NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Formulary Update

Formulary News (April 2012)

Please note some of the indications have been summarised for brevity but complete details can be found by following the links to the SMC advice.

Additions to Formulary

Greater Glasgow and Clyde Area Drug and Therapeutics Committee (ADTC) met on April 16th and added the following medicines/indications/ formulations to the GGC Formulary.  Additions are to the Total Formulary unless specified otherwise.

Bupivicaine and Fentanyl Epidural (Bufyl®) is included in the Total Formulary for epidural analgesia to relieve pain during labour and to control post operative pain. It is restricted to specialist use only.
For the relevant SMC advice click here

Capsaicin cutaneous patch (Qutenza®) is included in the Total Formulary for the treatment peripheral neuropathic pain in non-diabetic adults. It is restricted to specialist use for post herpetic neuralgia in line with local prescribing guidance.
For the relevant SMC advice click here

Dabigatran (Pradaxa®) for the prevention of stroke and systemic embolism in adult patients with non-valvular AF with one or more risk factors had its Formulary restriction revised.  Use is restricted to patients currently receiving warfarin who have poor INR control despite evidence that they are complying, patients with allergy or intolerable side effects from coumarin anticoagulants or for patients for whom warfarin has been clinically excluded as a therapeutic option but anticoagulation is deemed safe and appropriate.  Preference over warfarin for practical rather than clinical reasons remains non-Formulary.  Further information regarding dabigatran can be found in the National Consensus Statement on the NHS HIS website or local guidance
For the relevant SMC advice click here

Midazolam buccal liquid (Buccolam®) for the treatment of prolonged, acute, convulsive seizures in infants, toddlers, children and adolescents is included in the Preferred List.  It is restricted to specialist initiation.  It should be noted that many existing patients will be using an alternative unlicensed preparation (Epistatus®), and due to the difference in strength and associated risks, any agreed change of treatment to existing patients would require careful management.
For the relevant SMC advice click here

Rivaroxaban (Xarelto®) for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation with one or more risk factors had its Formulary restriction revised.  Use is restricted to patients currently receiving warfarin who have poor INR control despite evidence that they are complying,  patients with allergy or intolerable side effects from coumarin anticoagulants or for patients for whom warfarin has been clinically excluded as a therapeutic option but anticoagulation is deemed safe and appropriate.  Preference over warfarin for practical rather than clinical reasons remains non-Formulary.  Further information can be found in the National Consensus Statement on the NHS HIS website or local guidance
For the relevant SMC advice click here

New medicines, indications and formulations not included in the GGC Formulary

The following are not included in the GGC Formulary following the latest ADTC meeting. Where the reason is other than not recommended advice from SMC it is noted.  NB: these medicines may be included in the Formulary for other indications or for other formulations.  Please refer to Formulary.

Abiraterone (Zytiga®) is not included in the GGC Formulary for the treatment (with prednisolone or prednisone) of metastatic castration-resistant prostate cancer (mCRPC) in adult men whose disease has progressed on or after a docetaxel-based chemotherapy regimen.
For the relevant SMC advice click here

Asenapine (Sycrest®) is not included in the GGC Formulary for the treatment of moderate to severe manic episodes associated with bipolar 1 disorder in adults.
For the relevant SMC advice click here

Atorvastatin chewable tablet (Lipitor®) is not included in the GGC Formulary for the treatment of hypercholesterolaemia and primary prevention of cardiovascular events because ADTC considered that the medicine does not represent sufficient added benefit to other comparator medicines already available in the Formulary.
For the relevant SMC advice click here

Belimumab (Benlysta®) is not included in the GGC Formulary for add-on therapy in adult patients with active, autoantibody-positive systemic lupus erythematosus (SLE) with a high degree of disease activity (e.g. positive anti-dsDNA and low complement) despite standard therapy.
For the relevant SMC advice click here

Catumaxomab (Removab®) is not included in the GGC Formulary for intraperitoneal treatment of malignant ascites in patients with EpCAM-positive carcinomas where standard therapy is not available or no longer feasible
For the relevant SMC advice click here

Everolimus (Votubia®) is not included in the GGC Formulary for the treatment of patients aged 3 years and older with subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC) who require therapeutic intervention but are not amenable to surgery.
For the relevant SMC advice click here

Fampridine (Fampyra®) is not included in the GGC Formulary for the improvement of walking in adult patients with multiple sclerosis with walking disability.
For the relevant SMC advice click here

Fingolimod (Gilenya®) is not included in the GGC Formulary for single disease modifying therapy in highly active relapsing remitting multiple sclerosis (RRMS) for patients with high disease activity despite treatment with a beta-interferon or patients with rapidly evolving severe RRMS defined by two or more disabling relapses in one year, and with one or more gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI.
For the relevant SMC advice click here

Tocilizumab (RoActemra®) is not included in the GGC Formulary for monotherapy in patients who are intolerant to methotrexate or where continued treatment with methotrexate is inappropriate, for the treatment of moderate to severe active rheumatoid arthritis (RA) in adult patients who have either responded inadequately to, or who were intolerant to, previous therapy with one or more disease-modifying anti-rheumatic drugs (DMARDs) or tumour necrosis factor (TNF) antagonists.
For the relevant SMC advice click here

New medicines, indications and formulations not included in the Formulary pending protocol / consultation

The following new medicines, indications or formulations require the development of a protocol or further consultation before Formulary status can be concluded.  Until this process is complete, these medicines, indications or formulations are not included in the Formulary.

Bee/Wasp venom immunotherapy (Pharmalgen®) for the treatment of IgE-mediated bee and wasp venom allergy in people with severe systemic reaction to bee or wasp venom  is not included in the GGC Formulary pending the completion of the consultation exercise
For the relevant NICE advice click here

Icatibant acetate (Firazyr®) for the symptomatic treatment of acute attacks of hereditary angioedema (HAE) in adults (with C1-esterase-inhibitor deficiency).
For the relevant SMC advice click here

Imatinib (Glivec®) for the change in duration in therapy for adjuvant treatment of adult patients who are at significant risk of relapse following resection of a KIT (CD117) positive gastrointestinal stromal tumour (GIST).  Use for this indication is currently Formulary for up to one year’s duration of treatment.
For the relevant SMC advice click here