NHS England has announced the treatments that are to receive funding as a result of the latest Specialised Commissioning Prioritisation Process, a pathway to reimbursement designed for certain high cost medicines and specialised services. The process is under the direct control of NHS England, who negotiate directly and independently of NICE.
The treatments, which were considered by the Clinical Priorities Advisory Group (CPAG), were grouped into five levels, and ordered according to their clinical benefit relative to incremental cost. The treatments which provided the most clinical benefit relative to cost were classified as Level 1, whereas treatments providing the least benefit were classified as Level 5.
The treatments assessed were:
- Anakinra and tocilizumab for adult onset stills disease
- Anakinra for autoinflammatory
- Keraprosthesis for corneal blindness
- Left Atrial Appendage Occlusion for patients with atrial fibrillation and relative or absolute contraindications to anticoagulation (adults)
- Susoctocog alfa for acquired haemophilia A
- Bendamustine with rituximab for first line treatment of advanced indolent non-hodgkins lymphoma
- Bendamustine with rituximab for the treatment of relapsed mantle cell lymphoma
- Selective dorsal rhizotomy (note: updated 2019)
- Lomitapide for homozygous familial hypercholesterolemia
- Total pancreatectomy with islet transplantation for chronic pancreatitis
- Human coagulation factor X for hereditary factor X deficiency
- Selexipag for pulmonary arterial hypertension
Of these treatments, there is sufficient funding to approve treatments in Levels 1-3, which will go on to be routinely available on the NHS. The remaining three treatments in Levels 4-5 can be considered in the next prioritisation round, which is due in November 2018.