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Joint Formulary Newsletter

Bedfordshire and Luton Joint Formulary Newsletter

July 2020, Number 4

Incorporates Key Recommendations from The Bedfordshire and Luton Joint Prescribing Committee (JPC) 1st July 2020

FORMULARY UPDATE

The Bedfordshire and Luton Joint Formulary (a combined medicines formulary for use by BCCG, LCCG, Bedford Hospital and the Luton and Dunstable University Hospital) is now ‘live’. It can be accessed here

Unless otherwise stated decisions made apply to all organisations in the Joint Formulary Group.

FORMULARY TRAFFIC LIGHT STATUS INFORMATION
RED RED - Hospital Only - to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment
AMBER Amber medicines are considered suitable for GP prescribing following specialist initiation
GREEN These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations
SCG Shared Care - These medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place, status reverts to RED.
BLACK A decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. DO NOT PRESCRIBE
The following ADDITIONS to the Joint Formulary were agreed at the JPC Committee Meeting

The Committee approved the bulletin and addition of Prucalopride to the Joint Formulary for use in men in accordance with the criteria set out in NICE TA 211 for women. Specialist to initiate and GP to continue prescribing (amber).

Hospital Drug and Therapeutic Committee Updates

Luton and Dunstable Hospital DTC

Formulary Addition – Probiotic drops (Labinic) for preterm infants to prevent necrotising enterocolitis

Formulary Addition – Remdesivir – MHRA EAMS (as part of the COVID 19 response). Retrospective DTC approval will be sought.

CCG Prescribing Committees

BCCG Prescribing Committee

  • none

LCCG prescribing committee

  • none
Wound Care Formulary Group (Ratified by the JPC)

• No update from the Wound Care Group

Decisions Made By Joint Formulary Group (Ratified by the JPC)
1)    The Terms of Reference for the Formulary Subgroup

2)    Esomeprazole – change in traffic light status from green to amber. (i.e. hospital initiate with GP to continue).

3)    Chenodeoxycholic Acid – added with Non Formulary Status – no prescribing by any sector.

4)    Addition of statement’ Not for Fungal Nail Infections to the following drug entries – Itraconazole, Fluconazole, and Griseofulvin.

5)    Addition of statement ‘Low priority for funding for Fungal Nail Infections’ to terbinafine drug entry.

6)    Electronic cigarettes (e-cigarettes) and other novel nicotine containing products for tobacco dependence – added as Non-Formulary – not for prescribing in primary or secondary care in line with the JPC/PAC guidance approved at the February 2020 JPC meeting.

7)    Dihydrocodeine m/r 60 mg added to Formulary – for use as part of the C-section pathway only; Hospital only prescribing.

8)    Loestrin® – removed from Formulary as the product has been discontinued.

9)    Pabrinex® – erroneously in the ‘non-Formulary section’ – agreed status changed to ‘Formulary’.

10)  Dalivit/Abidec – Notes on Formulary entry amended as follows:- ‘Not recommended for routine supplementation: to be purchased OTC. Exclusions to this recommendation include use in pre-term infants and patients with medically diagnosed deficiency (including a lifelong/chronic condition or surgery resulting in malabsorption e.g. cystic fibrosis).’

11)  Change Formulary status for Circadin m/r (off label uses) and melatonin oral solution from ‘green’ (GP can initiate) to ‘amber shared care’ (Initiated by Specialist and GP to continue under shared care arrangements).

12)  Ulipristal – moved to non-Formulary due to suspension of licence.

NICE Updates
Joint Formulary updates following publication of NICE Technology Appraisal Guidance

 

CCG Commissioned

Fremanezumab for preventing migraine, Technology appraisal guidance [TA631] Published date: 03 June 2020. https://www.nice.org.uk/guidance/ta631

JPC Action – create and add to Formulary.

 

Ustekinumab for treating moderately to severely active ulcerative colitis

Technology appraisal guidance [TA633] Published date: 17 June 2020. https://www.nice.org.uk/guidance/ta633 JPC Action – Link added to Formulary – JPCTreatment of Moderate to Severe Ulcerative Colitis AFTER failure of conventional therapy Pathwayto be updated.

 

Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

Technology appraisal guidance [TA626] Published date: 24 June 2020

https://www.nice.org.uk/guidance/ta626  JPC Update – created and link added to Formulary.

 NHSE Commissioned- New drugs added

Impetigo: antimicrobial prescribing, NICE guideline [NG153] Published date: February 2020, https://www.nice.org.uk/guidance/ng153

JPC Action – review and update Community Antimicrobial Guidelines as necessary. Add Hydrogen peroxide cream to the Joint Formulary.

 

Heavy menstrual bleeding: assessment and management, NICE guideline [NG88] Published date: 14 March 2018 Last updated: 31 March 2020 https://www.nice.org.uk/guidance/ng88 JPC Action – remove Ulipristal from Joint Formulary.

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