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Dilemmas in commissioning biological therapies
  1. Michael Wilcock
  1. Pharmacy, Royal Cornwall Hospitals NHS Trust, Truro, UK
  1. Correspondence to Michael Wilcock, Pharmacy, Royal Cornwall Hospitals NHS Trust, Truro, UK; mike.wilcock{at}

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Biological therapies, often referred to as biologics, include a wide variety of products such as gene and cell therapies, therapeutic proteins, monoclonal antibodies and vaccines whose active substance is made by a living organism. Biologics are used to treat a range of long-term medical conditions including rheumatoid arthritis, Crohn’s disease and psoriasis and are typically initiated by secondary and tertiary care specialists. These medicines are usually expensive and represent an area of high NHS expenditure, though the introduction of biosimilars has reduced the cost of a number of biologics (eg, infliximab and adalimumab). Depending on the biologic and its indication, these therapies are commissioned in England either by NHS England or by Clinical Commissioning Groups (CCGs) in line with technology appraisal guidance issued by the National Institute for Health and Care Excellence (NICE). NICE’s technology appraisal process …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.