NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines

Non-Formulary Information, Non-Formulary Processes and Individual Patient Treatment Requests (IPTRs)

This section contains the supporting documentation for the non-Formulary processes within NHSGGC (see Medicines Policies for details) and a list of cumulative non-Formulary negative decisions between 1992 and the present.

Individual Patient Treatment Requests (IPTRs)

Please note: The Management of IPTRs are currently being reviewed and will shortly be replaced by the Peer Approved Clinical System (PACS) which are detailed further down this page.  Until this transition is complete, the IPTR process is subject to an Interim Policy Statement which is available in the medicines policies page of this website.

All requests for medicines not included in the GGC Formulary because they are not recommended for use in the NHS in Scotland by the Scottish Medicines Consortium (SMC) or NHS Health Improvement Scotland (NHS HIS), or are awaiting evaluation by the SMC require the submission of an Individual Patient Treatment Request (IPTR).

There is often confusion as to when an IPTR is required as opposed to different processes for off-label or unlicensed medicines or requests for medicines accepted by SMC.  The following flowchart (also available as a separate PDF) should be used to check that the correct documentation is selected before being completed (when used along with the relevant policies). If still unsure, then check with your clinical pharmacist, local pharmacy department, Medicines Information or the Formulary and Handbook Team (see contact us)

Relating to the above flow chart, the following documentation is available:

IPTR Documentation: 

The following should be referred to and used in accordance with the Management of IPTRs Policy available on the Medicines Policies page

  • IPTR & PACS List - non-oncology (guidance on which medicines require an IPTR or PACS form completion)
  • Form IPTR 2 (The IPTR documentation for medicines designated level 2 in the above IPTR List)
  • Form IPTR3 (The main IPTR documentation used in NHS Greater Glasgow and Clyde)
  • Form IPTR APPEAL (To be used by clinicians to appeal an IPTR decision)
  • IPTR Patient Information Leaflet (A guide for patients on the IPTR process when your care is provided in NHS GGC or when it is provided elsewhere by a doctor based in NHS GGC)

Peer Approved Clinical System (PACS)

PACS is currently the process used by clinicians to access ultra-orphan medicines which have been evaluated by the SMC under the ultra-orphan framework and are not recommended for use in NHSScotland.  The full policy can be accessed via the Medicines Policies page of this website.

Unlicensed medicine and Off-label documentation: 

The following should be referred to and used in accordance with the Unlicensed Medicines Policy available on the Medicines Policies page

Requests for licensed oncology medicines when they are either non-Formulary or being used outside of the regional protocols: 

  • Form SONFR (The Specialist Oncology Non-Formulary Request documentation)

Other supporting documentation for the acute non-Formulary processes can be found in the Medicines Policies page

What Medicines have been turned down for inclusion in the GGC Formulary?

The following links are a list of all the medicines/indications/formulations that have been rejected for inclusion in the GGC Formulary. Since around 2002, most of these have been because the medicine was not recommended for use in NHS Scotland following evaluation by the SMC or NHS Health Improvement Scotland.

From January 2016 onwards a cumulative list of local decisions relating to SMC advice and, where applicable NICE Multiple Technology Appraisals can also be found here