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Nicholson moves to end blacklisting of NICE-approved drugs

CCGs will have to publish a list of all the treatments they provide on the NHS by April next year and will not be allowed to add any restrictions on NICE-approved treatments, under plans revealed by the head of the NHS.

In a letter to primary care organisations NHS chief executive Sir David Nicholson warned he would be changing NHS contracts from April 2013 to include a standard clause ensuring that new drugs approved by NICE cannot be blocked.  

He said PCT clusters and CCG leaders will have to publish information online in a ‘clear' and ‘transparent' way that sets out which NICE Technology Appraisals are included in their formularies. 

An investigation by Pulse last year revealed primary care organisations were blacklisting a series of NICE-approved drugs, including gliptins, denosumab and atorvastatin.

But earlier this year, NICE was charged with standardising the process for drawing up and updating drug formularies as part of a ‘compliance regime' to ensure treatments recommended in legally binding technology appraisals were automatically included.

Under the new regime, CCGs would be compelled to include drugs in formularies within 90 days of a NICE approval being released.

In the letter to PCT and SHA chief executives as well as CCG leaders, Sir David    emphasised that formularies ‘should not duplicate NICE assessments or challenge an appraisal recommendation'.

He said: ‘Once on formularies, there should be no further barriers to the use or prescription of technologies or medicines.'

He added that although ‘some good progress' had been made, ‘there is much more to do to reduce variation'.

He said: ‘With that in mind, I want to see all NHS organisations publish information that sets out which NICE Technology Appraisals are included in their local formularies. PCT clusters and CCGs will need to take the lead in working towards publication by 1 April 2013 at the very latest.

‘It will be important that the publications are online and are clear, simple and transparent, so that patients, the public and stakeholders can easily understand them. We will work with the NHS to help with this. From 1 April 2013, I also intend to make this a standard term and condition in NHS contracts.'

He said that chief pharmaceutical officer Keith Ridge would be writing to NHS chief pharmacists to ask them to review local formulary processes.

Dr Charles Alessi, chair of the NAPC said he supported the move, but added: 'There is confusion around this as people think that everything that NICE says is what we should do but that is not the case.

'Any decision that NICE makes which is outside the technology appraisal can be interpreted in terms of the priorities that CCG leaders and PCTs have. There is no compulsion to implement it.'  

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