Policy number: SRP 002
Policy name: Medicines and Medicines Related Devices
Status: Overarching commissioning policy
Effective date: 1 April 2024
Next review date: 1 April 2026
Providers commissioned to provide services on behalf of MSE ICB are required to follow the MSE ICB medicines management standards, formulary and prescribing policies/guidance as published and, where applicable, as detailed in their contract Medicines Management Service Specification.
Decisions about which medicines and medicines related devices are available for use, and review of these decisions, are made by the MSE Medicines Optimisation Committee (MSE MOC) and ratified by the Integrated Pharmacy and Medicines Optimisation Committee. For a number of medicines/medicines related devices including High-Cost Drugs the ICB has specific position statements setting out restrictions on access based on evidence of effectiveness or relative priority for funding.
Drugs and technologies that are approved as the result of a NICE Technology Appraisal (TA) should be implemented within 3 months of the appraisal being published. The ICB will, within resource constraints, seek to ensure implementation of NICE TAs without delay but recognises that the ICB may take the full period of 3 months before a new commissioning arrangement can be put in place where significant service change and/or development/resources are required to provide appropriate access to the drug/technology. Service change/development may require approval through a full business case and will be subject to prioritisation as detailed in the ICB ‘Decision Making Policy’.
MSE ICB will not fund new drugs/technologies on an ad-hoc basis through the mechanism of individual case funding. To do so risks inequity, since the treatment will not be offered openly and equally to all with equal need. There is also the risk that diversion of resources in this way will de-stabilise other areas of health care which have been identified as priorities by the ICB.
NICE produces guidance e.g., clinical guidelines, interventional procedure guidance, medical technology guidance* which are a valuable source of good practice, and which may include recommendations around use of drugs/technologies. The ICB will take such guidelines into account in developing policy, but the ICB retains discretion and is not mandated by Directions to implement such Guidance within a fixed time period or at all.
The ICB expects consideration of new drugs/technologies/clinical guidance to take place within the established planning frameworks of the NHS. This will enable clear prioritisation against other calls for funding and the development of implementation plans which will allow access for all patients with equal need.
*See statement on mandated Medical Technologies