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Improving access to approved drugs

New guide to end 'postcode prescribing' in England
WebMD UK Health News
Medically Reviewed by Dr Keith David Barnard
variety of pills

21st February 2012 - If you've ever been turned down for a drug you will probably be familiar with the expression: 'It's not on our formulary'. Which is another way of saying that particular drug isn't on the PCT or Hospital Trusts list of approved medicines.

Local formularies provide a list of selected or preferred drugs available to local prescribers. However, there is currently no standard process or advice for putting together a local formulary. This has led to a 'postcode lottery' with variations across the country and patients missing out on drugs because of where they live.

Now the National Institute for Health and Clinical Excellence (NICE) is to produce a best-practice guide. This should help trusts develop local formularies, as part of a move to ensure that all patients in England have access to the same drugs.


A recent report into innovation in healthcare by the Department of Health has highlighted that not all local formularies are including all of NICE's recommendations. In some cases, local formularies have been duplicating NICE assessments and challenging appraisal recommendations, acting as a barrier to the uptake of NICE-approved medicines.

The report states: "There should be no local barriers to accessing technologies recommended in NICE appraisals, beyond a clinical decision relating to an individual patient."

It recommends that all NICE Technology Appraisal recommendations should - where clinically appropriate - be automatically incorporated into local formularies, and the process should take no longer than 90 days.

Best-practice guide

To help achieve this, NICE will develop a best-practice guide covering the creation and review of local formularies to assist local trusts and clinical commissioning groups.

Dr Gillian Leng, Deputy Chief Executive of NICE said in a prepared comment: "NICE will produce a best-practice guide on how to develop a local formulary. We will be holding a workshop to develop the guide, which will then go out to consultation before being published later this autumn.

“NICE-approved drugs should not be excluded from local formularies on the grounds of cost. We want all patients to have access to medicines that we consider to be effective."

Reviewed on February 21, 2012

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