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

Trazodone: significant cost increase

In recent months there have been a number of price increases affecting medicines prescribed for mental health indications.  It is projected that these price increases will cost NHSGGC an extra £600k in 2016/17 for trazodone alone. There is significant work being undertaken in primary care, especially in care homes, to review patients receiving trazodone to ensure this is the most appropriate drug and preparation.

Some of the affected agents and prices are listed in the table below:

 

Drug Pack Size March 2015 Drug Tariff Price February2016 Drug Tariff Price
Trazodone 50mg/5ml Liquid 120ml £40.12 £160
Trazodone 50mg Capsules   84 £24.37 £36.80
Trazodone 100mg Capsules   56 £28.69 £41.99
Trazodone 150mg Tablets 28 £18.59 £35.25
Nitrazepam 2.5mg/5ml 70ml £10.60 £114

 

For these medicines, searches should be run on GP systems to allow a case by case review of the patients’ situation and ongoing need for the medicine (and specifically the necessity for liquid formulations) with advice from specialist services or prescribing support pharmacists where appropriate.

Other agents affected by recent large price increases include:

  • Disulfiram 200mg tablets
  • Tranylcypromine 10mg tablets
  • Doxepin 25mg and 50mg tablets
  • Camcolit 250mg tablets

For some of the medicines, eg disulfiram, tranylcypromine and doxepin, there may be no viable alternative for individual patients. 

Messages highlighting costs have also been added to ScriptSwitch to prompt review where possible.