Market Access Overview

Executive Summary

Reimbursement in the UK is based on two major steps:

  1. Setting a price with the Department of Health and Social Care (DHSC) which applies to the four UK nations (England, Scotland, Wales and Northern Ireland)
  2. Enter the relevant reimbursement appraisal process in each of the UK nations (the time taken to review a product varies in each of the devolved nations)
    • In England, this will vary in complexity from a full NICE health technology assessment (HTA) process, to commissioning policies by NHS England, to negotiations at local level with hospitals and clinical commissioning groups (CCG)
    • The Scottish Medicines Consortium (SMC) in Scotland assesses all newly licensed medicines and all new formulations and new indications of established products
    • The AWMSG in Wales generally adopts the recommendations of NICE but can assess products if they have not and will not be assessed by NICE in the next 12 months
    • The Department of Health (DoH) in Northern Ireland conducts a review of products on a case by case basis in the absence of NICE or SMC guidance or advice respectively