Recent Updates

November 2018

Acidex advance 1g/200mg in 10ml oral suspension has been added to formulary for reducing symptoms of laryngopharyngeal reflux. Click here for more information.

Kyleena 19.5mg intrauterine system has been added to formulary for contraception in women, licensed for up to 5 years. Click here for more information.

Ciclosporin 1mg/1ml (Ikervis) single use eye drops have been reclassified from red to amber (specialist input) following consultation with local specialists. Click here for more information.

Following completion of the EMA safety review, ulipristal acetate 5mg (Esmya) tablets have been reclassified from amber to red (hospital only). Click here for more information.

Acute sinusitis: Following publication of NICE NG79 Sinusitis (acute): antimicrobial prescribing (October 2017)., formulary guidance has been revised and updated. Please see the formulary for further guidance.

Infantile colic: Using NICE CKS (2017): Colic – infantile and NICE clinical guideline CG37 (2015): Postnatal care up to 8 weeks after birth, local guidance has been updated and refreshed to provide easily accessible information to primary care prescribers. Please see the formulary for further guidance.

Anal irrigation systems: New guidance has been added to the formulary to offer advice and product suggestions recommended by local specialists. Please see the formulary for further guidance.

Anal inserts: New guidance has been added to the formulary to offer advice and product suggestions recommended by local specialists. Please see the formulary for further guidance.

Commissioning Policy: The routine commissioning of Tresiba® (insulin degludec) is accepted in Devon for the treatment of patients with type 1 diabetes who meet specific criteria (See Commissioning Policy for more information). Tresiba has been added to the formulary as an amber (specialist input) option in line with the policy. Click here for more information

Commissioning Policy: The routine commissioning of Tresiba® (insulin degludec) in Devon for the treatment of type 2 diabetes is unchanged and is not accepted (See Commissioning Policy for more information)

Commissioning Policy: The routine commissioning of Trelegy® Ellipta® (combination of fluticasone furoate, umeclidinium bromide, and vilanterol trifenatate) is accepted in Devon for maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) (See Commissioning Policy for more details). Trelegy Ellipta has been added in the formulary as a green (first line) option in line with the policy. Click here for more information

Consideration given to: West Devon shared care / Specialised Medicines Service (SMS) prescribing guidelines for DMARDs for rheumatological conditions have been updated and combined. The new guidelines provide guidance on the safe use and monitoring of the following medicines, when prescribed as part of shared care with rheumatology specialists at University Hospitals Plymouth NHS Trust:

  • Azathioprine
  • Ciclosporin
  • Leflunomide
  • Methotrexate
  • Mycophenolate mofetil
  • Sodium aurothiomalate (gold)
  • Sulfasalazine

This update includes changes to the monitoring requirements for some medicines; please refer to the guidelines for more details. The guidelines are available on the NEW Devon CCG website here, and are linked to from the relevant pages of the formulary.

September 2018

Tinidazole tablets for the treatment of giardiasis have been added to the formulary. Guidance on management of giardiasis has also been added to support clinicians treating these patients. Click here for more information.

Darbepoetin alfa has been reclassified as red; prescribing and monitoring is by secondary care only. Previous shared care documents have been archived, and are available for reference only on the CCG website (click here)

Flixotide® Evohaler® and Flixotide® Accuhaler® have been removed from the formulary. Alternative inhaled corticosteroid monotherapies are listed here

Parkinson's disease management: Following publication of NICE guideline 71: Parkinson's disease in adults (July 2017), formulary guidance has been revised and updated. The guideline reflects the current NICE guidance that levodopa should be used as a first line treatment option for patients with early stage Parkinson's disease whose motor symptoms impact their quality of life. Dopaminergic drugs used in Parkinson's disease have been reclassified as amber (specialist input). Please see the formulary for guidance, here.

Management of constipation in children: Following the update to NICE clinical guideline 99: Constipation in children and young people: diagnosis and management (July 2017), formulary guidance and entries for associated products have been revised and updated. The revision provides up to date and easily accessible information to primary care prescribers who treat these patients. Please see the formulary for guidance, here.

Commissioning Policy:The routine commissioning of opicapone is accepted in Devon for the treatment of patients with Parkinson's disease who have not been able to tolerate entacapone (see Commissioning Policy for more details). Opicapone tablets have been added to the formulary as an amber (specialist use) treatment. Click here for formulary entry.

July 2018

Escitalopram tablets 5mg, 10mg, and 20mg have been amended to include unipolar depression as a first line indication, it remains second line for generalised anxiety disorder. Please see the formulary for further information.

  • Citalopram has been amended to second line for unipolar depression.

Jobst UlcerCARE (ready to wear) and Jobst UlcerCARE (custom-fit) leg ulcer compression hosiery kits have been added into the formulary, as second line options, for patients with longer limbs and those who require a made-to-measure option. Please see formulary for further guidance.

Tadalafil 2.5mg and 5mg tablets have been removed from the formulary following national guidance from NHS England. Click here for more information.

Acute sore throat: Following publication of NICE NG84: Sore throat (acute): antimicrobial prescribing (January 2018) Formulary guidance has been revised and updated. Please see the formulary for further guidance.

Vitamin and mineral supplementation following bariatric surgery: New formulary guidance has been added to the formulary to offer support to prescribers on the nutritional supplementation for patients who have undergone bariatric surgery. The guidance can be found here.

Following public consultation; NHS England (NHSE) and NHS Clinical Commissioners (NHSCC) published guidance for CCGs on items which should not be routinely prescribed in primary care. Click here for more information. The following items have new guidance attached in the formulary:

Commissioning Policy: The routine commissioning of lurasidone is not accepted in Devon for patients with schizophrenia (see Commissioning Policy for more details)

Commissioning Policy: The routine commissioning of Relvar Ellipta is accepted in Devon for the treatment of asthma in adults and adolescents aged 12 years and older (see Commissioning Policy for more details). Relvar Ellipta has been added to the formulary as a blue (second line) option in patients with asthma aged 12 years and older. Click here for more information.

Consideration given to: Patients in the Plymouth area, with refractory cellulitis (failed on oral antibiotics), will no longer be automatically accepted by the Acute Care at Home team for IV ceftriaxone. From the 1st of August 2018 these patients can access an Acute GP service pathway at University Hospitals Plymouth NHS Trust (UHPNT) for a trial period. If patients are suitable for oral linezolid therapy, this will be prescribed by the Acute GP service. The trial of the pathway will run for 6 months during which time data will be collected for service evaluation. This pathway is for stable patients. If a patient is unwell / requires antibiotics for suspected cellulitis at a time when the Acute GP service is not available then they should be referred via the usual routes to the most suitable service (ED / AAU / MAU).

 

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