High Cost Drug Manual (K&M Health Economy NTE Drugs Manual)

Click here to download the Kent and Medway Health Economy National Tariff Excluded Drugs Manual
Also known as the High Cost Drugs (HCD) Manual. Last updated: November 2024

The purpose of this manual is to describe the process for funding high cost drugs or devices excluded from the National Tariff payment system, (previously known as National Tariff Exclusions). These drugs or devices are only commissioned for those indications listed under the individual drug. With regard to items commissioned by the ICB (formerly CCG), drugs or devices may not be commissioned across every ICB.

Drugs or devices may not be commissioned across every ICB. Information on whether an ICB has commissioned a drug can be found in the “Commissioned By” box. Blueteq forms must be completed in all cases. Invoices will be refused for indications not listed within this manual.

The tables below contain a summary of the high cost drugs, for full details please see the entries within the manual.

High cost drugs are identified in this formulary by the  icon.

Drug Name Indication Commissioner
Abaloparatide (Eladynos®) Osteoporosis ICB
Abatacept (Orencia®) Rheumatoid arthritis (1st line biologic ) ICB
Abatacept (Orencia®) Rheumatoid Arthritis (2nd line biologic) ICB
Abatacept (Orencia®) Juvenile Idiopathic arthritis (adult only)  ICB
Abrocitinib (Cibinqo®) Moderate to severe atopic dermatitis ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Ankylosing Spondylitis and Axial Spondyloarthritis  ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Chrohn’s Disease(1st and 2nd line biologic) ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Psoriasis ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Psoriatic Arthritis ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Rheumatoid arthritis (1st line biologic ) ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Rheumatoid Arthritis (2nd line biologic) ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Juvenile idiopathic arthritis (adult) ICB
Adalimumab (Humira®, Imraldi®, Amgevita®, Yuflyma®) Ulcerative Colitis (moderate to severe) ICB
Aflibercept (Eylea®) Macular degeneration(wet age-related) ICB
Aflibercept (Eylea®) Diabetic macular oedema ICB
Aflibercept (Eylea®) Choroidal Neovascularisation ICB
Aflibercept (Eylea®) Macular Oedema after BRVO(Branch Retinal Vein Occlusion) ICB
Aflibercept (Eylea®) Macular Oedema secondary to central retinal vein occlusion ICB
Alirocumab (Praluent®) Primary hypercholesterolaemia or mixed dyslipidaemia ICB
Alirocumab (Praluent®) Primary heterozygous-familial hypercholesterolaemia ICB
Alitretinoin (Toctino®) Eczema (chronic) ICB
Andexanet alfa (Andexxa®) Anticoagulation reversal from apixaban or rivaroxaban ICB
Apremilast (Otezla®) Psoriatic Arthritis ICB
Apremilast (Otezla®) Moderate to severe plaque psoriasis ICB
Atogepant (Aquipta®) preventing migraine ICB
Avatrombopag (Doptelet®) Primary chronic immune thrombocytopenia ICB
Avatrombopag (Doptelet®) Thrombocytopenia in people with chronic liver disease ICB
Baricitinib (Olumiant®) Moderate to severe atopic dermatitis ICB
Baricitinib (Olumiant®) Rheumatoid Arthritis ICB
Bevacizumab  (Avastin®) Choroidal neovascularisation (CNV) due to causes other than age-related macular degeneration (AMD) or pathological myopia (PM) ICB
Bimekizumab (Bimzelx®) Psoriatic Arthritis ICB
Bimekizumab (Bimzelx®) Axial spondyloarthritis ICB
Bimekizumab (Bimzelx®) Psoriasis ICB
Brodalumab (Kyntheum®) Moderate to severe plaque psoriasis ICB
Brolucizumab (Beovu®) Diabetic macular oedema ICB
Brolucizumab (Beovu®) Macular degeneration(wet age-related) ICB
Targeted-release budesonide (Kinpeygo®) Primary IgA nephropathy ICB
Certolizumab pegol (Cimzia®) Rheumatoid Arthritis ICB
Certolizumab pegol (Cimzia®) Moderate to severe plaque psoriasis ICB
Certolizumab pegol (Cimzia®) Psoriatic Arthritis ICB
Certolizumab pegol (Cimzia®) Ankylosing Spondylitis and Axial Spondyloarthritis  ICB
Collagenase clostridium hystoliticum (Xiapex®) Dupuytren’s contracture in patients with a palpable cord ICB
Deucravacitinib (Sotyktu®) Psoriasis ICB
Dexamethasone intravitreal implant (Ozurdex®) Macular oedema (retinal vein occlusion) ICB
Dexamethasone intravitreal implant (Ozurdex®) Non-infections uveitis ICB
Dexamethasone intravitreal implant (Ozurdex®) Diabetic macular oedema ICB
Digoxin immune fab (DigiFab®) Digoxin toxicity This drug has not been formally commissioned, however due the nature of the indication it is considered that all CCGs would fund.
Dimethyl Fumarate (Skilarence) Moderate to severe plaque psoriasis ICB
Dupilumab (Dupixent®) Moderate to severe atopic dermatitis after topical treatments ICB
Eltrombopag (Revolade®) Thrombocytopenia purpura ICB
Eltrombopag (Revolade®) Severe aplastic anaemia in adults ICB
Eptinezumab (Vyepti®) Migraine ICB
Erenumab (Aimovig®) Migraine ICB
Etrasimod (Velsipity®) Ulcerative Colitis (moderate to severe) ICB
Etanercept (Enbrel®, Erelzi®, Benepali®) Ankylosing spondylitis ICB
Etanercept (Enbrel®, Erelzi®, Benepali®) Psoriasis ICB
Etanercept (Enbrel®, Erelzi®, Benepali®) Psoriatic Arthritis ICB
Etanercept (Enbrel®, Erelzi®, Benepali®) Rheumatoid arthritis ICB
Etanercept (Enbrel®, Erelzi®, Benepali®) Juvenile arthritis (adult) ICB
Evolocumab (Repatha SureClick®) Primary hypercholesterolaemia or mixed dyslipidaemia ICB
Evolocumab (Repatha SureClick®) Primary heterozygous-familial hypercholesterolaemia ICB
Faricimab (Vabysmo®) Macular oedema after RVO ICB
Faricimab (Vabysmo®) Diabetic Macular Oedema ICB
Faricimab (Vabysmo®) Macular degeneration(wet age-related) ICB
Fidaxomicin Recurrent Clostridium Difficile Infection ICB
Filgotinib (Jyseleca®) Ulcerative Colitis (moderate to severe) ICB
Filgotinib (Jyseleca®) Moderate to Severe Rheumatoid Arthritis ICB
Fluocinolone acetonide (Iluvien®) Non-infections uveitis ICB
Fluocinolone acetonide (Iluvien®) Diabetic Macular Oedema ICB
Fomepizole Ethylene glycol poisoning and Methanol poisoning ICB
Fostamatinib (Tavlesse®) Chronic immune thrombocytopenia ICB
Fremanezumab (Ajovy®) Migraine ICB
Galcanezumab (Emgality®) Migraine ICB
Golimumab (Simponi®) Ankylosing Spondylitis ICB
Golimumab (Simponi®) Psoriatic arthritis ICB
Golimumab (Simponi®) Rheumatoid arthritis ICB
Golimumab (Simponi®) Ulcerative Colitis (moderate to severe) ICB
Guselkumab (Tremfya ®) Psoriatic arthritis ICB
Guselkumab (Tremfya ®) Moderate to severe plaque psoriasis ICB
Infliximab (Inflectra, Remsima, Remicade®) Ankylosing spondylitis ICB
Infliximab (Inflectra, Remsima, Remicade®) Crohn’s disease ICB
Infliximab (Inflectra, Remsima, Remicade®) Psoriasis ICB
Infliximab (Inflectra, Remsima, Remicade®) Psoriatic Arthritis ICB
Infliximab (Inflectra, Remsima, Remicade®) Rheumatoid arthritis ICB
Infliximab (Inflectra, Remsima, Remicade®) Diarrhoea and colitis relating to ICPI therapy ICB
Infliximab (Inflectra, Remsima, Remicade®) Ulcerative Colitis (moderate to severe) ICB
Ixekizumab (Taltz®) Moderate to severe plaque psoriasis ICB
Ixekizumab (Taltz®) Axial spondyloarthritis ICB
Ixekizumab (Taltz®) Psoriatic Arthritis ICB
Lebrikizumab (Ebglyss®) Moderate to severe atopic dermatitis ICB
Liothyronine Myxoedema coma ICB
Lusutrombopag (Mulpleo ®) Thrombocytopenia in people with chronic liver disease ICB
Mirikizumab (Omvoh®) Ulcerative Colitis (moderate to severe) ICB
Nirmatrelvir plus ritonavir (Paxlovid®) Covid-19 ICB
Ocriplasmin (Jetrea®) Retinal disorders- Vitreomacular traction ICB
Omalizumab (Xolair®) Severe Chronic Spontaneous Urticaria ICB
Ozanimod (Zeposia®) Moderately to severe ulceratve colitis ICB
Parathyroid Hormone (Preotact®) Osteoporosis ICB
Ranibizumab (Lucentis®/ Ongavia®) Macular oedema (Retinal vein occlusion) ICB
Ranibizumab (Lucentis®/ Ongavia®) Diabetic Macular Oedema ICB
Ranibizumab (Lucentis®/ Ongavia®) Macular degeneration(wet age-related) ICB
Ranibizumab (Lucentis®/ Ongavia®) Choroidal neovascularisation (CNV) associated with pathological myopia ICB
Remdesivir (Veklury®) Covid-19 ICB
Rimegepant (Vydura®) treating migraine ICB
Rimegepant (Vydura®) preventing Migraine ICB
Risankizumab (Skyrizi®) Ulcerative colitis ICB
Risankizumab (Skyrizi®) Psoriatic Arthritis ICB
Risankizumab (Skyrizi®) Crohn's disease ICB
Risankizumab (Skyrizi®) Moderate to severe plaque psoriasis ICB
Ritlecitinib (Litfulo®) Severe Alopecia areata ICB
Rituximab (Mabthera®, Truxima ®, Rixathon ®) Rheumatoid Arthritis ICB
Rituximab (Mabthera®, Truxima ®, Rixathon ®) Immune (idiopathic) thrombocytopenic purpura (ITP) ICB
Romiplostim (Nplate®) Thrombocytopenia purpura ICB
Romosozumab (Evenity®) Osteoporosis ICB
Roxadustat Symptomatic anaemia in chronic kidney disease ICB
Sarilumab (Kevzara®) Rheumatoid Arthritis ICB
Secukinumab (Cosentyx®) Ankylosing spondylitis ICB
Secukinumab (Cosentyx®) Moderate to severe plaque psoriasis ICB
Secukinumab (Cosentyx®) Non-radiographic axial spondyloarthritis ICB
Secukinumab (Cosentyx®) Psoriatic Arthritis ICB
Somatrogon (Ngenla®) Growth Failure ICB
Sotrivimab (Xevudy®) Covid-19 ICB
Tildrakizumab (Ilumetri®) Moderate to severe plaque psoriasis ICB
Tocilizumab (Tyenne®, RoActemra®) Covid-19 ICB
Tocilizumab (Tyenne®, RoActemra®) Rheumatoid Arthritis ICB
Tocilizumab (Tyenne®, RoActemra®) Juvenile arthritis (adult) ICB
Tofacitinib (Xeljanz®) Rheumatoid Arthritis ICB
Tofacitinib (Xeljanz®) Psoriatic Arthritis ICB
Tofacitinib (Xeljanz®) Moderately to severe ulceratve colitis ICB
Tofacitinib (Xeljanz®) Ankylosing spondylitis ICB
Tofacitinib (Xeljanz®) Juvenile Idiopathic arthritis (adult only)  ICB
Tolvaptan (Samsca®) Autosomal dominant polycystic kidney disease ICB
Tralokinumab (Adtralza®) Moderate to severe atopic dermatitis ICB
Upadacitinib (Rinvoq®) Crohn's disease ICB
Upadacitinib (Rinvoq®) Ulcerative Colitis ICB
Upadacitinib (Rinvoq®) Non-radiographic axial spondyloarthritis ICB
Upadacitinib (Rinvoq®) Moderate to severe atopic dermatitis ICB
Upadacitinib (Rinvoq®) Ankylosing spondylitis ICB
Upadacitinib (Rinvoq®) Psoriatic Arthritis ICB
Upadacitinib (Rinvoq®) Rheumatoid Arthritis ICB
Ustekinumab (Pyzchiva ®, Uzpruvo® ,Stelara®) Psoriasis ICB
Ustekinumab (Pyzchiva ®, Uzpruvo® ,Stelara®) Psoriatic Arthritis ICB
Ustekinumab (Pyzchiva ®, Uzpruvo® ,Stelara®) Crohn’s disease ICB
Ustekinumab (Pyzchiva ®, Uzpruvo® ,Stelara®) Ulcerative Colitis (moderate to severe) ICB
Vedolizumab (Entyvio®) Ulcerative Colitis (moderate to severe) ICB
Vedolizumab (Entyvio®) Crohn’s disease ICB
Verteporfin (Visudyne®) Central serous chorioretinopathy ICB
Verteporfin (Visudyne®) Polypoidal choroidal vasculopathy ICB