High Cost Drugs and Devices

Overview

Some high cost drugs and devices are paid for in addition to the national price for the related service.

As medical practice changes and new drugs and devices are developed and adopted, the lists of high cost drugs and devices needs to be kept as current as practically possible, requiring input from the health sector for changes to the lists, both additions and removals.

We are now inviting nominations for additions to, and removals from, the high cost drugs and devices lists for the next national tariff, due to come into effect in April 2019.

When considering which items to include in the lists for the 2019 national tariff, our guiding principle is that the drug or device should be high cost and represent a disproportionate cost compared to the other expected costs of care within the Healthcare Resource Group (HRG), which would affect fair reimbursement. We recognise however that for some new drugs or devices it can be difficult to produce cost and usage estimates, and so we will consider all relevant information available that will help to inform recommendations.