NHS England has approved the routine funding for a total of 14 specialised treatments. The treatments include a heart implant that is known to reduce the risk of stroke, a surgical procedure that improves the mobility of children with cerebral palsy, and a variety of drugs to treat cancer, haemophilia, and osteoporosis.
The funding case for each of the 14 treatments were assessed by the Clinical Priorities Advisory Group. The group, chaired by Nick Partridge, consists of doctors, specialists, and other stakeholders, such as patients’ representatives.
It is the responsibility of the group to assess treatments according to three key criteria: clinical effectiveness, benefit to patients, and overall value for money. As part of the group’s remit, consideration was given to the recommendations made by clinical reference groups and other teams that hold commissioning responsibilities.
What treatments have now been approved?
Two new treatments for haemophilia will now be routinely funded. NHS England believes that emicizumab represents a major breakthrough and departure from existing treatments for patients with bleeding disorders. A new treatment – susoctocog alfa – will now be available for patients with haemophilia A.
A surgical procedure that relieves the intense pain of chronic pancreatitis will now be routinely funded. The procedure involves the removal of the pancreas and transplanting islets into the patient’s liver. This enables them to continue to produce insulin. This is a massive step-up from current treatment options, which go no further than controlling and managing the symptoms through the use of opiate painkillers – and doing nothing to address the underlying problem.
The group has approved funding for left atrial appendage occlusion. This is a crucial alternative treatment for patients with fibrillation who are unable to take an oral anticoagulant. Essentially, the treatment involves a ‘plug’ being inserted in the heart where a clot is most likely to develop. This means that the subsequent risk of stroke is greatly reduced. NHS England estimates that more than 1000 patients will have benefitted from left atrial appendage occlusion within 5 years.
Another newly-approved treatment is selective dorsal rhizotomy. This is a complex operation to reduce the spasticity level in cerebral palsy. Carefully selected sensory nerves inside the spine are cut to improve mobility. This is an incredibly precise operation but one which around 200 children aged 3-9will require. This is a fantastic step forward in overall cerebral palsy treatment.
The committee did decide that certain treatments – three in total – human coagulation factor X for hereditary factor X deficiency, selexipag for pulmonary hypertension, and everolimus for refractory seizures associated with tuberous sclerosis complex were all lower in terms of priority and should not be put forward for funding at the present time. The committee will meet again later in the year, in November, and if the decision is overturned, funding could be available for the 2019-20 year.