Dear NHS Barking and Dagenham Clinical Commissioning Group,

I would like to request the information about the following points around the CCG's decisions with patient care and its structure.
• What criteria does the CCG use to select which inhalers should be prescribed for Asthma and COPD?
• How does the CCG compare the cost-effectiveness , efficacy, safety and patient usability of different inhalers when selecting which COPD and Asthma inhalers should be included on its local guidance?
• Over the past three years, has the CCG introduced a planned programme of care which resulted in the medicines optimisation team, contractors or GP practices proactively reviewing patients and aligning their COPD and/or Asthma inhalers to alternative options?
• Please list the alternative asthma and COPD inhalers that were introduced by the CCGs medicines optimisation team, contractors or GP practices during any planned programme of care that proactively reviewed the use of asthma and/or COPD inhalers over the past 3 years
.
• Over the past three years, has the CCG used a QIPP scheme to introduce a planned programme of care which resulted in the medicines optimisation team, contractors or GP practices proactively reviewing patients and aligning their COPD and/or Asthma inhalers to alternative options?
• Please list the alternative asthma and COPD inhalers that were introduced by the CCGs medicines optimisation team, contractors or GP practices when using a QIPP scheme to introduce a planned programme of care that proactively reviewed the use of asthma and/ or COPD inhalers over the past 3 years?

Yours faithfully,

Zarafshaan Hussain