The result of our meeting with NHS England on 8th September.
In July, Olivia’s Vision revealed that “The Adult and Paediatric Anti -TNF policies for Severe Refractory Uveitis” had not been approved for specialised commissioning.
Meaning that those with idiopathic uveitis, applying for Humira or Infliximab after 2nd July, were to be refused the drugs.
Olivia’s Vision has now met with NHS England to stress how detrimental this decision is to patients. It has been agreed that the clinical evidence from the adult VISUAL Humira trial, and the paediatric SYCAMORE Humira trial can be resubmitted, together with further evidence that NHS England has requested.
It is hoped that all of this information will be ready to be submitted in October 2015. The evidence will then be reviewed by NHS England in November. We have NOT been given a timeframe for the decision making process, but in the meeting it was suggested that it could, NOT WILL, be completed within three months.
If the further evidence is accepted, the policy denying access to Humira could then be approved in this financial year (2015-16), meaning that new applications for Humira would then be accepted.
Everybody already being prescribed Humira or Infliximab, will continue to have access to these drugs.
The current policy denying Humira and Infliximab, only applies to patients with idiopathic uveitis, that is: cause unknown.
The current policy does NOT apply if the uveitis patient has a secondary disease eg if a child is diagnosed with JIA and uveitis, the child can still be prescribed Humira or Infliximab.
The policy only applies to uveitis patients in England.
The Individual Funding Request (IFR) route is still available for patients who are significantly different from other patients with uveitis. BUT blinding disease alone will not make a patient eligible for an IFR. In reality this means a request for individual funding will be unsuccessful.
The clinically critically urgent (CCU) process remains open, but the criteria is usually based on having a life threatening disease, and so again, this process is unlikely to be successful for now.