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Updated document. Red RAG status now only applies to use of sodium zirconium cyclosilicate for the emergency treatment of hyperkalaemia (previously also included use in persistent hyperkalaemia). In-tariff use so no cost impact anticipated for CCGs.
Prescribing and monitoring of sodium zirconium cyclosilicate must be retained by the specialist for at least one month after the patient is stabilised on the optimum RAAS inhibitor therapy / sodium zirconium cyclosilicate combination, with stable urea and electrolytes.
Routine review at expiry, to be added to the static list due to no new evidence or significant changes within the document.
Formulary and Guidelines
New Red statement developed to support existing secondary care use for achalasia, gastric motility disorder and gastroparesis. It is estimated that there will be 50-60 patients per year across the Cheshire & Mersey Network. This is the number being treated currently and no change in patient numbers is expected, therefore no significant cost impact.
Prescribed by the Substance Misuse Service.
Pathway updated to include upadacitinib and filgotinib use in line with recent NICE technology appraisals previously presented to APC (upadacitinib TA665, filgotinib TA676).
Background information document to provide sufficient information for primary care prescribers to switch existing Freestyle Libre® users to Freestyle Libre® 2. Flash glucose monitoring statement updated to state switching may take place in primary care. Template GP letter for use by specialist if they suggest switching to Freestyle Libre® 2.
Change in designation from Black to Amber initiated for paediatrics only (remains designated Black for adults). Minimal cost impact.
Additional strength, less expensive than 6mg strength already included in formulary.
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