AWMSG recommends that iloprost trometamol (Ventavis®) should be made available for use within NHS Wales with the following restrictions: It is used according to its licensed indications within NHS Wales for the treatment of patients with New York Heart Association Class III primary pulmonary hypertension as a second-line treatment when oral treatments are ineffective or not tolerated. Iloprost trometamol (Ventavis®) should also be restricted for use only as an alternative in patients receiving other forms of prostacyclin treatment. Iloprost trometamol (Ventavis®) should be initiated by specialists in centres treating pulmonary hypertension.