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BNSSG Adult Joint Formulary
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Decisions 9th May 2023

 

New Drug Requests

Approved

  • Vericiguat (TLS Red) for the treatment of symptomatic chronic heart failure with reduced ejection fraction who are stabilised after a recent decompensation event requiring IV therapy onto the BNSSG adult formulary. This treatment is reserved for patients who are on optimised standard therapy with a recent decompensation who have exhausted all other options under the care of the secondary care cardiology team

Shared Care Protocols

Approved

  • Updated SCP approved for Sacubitril/Valsartan (Entresto®)  to reflect TLS Amber 1 month status.

 

Traffic Light Status Change Requests

  • Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia as an adjunct to diet in adults in line with NICE TA694 to be changed from TLS Red to TLS Blue. Local guidelines will be updated in due course.

  • Relugolix-estradiol-norethisterone acetate (Ryeqo®) for treating moderate to severe symptoms of uterine fibroids in line with NICE TA832 changed from TLS Red to TLS Amber Specialist Initiated, noting secondary care will complete the DEXA at 12 months 

  • Sacubitril/Valsartan (Entresto®) for treatment of symptomatic chronic Heart Failure with reduced ejection fraction in line with NICE TA388 changed from TLS Amber 3 months to TLS Amber 1 month 

TLS Changes following SCP Review work

  • Brivaracetam for adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in adult patients with epilepsy from TLS Amber 3 months to TLS Amber Specialist Initiation

  • Eslicarbazepine for the treatment/ management of adjuvant treatment of epilepsy with focal seizures with or without secondary generalisation from TLS Amber 3 months to TLS Amber Specialist Initiation

  • Hypertonic sodium chloride 6% Mucoclear from TLS Amber 3 months to TLS Amber Specialist Initiation and to add Hypertonic Sodium Chloride 7%

  • Perampanel for treatment of partial-onset seizures and primary generalised tonic-clonic seizures in patients with idiopathic generalised epilepsy from TLS Amber 3 months to TLS Amber Specialist Initiation 

  • Roflumilast for treatment of COPD from TLS Amber 3 months to TLS Amber Specialist Initiation

  • Rufinamide for the treatment/ management of/ adjuvant treatment of tonic or atonic seizures and adjuvant treatment of Lennox-Gastaut syndrome in patients from TLS Amber 3 months to TLS Amber Specialist Initation

  • Selegeline for treatment of PD or symptomatic parkinsonism from TLS Amber 3 months to TLS Amber Specialist Initiation

  • Zonisamide  for monotherapy in the treatment of partial seizures, with or without secondary generalisation, in adults with newly diagnosed epilepsy from TLS Amber 3 months to TLS Amber Specialist Initiation

  • Vortioxetine - The treatment of major depressive episodes in adults whose condition has responded inadequately to 2 antidepressants within the current episode from TLS Amber 3 months to TLS Amber Specialist Recommended

  • Sulfasalazine for treatment of IBD from TLS Blue to TLS Amber 1 month so it is in line with the TLS for Rheumatology, SCP to be updated and developed.

  • Tetrabenazine for huntington's disease to TLS Amber Specialist Initiated

 

Other Formulary Decisions

  • HRT Chapter minor changes: Elleste Solo MX patches discontinued so removed from formulary and replace with Evorel brand which is included on the menopause guidelines

  • Information on sunscreens updated on formulary page to direct clinician to select the most cost-effective product that is available for prescribing and available from community pharmacies.

  • Terms of Reference Updated and uploaded to Remedy website

Further Work

  • An application for Ferric maltol (Feraccru) for treatment of iron deficiency anaemia in adults as an alternative to intravenous IV iron where patients have a significant intolerance to standard oral iron preparations following appropriate interventions to minimise such adverse effects, was discussed and JFG were in agreement to approve as TLS Blue, once a guideline is in place to support clinicians with following appropriate interventions to minimise adverse effects. The current formulary position therefore remains until a guideline is in place.