Recent Updates

October 2019

Learning: *NEW Multiple Choice Quizzes for 2019*

New and updated multiple choice quizzes (MCQs) have been added to the formulary. The quizzes are designed to highlight key areas of formulary guidance and to help keep up-to-date with national and local guidance. Click here for more information. The following quizzes are new or have been updated:

  • Asthma (NEW)
  • Epilepsy (UPDATED)
  • Pain and analgesia (NEW)
  • Parkinson's Disease (NEW)

Estriol intravaginal cream 0.01% has been removed from the formulary in favour of estriol intravaginal cream 0.1%. Click here for more information.

GlucoRx CarePoint Ultra pen needles 4mm/31G have been added to the formulary as green (first line) options. Click here for more information.

Kelhale Aerosol inhalation metered dose inhalers (beclometasone dipropionate [BDP] extrafine) 50micrograms and 100micrograms have been added to the formulary as green (first line) options. BDP inhalers should be prescribed by brand since they are not all interchangeable. Click here for more information.

  • The following products have been reclassified as blue (second line) options:
    • Qvar Aerosol inhalation metered dose inhalers (BDP) 50micrograms and 100micrograms
    • Qvar Autohaler breath-actuated aerosol inhalation metered dose inhalers (BDP) 50micrograms and 100micrograms
    • Qvar Easi-breathe breath-actuated aerosol inhalation metered dose inhalers (BDP) 50micrograms and 100micrograms

The following changes have been made to formulary recommendations on bisphosphonates:

  • Ibandronic acid tablets 150mg have been reclassified as a blue (second line) option for the treatment of postmenopausal osteoporosis.
  • Risedronate sodium tablets 5mg, 30mg, and weekly tablets 35mg have been reclassified as a blue (second line) option for the treatment of osteoporosis
  • Click here for more information

Espranor (buprenorphine) oral lyophilisates 2mg and 8mg have been added to the formulary as an amber (specialist) option as substitution treatment for opioid drug dependence. Espranor is not interchangeable with other buprenorphine products, as the bioavailability of products differ.

Latanoprost / timolol single unit dose eye drops (preservative-free) 50micrograms / 5mg/ml have been added to the formulary as an amber (specialist) option. Click here for more information.

Following ongoing long-term supply issues and discontinuation of some branded nifedipine, the formulary entry has been updated to provide prescribers with supporting information. Click here for more information.

Pencillamine has been reclassified as red (hospital only)

Chapter 18. Continence Formulary: The chapter has undergone format changes and information has been consolidated to streamline the accessibility of clinically appropriate guidance and associated appliances. Please see the formulary for further guidance and recommended appliances.

Psoriasis management: Following updates to NICE Guideline CG153 Psoriasis: assessment and management (September 2017) and British Association of Dermatologists (BAD) Clinical Guideline: Psoriasis (October 2018). Formulary guidance has been extensively revised and updated. Please see the formulary for further guidance.

Commissioning Policy: The routine commissioning of glycopyrronium bromide oral solution is accepted in Devon for the symptomatic treatment of severe sialorrhoea (chronic pathological drooling) in children and adolescents aged 3 years and older with chronic neurological disorders (see Commissioning Policy for more details). Different formulations of glycopyrronium oral solution are not bioequivalent and so should be prescribed by brand. Sialanar is the recommended brand. Click here for more information

Commissioning Policy: The routine commissioning of Continuous Glucose Monitors (CGMs) is accepted in Devon for patients with type 1 diabetes mellitus in line with specific criteria (see Commissioning Policy for more details). Click here for more information

Following agreement of the Dapsone Specialised Medicines Service prescribing guideline, the formulary entry has been updated with a link to the guideline.

July 2019

GlucoRx CarePoint pen needles 4mm/31G, 5mm/31G, and 6mm/31G have been added to the formulary as green (first line) products for insulin delivery pen devices; GlucoRX FinePoint and BD Viva pen needles have been reclassified as blue (second line). Click here for more information.

  • Microdot droplet needles (all sizes) and Omnican Fine needles (31G sizes) have been removed

Desmopressin oral lyophilisates 25micrograms & 50micrograms have been added to the formulary as an amber (specialist) option for primary idiopathic nocturnal polyuria in adults; doses are gender specific. Click here for more information.

  • Desmopressin tablets 100micrograms, 200micrograms, oral lyophilisates 120micrograms, 240micrograms, and nasal spray 10micrograms have been reclassified as amber (specialist) drugs

UrgoStart Plus Pad 6cm x 6cm, 10cm x 10cm, 15cm x 20cm have been added to the formulary as an amber (specialist) option for diabetic foot ulcers. Click here for more information

  • UrgoStart Non-Adhesive 12cm x 19cm (heel) dressings have been removed

Secondary prevention of stroke / TIA in primary care: Formulary guidance has been reviewed and updated. Please see the formulary entry for further guidance.

Gender dysphoria and transgender prescribing: Interim guidance which summarises the prescribing responsibilities described by NHS England, and advice for GPs regarding requests by private online medical service providers has been added to the formulary. Please see the formulary for further information and links to useful resources.

Consideration given to: NHS England has published updated guidance for CCGs on items which should not be routinely prescribed in primary care. Click here for more information. New guidance has been added for the following items:

The Modafinil Specialised Medicines Service (SMS) prescribing guideline is now Devon-wide, the formulary entry has been updated to reflect this. The guideline can be found here

May 2019

Foodlink Complete with Fibre powder sachets have been added to the formulary as an amber (specialist) option for patients who require an enhanced fibre oral nutritional supplement. Click here for more information.

  • AYMES Shake sachets have been removed

Dermatonics® Once Heel Balm (25% urea) has been added to the formulary as an amber (specialist) option for the treatment of callused, anhidrotic, fissured, and hard foot skin conditions. Click here for more information.

Flexitol® 25% Urea Heel Balm has been added to the formulary as an amber (specialist) option for the treatment of callused, anhidrotic, fissured, and hard foot skin conditions. Click here for more information.

Ganciclovir 0.15% w/w eye gel has been added to the formulary as an amber (specialist) option for acute herpetic keratitis (dendritic and geographic ulcers). Click here for more information.

  • Aciclovir 3% w/w eye ointment has been removed, following discontinuation from the worldwide market by the manufacturer.

Commissioning Policy: The routine commissioning of semaglutide is accepted in Devon for patients with type 2 diabetes as described for glucagon-like peptide-1 (GLP-1) mimetics in NICE guideline NG28 (see Commissioning Policy for more details). Semaglutide has been added in the formulary as a green (first line) option in line with the policy. Click here for more information

Commissioning Policy: The routine commissioning of FreeStyle Libre is accepted in Devon for patients with diabetes mellitus in line with specific criteria (see Commissioning Policy for more details). Click here for more information.

Last updated: 28-10-2019

 

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