Prescribing in England to be led by a single national formulary

A single national formulary (SNF) for prescribing in England will be in place within the next two years under proposals, government has said in the NHS 10 Year Health Plan.

Backed by NICE, the SNF will reduce duplication and the ‘postcode lottery’ that has arisen out of locally derived formularies, the Government said.

A new formulary oversight board will be set up and given responsibility for sequencing products included in the formulary on the basis of clinical and cost effectiveness.

Prescribers will be ‘encouraged’ to use products ranked highly in the SNF.

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But they will ‘retain clinical autonomy’ as long as they prescribe in line with NICE guidance, the plan states.

‘The system for getting new medications to patients is needlessly complicated.

‘The process by which each local area decides which drugs are available is bureaucratic and creates a postcode lottery.

‘These local formularies do not make sense in a universal service that should provide a core standard of high-quality care to everyone,’ the plan continues.

Implementing the SNF will drive ‘rapid and equitable adoption of the most clinically and cost-effective innovations’, it adds.

‘We will work with industry throughout the implementation of these policies to make sure we realise these objectives together.’

Under the new Government plan for the NHS, NICE will also be tasked with deciding what treatments are no longer providing value for money.

One analysis had suggested 30% of the costs of treatment were no longer good value for money and in some areas such as heart failure lives could be saved by treating people earlier in the pathway, the plan said.

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‘To create more space for the myriad of innovations of the future, we will need to improve the outcomes and value we are delivering from innovations already in use.’

NICE will be asked to re-evaluate priority clinical pathways ‘on a rolling basis’, identifying where existing innovation should be retired, as well as instances when one technology should be sequenced after another to improve value.

‘We will link NHS compliance with these decisions to core clinical standards, best practice tariffs and incentives,’ the plan noted.

NICE’s technology appraisal process will be expanded to cover some devices, diagnostics and digital products. It will focus on those that meet the NHS’ most urgent needs and support financial sustainability, such as digital behavioural therapy for adolescents on mental health waiting lists, the Government said.

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Dr Sam Roberts, chief executive of NICE, said: ‘The plan gives NICE the power to get medicines to patients faster, reduces the postcode lottery for high impact health technology, and maximises the value for money of existing innovations used in the NHS.’

A version of this article was initially published by our sister publication Pulse.