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 The Welsh Assembly Minister for Health and Social Services has issued directions to the NHS in Wales on implementing NICE technology appraisal guidance. When a NICE technology appraisal recommends the use of a drug or treatment, or other technology, the NHS in Wales must usually provide funding and resources for it within 3 months of the guidance being published.
5.3 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 psoriatic arthritis and the doctor responsible for their care thinks that ustekinumab is the right treatment, it should be available for use, in line with NICE's recommendations.
5.4 The Department of Health and Janssen have agreed that ustekinumab will be available to the NHS with a patient access scheme, in which the company provides the 90‑mg dose (2 vials) at the same cost as the 45‑mg dose (1 vial), for people who weigh more than 100 kg and need the higher dose. Under the original patient access scheme the company provided 2x45 mg pre-filled syringes, for patients who needed the higher dose of 90 mg, at the same total cost to the NHS as for a single 45‑mg pre-filled syringe. The patient access scheme was withdrawn in January 2017 because the company now provides a 90‑mg vial at the same cost as the 45‑mg vial.