All material on this website is aimed at healthcare professionals working in BaNES, Swindon and Wiltshire.
Members of the public seeking advice on medicine-related matters are encouraged to speak with their GP, pharmacist or nurse, or out of hours contact the NHS 111 service by telephoning 111 or via their NHS App.
High Cost Drugs excluded from the National Tariff of Payment by Results
High Cost Drugs excluded from the National Tariff of Payment by Results
There are a number of High Cost Drugs and Devices that are excluded from the Payment by Results (PbR) tariff. They are typically specialist drugs and the commissioning arrangements for these drugs is to ensure their safe, effective and appropriate use within available funding.
Funding Arrangements for High Cost Drugs
There are lists of high-cost drugs and indications which are funded separately:
These are set annually as part of an NHS Payment Scheme.
NHS England » 2026/27 NHS Payment Scheme
Annex A - prices workbook tab 12bHC drugs lists high-cost drugs.
Check the separate lists below outlining the responsible commissioner (ICB /NHSE / CDF), indication, criteria / policy and payment mechanism.
NHS England » NHS England high cost drugs commissioning list
NHS England Commissioning Medicines for Children in Specialised Services
NHS England » National Cancer Drugs Fund list
BSW ICB High-Cost Drugs List (Being updated March 26)
Prices for these drugs are confidential and can be accessed by pharmacy staff:
Commercial Medicines Framework » NHS Pharmacy Catalogue » Login
Commercial Access and Pricing (CAP) Portal (NHSE SharePoint)
Prior Approval via Blueteq is required for many HCD and Devices. Information can be found on the Blueteq website (login required)
Exceptional Cases
If an individual falls outside the range of services and treatments that the ICB has agreed to commission then an Exceptional Funding Request can be made by a clinician, on behalf of a patient, to fund healthcare. The responsibility for demonstrating exceptional lies with the requesting clinician and based on the information provided the ICB must decide whether or not to support this view and agree to fund the request. The forms can be accessed here
A 'Free of Charge' (FOC) medicines scheme is defined as an arrangement where a UK licensed or unlicensed medicine is provided free of charge by the company to an individual patient or an identified cohort of patients. BSW APC has a FOC Policy and process for decision making based on RMOC guidance.
A significant proportion of high cost drugs excluded from tariff are commissioned by BSW ICB in line with NICE Technology Appraisals (from day 90).
Biologic algorithms for use in Dermatology, Gastroenterology, Ophthalmology and Rheumatology can be found on Blueteq page.