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26.09.16

Proposed medicine optimisation committees must avoid ‘operating in silos’

Proposed Regional Medicines Optimisation Committees (RMOCs) should be established with CCG involvement and operate jointly with one another, NHS Clinical Commissioners (NHSCC) has said in its response to the proposals.

Under new proposals from NHS England, the RMOCs will assume responsibility for evaluating new medicines that are not scheduled for review by NICE and publishing guidance on whether they should be locally adopted.

In its response, NHSCC said that the process of establishing RMOCs should involve “an effective steering group with CCG representation” in order to ensure that they “deliver for the wider system”.

It also said that RMOCs need to “operate as one single system”, where decisions are only made once, instead of “individual committees operating in silos”.

NHSCC recommended making RMOC operations more effective by ensuring that they update the blacklist of clinically ineffective treatments more regularly and review the use of unlicensed medicines in batches instead of individually.

RMOCs should also demonstrate health economic expertise, in order to “ensure the cost-effectiveness of treatments both for CCGs and the tax-payer” and produce analyses which explicitly state the cost and effectiveness of the treatments.

The response also says that the governance of RMOCs should balance commissioner and provider representatives with pharmacists and other providers. In addition, RMOCs should work with NHS England and CCGs to produce a statement of expected roles and responsibilities. Pharmaceutical industry representatives should serve as additional members but not have voting rights, and voting members have no “substantive” conflicts of interest.

NHSCC also said that the process of developing the initial list of priorities for RMOCs should be a joint decision to “avoid a work plan unacceptable to CCGs being imposed by NHS England” and should exclude pharmaceutical representatives.

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