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Decisions 24th November 2015
At the meeting that took place on 24th November, the following decisions were agreed:
New Drug Requests
Approved
Biosimilar Insulin Glargine 100 units (Abasaglar®)(TLS Bue)
- Approved for inclusion onto the formulary for insulin naive patients who meet the current NICE requirements for insulin glargine. Patients should not be switched from Lantus, and all prescribing should be by brand name.
Insulin Glargine 300 units (Toujeo Solostar®) (TLS Amber specialist recommendation, no SCP)
- High strength insulin glargine.
- Approved for inclusion onto the formulary for adult patients who are uncontrolled on basal or basal bolus insulin with type 2 diabetes at high risk of hypoglycaemia, and uncontrolled on basal bolus insulin with type 1 diabetes.
Dulaglutide (Trulicity®) (TLS blue)
- Approved for inclusion onto the formulary for adults with Type 2 Diabetes mellitus as monotherapy, or add-on therapy
Midodrine (TLS red/amber)
- Approved for inclusion onto the formulary for Severe orthostatic hypotension due to autonomic dysfunction, Hepatorenal syndrome, Intradialytic hypotension
- Approved as amber 3 months for orthostatic hypotension/intradialytic hypotension (SCP currently in development)
- Approved as red for hepatorenal syndrome
Not Approved
IDegLira (Xultophy®) Insulin degludec & Liraglutide
- The JFG did not approve the addition of IDegLIra onto the formulary. The JFG were not presented with evidence that the combination offered an evidence based and cost effective option in the treatment of type 2 over and above current formulary choices. The newly published NICE clinical guideline stated that 'The GDG agreed that there was strong evidence to indicate that insulin degludec was not cost-effective and therefore was confident that this option should not be recommended.' Insulin degludec is not included on the formulary for the treatment of type 2 diabetes.
Other
Sacubitril & Valsartan
- The JFG agreed that UHB Medicines Advisory Group could manage the small cohort of patients (<5) prior to the publication of the NICE technology appraisal.
Shared Care Protocols/TLS Change in Status
Denosumab
- Updated SCP approved for the prevention of osteoporotic fractures in women and men.
Ulipristal
- New SCP. Still in development. Due to be uploaded to the website Jan 2016.
Colesevelam
- New SCP for bile acid malabsorption. Still in development. Due to be uploaded to the website Jan 2016.