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Mexiletine for treating myotonia in adults with non-dystrophic myotonic disorders

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4 Implementation

4.1 If final guidance does not recommend mexiletine (Namuscla), commissioners are not required to continue to fund that medicine. This includes treatment via the interim agreement for mexiletine (Namuscla) for use as a 'pass through' drug for patients within specialised neurosciences centres, which came into effect on 1st April 2019.

4.2 This is a departure from NICE's usual practice that negative guidance ought not to affect NHS treatment started before the guidance is published. The reason for this is that NICE typically appraises new medicines that are not already established clinical practice. When NHS treatment that is outside the recommendation continues without change to the funding arrangements in place before the guidance was published, it does not commit the NHS to significant or prolonged costs.