Helping improve patient outcomes and access to new medicines

Our expert team advises on commercial agreements for high cost and new drug purchases.

We advise a range of clients including NHS England when it enters into specialist and bespoke commercial arrangements relating to new and innovative high cost treatments that are not in routine commissioning.

These highly confidential commercial arrangements allow our clients to make the best possible treatments available to patients across the country whilst still delivering value for money. Pharmaceutical companies are also able to benefit from access to the world’s largest publicly funded health service.

Main Areas Of Practice

Our team regularly advises on commercial agreements for high cost and new drug purchases in the following areas:

Cancer Drugs Fund (CDF)

CDF allows for promising new cancer drugs to be made available to patients before they are fully approved for use in the NHS. These specialised agreements focus on keeping spend within the CDF budget and providing the evidence collection and data sharing arrangements necessary to assess if the drug can be moved into routine commissioning.

Budget Impact Test (BIT)

If the budget impact of a new drug exceeds NICE's threshold of £20 million, in any of the first three years, NHS England may engage in commercial discussions with the company. These discussions are designed to mitigate the impact that funding the technology would have on the rest of the NHS.

Clinical Priorities Advisory Group (CPAG)

CPAG assesses drugs, medical devices and treatments according to their clinical effectiveness, benefit for patients and value for money. We provide advice to NHS England about the commissioning of recommended services where they are likely to have a major budgetary impact.

Highly Specialised Technologies (HST)

HST are recommendations by NICE on the use of new and existing highly specialised medicines and treatments within the NHS in England. These medicines are often very high cost, low volume treatments where NHS England needs to enter into confidential commercial arrangements with the company in order to be able to make the treatments available to patients whilst delivering value for money to the NHS.

The 2019 Voluntary Scheme for Branded Medicines Pricing and Access (VPAS)

Our team have been advising on this new scheme which allows NHS England to offer more innovative commercial solutions to companies to enable new high cost drugs to be offered to more patients whilst delivering better value for money for the NHS and the taxpayer.

Our Clients

Our expert team specialising in high cost and new drug procurement primarily advises the Specialised Commissioning Team within NHS England.


Advising the Specialised Commissioning Team at NHS England on the first commercial agreements to be entered into under the new VPAS scheme.

Advising the Team on implementing a multi-company commercial agreement process to allow for more combination therapies to be offered by the NHS and advising on the updated and streamlined BIT Commercial Agreement contracts and process.

Assisting the Team in carrying out a full review of the existing Commercial Agreement process following the increased scope of VPAS in comparison to the previous PPRS scheme.

Our Experts



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