NHS Ayrshire & Arran Formulary Bulletin - NHS Ayrshire and Arran.

More documents

Recommendations

Info

The following products have been recommended for use in NHS Scotland and included in the NHS Ayrshire & Arran formulary for specialist consultant initiation. 704/11 Filgrastim, 30 million units (300 micrograms)/0.5mL, 48 million units (480 micrograms)/0.5mL, solution for injection or infusion in pre-filled syringe (Zarzio®) Reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy (with the exception of chronic myeloid leukaemia and myelodysplastic syndromes) and reduction in the duration of neutropenia in patients undergoing myeloablative therapy followed by bone marrow transplantation considered to be at increased risk of prolonged severe neutropenia. The safety and efficacy of filgrastim are similar in adults and children receiving cytotoxic chemotherapy. · Mobilisation of peripheral blood progenitor cells (PBPC). · In children and adults with severe congenital, cyclic, or idiopathic neutropenia with an absolute neutrophil count (ANC) of ≤ 0.5 x 109/l, and a history of severe or recurrent infections, long term administration of filgrastim is indicated to increase neutrophil counts and to reduce the incidence and duration of infection-related events. · Treatment of persistent neutropenia (ANC ≤ 1.0 x 109/l) in patients with advanced HIV infection, in order to reduce the risk of bacterial infections when other therapeutic options are inappropriate. Filgrastim (Zarzio®) is a biosimilar product to a reference granulocyte colony stimulating factor, filgrastim (Neupogen®). The British National Formulary advises that it is good practice to prescribe biological medicinal products by brand name. Other granulocyte colony stimulating factor products are available at lower cost. 712/11 Retigabine, 50mg, 100mg, 200mg, 300mg and 400mg film-coated tablets (Trobalt®) Indication under review: Adjunctive treatment of partial onset seizures with or without secondary generalisation in adults aged 18 years and above with epilepsy. SMC restriction: patients with refractory epilepsy. Treatment should be initiated only by physicians who have appropriate experience in the treatment of epilepsy. In two placebo-controlled studies in patients with refractory epilepsy retigabine was superior to placebo in terms of the proportion of patients experiencing ≥ 50% reduction in partial seizure frequency per 28 days. An indirect comparison indicates that retigabine has similar efficacy to two other antiepileptic drugs used as adjunctive therapy. 724/11 Methotrexate 50mg/mL solution for injection (Metoject®) prefilled syringes 12.5mg, 17.5mg, 22.5mg, 27.5mg and 30mg Indication under review: polyarthritic forms of severe active juvenile idiopathic arthritis, when the response to non-steroidal anti-inflammatory drugs has been inadequate. For patients in whom treatment with disease modifying drugs is indicated and parenteral administration of methotrexate is appropriate, this adds to the range of pre filled syringes available. The Scottish Medicines Consortium has previously accepted methotrexate for the treatment of severe active rheumatoid arthritis in adult patients where treatment with disease modifying drugs is indicated. Methotrexate injection is listed in the British National Formulary for Children 2010 -11 for the treatment of juvenile idiopathic arthritis. √ Include (restricted) ADTC Decision – include in the formulary for specialist consultant initiation, as per any SMC restrictions Implication for all A & A Prescribers - for prescribing within NHS Ayrshire & Arran, on the recommendations of a consultant NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit August & September 2011 Page 2 of 8
The following products have been recommended for use in NHS Scotland and included in the NHS Ayrshire & Arran formulary for consultant initiation, as per the West of Scotland Cancer Network (WoSCAN) Prostate Cancer Guidelines. 557/09 Histrelin acetate, 50mg subcutaneous implant (Vantas®) For palliative treatment of advanced prostate cancer. Histrelin is restricted to use in patients with an anticipated life expectancy of at least one year in whom annual administration will offer advantages. In a single-arm study, histrelin provided effective suppression of testosterone levels in patients with advanced prostate cancer. It requires less frequent administration than other leutenising hormone releasing hormone (LHRH) agonists. Other LHRH agonists are available at a lower acquisition cost. 560/09 Resubmission Degarelix 120mg and 80mg powder and solvent for solution for injection (Firmagon®) Indication under review: degarelix is a gonadotropin-releasing hormone (GnRH) antagonist indicated for the treatment of adult male patients with advanced hormone-dependent prostate cancer. In one study that included patients with all stages of prostate cancer, degarelix was shown to be non-inferior to a luteinising hormone releasing hormone (LHRH) agonist in suppressing testosterone levels over a one year treatment period without an initial testosterone flare. This SMC advice takes account of the benefits of a patient access scheme (PAS) that improves the cost-effectiveness of degarelix. This SMC advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland. 705/11 Triptorelin (Decapeptyl SR®) 22.5mg powder and solvent for suspension for injection Indication under review: · Treatment of patients with locally advanced, non-metastatic prostate cancer, as an alternative to surgical castration. · Treatment of metastatic prostate cancer. √ Include (restricted) This new preparation of triptorelin allows 6-monthly administration (as triptorelin pamoate in a 22.5mg dose). Triptorelin 11.25mg (as acetate) is administered every 3 months and has previously been accepted by SMC. Bioequivalence of the pamoate and acetate salts has been demonstrated and the new preparation is cost neutral. Note: The indication for triptorelin 11.25mg formulation was reworded in 2007 to achieve consistency Europe-wide and now reads as per the indication for triptorelin 22.5mg ADTC Decision – include in the formulary for consultant initiation, as per WoSCAN Prostate Cancer Guidelines Implication for all A & A Prescribers - for prescribing within NHS Ayrshire & Arran, on the recommendations of a consultant Rivaroxaban 10mg film-coated tablets (Xarelto®) Indication Prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery. Comment Scottish Medicines Consortium No 519/08: accepted for use within NHS Scotland In three large phase III studies in patients undergoing either total knee or total hip replacement surgery, rivaroxaban was superior to low molecular weight heparin in reducing the incidence of VTE and all cause mortality with patients while having a similar incidence of major bleeding events. √ restricted ADTC Decision – include in formulary for initiation as per NHS Ayrshire & Arran orthopaedic thromboprophylaxis guidelines Implication for all NHS A & A Prescribers – for prescribing within NHS Ayrshire & Arran as per orthopaedic thromboprophylaxis guidelines NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit August & September 2011 Page 3 of 8
Page 1: Area Drug & Therapeutics Committee
Page 5 and 6: The following products have not bee
Page 7 and 8: Medicines under review by the Medic

NHS Ayrshire & Arran Formulary Bulletin - NHS Ayrshire and Arran.

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?