| There are a number of High Cost Drugs that are excluded from the Payment by Results (PbR) tariff. They are typically specialist |
drugs and the commissioning arrangements for these drugs is to ensure their safe, effective and appropriate use within available
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funding.
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Following the reorganisation of the NHS, from April 1st 2013, PbR Excluded Drugs are either;
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| > Commissioned by NHS England |
| > Commissioned by Clinical Commissioning Groups. |
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| A comprehensive list of medicines not reimbursed through the national prices and directly commissioned by NHS England is |
| available here - (version 14, published April 2019) |
| |
| A technical document is available which describes the prescribed specialised services, some of which are directly commissioned by |
| NHS England and some by CCG's. This Manual can be accessed here |
| |
| For a detailed list of the NHS National Tariff Payment System for 2019 to 2020 click here |
| |
| Exceptional Cases |
If an individual falls outside the range of services and treatments that the CCG has agreed to commission then an Exceptional
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Funding Request can be made by a clinician, on behalf of a patient, to fund healthcare. The responsibility for demonstrating
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exceptional lies with the requesting clinician and based on the information provided the CCG must decide whether or not to
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support this view and agree to fund the request. The form can be accessed here
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| Cancer Drugs Fund |
| NHS England are the responsible commissioners for the Cancer Drugs Fund (CDF). The CDF is a source of funding for cancer drugs |
in England To see which treatments are currently funded by the CDF, please see the Cancer Drugs Fund List
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| |
| Patient Access Schemes |
| Patient Access Schemes are pricing agreements proposed by pharmaceutical companies to enable patients to gain access to |
| high cost drugs that are not likely to be approved by NICE for use in the NHS because they are expensive and do not have |
| a significant benefit over existing treatments. |
| For a list of technologies with approved Patient Access Schemes click here |
| |
A significant proportion of high cost drugs excluded from tariff are commissioned by East Lancashire Health Economy in line with
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| NICE Technology Appraisals. Biologic algorithms for use in Dermatology, Gastroenterology, Opthalmology and Rhematology are |
| listed below: |
| |
