About us

Here you will find information about our member organisations, the member representatives, as well as the process we undertake when making recommendations.

Referral Criteria

Criteria for Referring Applications to the Lancashire Medicines Management Group

Introduction

Following agreement of the LMMG terms of reference and medicines application process, consideration has been given to how medicines might be identified as appropriate for referral to the LMMG process. As a result, the following criteria have been agreed.

Application criteria

Applications will only be accepted from LMMG member organisations. For a medicine application to be considered through the LMMG process, both the following criteria must first be met:

  • Commissioning responsibility will lie with CCGs rather than the NCB; AND
  • The medicine is not subject to NICE guidance for the proposed indication due to be issued within 6 months of the application.

IN ADDITION, at least one of the following criteria should be met:

  • The medicine is or will be a PbR tariff excluded product.
  • The annual cost per patient, inclusive of associated service costs, will exceed £5,000.
  • Use of the medicine could create a significant cost pressure in the primary care prescribing budget.
  • Use of the medicine could release significant cost savings in the prescribing budget.
  • The product is a genuinely novel treatment, i.e. first in class, or a significant new indication for an existing medicine.
  • There are existing variations in use of the medicine across Lancashire, which are undesirable on clinical, therapeutic or equitable access grounds.
  • There is a need for local interpretation or clarification of existing NICE guidance.
  • In the case of a medicine which has previously been considered by LMMG, substantial new clinical evidence should be available and be detailed in the application.

N.B. The following categories of product will not usually be considered through the LMMG:

  • Combination products of medicines already available for the same general indication.
  • A product which is an isomer or metabolite of an existing medicine for the same general indication.
  • A medicine which is a “me too” product, or a new delivery system or formulation of an existing medicine for the same general indication.

LMMG member organisations may request that prescribable items which do not fulfil these criteria be reviewed via the LMMG processes. All such requests will be considered by LMMG and added to its work plan if agreed by the Group.