NHSE Commissioning update Mandy Matthews 9 th December

NHSE Commissioning update Mandy Matthews 9 th December 2016 www. england. nhs. uk

Use of immunoglobulin in England • NHS England is responsible commissioner for immunoglobulin • Current forecast annual spend of approximately £ 150 million in England • Commissioned in line with national Clinical Guidelines • Inconsistent with commissioning of other high cost products • NHS England Immunoglobulin project group established www. england. nhs. uk

Immunoglobulin project: • Review clinical guidelines • Develop NHS England commissioning policies, including: • Eligibility criteria, dosing and efficacy outcomes • Ensure adherence to guidelines • Immunoglobulin assessment panels • Prior approval • Improving Value opportunities: • ITP dosing • Contract management support www. england. nhs. uk

Review guidelines: • Red indications: • Current therapy • Dose • Clinical outcomes • Clinical Reference Group (CRG) or other expert group involvement • Develop into routinely commissioned policy position www. england. nhs. uk

Review guidelines: • Blue and grey indications: • Current therapy • Dose • Clinical outcomes • CRG or other expert group involvement • Consider within NHS England policy proposition process • Prioritisation www. england. nhs. uk

Adherence to guidelines: • Role of the Immunoglobulin Assessment Panel (IAP): • Survey • Sharing best practice • Audit • Prior approval system: • Pilot MDSAS database • On-hold until commissioning criteria agreed • All use to be approved via the database www. england. nhs. uk

Improving Value opportunities: • Dosing in ITP: recommended at 1 g/kg • Previous audit suggests significant use of higher dose • Analysis of the database for use in 15/16: • Potential savings of £ 2 million www. england. nhs. uk

Contract management support: • All use of immunoglobulin to be recorded on database • Risk of non-reimbursement if not recorded • Recording of clinical outcomes • Standard criteria • Resources to support commissioners to ensure a consistent approach with trusts www. england. nhs. uk