Greater Manchester Medicines Management Group

Greater Manchester Clinical Standards Board



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News Summary

From this page you will be able to access a summary of additions or changes to the GMMMG website during Apr 2017

April 2017




Purdah Period:

A General Election for the UK Parliament has been called for 8 June 2017. In accordance with national guidance for NHS organisations, this website will not be updated during the pre-election period, other than to publish routine guidelines and/ urgent operational information. Health Care Professionals within GM will still be able to access all materials either via the password protected site or email.

High Cost Drugs Subgroup (HCDSG)

The GMMMG High Cost Drugs Subgroup (HCDS) met for the first time on 25th January 2017 and again in February, but did not meet in March. They will next meet on the 26th April.

The minutes of the January meeting are available from the GMMMG website. At the February meeting the group discussed:

  • Development of a process for the approval of Blueteq forms, this process is currently being trialed with the recent GM consultation for Blueteq forms for Adalimumab, Golimumab, Infliximab and Vedolizumab for UC and CD
  • Scoping of the Homecare service provision across GM
  • High Cost Drug Challenge Process and reporting
  • Changes in commissioning arrangements of PBRE drugs
  • Horizon scanning and financial planning for new high cost drugs

Formulary and Managed Entry Subgroup (FMESG)


The minutes of the January meeting are available from the GMMMG website

The following formulary additions/ amendments were approved by the group:

  • The formulary will be updated to reflect recent NICE guidance and MHRA Drug safety updates
  • Chapter 2 of the formulary will be updated to include a link to the GMMMG approved PCSK9 inhibitors recommendation for hypercholesterolemia. Rosuvastatin will be added to the formulary as an alternative to atorvastatin (green RAG status), in line with this recommendation. A link will be added to supporting information regarding ticagrelor and TA420.
  • The group approved the addition of commercial eyelid cleansing preparations to the DNP list. There is limited evidence to support the effectiveness of these products over traditional eyelid hygiene methods, and so they were deemed an ineffective use of NHS resources.

The following RAG status decisions were approved

  • Imiquimod for actinic keratosis – green
  • Imiquimod for genital warts – green specialist initiation (local commissioning arrangements may vary)
  • Pre-meds for patients receiving enzyme replacement therapy; A statement to be included on RAG list: ‘that any pre-meds for procedures/services commissioned by NHS England where GPs are not expected to be involved in the patients care must be provided by secondary or tertiary care provider’


At the March 2017 meeting the Formulary and Managed Entry Subgroup proposed the following RAG classifications, and now invite comments on these proposals from GM stakeholders. Industry are invited to comment on factual inaccuracy only. Please submit any comments here by 5pm on Monday 15th May 2017.

Pathways and Guidelines Development Subgroup (PaGDSG)


The following revised and updated Shared Care Protocols were approved at the April 2017 meeting of the GMMMG:


The Pathways and Guidelines Development Subgroup has approved a GMMMG Asthma Management Plan and GMMMG Asthma Inhaler Guide They can be found on the  GMMMG website (pathways section)


The Pathways and Guidelines Development Subgroup has approved a supporting information document for GPs on prescribing for Gender Dysphoria. It can be found on the  GMMMG website (Drug specific recommendations section).


The GMMMG harmonised biologics pathway for rheumatoid arthritis has been updated and is open for consultation.

The pathway is intended for use in patients under the care of the Greater Manchester health economy and we therefore seek comments from all GM NHS healthcare professionals.

To assist with the consultation, a change report has also been produced.

This consultation period is open until  5pm on Friday 26th May 2017).

Please be reminded that ALL comments must be received during the consultation period.

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