Patients in Wales will no longer have to prove they have “exceptional clinical circumstances” in order to access drugs that are not routinely available on the NHS.
From September 2017, patients will be entitled to access such drugs if they can show the drug will bring “significant clinical benefit” and that it represents “reasonable value for money”.
The changes follow a review of the Individual Patient Funding Request (IPFR) system, under which patients are entitled to make individual requests to specific health board panels for access to drugs not routinely available on the NHS.
The independent review, the findings of which were published in January 2017, found that the present system was confusing and that the commissioning arrangements were “inconsistent”, as was the whole IPFR process.
Social factors will no longer be considered as part of the decision-making process, according to the reforms, which were approved on 21 March 2017 by health secretary Vaughan Gething.
Ahead of a statement to the National Assembly to Wales, Gething said that the recommendations are “pragmatic” and will help health boards reach decisions which are often “sensitive” and “complex”.
“I am particularly pleased that the patient voice has centre stage in the report…,” he said. “I believe the recommendations… will have a positive impact on the IPFR process. It will make the system more easily understandable and less prone to being misused — something I’m sure the people of Wales will welcome.”
The changes were welcomed by Richard Greville, director of the Association of the British Pharmaceutical Industry Cymru Wales, who says patients would now have “level access to treatment based on clinical need”.