Funding Position of CCG Commissioned High Cost Drugs within Lancashire Health Economy Updated February 2016

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Stephany Holland
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Funding Position of CCG Commissioned High Cost Drugs within Lancashire Health Economy Updated February 2016 Drugs can only be recharged to CCGs if used in line with local or national policies as

1 Funding Position of CCG Commissioned High Cost Drugs within Lancashire Health Economy Updated February 2016 Drugs can only be recharged to CCGs if used in line with local or national policies as outlined below. We are moving towardsvalidating all supplies using the blueteq system, if you do not have a logon please contact blueteq directly or your organisations super user. Please note: The responsible commissioner of a particular drug, is dependent on the indication that it is used for. If the specific combination of drug/indication is not listed on this spreadsheet, it is not routinely comissioned by CCGs and a new drug application or IFR should be completed as appropriate. Generic Name Brand Name Indication Type of Policy Link to Policy Mechanism of Approval Colour Licensed Indication Comments Link to Position comssioner for children with JIA. (1st line biologic infusion) (2nd line biologic infusion) in combination with methotrexate (3rd line) Recommended Biologic Pathway monotherapy (3rd line) Recommended Biologic Pathway Ankylosing Spondylitis NICE TA TA 143 Crohn's Disease NICE TA TA 187 Link to Position comssioner for children with JIA. Psoriasis NICE TA TA 146 Psoriatic Arthritis (1st line NICE TA TA 199 Recomendation for use of

2 (2nd line Ulcerative Colitis NICE TA TA 329 Aflibercept Aflibercept VEGF Trap VEGF Trap Wet age related macular degeneration, opthalmology Macular Oedema 2ndry to Central Vein Occlusion NICE TA TA 294 NICE TA TA 305 Aflibercept VEGF Trap Diabetic Macular oedema NICE TA TA 346 Alitretinoin Toctino Alteplase Alteplase Alteplase Actilyse Actilyse Actilyse Severe Chronic Hand Eczema Acute Ischaemic Stroke (Thrombolysis) Massive Pulmonary Embolism (Thrombolysis) Myocardial Infarction (Thrombolysis) NICE TA TA 177 NICE TA TA 264 N/A NICE TA TA 52 Group Approval No Recharge Group Approval No Recharge Group Approval No Recharge Anakinra Kineret NICE CG NICE CG79 N/A BLACK See also Opthalmology Macular Pathways See also Opthalmology Macular Pathways Dealt with as an adjustment on tariff - not to be recharged separately Dealt with as an adjustment on tariff - not to be recharged separately Dealt with as an adjustment on tariff - not to be recharged separately Bevacizumab Avastin Ophthalmic use Recommendation on bevacizumab for opthalmic use N/A BLACK Blepharospasm Botulinum Toxin Type A comissioning position Group Approval Botox Chronic Migraine NICE TA TA 260 Use of Dysport or Xeomin brands for this indication is offlicense

3 Contracture of the joint in MS NICE CG Botulinum Toxin Type A comissioning position. Contracture of the Joint Use approved for a restricted patient group subject to submission of audit data NICE CG186 does not make a recommendation on use of botulinum toxin A for contracture of the joint in MS and states that problems are 'complex and need individual assesment. Botox Detrusor overactivity-urology NICE CG CG 171 Group Approval NHS England is responsible for commissioning treatment of incontinence associated with neurological conditions such as paraplegia or multiple sclerosis. Use of Dysport or Xeomin brands for this indication is offlicense Focal Spasticity Botulinum Toxin Type A comissioning posistion Group Approval Use of Xeomin for this indication is off-license Hand and wrist disability associated with stroke Botulinum Toxin Type A comissioning posistion Group Approval Yes Hemifacial Spasm Botulinum Toxin Type A comissioning posistion Group Approval Yes Use of Xeomin for this indication is off-license Botox Hyperhidrosis due to social anxiety disorder NICE TA CG159 (-ve) N/A BLACK Use of Dysport or Xeomin brands for this indication is offlicense Spasmodic Torticollis Botulinum Toxin Type A comissioning posistion Group Approval Spasticity in MS NICE CG Botulinum Toxin Type A comissioning position. Spasticity in MS Use approved for a restricted patient group subject to submission of audit data NICE CG186 does not make a recommendation on use of botulinum toxin A for spasticity in MS due to the limited evidence base, but states it may have a place in specialist services Certolizumab Cimzia Ankylosing Spondylitis (1st Line Recomendation on use of certolizumab in AS Certolizumab Cimzia Psoriatic Arthritis (1st Line Recomendation on use of certolizumab in PsA

4 Certolizumab Cimzia Certolizumab Cimzia Collagenase Xiapex Dexamethasone Implant Dexamethasone Implant Dupuytren's Contracture in patients with a palpable chord (only when used in outpatients) Recomendation for use of ELMMB ELMMB Collagenase Policy Ozurdex Diabetic Macular oedema NICE TA TA 349 Ozurdex Macular Oedema-Retinal Vein Occulsion Digoxin Immune fab DigiFab Digoxin Antidote Eltrombopag Revolade Eltrombopag Revolade Idiopathic thrombocytopenic purpura (ITP) Thrombocytopenia in Hep C with non-genotype 1 HCV infection Ankylosing Spondylitis NICE TA TA 229 recommendation on digoxin immune fab NICE TA TA 293 Recomendation for Eltrombopag in adults with Hep C NICE TA TA 143 Link to Position Plaque Psoriasis NICE TA TA103 Benepali Psoriatic Arthritis (1st line (1st line biologic infusion) NICE TA TA 199 Recomendation for use of for EL & BwD CCGs only Group Approval Group Approval Approved for use by EL & BwD CCGs only. Not routinely commissioned by other CCGs comssioner biologics for children with JIA.

5 Fluocinolone Acetonide Fomepizole Benepali (2nd line Iluvien Diabetic Macular oedema NICE TA NICE TA301 Antizol Emergency treatment of ethylene glycol or methanol poisoning Ankylosing Spondylitis (1st line Psoriatic Arthritis (1st line (1st line (2nd line reommendation on use of fomepizole for treatment of poisoning NICE TA TA 233 NICE TA TA 220 Recomendation for use of NICE TA TA 225 Ulcerative Colitis NICE TA TA 329 Growth Hormone- Somatropin Growth Hormone- Somatropin Genotropin Humatrope Norditropin NutropinAq Omnitrope Saizen Zomacton Genotropin Humatrope Norditropin NutropinAq Omnitrope Saizen Zomacton Growth hormone deficiency in children, endocrinology Growth hormone deficiency in adults NICE TA TA 188 NICE TA TA 64 Group Approval Orphan drug AMBER 0 AMBER 0 Ankylosing Spondylitis NICE TA TA 143 -ve N/A BLACK

6 Ocriplasmin Jetrea Omalizumab Pegaptanib Ranibizumab Xolair Macugen Lucentis Crohn's Disease NICE TA TAG 187 Psoriatic Arthritis (1st line Link to Position NICE TA TA 199 Recomendation for use of Psoriasis (Severe) NICE TA TA 134 Pyoderma Gangrinosum ELMMB N/A (2nd line Ulcerative Colitis - Moderate to Severe Ulcerative Colitis (acute excerbations) Focal vitreomacular adhesions Severe Chronic spontaneous urticaria Wet age related macular degeneration Wet age related macular degeneration, opthalmology NICE TA TA 329 NICE TA TA 163 NICE TA TA 297 NICE TA TA 339 for EL & BwD CCGs only NICE TA TA 155 -ve N/A BLACK NICE TA TA 155 comssioner for children with JIA. Approved for use by EL & BwD CCG only, not routinely comissioned by other CCGs comissioner for the treatment of children or young people with severe ulcerative colitis. comissioner for the treatment of children or young people with severe ulcerative colitis. Updated Jan 2016: NHSE CCG Bulletin Issue 110 clarified CCGs are the responsible commissioner for this indication

7 Ranibizumab Lucentis Diabetic Macular oedema NICE TA TA 274 Ranibizumab Lucentis Macular oedema NICE TA TA 283 Ranibizumab Lucentis Choroidal neovascularisation NICE TA TA 298 Riluzole Rilutek Amyotropic lateral sclerosis in motor neurone disease Idiopathic Thrombocytopenia (Refractory) NICE TA TA 20 ELMMB N/A AMBER 1 for EL & BwD CCGs only Approved for use by EL & BwD CCG only, not routinely comissioned by all other CCGs 1st line (severe CHF) Recommended Biologic Pathway N/A BLACK Romiplostin Nplate 1st line (mod CHF) 1st line (cancer last 5 yrs, melanoma, ILD) (2nd Line (Refractory) monotherapy Chronic immune thrombocytopenic purpura (ITP) Recommended Biologic Pathway Recommended Biologic Pathway Recommended Biologic Pathway NICE TA TA 221 Secukinumab Cosentyx Plaque Psoriasis NICE TA TA 350 Sodium Oxybate Zyrem Narcolepsy with catalepsy Teriparatide Forsteo Osteoporosis (in women ONLY) Recommendation on the use of sodium oxybate for Narcolepsy with Cataplexy NICE TA TA 161 BLACK for Blackpool CCG; all other CCGs Off-licence N/A BLACK Yes comissioner for osteoporosis in men.

8 Tocilizumab Tocilizumab Tocilizumab Tocilizumab RoActemra RoActemra RoActemra RoActemra (1st Line (2nd /3rd Line as Subcutaneous Link to Position NICE TA TA 247 Recommended Biologic Pathway comssioner for children with JIA. Tolvaptan Jinarc Autosomal dominant polycystic kidney disease NICE TA TA358 commissioner of dialysis and kidney transplants, hyponatraemia and other endocrine uses. Ustekinumab Stelara Psoriatic Arthritis NICE TA TA 340 Ustekinumab Stelara Severe Psoriasis NICE TA TA 180 Vedolizumab Entyvio Crohn's Disease (2nd Line TA 352 Vedolizumab Entyvio Ulcerative Colitis NICE TA TA342 Verteporfin Visudyne Wet age related macular degeneration NICE TA TA 68 In combination with photodynamic therapy in patients with a confirmed diagnosis of classic CNV with no evidence of an occult component.

Payment by Results 2013/2014 Drug and Device Exclusions

Payment by Results 2013/2014 Drug and Device Exclusions 1. Introduction The tariff payment system is nationally calculated averages. It is expected that against the tariff, providers will incur a deficit