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Joint Formulary Newsletter

Bedfordshire and Luton Joint Formulary Newsletter

October 2020, Number 4

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
  • Melatonin 10mg/5ml oral suspension as the preferred liquid formulation of melatonin where modified release tablets are unsuitable (amber shared care)
  • Slenyto (melatonin prolonged release tablets) was not approved for use due to lack of cost effectiveness data (Black – non-formulary).
  • Melatonin 1mg/ml (Colonis Pharma) is now non-formulary (black) as it not recommended for use in children due to safety and efficacy concerns.
  • Nebulised Tobramycin and Colistimethate sodium for prophylaxis of exacerbations of Non-Cystic Fibrosis Bronchiectasis (Adult Patients).
  • Acamprosate – status changed from red to amber shared care.
  • Vedoclizumab subcutaneous injection – red hospital only
Hospital Drug and Therapeutic Committee Updates
  • Formulary Addition – approved intra-articular ketorolac (off-label route) for 2nd line use after corticosteroids during COVID-19 pandemic, for patients with significant pain secondary to osteoarthritis or post joint replacement who shouldn’t have corticosteroids.
CCG Prescribing Committees

BCCG Prescribing Committee

  • Formulary Addition – Evolve Carbomer 980

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. Enoxaparin Traffic Light Status amended – Red for obstetrics at L and D and Amber Shared Care at Bedford sites.
  2. Budesonide foam enema (subject to clinician approval) added to formulary as alternative to prednisolone foam enema and a more cost effective alternative to prednisolone suppositories.
  3. Sirolimus – change of status from non-formulary. Red- for new initiation in transplant patient. Amber for continuation (historic patients). In line with existing products
  4. Calvive 1000 Effervescent Tablets is the new name for Sandocal. Formulary amended to reflect this.
  5. Phentolamine injection entry amended to remove strength.
  6. Colecalciferol – plenachol not available. Strengths to be changed to reflect current products
  7. Hydrocortisone – note added to entry to state the standard strength of liquid which should be supplied if required
  8. Sodium Chloride liquid – note added to 5mmol/ml formulary entry to say for use only in exceptional circumstances where the licensed 1mmol/ml solution is unsuitable.
NICE Updates

Joint Formulary updates following publication of NICE Technology Appraisal Guidance

NHSE Commissioned- New drugs added

Gilteritinib for treating relapsed or refractory acute myeloid leukaemia

Technology appraisal guidance [TA642] Published date: 12 August 2020

https://www.nice.org.uk/guidance/ta642 – recommended – JPC Action – Created and Link added to Joint Formulary

Entrectinib for treating ROS1-positive advanced non-small-cell lung cancer

Technology appraisal guidance [TA643] Published date: 12 August 2020

https://www.nice.org.uk/guidance/ta643 – recommended – JPC Action – Created and Link added to Joint Formulary

Entrectinib for treating NTRK fusion-positive solid tumours

Technology appraisal guidance [TA644] Published date: 12 August 2020

https://www.nice.org.uk/guidance/ta644 – recommended – JPC Action – Created and Link added to Joint Formulary

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