Formulary Update (August 2020)
To view the ADTC decisions on new medicines from the meeting on 31st August click here (opens as a separate PDF)
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In Scotland, a newly licensed medicine is routinely available in a health board only after it has been:
- accepted for use in NHSScotland by the Scottish Medicines Consortium (SMC), and
- accepted for use by the health board’s Area Drug and Therapeutics Committee (ADTC).
All medicines accepted by SMC are available in Scotland, but may not be considered ‘routinely available’ within NHS Greater Glasgow and Clyde (NHSGGC) or another health board because of available services and preferences for alternative medicines.
‘Routinely available’ means that a medicine can be prescribed by the appropriately qualified person within a health board.
As with each health board, NHS Greater has an ADTC. The ADTC is responsible for advising the health board on all aspects of the use of medicines.
Medicines routinely available within a health board are usually included in the local formulary. The GGC Formulary is a list of medicines for use in the health board that has been agreed by ADTC in consultation with local clinical experts. It offers a choice of medicines for healthcare professionals to prescribe for common medical conditions. The GGC Formulary can help improve safety as prescribers are likely to become more familiar with the medicines in it and also helps make sure that standards of care are consistent across NHSGGC.
How does the NHSGGC decide which new medicines to make routinely available for patients?
The ADTC in a health board will consider national and local guidance before deciding whether to make a new medicine routinely available.
What national guidance does the ADTC consider?
- SMC advice: The SMC considers newly licensed medicines and advises health boards in Scotland whether they should be available. When SMC considers a new medicine for the NHS in Scotland, it looks at:
- how well the medicine works,
- which patients might benefit from it ,
- whether it is as good or better than medicines the NHS already uses to treat the medical condition, and
- whether it is good value for money.
In the table linked to this Formulary Update, national guidance usually refers to SMC advice. Links to SMC advice for individual medicines are also included in the table.
In some cases, other agencies may also provide guidance on how medicines should be used. For example, Healthcare Improvement Scotland issues alerts to advise if National Institute for Health and Care Excellence Multiple Technology Appraisals (NICE MTAs) are applicable in Scotland.
What local guidance does the ADTC consider?
Advice from local clinical experts who would be expected to prescribe a particular medicine, where that service is available in a health board.
Why is a particular medicine not routinely available in my health board?
- This is usually because the medicine is not recommended for use in NHSScotland by the SMC.
- The medicine may not be routinely available in a health board, particularly in smaller health boards, because there is not a suitable specialist who may use the medicine.
- There may also be differences in which medicines are preferred in health boards. Sometimes SMC accepts more than one medicine for treating a specific medical condition. Clinical experts in each health board consider whether to add new medicines to their formulary and advise the ADTC. Sometimes it is agreed that established medicines are a better choice than new medicines.
What happens if a particular medicine is not routinely available in my health board?
If a medicine is not routinely available and included on the GGC Formulary and there are no suitable alternatives, a healthcare professional can request to prescribe a medicine that is not on the Formulary if they think you will benefit from using it. NHS Greater Glasgow and Clyde have procedures in place to consider requests when a healthcare professional feels a medicine that is not on the formulary would be right for a particular patient.
The table linked within this Formulary Update lists NHSGGC decisions on new medicines from the related meeting. For Formulary changes not based on SMC advice, please see Formulary Update MU blogs.
If you need more information on medicines decisions in NHS Greater Glasgow and Clyde, please email the GGC Formulary Team via firstname.lastname@example.org