Freedom of Information Request: 0857 2020/21

The Trust does hold all the information you have requested, but we are withholding some of it for the following reasons:

Questions 2 and 3: Cost Limit

Section 12 of the Freedom of Information (FOI) Act makes provision for public authorities to refuse requests for information where the cost of dealing with them would exceed the appropriate limit, which for local government is set at £450. This represents the estimated cost of one person spending more than 18 hours in determining whether the department holds the information, locating, retrieving and extracting the information.

The Trust does hold this information but it is not centrally recorded. Treatments prior to beginning treatment with apremilast are not recorded centrally; this information will be within patient files.

We have a total of 1,282 patients who were issued DMARDs from either Dermatology or Rheumatology. Unfortunately, it is not possible for us to see which patients are biologic-naïve without access to their clinical notes. We are also not able to differentiate between the indications specified in these questions.

To collate these figures would require a review of 1,296 records which would take in excess of the 18 hours allowed under the FOI Act, we are therefore exempting this information under Section 12 of the FOI Act.

Please see the below Freedom of Information request:

• Please detail the number of patients currently prescribed apremilast with a current primary diagnosis of: a) Psoriasis b) Psoriatic Arthritis?

Please note our pharmacy systems do not record indication against prescription of drugs, therefore we cannot differentiate between those who have a primary diagnosis of between Psoriasis and Psoriatic Arthritis.

We can confirm that 14 patients have been prescribed Apremilast.

• Of the patients prescribed apremilast in the last 12 months for Psoriasis and Psoriatic Arthritis, what number of patients received treatment with targeted small molecules or biologic therapies* prior to beginning treatment with apremilast? (*See annex 1 for a list of small molecule/biologic therapies)

This information is withheld under Section 12 of the Freedom of Information Act, please see above for details.

• How many small molecule- and/or biologic-naive patients in the Trust are currently receiving a conventional non-biologic systemic therapy for Psoriasis or a conventional non-biologic disease-modifying anti-rheumatic drug (DMARD) for Psoriatic Arthritis? (e.g. methotrexate)

This information is withheld under Section 12 of the Freedom of Information Act, please see above for details.

• Is CCG prior-approval required for the prescribing of apremilast? Yes.  

1. 1. If Yes, please tick the system you use: Blueteq ☒ / Other ☐.
   2. If other, what system do you use? Not Applicable

We do not hold the information requested for the below questions – please redirect these questions to the CCG, please visit the following link for more information on how the CCG process Freedom of Information Requests. https://www.birminghamandsolihullccg.nhs.uk/about-us/freedom-of-information

• Is apremilast listed individually or grouped with biologic therapies on the prior-approval form for Psoriasis and Psoriatic Arthritis?

1. 1.  Psoriatic Arthritis: Individually ☐ grouped ☐.
   2. Psoriasis: Individually ☐ grouped ☐

• Please provide the wording used on the CCG’s prior-approval form for the prescribing of apremilast.

Annex 1