REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary
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Decisions 20th July 2021

At the meeting on the 20th July the following decisions were agreed

 

New Drug Requests 

Approved

 

Cefiderocol (TLS Red)

  • Restricted - microbiology only - see local guidelines

  • For treatment of multidrug resistant aerobic gram-negative infections where there are no other treatment options available

Dequalinium chloride (Fluomizin® 10mg vaginal tablets) (TLS Red)

  • For treatment of trichomoniasis vaginalis

Dequalinium chloride (Fluomizin® 10mg vaginal tablets) (TLS Amber No SCP)

  • For treatment of bacterial vaginosis 

Sanatogen Complete A-Z (TLS Amber No SCP)

  • Complete vitamin and mineral supplement to maintain normal levels in intestinal failure patients under the care of the nutrition team

Forceval soluble tablets (TLS Amber No SCP)

  • Complete vitamin and mineral supplement to maintain normal levels in intestinal failure patients who have swallowing difficulties under the care of the nutrition team

 

Shared Care Protocols/TLS changes

New SCPs:

Testosterone (Sustanon and Nebido) 

Updated SCPs:

Nil

TLS Changes:

Mycophenolate for neurological indications changed from TLS Red to TLS Amber 3 months pending incorporation into the existing SCP for Mycophenolate.

 

Other Formulary Decisions:

Budesonide orodispersible tablet (TLS red)

  • For inducing remission of eosinophilic oesophagitis with treatment of up to 12 weeks in line with NICE TA708

Pigmanorm (TLS red)

  • additional information added onto the the formulary to state ‘subject to the Cosmetic Surgery or Treatment Policy’ as well as a link to the Remedy Pathway for cosmetic skin treatments

Dalteparin

  • additional information added onto the Formulary website to state ‘for use where enoxaparin not appropriate for obstetric patients due to allergy/reaction’ in line with current practice. 

Sodium aurothiomalate (TLS red)

  • Joint Formulary group agreed to withdraw shared care protocol for sodium aurothiomalate as SCP no longer required and has not been prescribed in the last year. 

  • Joint Formulary group agreed to change TLS status to red. 

Eplerenone (TLS Amber No SCP)

  • Joint Formulary group agreed to withdraw prescribing guidelines for eplerenone as this has been superseded by new heart failure guidance. 

 

Further Work:

Bempedoic acid with ezetimibe (TLS red) 

  • For primary hypercholesterolemia or mixed dyslipidaemia for patients under the care of the Lipid team as per NICE TA694

  • TLS status to be reviewed once NICE TA for inclisiran published and following completion of further work to establish place in pathway.