Each financial year NHS England runs a process for making discretionary investment decisions about which new specialised treatments can be routinely commissioned (funded).

This process is supported by an independently chaired Clinical Priorities Advisory Group (CPAG) and is often referred to as the CPAG annual prioritisation process.

Final funding decisions are based on advice from CPAG, which advises on the relative priority for investment of all the treatments under consideration, against a discretionary level of investment which is determined annually and based on affordability. Full details of this process can be found in our published methods.

2024/25 Clinical Priorities Advisory Group annual prioritisation round

We are pleased to let you know that we are now in a position to conclude the 2024/25 CPAG annual prioritisation and confirm that the following 3 policies which were prioritised as having the greatest impact will now be routinely commissioned:

• 2312 Abiraterone acetate and prednisolone for high-risk, hormone sensitive, non-metastatic prostate cancer (adults)
• 2122 Pre-implantation genetic testing of embryos at significant risk of serious genetic conditions (update to current policy to align with National Institute for Health and Care Excellence guidelines – this policy will be published later in 2026 as further work required)
• 2270 Human normal immunoglobulin for preventative treatment of idiopathic systemic capillary leak syndrome following an acute episode (adults)

There was not however sufficient resource to fund the remaining policies:

• 2318 Vemurafenib plus rituximab for patients with relapsed or refractory classic hairy cell leukaemia (adults)
• 2254 Transcatheter edge to edge repair (percutaneous mitral valve leaflet repair) for moderately severe or severe secondary mitral valve regurgitation due to left ventricular dysfunction and/or dilatation (adults)
• 2268 Dabrafenib for BRAFV600E mutation positive histiocytic neoplasms where standard care has failed (all ages)
• 2121 Obinutuzumab for systemic lupus erythematosus with secondary non-response to rituximab (adults and post-pubescent children)
• 2309 Abatacept for autoimmune complications of primary immunodeficiencies caused by CTLA-4 or LRBA genetic mutation (aged 2 years and over)
• 2206 Direct skeletal fixation for transfemoral limb loss (adults)
• 2269 Neoadjuvant vismodegib for locally advanced basal cell carcinoma prior to curative treatment for lesions likely to result in functional sequelae or significant aesthetic sequelae (adults)
• 2002 Canakinumab for patients with still’s disease refractory to anakinra and tocilizumab (adults and children 2 years and over)

Any treatments that were not prioritised for funding during 2024/25 will automatically be eligible to be reconsidered at subsequent CPAG prioritisation rounds in line with our published methods. The exception to this is the proposed policy for canukinumab which has now been considered 3 times and is therefore ineligible for further consideration.