NICE and easy? Ensuring equitable access to NICE-approved treatments in children and young people

The National Institute for Health and Care Excellence (NICE) recently approved Palforzia, an oral immunotherapy product for the treatment of peanut allergy in peanut-allergic children aged 4–17 years.1 Palforzia contains precise amounts of defatted peanut powder and can be used to gradually increase the body’s ability to tolerate small amounts of peanut. It may also help reduce the severity of allergic reactions after being exposed to peanut.

The approval of Palforzia represents a major step forward for the management of food-allergic patients in the National Health Service (NHS). There are approximately 140 000 eligible patients with peanut allergy, but only a handful of specialist services able to provide the multiple visits needed to administer the treatment. These visits require significant space and staff resources, which many services lack. As a result, NHS England (NHSE) is limiting the number of eligible patients to 600 in the first year (and up to 2000 per annum thereafter).2

Treatments recommended by NICE in its technology appraisal programmes must be funded by the NHS, under the Health and Social Care Act 2012, through what is called the ‘funding directive’.3 Normally, when the funding directive is applied, NHSE has 90 days to make the treatment available. This is to allow local Clinical Commissioning Groups to make arrangements to support the NICE recommendation and does not apply to the availability of the treatment by individual NHS Trusts. Such a timeline can …

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