The National Institute for Health and Care Excellence (NICE) and the All Wales Medicines Strategy Group (AWMSG) have a shared interest in the drive to improve patient access to new medicines and treatments.
Both organisations recognise that by working together they can enhance and develop timely, independent and authoritative guidance on new medicines and new licence indications or formulations for existing medicines, and on the cost implications of making them routinely available on the NHS.
A memorandum of understanding exists which formally sets out a collaboration between NICE and AWMSG. The memorandum sets out the circumstances in which NICE and AWMSG will work together and includes the appraisal work programme (scheduling), implementation, support of guidance and patient access schemes. The aim is to join up the strategic planning, development and delivery of guidance in England and Wales, avoiding duplication or conflict of work, yet complementing and supporting the work of NICE and AWMSG.
Medicines are funded by NHS Wales following guidance from two sources: AWMSG and NICE. AWMSG takes NICE's future work programme into account when they consider whether to appraise a medicine. AWMSG will not usually consider appraising a medicine if NICE will publish a final appraisal of the same medicine within 12 months of the date of the medicine's marketing authorisation. AWMSG advice is interim to NICE guidance, if NICE guidance is published later.
In the absence of AWMSG or NICE guidance, individual prescribers should exercise their clinical judgement unless there is evidence not to do so in the light of particular circumstances of an individual patient.
In November 2013, for equity in access to medicines for patients in Wales, AWMSG agreed to consider applications to appraise medicines that have previously received a negative recommendation from NICE because of lack of cost-effectiveness, and which are funded in England through alternative national commissioning routes.