The National Institute for Health and Care Excellence (NICE) and the All Wales Medicines Strategy Group (AWMSG) have a shared interest in the drive to improve patient access to new medicines and treatments. Both organisations recognise that by working together they can enhance and develop timely, independent and authoritative guidance on new medicine and/or new licence indications or formulations for existing medicines, and on the cost implications of making them routinely available on the NHS.
In May 2012, a memorandum of understanding was agreed which formally sets out a collaboration between NICE and AWMSG. The Memorandum sets out the circumstances in which NICE and AWMSG will work together and includes the appraisal work programme (scheduling), implementation, support of guidance, patient access schemes and value based pricing. The aim is to join up the strategic planning, development and delivery of guidance in England and Wales, avoiding duplication or conflict of work, yet complementing and supporting the work of NICE and AWMSG.
Medicines are funded by NHS Wales following guidance from two sources, AWMSG and NICE. AWMSG will take into account the NICE future work programme when considering whether a medicine will be appraised. AWMSG will not normally consider appraising a product if NICE intends to publish their final appraisal of the same product within 12 months of the date of marketing authorisation. AWMSG advice, is interim to NICE guidance should this be subsequently published.
In the absence of AWMSG or NICE guidance individual prescribers should exercise their clinical judgement unless there is evidence not to do so in the light of particular circumstances of an individual patient.
In November 2013, and with regard to equity in Welsh patients’ access to medicines, AWMSG agreed to consider applications for appraisal of medicines which have previously received a negative recommendation from NICE on the grounds of lack of cost-effectiveness, but which are funded in England via alternative national commissioning routes.