Below are NHS England clinical commissioning policies for drugs which have been removed from the NHS Payment Scheme Annex A. Generic or biosimilar versions are available, meaning acquisition costs have significantly reduced over time, supporting removal from Annex A and into prices (tariffs). These drugs will not be reimbursed outside of prices.

Providers should ensure they have appropriate governance arrangements in place when considering the off-label use of medicines; access to these legacy policies has been maintained for providers to refer to if required to support their local decision-making and governance.

These policies have only been updated to reflect that the drugs are no longer considered high-cost and to remove the requirement for prior approval (Blueteq). They will not be updated further and Trusts should consider any future NICE guidance specific to the indication.

• Etanercept and adalimumab for the treatment of deficiency of adenosine deaminase type 2 (aged 5 years and older)
• Biologic therapies for the treatment of juvenile idiopathic arthritis
• Everolimus for subependymal giant cell astrocytoma associated with tuberous sclerosis complex
• Everolimus for refractory focal onset seizures associated with tuberous sclerosis complex (ages 2 years and above)
• Everolimus (Votubia®) for treatment of angiomyolipomas associated with tuberous sclerosis
• Infliximab for refractory sarcoidosis (excluding neurosarcoidosis)
• Infliximab for refractory or progressive neurosarcoidosis (adults and post-pubescent children)
• Rituximab for the treatment of ANCA-associated vasculitis in adults
• Rituximab as a second line agent for the eradication of inhibitors in patients with acquired haemophilia
• Rituximab for second line treatment for anti-NMDAR autoimmune encephalitis (all ages)
• Rituximab for cytopaenia complicating primary immunodeficiency
• Rituximab and eculizumab for the prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies
• Rituximab for the treatment of dermatomyositis and polymyositis (adults)
• Rituximab for refractory Systemic Lupus Erythematosus (SLE) in adults and post-pubescent children
• Rituximab for immunoglobulin G4-related disease (IgG4-RD)
• Rituximab for the treatment of IgM paraproteinaemic demyelinating peripheral neuropathy in adults
• Rituximab therapy for the treatment of nodal/paranodal antibody positive inflammatory/autoimmune neuropathy in adults and postpubescent children
• Rituximab biosimilar for the treatment of myasthenia gravis (adults)
• Rituximab for immunobullous disease
• Rituximab for the treatment of relapsing steroid sensitive nephrotic syndrome
• Rituximab for the treatment of steroid resistant nephrotic syndrome in paediatric patients
• Rituximab for the treatment in acute thrombotic thrombocytopenic purpura (TTP) and elective therapy to prevent TTP relapse
• Addition of rituximab to first-line standard chemotherapy for CD20 positive B-cell precursor acute lymphoblastic leukaemia (adults)
• Sorafenib maintenance for adults with FLT3-internal tandem duplication (FLT3-ITD) acute myeloid leukaemia (AML) undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT)