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Overview of AWMSG's appraisal process

Step 1 

A pharmaceutical company provides information on a new, licensed medicine to the All Wales Therapeutics and Toxicology Centre (AWTTC).

Step 2 

AWTTC prepares a draft report, assessing the medicine's clinical effectiveness and cost-effectiveness. AWTTC invites the pharmaceutical company to comment on the draft report. AWTTC also asks patients, carers, patient organisations and clinical experts to give their views on the medicine.

Step 3 

A subgroup of AWMSG, the New Medicines Group (NMG), meets in private to consider:

  • the information from the company
  • AWTTC's draft assessment report
  • the company's response to AWTTC's report
  • views from patients, carers and patient organisations
  • clinical experts' opinions.

AWTTC's draft report is finalised and NMG members agree on a preliminary recommendation. The company is invited to comment on NMG's recommendation.

Step 4

Before AWMSG members meet, the meeting papers are posted on AWMSG's website (views from patients, carers and patient organisations are confidential and are not available on our website). AWMSG meets in public to consider:

  • AWTTC's final assessment report 
  • NMG's preliminary recommendation
  • the company's response to the preliminary recommendation
  • views from patients, carers and patient organisations
  • clinical experts' opinions.

Unlike NMG, AWMSG considers budget impact and the broader impact on society, in addition to the clinical effectiveness and cost-effectiveness of the medicine. AWMSG members agree (in private) on a final recommendation, which is then announced in public at the meeting.

Step 5 

After the pharmaceutical company has accepted AWMSG's final recommendation, AWMSG advises Welsh Government. Welsh Government takes account of AWMSG's advice and decides whether the medicine should be made routinely available in NHS Wales. No fixed timescale can be given for their decision: it depends on competing Welsh Government priorities.

Step 6

Medicines that are recommended for use (for the health condition considered) are made routinely available in the NHS across Wales within two months. Medicines not recommended for use (for the health condition considered) will not be routinely available in the NHS across Wales.