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Decisions 12th December 2023
New Drug Requests:
Approved
Capsaicin (Qutenza®) patch (TLS Red)
- for pain relief in diabetic neuropathy for use in pain clinic only
- note, this patch is already on the formulary for non-diabetic peripheral neuropathy
Formoterol, budesonide, glycopyrronium (Trixeo®) pressurised inhaler (TLS Green)
- as an option for moderate to severe COPD
Traffic light status changes:
- Ketorolac injection- to change to TLS Red on 10.4, 15.1 to be used in hospital setting only and to change to TLS Amber specialist recommended for palliative care (for rare cases).
- Bupivacaine formulations to change to TLS Red for local anaesthesia:
Bupivacaine 0.25% & 0.5% injection, Bupivacaine 5mg / Glucose 80mg/mL injection, Bupivacaine 0.25% / Adrenaline 1 in 200,000 injection,, Bupivacaine 0.5% / Adrenaline 1 in 200,000 injection, Bupivacaine 0.1% for epidural infusion, Bupivacaine 0.1% / Fentanyl 2micrograms/mL, Bupivacaine 0.1%/fentanyl 5 micrograms/ml infusion
Other decisions and discussions:
- Spacer devices for inhalers- it was agreed to update this section and refer to the devices generically. Clinicians are encouraged to prescribe the most appropriate and cost-effective spacer for the patient.
- Gepretix brand of micronised progesterone capsules added to BNSSG adult formulary as preferred brand.
- Rimegepant for treating migraine as per NICE TA919 to be added as TLS Blue in line with implementation period (18th January 2024)
- Daridorexant for treating long-term insomnia as per NICE TA922 to be added as TLS Blue in line with implementation period (18th January 2024)
- iron isomaltoside 1000 changed to ferric derisomaltose due to name change
- cilest brand removed from formulary (discontinued)
- SCP template for mental health drugs discussed- consideration of use of NHS England template when possible and the combined BNSSG/BSW template to facilitate continued collaboration with BSW. The group agreed to use the combined template for the ADHD stimulany/ atomoxetine SCP. The group agreed to use the national NHSE (RMOC) SCP template for lithium.
Decisions from December JFG meeting which are awaiting further work before can be actionned:
New Drug Request applications:
- Doxylamine succinate/ pyridoxine hydrochloride (Xonvea) for treatment of nausea and vomiting in pregnant women aged 18 years and over who do not respond to conservative management as a third line option onto the BNSSG adult formulary as TLS Amber specialist initiated, pending agreement with specialist team of clear criteria.
- N-acetylcisteine (NAC) mixed with simeticone to improve mucosal visibility during upper GI endoscopy onto the BNSSG Adult formulary as TLS Red, pending development of a protocol to support use and ensure preparation is consistent and safe.
Traffic Light Status requests:
- Potassium binders (sodium zirconium and patiromer) for patients on a stable dose of potassium binder and RAASI drug. The group were supportive with the proposal of change to TLS Amber specialist initiated, pending development and approval of guideline.