PACS Tier 2: Access to Orkambi and Symkevi in Scotland

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In late December 2018, NHS Scotland and Vertex Pharmaceuticals reached a deal on access to precision medicines through a system called PACS Tier 2. Find out how this system works and what it could mean for people with CF in Scotland.

The Scottish Government’s announcement that NHS Scotland and Vertex Pharmaceuticals had reached a deal to provide interim access to Orkambi and Symkevi, through a system known as Peer Approved Clinical System Tier 2 (PACS Tier 2), was a significant breakthrough.

The interim arrangement was conditional on Vertex submitting Orkambi and Symkevi to the Scottish Medicines Consortium (SMC) for reviews. Submissions were made earlier this year, and access is intended to be provided through PACS Tier 2 in the meantime.

What is PACS Tier 2?

PACS Tier 2, introduced by the Scottish Government in June 2018, is an individual application for patient access to drugs not recommended by the SMC and not routinely available on the NHS.

To use PACS Tier 2, doctors must apply for access on behalf of their patients. Each application is considered by an independent board made up of other doctors. This means the process takes a number of weeks from application to access.

We are monitoring and supporting the roll-out of PACS Tier 2 closely to ensure the process is working as smoothly as possible.

How do I find out if I’m eligible?

If you believe you or your child are eligible for either Orkambi or Symkevi and receive your CF care in Scotland, speak to your CF team.

To find out more about PACS Tier 2 and how it works visit the Healthcare Improvement Scotland website.

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