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LOOKING BACK, LOOKING FORWARD: The view from Health Boards

LOOKING BACK, LOOKING FORWARD: The view from Health Boards. Tom Divers, SMC Member and CE, NHS Greater Glasgow & Clyde. LOOKING BACK, LOOKING FORWARD: Budget Impact Analysis. Peripheral to SMC decision … but Central to NHS Planning SMC ‘Intelligence’ Submission Expert Comments

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LOOKING BACK, LOOKING FORWARD: The view from Health Boards

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  1. LOOKING BACK, LOOKING FORWARD:The view from Health Boards Tom Divers, SMC Member and CE, NHS Greater Glasgow & Clyde

  2. LOOKING BACK, LOOKING FORWARD:Budget Impact Analysis • Peripheral to SMC decision … but • Central to NHS Planning • SMC ‘Intelligence’ • Submission • Expert Comments • Support for SMC User Group Review • Consistent & transparent structure • Gross & net costs • Adaptable to local circumstances

  3. LOOKING BACK, LOOKING FORWARD:Patient and Public Involvement • Public Petitions Committee • Availability of and access to new medicines • Openness, clarity, transparency … Flowchart • Respective roles of national and local processes? • Distinctive contribution • Continuum for managed introduction of new medicines • Joint challenge for SMC & NHS Boards • Public perception of NHS prescribing? • Examples • Cancer medicines • Antimicrobial therapy

  4. LOOKING BACK, LOOKING FORWARDOrphan Drugs - A Wicked Issue? Often areas of greatest debate at SMC - less confident touch in decisions Cost-effectiveness is generally challenging Is it inevitable that decision-making is pushed down to NHS Board and individual patient level? Boards’ ‘risk-sharing’ arrangement is pragmatic ‘holding’ position

  5. LOOKING BACK, LOOKING FORWARD“Accepted for use” – Too broad a church? • Force of SMC decisions not well understood by some politicians and media - local ADTC now determines formulary status • ‘Unique’ status is rare attribution • ‘Accepted for use’: from elements of ‘unique’ to ‘me too’ • Is any finer gradation reasonable or possible? • Can we rely on maturity of ADTCs to ensure that important advances are implemented consistently?

  6. LOOKING BACK, LOOKING FORWARD:View from Health Boards • Evaluation success • Comprehensive horizon scanning • Timely ADTC advice • Effective communication networks • Challenges • Orphan medicines • Accepted for use … • Budget impact analysis • Public involvement • Future • Development of SMC / NHS B partnership

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