3 January, 2013

NICE Local Formularies Guide will "Reduce Variation in Prescribing"

NICE has produced a good practice guide to help trusts develop and update local formularies, as part of a move to ensure that all patients in England have access to clinically and cost-effective drugs.

Local formularies provide a list of selected or preferred drugs available to local prescribers and have an important role in underpinning safe and effective use of medicines.

However, there is currently no standard process or advice for putting together a local formulary which has led to variations across the country.

This was highlighted in a Department of Health report into innovation in healthcare, which found that not all local formularies are including all of NICE's technology appraisals.

The NICE good practice guiderecommends that medicines with a positive NICE technology appraisal are included into the local formulary automatically, where clinically appropriate and relevant to the services provided by the organisation. This process should take place within 90 days.

For medicines where there is a NICE technology appraisal, trusts should ensure there is no further duplication of the NICE evidence assessment, or challenge to an appraisal recommendation.

All relevant local formulary information should be published online, in a clear, simple and transparent way, so that patients, the public and stakeholders can easily understand, says NICE.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “It is important that patients should have access to NICE-approved drugs where these are clinically appropriate.

“It is also important that the NHS embraces and allows the rapid uptake of innovative medicines and treatments. Both these imperatives have been enshrined in recent legislation - most notably the NHS Constitution for England.

“Together with changes to NHS commissioning arrangements, these changes to the regulatory framework have persuaded many local healthcare providers and commissioners of the need to review their local formulary structures and the processes that underpin them.

“This good practice guidance will support the development of local formularies that adhere to statutory requirements while reflecting local needs and reducing variation in prescribing.”

Dr Keith Ridge, Chief Pharmaceutical Officer, said: “This guidance is an important step in ensuring patients continue to have prompt access to the medicines they need.

“I would encourage local health systems to use this guidance to review their approach to formularies - ensuring they are patient focused, outcomes based and support optimised use of medicines."

Professor Alan Silman, Medical Director, Director of Research Strategy and Policy, Arthritis Research UK, and Chair of the Guidance Development Group, said: “A local health formulary is an important tool in educating and guiding prescribers.

“The guidance provided in this document allows formularies to continue to responding to local needs and circumstances but also ensure that NICE's decisions to approve an intervention and other appropriate inputs into formulary production are taken up in a timely and transparent manner.”

Helen Gordon, Chief Executive, Royal Pharmaceutical Society, said: “Local formularies are taking centre stage in the drive to improve patient outcomes and reduce variation in access to medicines. This guidance will spread best practice and support the clinical leadership that Chief Pharmacists have already shown by making formularies responsive to patient needs.”

Trevor Beswick, Chair, UK Medicines Information Executive and member of the Guidance Development Group, added: “The guidance highlights the need for local decision making groups to collaborate and to avoid wastefully duplicating effort by making use of existing medicines information resources from relevant organisations.”