Recommendations
NARCOLEPSY, Aintree University Hospital Sleep Service Pathway
Routine review to include solriamfetol as a third line option and the positioning of pitolisant and sodium oxybate have been updated accordingly. A statement has been added regarding the management of narcolepsy in women of child-bearing potential and the requirement for effective contraception if indicated. An additional statement has been added to confirm that the drugs in the pathway should not be used in combination.
RED PITOLISANT tablets (Wakix®▼) for narcolepsy with or without cataplexy
There is no new evidence and no significant changes have been made. Minor revisions include costs and updates in line with the SPC. Pitolisant is now positioned as fourth line in the narcolepsy pathway, following the addition of solriamfetol to the pathway as a third line option. Reference to the responder programme has been removed as the corresponding programme for sodium oxybate is now obsolete.
Tariff-excluded high cost drug for specialist use only. No additional financial impact as this is established in clinical practice.
RED SODIUM OXYBATE oral solution for narcolepsy with cataplexy
There is no new evidence and no significant changes have been made. Minor revisions include costs and updates in line with the SPC. Sodium oxybate is now positioned as fifth line in the narcolepsy pathway, following the addition of solriamfetol to the pathway as a third line option. Reference to the UCB Pharma Xyrem responder programme has been removed as sodium oxybate is now available as a generic product, which is used at LUHFT.
Tariff-excluded high cost drug for specialist use only. No additional financial impact as this is established in clinical practice.
GREY FINERENONE film-coated tablets (Kerendia®▼) for chronic kidney disease in type 2 diabetes
Not recommended until NICE TA published.
GREY VEDOLIZUMAB solution for infusion (Entyvio®) for chronic refractory pouchitis after surgery for ulcerative colitis
Not recommended until NICE TA published.
GREEN Inclisiran injection (Leqvio®▼) for primary hypercholesterolaemia or mixed dyslipidaemia
Minor update to reflect changes to secondary care funding arrangements. The update around secondary care funding does not alter the RAG designation as primary care are still expected to carry out the majority of treatment initiation.
Formulary and Guidelines
AMBER INITIATED Mesalazine – ulcerative colitis
Addition of mesalazine (Octasa®) 1g suppositories and mesalazine (Salofalk®) 1g/ application foam enema to formulary. Removal of mesalazine (Asacol®) 250mg suppositories and mesalazine (Asacol®) 1g/ application foam enema (products discontinued).
No cost changes result from this.
GREEN Rosuvastatin tablets
Removal of Pan Mersey statement on rosuvastatin which is now comparable in cost to atorvastatin. National guidance states rosuvastatin may be used as an alternative to atorvastatin if compatible with other drug therapy.
No significant cost implication resulting from this change.
Shared Care
AMBER RETAINED Nitrazepam prescribing support information
Routine review with minor changes
AMBER INITIATED Glyceryl trinitrate patch prescribing support information
Routine review with minor changes
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