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

Formulary News (August 2013)

Additions to the GGC Adult Formulary

Greater Glasgow and Clyde Area Drug and Therapeutics Committee (ADTC) met on August 12th 2013 and added the following medicines/indications/ formulations to the GGC Formulary.  Additions are to the Total Formulary unless specified otherwise.

Abatacept (Orencia®) for subcutaneous injection in combination with methotrexate, for the treatment of moderate to severe active rheumatoid arthritis in adult patients who responded inadequately to previous therapy with one or more disease-modifying anti-rheumatic drugs including methotrexate or a TNF-alpha inhibitor is included in the GGC Total Formulary. It is restricted to specialist use only.

For relevant SMC advice click here

Alteplase (Actilyse Cathflo®) for the thrombolytic treatment of occluded central venous access devices including those used for haemodialysis is included in the GGC Total Formulary. It is restricted to specialist use and second line use after urokinase.

For relevant SMC advice click here

Argatroban (Exembol®) for anticoagulation in adult patients with heparin-induced thrombocytopenia type II who require parenteral antithrombotic therapy is included in the GGC Adult Total Formulary. It is restricted to specialist use where other options are not suitable or not available in accordance with local protocol (to be updated).

For relevant SMC advice click here

Calcium polystyrene sulphonate (Sorbisterit®) for the treatment of hyperkalaemia, in patients with acute and chronic renal insufficiency, including patients undergoing dialysis treatment, is included in the GGC Total Formulary. It is restricted to hospital use only.

For relevant SMC advice click here

Elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil (as fumarate) tablet (Stribild®) for treatment of human immunodeficiency virus-1 (HIV-1) infection in adults aged 18 years and over who are antiretroviral treatment-naïve or are infected with HIV-1 without known mutations associated with resistance to the three antiretroviral agents in Stribild® is included in the GGC Total Formulary. It is restricted to use by HIV specialists.

For relevant SMC advice click here

Latanoprost preservative-free eye drops (Monopost®) for the reduction of elevated intraocular pressure in patients with open angle glaucoma and ocular hypertension is included in the GGC Total Formulary. It is restricted to specialist initiation and use in patients who have proven sensitivity to the preservative benzalkonium chloride.

For relevant SMC advice click here

Pirfenidone (Esbriet®) for the treatment of mild to moderate idiopathic pulmonary fibrosis (IPF) in adults is included in the GGC Total Formulary pending protocol. It is restricted to specialist use only in patients with a predicted forced vital capacity (FVC) less than or equal to 80% where an Interstitial Lung Disease Multidisciplinary Team have agreed it is appropriate.

For relevant SMC advice click here

Ranibizumab (Lucentis®) for the treatment of visual impairment due to diabetic macular oedema (DMO) in adults is included in the GGC Total Formulary pending protocol restricted to specialist use.

For relevant SMC advice click here

Sugammadex injection (Bridion®) for the routine reversal of neuromuscular blockade induced by rocuronium or vecuronium in adult and paediatric patients is included in the GGC Total Formulary. It is restricted to specialist use for the routine reversal of neuromuscular blockade induced by rocuronium or vercuronium in high risk adults (only rocuronium in children/adolescents). A prescribing note within the Formulary outlines the characteristics of high risk patients.

For relevant SMC advice click here

Ursodeoxycholic acid tablets (Ursofalk®) for the dissolution of cholesterol gallstones in the gall bladder and for the treatment of primary billiary cirrhosis (PBC), provided there is no decompensated hepatic cirrhosis, is added to the GGC Preferred List.  It is restricted to specialist initiation.

For relevant SMC advice click here

 

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

The following are not included in the GGC Adult 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.

Aflibercept concentrate (Zaltrap®), in combination with irinotecan/5-fluorouracil/folinic acid (FOLFIRI) chemotherapy, in adults with metastatic colorectal cancer (mCRC) that is resistant to or has progressed after an oxaliplatin-containing regimen is not included in the GGC Adult Formulary for the indication in question.

For relevant SMC advice click here

Chloroprocaine hydrochloride (Ampres®) for spinal anaesthesia in adults where the planned surgical procedure should not exceed 40 minutes is not included in the GGC Adult Formulary for the indication in question.

For relevant SMC advice click here

Everolimus (Afinitor®) for the treatment of hormone receptor-positive, human epidermal growth factor type 2 (HER2)/neu negative advanced breast cancer, in combination with exemestane, in postmenopausal women without symptomatic visceral disease after recurrence or progression following a non-steroidal aromatase inhibitor is not included in the GGC Adult Formulary for the indication in question.

For relevant SMC advice click here

Nomegestrol acetate / estradiol (Zoely®)  for oral contraception is not included in the GGC Adult Formulary for the indication in question.

For relevant SMC advice click here

 

Additions to GGC Paediatric Formulary

The following new medicines, indications or formulations have been considered for the GGC Paediatric Formulary Decisions.

Adalimumab (Humira®) for the treatment of severe active Crohn's disease in paediatric patients (6 to 17 years of age) who have had an inadequate response to conventional therapy including primary nutrition therapy, a corticosteroid, and an immunomodulator, or who are intolerant to or have contraindications for such therapies is included in the GGC Paediatric Formulary. It is restricted to specialist use in paediatric gastroenterology.

For relevant SMC advice click here 

Adalimumab (Humira®) in combination with methotrexate for the treatment of active polyarticular juvenile idiopathic arthritis, in children and adolescents aged 2 to 17 years who have had an inadequate response to one or more disease-modifying anti-rheumatic drugs (DMARDs) is included in the GGC Paediatric Formulary. It is restricted to specialist use within specialist rheumatology services (including those working within the network for paediatric rheumatology).

For relevant SMC advice click here 

 

Other Formulary Information

Following a NICE Multiple Technology Appraisal:

Denosumab (Xgeva®) for the prevention of skeletal related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with bone metastases from solid tumours is Included in the GGC Total Formulary. It is restricted to specialist use in accordance with regional protocol.

For the relevant NICE/ NHS HIS  click here

 

Other changes to Formulary not directly related to SMC advice, NICE advice or Formulary appeals are noted below:

Aprepitant (Emend®) /fosaprepitant (IVEmend®) for the prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based chemotherapy is restricted to use according to regional protocol for the prevention of acute and delayed nausea and vomiting with highly emetogenic cisplatin-based chemotherapy in adults. The prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy is not recommended by SMC and remains non-formulary.