Recommendations
RED DEXAMETHASONE INTRAVITREAL IMPLANT (Ozurdex®) for treating visual impairment caused by diabetic macular oedema
Tariff-excluded high cost drug for specialist use only. No significant cost impact is anticipated because dexamethasone is a further treatment option and the overall cost of treatment will be similar to the current treatment options.
RED ELTROMBOPAG and ROMIPLOSTIM for chronic immune (idiopathic) thrombocytopenic purpura (ITP)
Non-renewal of expired NICE TA red statements which will be archived and the link to the NICE TA retained in respective formulary entries
RED FOSTAMATINIB tablets (Tavlesse®▼) for treating refractory chronic immune thrombocytopenia
Tariff-excluded high cost drug for specialist use only. No significant cost impact is anticipated because fostamatinib is a further treatment option and the overall cost of treatment will be similar to the current treatment options.
RED OZANIMOD capsules (Zeposia®▼) for ulcerative colitis
Tariff-excluded high cost drug for specialist use only. No significant cost impact is anticipated because ozanimod is a further treatment option and the overall cost of treatment will be similar to the current treatment options.
RED UPADACITINIB prolonged-release tablets (Rinvoq®▼) for active ankylosing spondylitis
Tariff-excluded high cost drug for specialist use only. No significant cost impact is anticipated because upadacitinib is a further treatment option and the overall cost of treatment will be similar to the current treatment options.
AMBER INITIATED RELUGOLIX-ESTRADIOL-NORETHISTERONE ACETATE tablets (Ryeqo®▼) for treating uterine fibroids
The specialist may then request the patient’s GP to take over prescribing responsibility following the stabilisation of the patient’s condition and the patient has been reviewed by the specialist. However, the patient should remain under the care of the specialist, i.e., not discharged, for the first year of treatment and until the results of the DXA scan have been actioned. The decision to stop or continue treatment should be clearly communicated to the patient’s GP. No significant cost impact is anticipated.
GREY DROSPIRENONE 3mg / ESTETROL 14.2mg tablets (Drovelis®▼) for contraception
Not recommended. This will be reviewed if a formal application for use is received and prioritised for in-year review.
GREY TIRZEPATIDE (Mounjaro®▼) injection for type 2 diabetes
Not recommended until NICE TA published.
Formulary and Guidelines
RED Dibotermin for non-union fracture
This is a tariff-excluded high cost drug for specialist use only within specialist services. The additional cost from using this drug is estimated to be £3,480 per 100,000 population.
RED Metolazone
Addition of Xaqua® brand of metolazone 5mg. Brands are not interchangeable and metolazone must be prescribed by brand name. Patients unintentionally switched between products may experience toxicity or subtherapeutic effects as a result of the difference in bioavailability.
AMBER RECOMMENDED Continuous Glucose Monitoring
The RAG rating will be reviewed in six months and recognises that many people in primary care have expertise in the management of diabetes. Training and support are available for patients and healthcare professionals for all of the devices. In the early stage of implementation, it is suggested that FreeStyle Libre 2 be used as the first line as practices are already familiar with this device.
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