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 July 2017

August 2017


Formulary and Managed Entry Subgroup (FMESG)


A draft copy of the updated GMMMG formulary section 6.2 drugs used in diabetes [Link removed - consultation closed] is currently open for comments. Comments from GM NHS healthcare professionals are invited. Industry may comment on factual inaccuracy of this content only. This consultation period is open until 5pm on 11th  September 2017, comments should be submitted via the feedback form [Link removed - consultation closed].


The FMESG met on the 25th July 2017.

The minutes of the May (postponed until the 13th June) meeting are available here.

The following amendments to the formulary were approved at the August GMMMG meeting:

  • The formulary was updated to reflect NICE TA and MHRA recommednations
  • Invicorp was added to chapter 7 for those patients who have failed on PDE5 inhibitors and find Caverject® injections painful
  • Opicapone and safinamide were added to chapter 4 of the formulary, and Tolcapone was removed.
  • Nefopam was added to the grey list only for use in those patients with moderate to severe chronic liver disease who require analgesia stronger than paracetamol in whom NSAIDS and moderate strength opiates are contraindicated
  • An application to include Enstilar® within the formulary was rejected (further details can be found in the May meeting minutes)

High Cost Drugs Subgroup (HCDSG)


The GMMMG High Cost Drugs Subgroup (HCDSG) met on the 26th June.

The minutes of the June meeting are available here.

At the June meeting the group agreed the following recommendations:

  • GM biosimilar gain share agreement
  • Biosimilar rituximab: early adoption across GM

These items were approved by GMMMG in July 2017, and have been submitted to AGG for approval. The rituximab biosimilar recommendation is available from the GMMMG website, the gain share recommendation will follow after approval by AGG.

HCDSG approved the ophthalmology pathway at the May meeting and sought GMMMG gained GMMMG approval in July. The pathway has now been forwarded to AGG for approval as it presents a cost pressure. The group also requested that GMMMG consider the pressures facing GM ophthalmology services across GM, and whether there is scope for these issues to be considered via the GMMMG work stream.

HCDSG approved the updates to the harmonized biologics pathway for rheumatoid arthritis, this was approved by GMMMG in August and will be available from the GMMMG website shortly. The GM biologics for psoriasis pathway has been updated and opened for GM wide consultation until 5pm on Friday 25th August.

HCDSG have undertaken a review of the workforce involved in the direct and indirect HCD and homecare processing and management activities. The outcomes of this exercise may influence future workforce arrangements within clinical services associated with HCDs. HCDSG considered the information provided and agreed that this information would be forwarded to the HPTP at this stage.

HCDSG have undertaken a review of the HCDs data challenge reports. Since 2015 the GMSS have been analyzing and challenging PBRex HCDs on behalf of the GM CCGs. Whilst there has been some improvement in the quality and quantity of data submitted by the GM Trusts, variation in the quality of data submitted remains. The group considered the types and level of reporting and has agreed a number of recommendations which will now be forwarded to DoFs for their approval

The current HCDSG work plan is available here.



At the August meeting, GMMMG updated their travel abroad policy, a copy of which is available here:


GMMMG updated their terms of reference and this has now been published.

GM Diabetes Strategy


The Greater Manchester and Eastern Cheshire Strategic Clinical Network is currently developing a Diabetes strategy. A copy of the draft document is available for comments within the password protected area of the website.

Pathways and Guidelines Development Subgroup (PaGDSG)


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

  • Growth hormone for use in adults
  • Methylphenidate for ADHD in children and adolescents
  • Atomoxetine for ADHD in children and adolescents
  • Dexamfetamine for ADHD in children and adolescents
  • Lisdexamfetamine for ADHD in children and adolescents
  • Risperidone Long-acting antipsychotic injection
  • Aripiprazole Long-acting antipsychotic injection
  • Paliperidone Long-acting antipsychotic injection
  • Hydroxycarbamide for sickle cell disease
  • Hydroxycarbamide for myleoproliferative disorders


The following reviewed and updated  Information Leaflet for Green (following specialist initiation) Drugs were approved at the August 2017  meeting of the GMMMG:

  • Drugs for Dementia - Information for primary care
  • Donepezil - information for primary care
  • Galantamine - information for primary care
  • Memantine - information for primary care
  • Rivastigmine - information for primary care


The Greater Manchester psoriasis biologics pathway [Link removed - consultation closed] has been updated by Greater Manchester NHS psoriasis specialists with the support of Greater Manchester Shared Service.. This pathway is intended for use in patients with severe psoriasis  under the care of the Greater Manchester health economy and we now seek the comments of all GM NHS healthcare professionals. This consultation period is open until 5pm Friday 25th August 2017. Comments should be submitted here [Link removed - consultation closed]. Industry are invited to comment on factual inaccuracies only.

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