A single national formulary (SNF) for prescribing in England will be in place within the next two years under proposals, the Government has announced.
Outlined in the new NHS 10-year plan and backed by the National Institute for Health and Care Excellence (NICE), the SNF will reduce duplication and the ‘postcode lottery’ that has arisen out of locally derived formularies, the Government said.
A new formulary oversight board will be set up and given responsibility for sequencing products included in the formulary on the basis of clinical and cost effectiveness.
Prescribers such as clinicians and pharmacists will be ‘encouraged’ to use products ranked highly in the SNF. But they will ‘retain clinical autonomy’ as long as they prescribe in line with NICE guidance, the plan states.
‘The system for getting new medications to patients is needlessly complicated,’ the plan continues.
‘The process by which each local area decides which drugs are available is bureaucratic and creates a postcode lottery.
‘These local formularies do not make sense in a universal service that should provide a core standard of high-quality care to everyone.’
It is hoped that implementing a SNF will drive ‘rapid and equitable adoption of the most clinically and cost-effective innovations’.
‘We will work with industry throughout the implementation of these policies to make sure we realise these objectives together.’
An expanded medicines role for NICE
Under the new Government plan for the NHS, NICE will also be tasked with deciding what treatments are no longer providing value for money.
One analysis had suggested 30% of the costs of treatment were no longer good value for money and in some areas such as heart failure lives could be saved by treating people earlier in the pathway, the plan said.
‘To create more space for the myriad of innovations of the future, we will need to improve the outcomes and value we are delivering from innovations already in use.’
NICE will be asked to re-evaluate priority clinical pathways ‘on a rolling basis’, identifying where existing innovation should be retired, as well as instances when one technology should be sequenced after another to improve value.
‘We will link NHS compliance with these decisions to core clinical standards, best practice tariffs and incentives,’ the plan noted.
NICE’s technology appraisal process will be expanded to cover some devices, diagnostics and digital products. It will focus on those that meet the most urgent needs in the NHS and support financial sustainability, such as digital behavioural therapy for adolescents on mental health waiting lists, the Government said.
Getting medicines to patients faster
Dr Sam Roberts, chief executive of NICE, said: ‘The plan gives NICE the power to get medicines to patients faster, reduces the postcode lottery for high impact health technology, and maximises the value for money of existing innovations used in the NHS.’
And Dr Roberts outlined the ways in which NICE will work to achieve this, including new recommendations to extend access to effective treatments beyond their initial indications, providing advice and clearer decision pathways for clinicians on which treatments to try first when there are many choices for the same condition, and helping the NHS to identify and phase out innovations that no longer represent good value or best care.
A version of this article was originally published by our sister publication Pulse.
