Greater Manchester Medicines Management Group

Greater Manchester Clinical Standards Board

NHS

Current Adult Red Amber Green (RAG) List - Date order

On this page you will find our RED AMBER GREEN DNP/GREY list for adults(scroll down to see the list).

Please note that only drugs added since 29th June 2018 are displayed here. To view the full list, please click here.

Red Amber Green Classifications

Red

Drugs considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.

Amber

Drugs suitable for shared care arrangements under a shared care protocol.
Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.

Green
specialist initiation

Drugs designated green with specialist initiation are suitable for on-going prescribing within primary care. Little or no monitoring is required. Transfer of prescribing should occur after initiation and an initial review (unless specified) in secondary care.

Green
following specialist
recommendation

For drugs that can be initiated by primary care following written or verbal advice from a specialist and can then subsequently be safely prescribed in primary care with little or no monitoring required.

Green

Drugs designated green are suitable for initiation (unless specified otherwise) and ongoing prescribing within primary care.

DNP

Products which have been reviewed by the GM Formulary & Managed Entry Subgroup and have been deemed not suitable for prescribing for adults and children in primary or secondary care within Greater Manchester (in addition to all medicines with a “not NHS” or “DLCV” classification in the BNF, those agents with a NICE “Do not do” recommendation, and those agents included in the NHS England: “Items which should not routinely be prescribed in primary care” guidance).

Grey

Items which are listed as Grey are deemed not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient. A patient may be deemed exceptional if the patient has a clinical picture that is significantly different to the general population of patients with that condition and as a result of that difference the patient is likely to derive greater benefit from the intervention than might normally be expected for patients with that condition.

Criteria for inclusion on DNP/grey lists:

 

 

Criterion 1:

Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns.

 

Criterion 2:

Products which are clinically effective but where more cost-effective products are available, including products that have been subject to excessive price inflation.

 

Criterion 3:

Products which are clinically effective but, due to the nature of the product, are deemed a low priority for NHS funding.

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Filter list by RAG status

 

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Filter list by BNF Chapter

 

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Filter list by Formulary drug

 

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Drug (proprietary
examples)

BNF
Chapter

Indications and
rationale

Formulary
drug

RAG
status

Information

Responsible
commissioner

Date added

Cenegermin 

11 

Criterion 1 

DNP  

DNP
 

NICE TA532 

 

12 11 2018 

Dupilumab 

13 

Biologics/cytokine modulators 

Yes  

Red
 

NICE TA534 

CCG 

12 11 2018 

Ixekizumab 

10 

Biologics/cytokine modulators 

Yes  

Red
 

NICE TA442 (plaque psoriasis) and NICE TA537 (psoriatic arthritis) 

CCG 

12 11 2018 

Ketamine oral solution 

Specialist use only, for short-term use as an opiate-sparing agent 

Yes  

Red
 

 

CCG 

12 11 2018 

Megestrol 

Treatment of breast cancer 

Yes  

Green
Green
following
specialist

 

NHSE 

12 11 2018 

Ocrelizumab 

Relapsing–remitting multiple sclerosis 

Yes  

Red
 

NICE TA533: Ocrelizumab for treating relapsing–remitting multiple sclerosis 

NHSE 

12 11 2018 

Emollient bath additives 

13 

Criterion 1
When used for the management of eczema in children. This recommendation does not apply to the use of standard emollients when used in the bath as a soap substitute  

DNP  

DNP
 

 

 

27 09 2018 

Emollient bath additives containing antimicrobials 

13 

Criterion 1
Only for short term use in patients with infected eczema.  

Grey  

Green
 

 

CCG 

27 09 2018 

Paravit-CF® 

Criterion 3
Only for use in patients with cystic fibrosis  

Grey  

Green
 

 

CCG 

27 09 2018 

Tadalafil 

Treatment of erectile dysfunction 

Yes  

Green
 

 

CCG 

27 09 2018 

Therabite 

10 

Criterion 1 

DNP  

DNP
 

 

 

27 09 2018 

Benzydamine oral spray and rinse 

12 

For use in palliative care or following radiotherapy 

Yes  

Green
 

 

CCG 

12 09 2018 

Ciprofloxacin ear drops (Cetraxal®

12 

Criterion 3.
For treatment of otitis externa only in cases of proven Pseudomonas infection 

Grey  

Green
 

 

CCG 

22 08 2018 

Guselkumab 

13 

Biologics/Cytokine modulators 

Yes  

Red
 

 

CCG 

20 07 2018 

Brodalumab 

13 

Biologics/Cytokine modulators 

Yes  

Red
 

 

CCG 

19 07 2018 

Cariprazine 

Criterion 2 

DNP  

DNP
 

 

CCG 

19 07 2018 

Dicycloverine 

Criterion 2 

DNP  

DNP
 

 

CCG 

19 07 2018 

Lurasidone 

For the treatment of schizophrenia in adults aged 18 years and older who require antipsychotic treatment, who have previously had a trial of but not responded to aripiprazole, and who fulfil one of the following criteria:
• Patient gained weight on other antipsychotics and there is a need for the BMI to move towards the normal range
• Patients for whom there is a need to avoid weight gain and metabolic adverse effects, e.g. patients with diabetes, cardiovascular disease
• Patients with a prolonged QTc interval  

Grey  

Amber
 

Treat as RED
pending SCP 

CCG 

19 07 2018 

Tocilizumab 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

CCG 

19 07 2018 

Triptorelin (Salvacyl) 

Testosterone castration in sex offenders 

 

Red
 

 

CCG 

29 06 2018 


20 records found 

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