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Guidance for local formularies in England could improve uptake

NICE publishes recommendations to address variations

NICE formularies guidance

Local NHS organisations in England now have access to best practice guidance on how to develop and update formularies, in a move that could help improve uptake of new medicines.

The National Institute for Health and Clinical Excellence (NICE) published the guidance, which was developed with the Department of Health, to address variations in local formularies – defined by NICE as “the output of processes to support the managed introduction, utilisation or withdrawal of healthcare treatments within a health economy, service or organisation”.

These variations included the number of NHS organisations covered by the formulary; the range of medicines the formulary includes; and the processes for developing and updating the formulary.

By addressing these differences across the country, the guidance aims to bring the use of local formularies to better fit the recently updated NHS Constitution, which provides patients with the right that NICE-approved medicines should be made available and therefore included within the formulary adopted by local healthcare providers and commissioners.

Recommendations include advice on relationships with other decision-making bodies; the size of the patient population to be covered; the range of treatments to be included; and how best to develop engagement with such stakeholders as patient groups and the companies that actually make the medicines.

There is also a specific recommendation that medicines with a positive NICE technology appraisal are adopted “automatically” into the formulary within three months of NICE's decision.

 “It is important that patients should have access to NICE-approved drugs where these are clinically appropriate,” said Professor Mark Baker, director of the centre for clinical practice at NICE.

“It is also important that the NHS embraces and allows the rapid uptake of innovative medicines and treatments.”

The guidance was welcomed by a number of healthcare bodies, including the Association of the British Pharmaceutical Industry (ABPI).

The trade body's CEO Stephen Whitehead said: “The NHS Constitution states that patients should always have the right to a medicine if it has been appraised by NICE – but at the moment, this is not always happening and some treatments are unavailable to patients because of where they live in the UK.

“The NICE formularies good practice guidance is an important part of supporting this wider agenda. The next steps will be to ensure that there is strong local implementation of this guidance before formularies are due to be published by all NHS organisations by April 1, 2013.”

Helen Gordon, chief executive of the Royal Pharmaceutical Society, gave a pharmacist perspective: “Local formularies are taking centre stage in the drive to improve patient outcomes and reduce variation in access to medicines. This guidance will spread best practice and support the clinical leadership that chief pharmacists have already shown by making formularies responsive to patient needs.”

19th December 2012

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