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 |