


SARILUMABPAEDIATRIC INDICATIONS (WHERE

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

SEBELIPASE ALFA LYSOSOMAL ACID LIPASE DEFICIENCY NHS ENGLANDDRUGS USED IN METABOLIC

DISORDERS


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

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

SELEXIPAGPULMONARY ARTERIAL




HYPERTENSION



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


SIALIC ACID MYOPATHY NHS ENGLANDDRUGS USED IN METABOLIC


SILDENAFILPULMONARY ARTERIAL




HYPERTENSION


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

AS PER POLICY

PRODUCT WITH LOWEST


√

SIMEPREVIR/PEGINTERFERON +

RIBAVIRINHEPATITIS C NHS ENGLAND


RESPIRATORY SYNCYTIAL VIRUSTA 331 NICE NICE HEPATITIS C MDS √ √

SIRUKUMABPAEDIATRIC INDICATIONS (WHERE




SODIUM OXYBATENARCOLEPSY - PEADIATRIC SERVICES

ONLYNHS ENGLAND HYPNOTICS & ANXIOLYTICS


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

SODIUM PHENYLBUTYRATE UREA CYCLE DISORDERS NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


SOFOSBUVIR/DACLATASVIR +




SOFOSBUVIR/LEDIPASVIR +/-




SOFOSBUVIR/PEGINTERFERON+




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


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



REQUIREMENTS

PRIOR

APPROVAL

PROFORMA

REQUIRED

SPECIALIST

CENTRE ONLY

(includng outreach

when delivered as

part of a provider

network)

SUITABLE FOR

SHARED CARE

BETWEEN

SPECIALIST

AND

SECONDARY

CARE VIA

NETWORK

MODEL

SUITABLE FOR

SHARED CARE

WITH PRIMARY

CARE (IF

SUPPORTED BY

LOCAL

PRESCRIBING

COMMITTEE)

STAVUDINEHIV IN COMBINATION WITH OTHER ANTI-


SUBCUVIA AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






SUBGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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

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

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

TADALAFILPULMONARY ARTERIAL




HYPERTENSION



TAFAMANDIS 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


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


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


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

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

RESPIRATORY SYNCYTIAL VIRUSTA252 NICE NICE HEPATITIS C MDS √ √

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




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

TENOFOVIR


RETROVIRAL DRUGS

HEPATITIS B +/- OTHER ANTI-

RETROVIRAL DRUGS

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

REGIONAL GUIDELINES FOR HIV

BHIVA GUIDELINES (8)

NICE

BHIVA GUIDELINES (8)

NICEHARS DATASET √

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

TENOFOVIR ALAFENAMIDEHIV IN COMBINATION WITH OTHER ANTI-




TENOFOVIR ALAFENAMIDE +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE (GENVOYA®)





TENOFOVIR DISOPROXIL +

COBICISTAT + ELVITEGRAVIR +

EMTRICITABINE (STRIBILD®)





F03/P/b/AGREED REGIONAL GUIDELINES


TENOFOVIR + EMTRICITABINE +

EFAVIRENZ



TENOFOVIR + EMTRICITABINE +

RILPIVIRINE



TERIFLUNOMIDE MULTIPLE SCLEROSIS NHS ENGLAND IMMUNOMODULATING DRUGSTA303

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

TERIPARATIDE OSTEOGENESIS IMPERFECTA NHS ENGLANDDRUGS AFFECTING BONE

METABOLISM


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


TETRAHYDROBIOPTERIN PHENYLKETONURIA NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


TEZACAFTOR CYSTIC FIBROSIS NHS ENGLAND MUCOLYTICS 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 √

THROMBIN PSEUDOANEURYSM NHS ENGLAND BLOOD-RELATED PRODUCTS IPG060 IPG060 NICE √

TIPRANAVIRHIV IN COMBINATION WITH OTHER ANTI-


TOBRAMYCIN CYSTIC FIBROSIS NHS ENGLAND ANTIBACTERIAL DRUGS



TA276

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE

NHS ENGLAND POLICY

NICE AUDIT√* √*

TOCILIZUMAB IV JUVENILE ARTHRITIS-PAEDIATRIC NHS ENGLAND CYTOKINE MODULATORS



373


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 MODULATORSNOT ROUTINELY COMMISSIONED NHS


TOCILIZUMAB IVPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS AS PER ADULT TA'S (TA247 and TA375) NICE NICE NICE AUDIT √

TOFACITINIBPAEDIATRIC INDICATIONS (WHERE

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

TOLVAPTAN HYPONATRAEMIA IN CANCER NHS ENGLANDPOSTERIOR PITUITARY HORMONES

AND ANTAGONISTS


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 √

TREPROSTINIL DIETHANOLAMINE PULMONARY ARTERIAL




HYPERTENSION

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

TREPROSTINIL SODIUMPULMONARY ARTERIAL




HYPERTENSION

NOT ROUTINELY COMMISSIONED FOR

NEW PATIENTS - NHS ENGLAND

CLINICAL COMMISSIONING POLICY:

A11/P/c


TRIENTENE WILSONS DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


TUROCTOCOG ALFA (NovoEight)AS PER BCSH GUIDELINES FOR

SPECIALISED INDICATIONSNHS ENGLAND BLOOD-RELATED PRODUCTS BCSH GUIDELINES: See also SSC 1818 BCSH GUIDELINES BCSH GUIDELINES √

USTEKINUMABPAEDIATRIC INDICATIONS (OR WHERE


DRUGS AFFECTING IMMUNE

RESPONSE

AS PER TA455 AND ADULT TA's (TA180,

TA340)NICE NICE NICE √ √



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)

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




√

VANDETANIB THYROID CANCER CDF PROTEIN KINASE INHIBITORS CDF POLICY CDF CDFSACT

CDF NATIONAL AUDIT√

VEDOLIZUMABPAEDIATRIC INDICATIONS (WHERE

ADULT TA AVAILABLE)NHS ENGLAND CYTOKINE MODULATORS AS PER ADULT TA's (TA 342, TA 352) NICE NICE NICE AUDIT √ √

VELAGLUCERASE ALFA GAUCHER'S DISEASE NHS ENGLANDDRUGS USED IN METABOLIC


HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED


VELCALCETIDE HYPERPARATHYROIDISM NHS ENGLANDDRUGS AFFECTING BONE


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

VIGAM AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






VIVAGLOBIN AS PER NATIONAL DMP NHS ENGLANDINTRAVENOUS/SUBCUTANEOUS






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 √

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




√

VORICONAZOLECHRONIC PULMONARY

ASPERGILLOSISNHS ENGLAND ANTIFUNGALS HIGHLY SPECIALISED CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY

HIGHLY SPECIALISED

CRITERIA ONLY√

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


ZIDOVUDINEHIV IN COMBINATION WITH OTHER ANTI-


ZIDOVUDINE + LAMIVUDINEHIV IN COMBINATION WITH OTHER ANTI-


ZIDOVUDINE + LAMIVUDINE +

ABACAVIR



OTHER DRUGS NOT LISTED

UNDER PBR EXCLUSIONS

3,4 DIAMINOPYRIDINELAMBERT EATON MYASTHENIC

SYNDROMENHS ENGLAND AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

AFLIBERCEPT CANCER NHS ENGLAND CANCER EXCLUSION NOT ROUTINELY COMMISSIONED AS PER CDIFR APPROVAL AS PER CDIFR APPROVAL SACT √

ALBUMIN BOUND PACLITAXEL

TREATMENT OF BREAST CANCER

PATIENTS WITH DOCUMENTED

TAXANE HYPERSENSITIVITY

NHS ENGLAND CANCER EXCLUSION TA 476 NICE NICE SACT √ √

ATEZOLIZUMAB CANCER CDF CANCER EXCLUSION CDF (TA 492) CDF CDF SACT √ √

AUTOLOGOUS CHONDROCYTE

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

AZATHIOPRINETRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

NEW PATIENTS ONLY UNTIL FORMAL

REPATRIATION AGREEDTRUST GUIDELINES TRUST GUIDELINES √* √*

BENDAMUSTINE CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

TA216

CDF POLICY

NICE

CDF

NICE

CDFSACT √

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

BRENTUXIMAB CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

TA446, TA478

CDF POLICY

NICE

CDF

NICE

CDFSACT √ √

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

CABOZANTINIB CANCER NHS ENGLAND/CDF CANCER EXCLUSIONTA 463

CDF POLICY

NICE

CDF

NICE

CDF SACT √ √

CARFILZOMIB CANCER NHS ENGLAND CANCER EXCLUSION TA 457 NICE NICE 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


REPATRIATION AGREEDTRUST GUIDELINES TRUST GUIDELINES

PRODUCT WITH LOWEST

PROCUREMENT COST TO BE USED√* √*

CINACALCETHYPERPARATHYROIDISM - DIALYSIS

PATIENTS ONLYNHS ENGLAND

DRUGS FOR MINERAL BONE

DISORDERSTA117 NICE NICE √

CLOFARABINE CANCER CDF CANCER EXCLUSION CDF POLICY CDF CDF SACT √

COLESTILAN ADULT RENAL DIALYSIS ONLY NHS ENGLANDDRUGS FOR MINERAL BONE

DISORDERSTRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

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

DARBEPOETIN DIALYSIS-INDUCED ANAEMIA NHS ENGLAND ERYTHROPOETINS

RENAL DIALYSIS ONLY, INCLUDING VIA

OUTPATIENTS, AND ONLY AS PER NICE

CG114

TRUST GUIDELINES TRUST GUIDELINESPRODUCT WITH LOWEST


EPOETIN (ALL VARIANTS) DIALYSIS-INDUCED ANAEMIA NHS ENGLAND ERYTHROPOETINS

RENAL DIALYSIS ONLY, INCLUDING VIA

OUTPATIENTS, AND ONLY AS PER NICE

CG114

NICE

TRUST GUIDELINES (RENAL

USE ONLY)

NICE

TRUST GUIDELINES (RENAL

USE ONLY)

PRODUCT WITH LOWEST


(NICE CG114)

√

ERIBULIN CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

NICE TA 423

CDF POLICY

NICE

CDF

NICE

CDF SACT √

ETELCALCETIDEHYPERPARATHYROIDISM - DIALYSIS

PATIENTS ONLYNHS ENGLAND

DRUGS FOR MINERAL BONE

DISORDERSTA448 NICE NICE √ √

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 √

IBRUTINIB CANCER NHS ENGLAND/CDF PROTEIN KINASE INHIBITORSTA429

CDF (TA491)

NICE

CDF

NICE

CDF SACT √ √

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

IPILIMUMAB CANCER NHS ENGLAND CANCER EXCLUSION TA268, TA319, 400 NICE NICE SACT √

LANTHANUM ADULT RENAL DIALYSIS ONLY NHS ENGLANDDRUGS FOR MINERAL BONE

DISORDERSTRUST GUIDELINES TRUST GUIDELINES √

LENVATINIB CANCER NHS ENGLAND PROTEIN KINASE INHIBITORS TA498 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 √



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)

MYCOPHENOLATE MOFETILTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482


REPATRIATION AGREED

NICE NICEPRODUCT WITH LOWEST


MYCOPHENOLIC ACIDTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482


REPATRIATION AGREED



NELARABINE CANCER CDF CANCER EXCLUSION CDF POLICY CDF CDF SACT √

NIVOLUMAB CANCER NHS ENGLAND/CDF CANCER EXCLUSIONTA 384, 400, 417, 462

CDF (TA 483, TA 484, TA 490)

NICE

CDF

NICE

CDF SACT √ √

OBINUTUZUMAB CANCER NHS ENGLAND/CDF CANCER EXCLUSIONTA343 & 513

CDF (TA472)

NICE

CDF

NICE

CDFSACT √ √

OLAPARIB CANCER NHS ENGLAND CANCER EXCLUSION TA 381 NICE NICE SACT √

OLARATUMAB CANCER CDF CANCER EXCLUSION CDF (TA 465) CDF CDF SACT √ √

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

PALBOCICLIB CANCER NHS ENGLAND CANCER EXCLUSION TA 495 NICE NICE SACT √ √

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 CANCERNHS ENGLAND/

CDFCANCER EXCLUSION

TA135, TA181, TA190, TA 402 NICE

CDF

NICE

CDFSACT √

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 & 509 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 CANCERNHS ENGLAND/

CDFCANCER EXCLUSION NICE TA 376, TA 412

NICE

CDF

NICE

CDFSACT √

RAMUCIRUMAB CANCER NHS ENGLAND CANCER EXCLUSIONNOT ROUTINELY COMMISSIONED -

TA 378CDIFR CDIFR AS PER IFR APPROVAL √

RIBOCICLIB CANCER NHS ENGLAND CANCER EXCLUSION TA 496 NICE NICE SACT √ √

SEVELAMER ADULT RENAL DIALYSIS ONLY NHS ENGLANDDRUGS FOR MINERAL BONE

DISORDERSTRUST GUIDELINES TRUST GUIDELINES √

SIROLIMUS (RAPAMUNE)TRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482


REPATRIATION AGREED



STRIMVELIS

ADENOSINE DEAMINASE DEFICIENCY-

SEVERE COMBINED

IMMUNODEFICIENCY

NHS ENGLAND ATMP HST7 NICE NICE NICE AUDIT √

SUCROFERRIC OXYHDROXIDECONTROL OF SERUM PHOSPHORUS

LEVELS IN DIALYSIS PATIENTS NHS ENGLAND PHOSPHATE BINDING AGENTS AGREED TRUST GUIDELINES TRUST GUIDELINES TRUST GUIDELINES √

TACROLIMUSTRANSPLANT IMMUNOSUPPRESSION

ONLYNHS ENGLAND

TA481, TA482


REPATRIATION AGREED



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

TEMOZOLOMIDEENDOCRINOLOGY; NON-MALIGNANT

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

TIVOZANIB CANCER CDF CANCER EXCLUSION TA 512 CDF CDF SACT √ √TRABECTEDIN CANCER NHS ENGLAND ANTINEOPLASTIC DRUGS TA185 NICE NICE SACT √TRAMETINIB CANCER NHS ENGLAND CANCER EXCLUSION TA 396 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 √

VENETOCLAX CANCER CDF CANCER EXCLUSION CDF (TA 487) CDF CDF SACT √ √

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

NEW LINES ADDED TO V13 LIST

CHANGES TO V12 17/18 LIST

ADDITIONAL NOTES:

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 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

** 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

9. CINACALCET FOR COMPLEX PRIMARY PARATHYROIDISM IS IN TARIFF

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. A PRESCRIBING POLICY IS IN

DEVELOPMENT TO CLARIFY THESE ARRANGEMENTS”. THIS WILL APPLY TO ANY DRUG WHERE WE HAVE STATED “AS PER ADULT TA” AS THE TA/ POLICY. A PRIOR APPROVAL SYSTEM WILL BE IMPLEMENTED ALONG SIDE THE POLICY.

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

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


MEDICINES NOT REIMBURSED THROUGH … ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES...

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Transcript of MEDICINES NOT REIMBURSED THROUGH … ENGLAND AIDS/HIV ANTIRETROVIRALS AGREED REGIONALGUIDELINES...