NHS England has struck a deal with pharmaceutical corporation Novartis to maintain GP access to inclisiran at the same price until the end of 2027.
The commissioner confirmed this week that it has renegotiated access to the injectable cholesterol-lowering drug, which is used to treat patients at risk of cardiovascular disease.
The new deal maintains current pricing for NHS patients in England until December 2027, and any changes to the agreement from January 2028 ‘will not affect patients already receiving treatment’, NHSE said.
Currently, GP practices can buy inclisiran directly from the national wholesaler for £45 per syringe. The drug is available as a ‘personally administered item reimbursed via an FP10 prescription’, the most recent guidance from NHS England stated.
For general practice, inclisiran is reimbursed via ICBs at £60 per injection, against the £45 nominal charge, but NHS England clarified that there are ‘no specific incentives’ to support the use of inclisiran and the focus ‘remains on a clinical pathway’, with patients where appropriate first supported with high intensity statins.
The guidance added that inclisiran is funded centrally from the national NHS budget so that ‘local finances are not a barrier to access’.
It continued: ‘General practice and community pharmacy can purchase inclisiran directly from the national wholesaler (AAH) at an agreed “nominal charge” that helps make inclisiran more affordable.
‘This is the price at which they will be able to purchase the medicine and is met from the drugs budgets held by ICBs.’
In an update to GPs this week, NHSE said: ‘This new agreement ensures comprehensive lipid management pathway coverage, providing an option for patients whose cholesterol has not been effectively reduced by statins alone or combined with ezetimibe.’
These arrangements followed NICE’s 2021 guidance which recommended inclisiran for patients with high cholesterol who have previously suffered a cardiovascular event.
NICE guidance said inclisiran can be given twice a year in primary care settings, and can be used on its own or in conjunction with statins or other cholesterol-lowering drugs.
At the time, both the BMA and the RCGP warned of ‘serious concerns’ around the rollout of the drug in general practice, including the lack of capacity among GPs to manage the additional workload.
And last year, local GP leaders across the country stressed to practices that they are ‘under no obligation’ to prescribe the drug without a local enhanced service (LES) in place.
They reminded GPs that prescribing inclisiran is not part of the core contract after NHS England had suggested the potential population health gains from the drug relied on ‘delivery at scale in primary care’.
More recently, collective action by GPs has resulted in some ICBs agreeing to additional funding for inclisiran prescribing, including in Somerset and Kent.
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