NICE-backed drugs must be on NHS contracts from April 2013

From April next year, it will no longer be possible for National Health Service (NHS) formularies to exclude drugs recommended by the UK's National Institute for Health and Clinical Excellence (NICE).

In an open letter to primary care trust (PCT), clinical commission group (CCG) and strategic health authority (SHA) cluster chef executives, NHS chief executive Sir David Nicholson has made it clear that local blacklists can no longer take precedence over NICE rulings.

"Formularies have an important role in underpinning safe and effective use of medicines … they should not duplicate NICE assessments or challenge an appraisal recommendation," writes Sir David in the letter.

The directive - dubbed the NICE Compliance Regime - comes in the wake of mounting evidence that some NHS formularies have been prohibiting the use of some more expensive medicines even though NICE has deemed they are cost-effective, leading to variations in access to new drugs across the country.

Towards the end of last year, the UK Department of Health published a report revealing that not all local formularies were incorporating NICE technology appraisals, while some were adding another layer of review and in some cases overturning NICE decisions.

"I want to see all NHS organisations publish information which sets out which NICE technology appraisals are included in their local formularies," says Sir David.

He goes on to say that PCT clusters and CCGs should need to take the lead in working towards publication of this information "by April 1, 2013, at the very latest". 

At that time this requirement will become part of the standard terms and conditions in NHS contracts.

The move marks a further consolidation of the central role NICE plays in NHS prescribing decisions, and comes after the agency was given the task of developing a best practice guide for local formulary development earlier this year.

As in this case, the aim is to ensure patients across England have uniform access to the drugs and do away with so-called "postcode prescribing".