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386477

	registered interest
	date	30/06/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they are taking to ensure that NHS England provides patients with hepatitis C access to new drugs approved by the National Institute for Health and Care Excellence without delay, and to ensure that NHS England continues to assess new technologies based on cost-effectiveness rather than affordability.
	tabling member printed	Baroness Randerson
	uin	HL972
	answer	answer is ministerial correction date of answer 09/07/2015 answer text <p>Commissioners are legally required to fund drugs and treatments recommended in National Institute for Health and Care Excellence (NICE) technology appraisal guidance.</p><p> </p><p> </p><p> </p><p>In the absence of guidance from NICE, it is for commissioners, including NHS England, to make funding decisions based on the available evidence.</p><p> </p><p> </p><p> </p><p>Commissioners are required to have in place clear and transparent arrangements for local decision making and for considering individual funding requests taking into account patients’ clinical circumstances.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 09/07/2015 12:59:51 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	4230 label Biography information for Baroness Randerson

450491

	registered interest
	date	03/02/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether the collaborative commissioning arrangements for new hepatitis C medicines outlined in the report by NHS England<i> Improving Value for Patients from Specialised Care, Commissioning Intentions 2016/2017 for Prescribed Specialist Services</i> will include plans to ensure that the areas covered by Operational Delivery Networks and Clinical Commissioning Groups are coterminous.
	tabling member printed	Baroness Randerson
	uin	HL5853
	answer	answer is ministerial correction date of answer 11/02/2016 answer text <p>NHS England has been supporting Operational Delivery Networks (ODNs) to identify the clinical commissioning groups (CCGs) that are relevant to their geography.</p><p> </p><p>In many cases boundaries are co-terminous and this will assist in communications. Where this is not the case, this will mean that CCGs, ODNs, and NHS England commissioning hubs will work across a wider footprint to collaborate on relevant matters.</p> answering member printed Lord Prior of Brampton question first answered 11/02/2016 12:56:07 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	4230 label Biography information for Baroness Randerson

632754

	registered interest
	date	09/11/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether NHS England has undertaken procurement exercises in relation to hepatitis C medicines which have enabled those medicines to be obtained at a lower cost than the cost used for the purposes of appraisal by the National Institute for Health and Care Excellence.
	tabling member printed	Baroness Randerson
	uin	HL3152
	answer	answer is ministerial correction date of answer 17/11/2016 answer text <p>The Department’s Commercial Medicines Unit (DHCMU), rather than NHS England, is responsible for medicines procurement in secondary care.</p><p> </p><p>DHCMU manages, on behalf of the National Health Service in secondary care, a tender process which establishes price framework agreements for hepatitis C medicines. This programme commenced in August 2015 and has resulted in ongoing price reductions. The six-monthly rolling regional tender programme undertaken on behalf of NHS trusts in England has continued to exert a downward pressure on the prices paid (costs) for the new oral hepatitis C medicines.</p><p> </p><p>The evaluation of hepatitis C products by the National Institute for Health and Care Excellence (NICE) is completely separate to the DHCMU tender process. In developing its guidance on several hepatitis C drugs, NICE took into account prices that had been agreed by the DHCMU at the time its guidance was being developed, as the companies provided this information as part their evidence submissions to NICE.</p><p> </p><p>In common with other medicines, where new competing products become available, procurements managed by the DHCMU may secure reduced prices in the years following NICE’s decisions. As with other medicines, NHS England has taken account of the prices DHCMU procurements achieve for hepatitis C medicines to inform the additional investment required in meeting its commitments to roll out the new treatments.</p> answering member printed Lord Prior of Brampton question first answered 17/11/2016 12:55:40 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	4230 label Biography information for Baroness Randerson

663160

	registered interest
	date	21/12/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether the NHS Commercial Medicines Unit has procured a new Hepatitis C treatment in the last 12 months; and if so, what was the cost.
	tabling member printed	Baroness Randerson
	uin	HL4375
	answer	answer is ministerial correction date of answer 06/01/2017 answer text <p>The Department’s Commercial Medicines Unit has continued to procure medicines for hepatitis C as part of a nationally agreed programme, established in 2015, which establishes framework agreements.</p><p> </p><p>The Unit undertakes a six-monthly rolling regional tender programme on behalf of National Health Service trusts in England, which includes all the new hepatitis C medicines on the market at the time of tendering. Regional annual framework agreements are then established for use by NHS trusts.</p><p> </p><p>The costs associated with the regional tender programme are not separately identifiable.</p> answering member printed Lord O'Shaughnessy question first answered 06/01/2017 13:58:57 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson

663161

	registered interest
	date	21/12/2016
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether NHS England intends to reassess the cap on new Hepatitis C treatments for patients; and if not, why not.
	tabling member printed	Baroness Randerson
	uin	HL4376
	answer	answer is ministerial correction date of answer 06/01/2017 answer text <p>The guidance issued by the National Institute for Health and Care Excellence (NICE) in relation to new direct acting antivirals specifically requires Operational Delivery Networks (ODNs) to prioritise hepatitis C patients on the basis of highest unmet clinical need. NHS England’s commitment to treat 10,000 patients in 2016-17, increasing to 12,500 in 2017-18 and rising to 15,000 in 2021 is in line with NICE’s estimate of activity included in the costing tools published to support implementation of the guidance. Each ODN has a number of treatment slots available each month to treat eligible patients. This is known as the monthly treatment run rate, and it ensures the expansion of treatment takes place equitably across the country.</p><p> </p><p>The High Court has considered NHS England’s approach. Its judgement in September 2016 stated “a monthly run rate is not an arbitrary cap but a legitimate way of giving effect to the guidance”.</p><p> </p><p>The planning approach for hepatitis C is set out in the NICE Technological Appraisals 363, 364 and 365.</p> answering member printed Lord O'Shaughnessy question first answered 06/01/2017 13:58:14 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson

775971

	registered interest
	date	23/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend to review run rates for Operational Delivery Networks providing treatment for hepatitis C, in the light of current variations in the level of demand in relation to capacity.
	tabling member printed	Baroness Randerson
	uin	HL2379
	answer	answer is ministerial correction date of answer 02/11/2017 answer text <p>NHS England will keep the run rates for each Operational Delivery Network (ODN) under review, as in 2016/17, taking into account available data on estimated need and performance across the Networks.</p><p> </p><p>NHS England has a Commissioning for Quality and Innovation scheme in place for hepatitis C virus, which provides a substantial opportunity for hospitals to earn additional income for success, rather than any financial penalties. All hospitals who deliver between 90% and 100% of the planned rates of expansion receive the additional payment. In 2016/17, no ODN exceeded their run rate.</p> answering member printed Lord O'Shaughnessy question first answered 02/11/2017 14:59:03 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson

775972

	registered interest
	date	23/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether any financial penalties have been applied to those Operational Delivery Networks which have exceeded their run rates for the treatment of hepatitis C.
	tabling member printed	Baroness Randerson
	uin	HL2380
	answer	answer is ministerial correction date of answer 02/11/2017 answer text <p>NHS England will keep the run rates for each Operational Delivery Network (ODN) under review, as in 2016/17, taking into account available data on estimated need and performance across the Networks.</p><p> </p><p>NHS England has a Commissioning for Quality and Innovation scheme in place for hepatitis C virus, which provides a substantial opportunity for hospitals to earn additional income for success, rather than any financial penalties. All hospitals who deliver between 90% and 100% of the planned rates of expansion receive the additional payment. In 2016/17, no ODN exceeded their run rate.</p> answering member printed Lord O'Shaughnessy question first answered 02/11/2017 16:27:03 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson

776805

	registered interest
	date	24/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hepatitis: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 18 July (HL529), whether the figure of £200 million represents only the cost of medicines for the treatment of hepatitis C, or whether it includes the cost of associated ancillary treatments; whether the NHS procurement process for hepatitis C drug treatments has achieved any cost savings; and if so, what is the value of those savings.
	tabling member printed	Baroness Randerson
	uin	HL2469
	answer	answer is ministerial correction date of answer 02/11/2017 answer text <p>NHS England spent in excess of £200 million on direct acting antivirals for hepatitis C in 2016-17. This figure does not include associated ancillary treatments. Through twice yearly drug procurements and working closely with industry, NHS England has secured reduced prices, which is on course to generate savings of more than £50 million. Reductions in drug price enables the year on year expansion in treatments to remain affordable.</p> answering member printed Lord O'Shaughnessy question first answered 02/11/2017 15:27:12 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4230 label Biography information for Baroness Randerson