Formulary Update (February 2016)
In Scotland, a newly licensed medicine is routinely available for use in an NHS board only after it has been
- accepted for use in the NHSScotland by the Scottish Medicines Consortium (SMC), and/or
- accepted for use by the NHS board’s Area Drug and Therapeutics Committee (ADTC).
How does the NHS board decide which new medicines to make available for patients?
Each NHS board has an ADTC. The ADTC is responsible for advising the NHS board on all aspects of the use of medicines. ADTCs take account of national and, where applicable, local guidance when deciding which medicines should be routinely available.
What national guidance does the ADTC consider?
- SMC advises on the use of newly licensed medicines in NHSScotland. In the table, national guidance usually refers to SMC advice. Links to SMC advice for individual medicines are included in the table.
- In some cases, other agencies may also provide guidance on how medicines should be used. For example Healthcare Improvement Scotland provides advice on some health technology assessments, including National Institute for Health and Care Excellence Multiple Technology Appraisals (NICE MTAs).
What local guidance does the ADTC consider?
- Sometimes SMC accepts more than one medicine for treating a specific medical condition. Clinical experts in each NHS board provide advice to their ADTCs on which medicines can be routinely used. Sometimes clinical experts decide that established medicines are a better choice than new medicines.
- Medicines routinely available for use within an NHS board are usually included in the 'local formulary'. The formulary is a list of medicines for use in the NHS board that has been agreed by ADTC in consultation with local clinical experts. The formulary encourages prescribers to become familiar with a limited list of medicines which can be used to treat the majority of medical conditions.
What if a particular medicine is not routinely available in my NHS board?
- This is usually because the medicine has not been accepted by SMC for use in NHSScotland.
- There may also be differences in which medicines are preferred in NHS boards. If SMC accepts a number of medicines for which there are other medicines already available to treat a specific medical condition, the NHS board's decision may depend on clinical experts, preferences and experiences with the medicine in their local population and on local prescribing guidance. If a decision is made for a medicine not to be routinely prescribed, there are usually alternative medicines available on the formulary.
- If a medicine is not routinely available and there are no suitable formulary alternatives, a doctor can make a request to prescribe the medicine if they believe it will benefit an individual patient. All NHS boards have procedures in place to consider individual requests when a doctor considers that a medicine not included on the formulary would be the best treatment option for an individual patient.
The table below lists NHS Greater Glasgow and Clyde's decisions on new medicines.
If you need more information on medicines decisions in your NHS board area, please email hcis.adtc-collaborative@nhs.net
- Drug names in Medicine column link to the Formulary entry and any restrictions or prescribing notes where applicable
- Other links in the Medicine column take you to relevant national guidance
NHS Greater Glasgow and Clyde medicines decisions
|
Medicine |
Condition being treated | NHSGGC decision | Date of decision |
|
Abatacept, adalimumab, etanercept. tocilizumab |
Juvenile idiopathic arthritis | Available in line with national guidance | 22/02/2016 |
|
Albiglutide pre-filled pen (Eperzan) |
Treatment of type 2 diabetes mellitus in adults to improve glycaemic control in combination with other glucose-lowering medicinal products including basal insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. |
Available in line with national guidance | 22/02/2016 |
|
Dulaglutide pre-filled pen (Trulicity) |
In adults with type 2 diabetes mellitus to improve glycaemic control as add-on therapy in combination with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. |
Available in line with national guidance | 22/02/2016 |
|
Eculizimab infusion (Soliris) |
In adults and children for the treatment of patients with atypical haemolytic uraemic syndrome (aHUS) |
Not available as not recommended for use in NHSScotland | 22/02/2016 |
| Non-small cell lung cancer that has progressed after prior chemotherapy | Available in line with national guidance | 22/02/16 | |
|
Fulvestrant injection (Faslodex) |
Treatment of postmenopausal women with oestrogen receptor positive, locally advanced or metastatic breast cancer for disease relapse on or after adjuvant anti-oestrogen therapy, or disease progression on therapy with an anti-oestrogen. |
Available in line with local (regional) guidance for prescribing | 22/02/2016 |
|
Golimumab sub-cutaneous injection (Simponi) |
Treatment of adults with severe, active non-radiographic axial spondyloarthritis with objective signs of inflammation as indicated by elevated C-reactive protein (CRP) and/or magnetic resonance imaging (MRI) evidence, who have had an inadequate response to, or are intolerant to non-steroidal anti-inflammatory drugs (NSAIDs). |
Available in line with national guidance | 22/02/2016 |
|
Guanfacine prolonged-release tablets (Intuniv) |
Treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents 6 to 17 years old for whom stimulants are not suitable, not tolerated or have been shown to be ineffective. Treatment must be used as part of a comprehensive ADHD treatment programme, typically including psychological, educational and social measures. |
Not routinely available as local implementation plans are being developed or the ADTC is waiting for further advice from local clinical experts - decision expected by 18/04/2106 | 22/02/2016 |
|
Netupitant with palonesetron capsules (Akynzeo) |
Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer chemotherapy and moderately emetogenic cancer chemotherapy in adult patients. |
Available in line with local (regional) guidance for prescribing | 22/02/2016 |
|
Panobinostat capsules (Farydak) |
In combination with bortezomib and dexamethasone, for the treatment of adult patients with relapsed and/or refractory multiple myeloma who have received at least two prior regimens including bortezomib and an immunomodulatory agent. |
Available in line with local (regional) guidance for prescribing | 22/02/2016 |
|
Pixantrone infusion (Pixuvir) |
Monotherapy for the treatment of adult patients with multiply relapsed or refractory aggressive Non Hodgkin B-cell Lymphomas |
Not available as not recommended for use in NHSScotland |
22/02/2016 |
|
Sorafenib tablets (Nexavar) |
Treatment of hepatocellular carcinoma |
Available in line with local (regional) guidance for prescribing | 22/02/2016 |
|
Teduglutide injection (Revestive) |
Treatment of adult patients with Short Bowel Syndrome |
Not available as not recommended for use in NHSScotland |
22/02/2016 |
|
Tolvaptan tablets (Jinarc) |
To slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adults with chronic kidney disease stage 1 to 3 at initiation of treatment with evidence of rapidly progressing disease. |
Available in line with national guidance | 22/02/16 |
|
Ulipristal acetate tablets (Esmya) |
Intermittent treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age. |
Available in line with national guidance | 22/02/16 |
|
Ustekinumab injection (Stelara) |
Treatment of moderate to severe plaque psoriasis in adolescent patients from the age of 12 years and older, who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies. |
Available in line with national guidance |
22/02/2016 |