4.1 Because the committee's recommendation was based on a dose of lenalidomide that is outside of its marketing authorisation, the Department of Health and Social Care has referred the topic to NICE under regulation 5 of the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013. This means the recommendation is not associated with mandatory funding; however, NHS England and NHS Improvement will advise the NHS that the recommendation will be funded as per usual arrangements for technology appraisals.
4.2 The Welsh ministers have 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 2 months of the first publication of the final appraisal document.
4.3 When NICE recommends a treatment 'as an option', the NHS must make sure it is available. This means that, if a patient requires maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma and the doctor responsible for their care thinks that lenalidomide is the right treatment, it should be available for use, in line with NICE's recommendations.