Gateshead Medicines Management Committee

Gateshead Medicines Management Committee Decision Summary Gateshead Medicines Management Committee

Summary of decisions made regarding new product requests considered at a meeting of the Committee on Wednesday 12th June 2013.

Classification of Products: Red = Hospital use only Amber = Drugs with shared care agreement Green + = Initiated by Primary or Secondary Care Specialist but can be safely maintained in primary care without ongoing specialist monitoring. Green = GP & Hospital use. Drugs not classified as Red, Amber or Green + are classified as Green by default

Product Decision Comments/notes Approved Refused Deferred 1) Requests deferred from previous meetings Linaclotide  Red Requested for treatment of moderate to severe Irritable Bowel Syndrome with Constipation in adults. Decision: Approved for use by Mr Mercer Jones and Dr Johns only. Formulary status to reviewed in March 2014. 2) New Requests Abatacept for Red Decision: Approved in line with NICE Rheumatoid TAG. Arthritis Flutiform Green Decision: approved for use in treatment of asthma only Pirfenidione for Red Decision: Approved in line with NICE pulmonary fibrosis TAG. Noted only available via clinics approved by NHS England Specialised Commissioning. Glycopyrronium  Requested as 2nd LAMA bronchodilater in bromide inhaler COPD in addition to tiotropium. (Seebri®) Decision: Refused. The group noted that there are now three LAMA available. The GMMC felt that to accept a second LAMA onto the formulary it should offer differences to tiotropium (e.g. design of inhaler), and Seebri® device is similar in design to Tiotropium. 3) New formulations & extensions to use None received 4) Products considered by NETAG None received 5) Products considered by NECDAG None received 6) Products considered by NICE TA278 – Asthma – Red Approved in line with NICE TAG. Omalizumab (review of TA133 + Page 1 of 3 GMMC Decision Summary 12.6.13 Gateshead Medicines Management Committee Decision Summary

TA201) TA280 – Red Approved in line with NICE TAG. Rheumatoid arthritis – abatacept (rapid review of TA234) TA281 – Gout -  Noted appraisal terminated by NICE. Canakinumab TA282 – Idiopathic Red Approved in line with NICE TAG. pulmonary fibrosis - Noted only available via clinics approved Pirfenidone by NHS England Specialised Commissioning. TA283 - Macular Red Approved in line with NICE TAG oedema (retinal Noted not applicable to GHFNT as vein occlusion) - patients treated for this condition at ranibizumab Newcastle/Sunderland. TA284 -  Not approved by NICE. Bevacizumab in combination with paclitaxel and carboplatin for first- line treatment of advanced ovarian cancer TA285 -  Not approved by NICE. Bevacizumab - Ovarian, fallopian tube and primary peritoneal cancer (recurrent advanced, platinum-sensitive or partially platinum-sensitive) TA286 - loxapine  Noted appraisal terminated by NICE. inhalation - Noted not applicable to GHFNT as Schizophrenia or patients treated for this condition in NTW bipolar disorder Mental Health Trust. 7) Appeals against earlier decisions by GMMC None received 8) Miscellaneous decisions by GMMC

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Buccolam Green + Until recently, only unlicensed midazolam products were available for administration via the buccal route. The preferred and most commonly used unlicensed product is Epistatus (10mg/ml). A licensed product, Buccolam®, is now available. It is licensed for status epilepticus in children aged 3 months to 18 years. Decision: Buccolam® will be added to the formulary and should be used within its licensed indications as the preferred product. A coordinated active switching programme in appropriate patients will be facilitated with the input of the appropriate specialist teams. Epistatus may also be required in some paediatric and adult epilepsy patients depending on clinical need. Fexofenadine Green Decision: approved as 2nd line choice or 1st line on advice of specialist Myophenolate for  Decision: Refused. Use of Idiopathic mycophenolate is unlicensed for this Pulmonary Fibrosis indication, with limited evidence, and not supported by NICE in their Clinical Guideline on IPF. Filgrastim Amber Is a biosimilar to filgrastim which offers (Zarzio®) some cost savings. Decision: approved as 1st line formulary choice in neutropenic patients only who do not require pegfilgrastim or lenograstim. Pegfilgrastim will remain on formulary for chemo patients and lenograstim for stem cell transplant patients Rivaroxaban Green + Decision: approved for patients with patients with DVT/PE whom the anticoagulant service PE/DVT unstable have identified as difficult to manage on on warfarin and/or tinzaparin, and have warfarin/phenidione referred to a haematologist for advice on their management. Rivaroxaban remains non-formulary for all newly diagnosed DVT/PE patients as this requires input from the CCG commissioners to redesign the DVTPE pathway in Gateshead and the service provided by the ambulatory clinic on MAU. All newly diagnosed patients should continue to receive warfarin and tinzaparin as per current practice

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