5.1 Section 7(6) of the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013 requires clinical commissioning groups, NHS England and, with respect to their public health functions, local authorities to comply with the recommendations in this appraisal within 3 months of its date of publication.
5.2 At the time of publication (February 2015), axitinib has a UK marketing authorisation for use only after failure with first‑line sunitinib or a cytokine. If it is considered for use after any other first‑line treatments, the prescriber should obtain and document informed consent and follow the relevant guidance published by the General Medical Council.
5.3 Because the remit referred to NICE by the Department of Health for this technology appraisal only includes adults who have been previously treated with sunitinib, the use of axitinib after treatment with other tyrosine kinase inhibitors is not subject to statutory funding.
5.4 When NICE recommends a treatment 'as an option', the NHS must make sure it is available within the period set out in the paragraph above. This means that, if a patient has advanced renal cell carcinoma and the doctor responsible for their care thinks that axitinib is the right treatment, it should be available for use, in line with NICE's recommendations.
5.5 The Department of Health and the company have agreed that axitinib will be available to the NHS with a patient access scheme which makes axitinib available with a discount. The size of the discount is commercial in confidence. It is the responsibility of the company to communicate details of the discount to the relevant NHS organisations. Any enquiries from NHS organisations about the patient access scheme should be directed to: Mr Stephen Skyrme, Commercial Strategy Lead – Oncology. His correspondence address is Pfizer Ltd, Walton Oaks, Dorking Road, Walton‑on‑the‑Hill, Tadworth, Surrey KT20 7NS.
 For further information see the General Medical Council's Prescribing guidance: prescribing unlicensed medicines.