NICE produces new formulary guidelines

 NICE has produced a new ‘best practice guide’ to stop ‘postcode prescribing’ and ensure that medicines it has recommended are included in local formularies.

The guide, which covers the creation and review of local formularies, states that medicines approved by NICE should be “automatically incorporated” into lists of available drugs within 90 days.

This measure is intended to combat the growing trend of PCT clusters and CCGs placing more expensive new drugs on a ‘red list’ of products to be avoided in order to achieve spending cuts.

The recent DH report Innovation Health and Wealth highlighted the barriers to innovation at local level, where formularies often do not take account of recent NICE drug appraisals; in some cases, these appraisals are challenged by local bodies.

Refusal to provide more expensive drugs (such as cancer drugs) and over-dependence on the cheapest generics were both identified as issues.

The report said that there should be no barrier to the use of new NICE-approved drugs “beyond a clinical decision relating to an individual patient”.

Dr Gillian Leng, Deputy Chief Executive of NICE, commented on the best practice guide: “We want all patients to have access to medicines that we consider to be effective.”

NICE will publish details of any measures to be taken against local prescribers for ignoring the new guidance this autumn.

Dr Bill Beeby, Chairman of the prescribing subcommittee of the BMA’s GPs’ Committee, said that these measures were to be welcomed, but that more money had to be made available for prescription of more expensive drugs.

The new formulary guide is the first attempt to standardise the process of developing local formularies across the NHS in England. It reflects the complexity of seeking to give local prescribers more choice while imposing budget cuts.

Further plans outlined by the Innovation report include the introduction of a NICE Compliance Regime to drive rapid and consistent uptake of NICE-recommended products, and the establishment of a NICE Implementation Collaborative bringing NHS and DH organisations together with industry.