Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of whether principle 4 of NHS England's Commercial Framework for New Medicines affects the availability of commercial flexibilities for multi-indication medicines.

Principle 4 of NHS England’s Commercial Framework for New Medicines says that complex confidential commercial deals should normally only be considered for medicines that offer value at, or below, the lower end of the standard National Institute for Health and Care Excellence threshold, or any other relevant threshold. This helps ensure these flexibilities are used for new treatments that offer good value, and helps protect the National Health Service from paying more than it should.

For medicines used to treat more than one condition, NHS England prefers a single price where possible. This is simpler for NHS payments and helps secure the best overall value for the NHS. However, the NHS in England can and does use indication-specific pricing where it is appropriate. The principles for using this approach were included in the first consultation on the framework in 2024, and are set out in the current NHS Commercial Framework for New Medicines.

As part of the 2024 voluntary scheme for branded medicines pricing, access and growth, NHS England agreed to hold two consultations on updates to the NHS Commercial Framework for New Medicines. The second consultation is expected to begin later in 2026.