Sir David said that PCT clusters and clinical commissioning groups (CCGs) would need to publish clear online documents setting out which NICE technology appraisals are included in local formularies. NHS chief pharmacists will also be asked to review local formularies.
Last year, GP revealed that one in four PCTs were blacklisting drugs recommended by NICE. Drugs on the lists were listed as 'not recommended for use' or 'not prescribable' because they were deemed too expensive or not effective enough.
Sir David’s letter sets out the DH’s view of the appropriate role of local formularies developed by NHS trusts.
‘Formularies have an important role in underpinning safe and effective use of medicines,’ he said. ‘However, they should not duplicate NICE assessments or challenge an appraisal recommendation. Once on formularies, there should be no further barriers to the use or prescription of technologies or medicines.’
Sir David said ‘good progress has been made’ in improving access to drugs recommended by NICE, but that ‘there is much more to do to reduce variation’.
‘I want to see all NHS organisations publish information which sets out which NICE technology appraisals are included in their local formularies,’ he said.
‘PCT clusters and CCGs will need to take the lead in working towards publication by 1 April 2013 at the very latest.’
Sir David added: ‘It will be important that the publications are online, and are clear, simple and transparent, so that patients, the public and stakeholders can easily understand them.’
‘From 1 April 2013, I also intend to make this a standard term and condition in NHS contracts.'
The chief pharmaceutical officer, Keith Ridge, will also be writing to NHS chief pharmacists to ask them to review local formulary processes, Sir David said.