1. TECHNOLOGY APPRAISAL IN ACTION Mrs Karen Samuels Programme Manager

2. WHO WHAT WHERE RELATED ORGANISATIONS CHALLENGES FUTURE

3. WMP MULTIDISCIPLINARY PARTNERSHIP 1. WMIC 2. WeMeReC 3. WCM Therapeutics and Toxicology Centre 4. YCC Wales (Core WMP)

4. ESTABLISHED 2002 Appraised up to 8 High cost drugs per year Strategic advice Met 4 times per year

5. ORGANISATIONAL STRUCTURE AWMSG NHSIFAWPAG

6. INITIAL PERIOD (2002-2006) One step process Public meeting WMP appraisal team One medical expert Patient perspective Two pharmaceutical company representatives

7. CHALLENGES One step Public nature Medical expert PIG submission Health Economic issues

8. CHALLENGES (continued) Small number of specialist medicines Dependent on pharmaceutical Industry submission Service links Need Commissioners (HCW) Public demand e.g. trastusumab

9. APRIL 2007 Second phase, 32 appraisals per year 1. High cost 2. Cancer drugs 3. Cardiovascular drugs

10. MODIFIED PROCESS Met with SMC New sub group NMG

11. PROCESS In the pipeline MHRA licence (MA) Company launch in the UK Preliminary application (Form A) Detailed application (Form B) Patient Interest Groups

12. NMG ROLE AND MEMBERSHIP Expert clinical & cost effectiveness advice to AWMSG Broad spectrum membership Lay representative ABPI representative Not in public

13. DATA CONSIDERED WMP assessment report (AS AR) Company response Company’s detailed application (Form B) Advice from Medical Expert (s) Patient interest group submission

16. AWMSG ROLE AND MEMBERSHIP Consider strategic, societal, affordability aspects Broader strategic Senior NHS managers Senior Finance directors Lay representative ABPI representative

17. DATA CONSIDERED NMG preliminary appraisal report (PAR) Company response to the PAR Patient Interest Group submissions

19. HOW? In public Announced at the meeting Minister for Health and Social Services

20. RELATED ORGANISATIONS NICE/AWMSG/SMC ABPI CDG All-Wales Cardiac and Cancer networks Health Commission Wales

21. REQUEST FOR APPRAISAL OF CANCER DRUGS Is drug/indication licensed? Is drug being Appraised by NICE? Await NICE guidance Refer to AWMSG for appraisal Refer to Cancer New Drugs Group for appraisal Yes No

22. ALL WALES CANCER DRUGS GROUP No backlog AWCDG to help prioritise Engaging network –Oncologists –Oncology pharmacists Horizon scanning

23. England and Wales - NICE takes precedence Wales - AWMSG Local MTC’s

24. SCOTLAND SMC Streamlined process Similar paperwork Simultaneous submissions

25. ABPI Users Group Regular Input process

26. FUTURE Extend to all new medicines? Increased links with patient groups Further collaboration with NICE/SMC Review process after 2 cycles