We have written to 18 NHS Integrated Care Boards (ICBs) across England to raise concerns about equitable access to dupilumab for people living with severe chronic rhinosinusitis with nasal polyps (CRSwNP), following its recommendation by the National Institute for Health and Care Excellence in February.

Dupilumab, as an add-on to intranasal corticosteroids, can be used as an option to treat severe chronic rhinosinusitis with nasal polyps in adults if:

• the condition is not controlled well enough by systemic corticosteroids or sinus surgery, and
• they have had at least 1 sinus surgery, and
• the 22-item sinonasal outcomes test (SNOT-22) score is at least 50

Dupilumab has been made available via the NHS Innovative Medicines Fund in line with these recommendations, with access currently limited to the following NHS Trusts:

Barts Health NHS Trust
Cambridge University Hospitals NHS Foundation Trust
Epsom and St Helier University Hospitals NHS Trust
Guy’s and St Thomas’ NHS Foundation Trust
Homerton University Hospital NHS Foundation Trust
Hull University Teaching Hospitals NHS Trust
Imperial College Healthcare NHS Trust
King’s College Hospital NHS Foundation Trust
Lancashire Teaching Hospitals NHS Foundation Trust
Leeds Teaching Hospitals NHS Trust
Liverpool University Hospitals NHS Foundation Trust
Manchester University NHS Foundation Trust
North Bristol NHS Trust
Northern Care Alliance NHS Foundation Trust
Nottingham University Hospitals NHS Trust
Oxford University Hospitals NHS Foundation Trust
Royal Surrey County Hospital NHS Foundation Trust
Sandwell and West Birmingham Hospitals NHS Trust
Sheffield Teaching Hospitals NHS Foundation Trust
The Dudley Group NHS Foundation Trust
The Newcastle upon Tyne Hospitals NHS Foundation Trust
University College London Hospitals NHS Foundation Trust
University Hospital Southampton NHS Foundation Trust
University Hospitals Birmingham NHS Foundation Trust
University Hospitals Bristol and Weston NHS Foundation Trust
University Hospitals of Leicester NHS Trust
University Hospitals of North Midlands NHS Trust
University Hospitals Plymouth NHS Trust
University Hospitals Sussex NHS Foundation Trust

Not all areas of the country have a commissioned centre. We have therefore written to the following ICBs to understand how patients in their areas are able to access treatment:

NHS Cornwall and the Isles of Scilly ICB
NHS Norfolk and Waveney ICB
NHS Lincolnshire ICB
NHS Somerset ICB
NHS Kent and Medway ICB
NHS Frimley ICB
NHS Hertfordshire and West Essex ICB
NHS Mid and South Essex ICB
NHS Derby and Derbyshire ICB
NHS Northamptonshire ICB
NHS Herefordshire and Worcestershire ICB
NHS Shropshire, Telford and Wrekin ICB
NHS Coventry and Warwickshire ICB
NHS Dorset ICB
NHS Gloucestershire ICB
NHS Bath and North East Somerset, Swindon and Wiltshire ICB

Through this work, we are seeking transparency on referral pathways, waiting times, and how health inequalities in access are being addressed. Everyone who is eligible for NICE-approved treatments should be able to access them, regardless of where they live.
We will share updates as we receive responses.