Access to new medicines in the NHS - GGC Prescribing

Access to new medicines inthe NHSA guide to Individual Patient Treatment RequestsWhat is this factsheet about?You have been given this factsheet because your doctor has requested amedicine for your condition that has not been recommended for use in NHSScotland by the Scottish Medicines Consortium (SMC). The SMC carries outan evaluation of the clinical and cost effectiveness of all new medicines andadvises Health Boards on their use in NHS Scotland. Further information onthis process and reasons why medicines might not be approved can be foundat: www.scottishmedicines.org.uk/Public_Involvement/Public_InvolvementThis factsheet explains what happens next.Your doctor may believe that your individual clinical circumstances are different and youare more likely to benefit from a medicine than others with the same condition. If this isthe case, there is a system in NHS Greater Glasgow and Clyde (GG&C) that your doctormay follow.My doctor wants me to get amedicine that is not recommendedfor use in the NHS in Scotland.What happens next?Your doctor may complete an individualpatient treatment request (IPTR) form.This form will give details of why yourdoctor thinks you should receive themedicine. This request will be assessedby a panel of healthcare professionalsand they will decide if your treatmentshould be funded on the NHS.Written by Medicines Information ServiceNHS Greater Glasgow and ClydeFebruary 2012Who decides if my treatmentrequest is accepted or rejected?The treatment request will be consideredby a panel of healthcare professionalsincluding a senior doctor, pharmacist anda manager within NHS GG&C.What does this panel consider?Your doctor will explain why yourindividual clinical circumstances aredifferent and why you are more likely tobenefit from the medicine than otherswith the same condition. The submissionwill include a description of your case aswell as details of any published clinical

trials or evidence that support thesepoints. The panel will consider all theinformation provided as well as, in somecases, independently preparedinformation for this medicine when usedfor your condition.Do I get any say?You have the right to submit a writtenstatement to go with the IPTR form if youwish. Your doctor can provide you withfurther details on how to do this.How long will it take to hear aboutthe treatment request?The panel will consider the urgency of therequest and come to a decision at theearliest opportunity. However it is theaim that the timescale for the decision tobe made is no longer than 20 workingdays from when the IPTR was received.How will I find out if my doctor’srequest has been successful?Immediately after conclusion of the IPTRreview, your doctor should be informed ofthe panel’s decision. Your doctor will thencommunicate the decision to you. Youwill receive a copy of the IPTR decisionpaperwork and will be given informationon what options there are if your requesthas been turned down.My doctor’s treatment request hasbeen accepted. What happens now?Your doctor can prescribe the medicinefor you on the NHS.My doctor’s treatment request hasbeen turned down. What happensnext?Your doctor will explain the reasons whythe request has been turned down.He/she will then discuss with you anyalternative treatment options. You andyour doctor may also consider whetheryou believe there are grounds for anappeal. If you both believe this to be thecase your doctor can appeal the decision.The appeal may reconsider the evidenceand / or may consider whether theappropriate process was followed in orderto reach the original decision. This panelwill have a different membership but itsdecision will be based the same criteriaas before i.e. why your circumstances aredifferent and why you are more likely torespond to the medicine. Unless boththese criteria are met the treatment willnot be prescribed.The aim is that the panel decision will bemade within 20 working days from whenthe appeal was received; this will becommunicated to you by your doctor.If there are no grounds for appeal or ifthe appeal is unsuccessful, you may wishto consider the option of paying for themedicine privately. This should only applywhen all NHS options have beenexhausted. Your doctor should be able todiscuss the feasibility of this with you.If national advice on the medicine shouldchange to a position where it is acceptedfor use in NHS Scotland, your doctor willbe able to prescribe the medicine. Also,if your clinical condition andcircumstances change so that youbecome different from others with thesame condition and more likely to benefitfrom the medicine, then your doctor maysuggest a new IPTR application.Where can I get furtherinformation/advice?If you require help and advice, yourdoctor should be able to provide this. Ifhowever, you still have questions aboutthis process or the appeals process, youmay contact us by email:medicines&prescribing@ggc.scot.nhs.ukInformation on the process thatmedicines go through before NHS doctorsin Scotland can routinely prescribe them,can also be found athttp://www.hris.org.uk/resources/newmedicines-pdf-factsheet/Written by Medicines Information ServiceNHS Greater Glasgow and ClydeFebruary 2012