The Surrey Medication Safety Committee have reviewed the guidance for the safe prescribing of biological medicines (biologics). See document below

GPs should ensure that patient's records include the use of biologic medicines even if the GP is not the prescriber - see guidance for recording non-GP prescribed medication: https://surreyccg.res-systems.net/PAD/Guidelines/Detail/5677

The Surrey Heartlands Integrated Care System Area Prescribing Committee have agreed the Biologicals and biosimilar of best value policy.

The policy is intended to provide a process for Trusts to manage the introduction of new biologics/biosimilars in a timely manner and requires engagement across clinical teams, pharmacy, procurement and senior managers.

The Surrey Heartlands integrated care system Area Prescribing Committee (APC) agreed the following: 
Patient with two conditions – use of two biologics for different conditions
Surrey Heartlands CCG will routinely commission as follows:

• Both biologics should be NICE approved
• There should be a Multi Disciplinary Team (MDT) (with both specialities) and/or a Drugs & Therapeutics Committee (DTC) agreement. Confirmation will be requested by the high cost drugs team.
• One biologic treatment should be considered (if NICE approved for both conditions) where appropriate, from a safety perspective prior to consideration of two biologic treatments.
• Blueteq forms are available for all biologic treatments that are NICE approved and these should be completed by the individual teams at initiation and at follow up.

Patient with two conditions – use of one biologic for both conditions 
Surrey Heartlands CCG will routinely commission as follows:

• Both specialities should agree a common approach to treatment
• Treatment should be NICE approved for both conditions
• Blueteq forms are available for all biologic treatments that are NICE approved and these should be completed by the individual teams at initiation and at follow up.

Patient with one condition – use of two biologics for same condition

• Surrey Heartlands CCG will NOT routinely commission and the IFR process should be followed if patient is clinically exceptional. Information on the IFR process can be provided by emailing the high cost drugs team at highcost.drugs@nhs.net or the IFR policy is available here: https://www.surreyheartlandsccg.nhs.uk/documents/documents/about-us/policy-and-guidance/clinical-policies