Proforma Index 2010-2011
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| Drug | Indication | NICE TAG | Local Policy | Proforma | Notification or prior approval |
|---|---|---|---|---|---|
| Adalimumab | Psoriatic arthritis | 125 |  |
Notification only | |
| Adalimumab | Psoriasis adults | 146 |  |
Notification only | |
| Adalimumab | Rheumatoid arthritis | 130 | |
Notification only | |
| Adalimumab | Ankylosing spondylitis | 143 | |
Notification only | |
| Adeforvir dipivoxil | Chronic Hepatitis B | 96 | |
Notification only | |
| Botulinum A toxin | Severe Blepharospasm, Hemifacial spasm, Laryngeal dystonia, Cervical dystonia, Chronic anal fissures, Severe axillary hyperhidrosis, Freys syndrome, Lower limb treatment in paediatric cerebral palsy, overactive bladder, achalasia | Yes | |
Notification only | |
| Bortezomib monotherapy | Multiple myeloma (MM) relapsed | 129 | |
Notification of Patient Access Scheme | |
| Certolizumab pegol | Rheumatoid arthritis | 186 | |
Notification of Patient Access Scheme | |
| Cetuximab | First line treatment of metastatic colorectal cancer | 176 | |
Notification of Patient Access Scheme | |
| Desferasirox | Chronic iron overload | Yes | |
Notification only | |
| Desferrioxamine or deferiprone | Chronic iron overload | Yes | |
Notification only | |
| Entecavir | Chronic Hepatitis B | 153 | |
Notification only | |
| Erlotinib | Non small cell lung cancer (NSCLC) | 162 | |
Notification of Patient Access Scheme | |
| Etanercept | Rheumatoid arthritis | 130 | |
Notification only | |
| Etanercept | Ankylosing spondylitis | 143 | |
Notification only | |
| Etanercept | Psoriatic arthritis | 104 | |
Notification only | |
| Etanercept | Psoriasis adults | 103 | |
Notification only | |
| Etanercept | Juvenile idiopathic rheumatoid arthritis | 35 | |
Notification only | |
| Glatiramer | Multiple sclerosis (MS) | |
Notification only | ||
| Infliximab | Rheumatoid arthritis | 130 | |
Notification only | |
| Infliximab | Psoriatic arthritis | 104 | |
Notification only | |
| Infliximab | Crohn's | 40 | For episodic treatment | |
Notification only |
| Infliximab | Psoriasis adults | 134 | |
Notification only | |
| Infliximab | Ulcerative colitis acute exacerbations | 163 | |
Notification only | |
| Interferon Beta | Multiple sclerosis (MS) | |
Notification only | ||
| Interferon alfa (pegylated and non pegylated) | Chronic Hepatitis C | 75 | |
Notification only | |
| Lenalidomide | Relapsed Multiple Myeloma | 171 | |
Notification of Patient Access Scheme | |
| Natalizumab | Multiple sclerosis (MS) | 127 | |
Notification only | |
| Omalizumab | Severe Persistant Allergic Asthma | 133 | |
Notification only | |
| Peginterferon alfa 2a | Chronic Hepatitis B | 96 | |
Notification only | |
| Peginterferon alfa 2a | Mild Chronic Hepatitis C | 106 | |
Notification only | |
| Ranibizumab (Lucentis) | Wet age related macular degeneration (Wet AMD) | 155 | |
Notification only | |
| Ribavirin | Chronic Hepatitis C | 75 | |
Notification only | |
| Ribavirin | Mild Chronic Hepatitis C | 106 | |
||
| Rituximab | Refractory vasculitis or Systemic lupus erythematosus (SLE) | Yes | |
Prior approval | |
| Rituximab | Rheumatoid arthritis | 126 | |
Notification only | |
| Somatropin | Growth Hormone deficiency in adults up to 25 years | 64 | |
Notification only | |
| Somatropin | Growth Hormone deficiency in adults over 25 years | 64 | |
Notification only | |
| Somatropin | Growth Hormone in children with growth failure | 42 | |
Notification only | |
| Sunitinib | Metastatic Renal cell carcinoma (RCC) | 169 | |
Notification of Patient Access Scheme | |
| Sunitinib | Gastrointestinal Stromal Tumours | 179 | |
Notification of Patient Access Scheme | |
| Tenofovir disoproxil | Chronic Hepatitis C | 173 | |
Notification only | |
| Teriparatide | Secondary prevention of osteoporotic fractures | 161 | |
Notification only | |
| Tolvaptan | Hyponatraemia secondary to inappropriate antidiuretic hormone secretion (SIADH) | Yes | |
Prior approval | |
| Trabectedin | Advanced soft tissue sarcoma | 185 | |
Notification of Patient Access Scheme | |
| Ustekinumab | Moderate to severe psoriasis adults | 180 | |
Notification of Patient Access Scheme |
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