5 Implementation

5 Implementation

5.1 The Secretary of State and the Welsh Assembly Minister for Health and Social Services have issued directions to the NHS in England and Wales on implementing NICE technology appraisal guidance. When a NICE technology appraisal recommends use of a drug or treatment, or other technology, the NHS must usually provide funding and resources for it within 3 months of the guidance being published. If the Department of Health issues a variation to the 3-month funding direction, details will be available on the NICE website. When there is no NICE technology appraisal guidance on a drug, treatment or other technology, decisions on funding should be made locally.

5.2 The Department of Health and the manufacturer have agreed that denosumab will be available to the NHS with a patient access scheme in which a discount is applied to all invoices. The level of the discount is commercial in confidence. It is the responsibility of the manufacturer to communicate the level of discount to the relevant NHS organisations. Any enquiries from NHS organisations about the patient access scheme can be directed to the manufacturer at: xgeva-nicepas@amgen.com

5.3 The technology in this appraisal may not be the only treatment for bone metastases from solid tumours. If a NICE technology appraisal recommends use of a technology, it is as an option for the treatment of a disease or condition. This means that the technology should be available for a patient who meets the clinical criteria set out in the guidance, subject to the clinical judgement of the treating clinician. The NHS must provide funding and resources (in line with section 5.1) when the clinician concludes and the patient agrees that the recommended technology is the most appropriate to use, based on a discussion of all available treatments.

5.4 NICE has developed tools to help organisations put this guidance into practice (listed below). These are available on our website.

  • Costing template and report to estimate the national and local savings and costs associated with implementation.

  • Audit support for monitoring local practice.

  • National Institute for Health and Care Excellence (NICE)