Consultation: actions from June meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the June 2022 CRG meeting.

Actions in this consultation include:

  • Minoxidil foam to be DNP, and formulary updated to clarify that other topical minoxidil preparations are not prescribable
  • Lixisenatide to be removed from formulary following discontinuation of initiation packs
  • Romosozumab for severe osteoporosis to be RED, and added to formulary as a first line anabolic treatment alongside teriparatide
  • Selumetinib for symptomatic and inoperable plexiform neurofibromas to be RED
  • Links to NICE clinical guidance on baricitinib for COVID-19 to be added to formulary in chapters 10 & 13.

For information:

  • Epiduo gel: strength to be removed from formulary, to align with primary care dermatology acne pathway
  • Brand name and formulation for topical calcipotriol / betamethasone to be removed from formulary, and replaced with a statement that prescribers should choose the most cost-effective option.
  • Formulary restriction to macrogol 3350 to be removed, replaced with a statement that prescribers should choose the most cost-effective macrogol formulations.

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Thursday 28th July 2022

Consultation: actions from May meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the May 2022 CRG meeting.

Actions in this consultation include:

  • Sitagliptin to replace alogliptin as first choice DPP4 inhibitor
  • Anti-reflux formula milks to be DNP
  • Nirmatrelvir & ritonavir (Paxlovid) to be added to formulary as RED
  • Links to NICE clinical guidance to be added to formulary: NG215 (medicines associated with dependence or withdrawal symptoms) and NG217 (epilepsies in children, young people and adults).
  • Links to MHRA safety advice to be added to formulary: pregabalin: findings of safety study on risks during pregnancy

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Thursday 30th June 2022.

Consultation: actions from March meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the March 2022 CRG meeting.

Actions in this consultation include:

  • Moxonidine – GREEN following specialist initiation
  • Ponesimod for relapsing-remitting multiple sclerosis – RED
  • Upadacitinib for active psoriatic arthritis – RED
  • Palforzia for peanut allergy in children and young people – RED on the paediatric RAG list, and GREY and RED on the adult RAG list, only for use in people aged 18 and over if treatment is started between the ages of 4 and 17, as per NICE guidance
  • Odevixibat for progressive familial intrahepatic cholestasis – RED

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Thursday 21st April 2022.

Consultation: actions from February meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the February 2022 CRG meeting.

Actions in this consultation include:

  • Modafinil for narcolepsy and in Parkinson’s disease: GREEN following specialist initiation
  • Dacepton (apomorphine): AMBER; to be added to existing shared care protocol
  • Bempedoic acid: GREEN following specialist advice (previously specialist initiation)
  • Sotrovimab for COVID-19: RED
  • Mexiletine for myotonia: RED
  • Liraglutide for obesity in people aged 12-17: Do Not Prescribe
  • Dupilumab for severe asthma: RED
  • Belimumab for SLE: RED
  • Cenobamate for epilepsy: GREEN following specialist initiation (by a tertiary epilepsy service)
  • Risdiplam for spinal muscular atrophy: RED
  • Solriamfetol for narcolepsy: RED
  • Fostamatinib for chronic ITP: Do Not Prescribe

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Monday 4th April 2022.

New consultations: pathway updates and formulary amendments

A batch of new consultations has been opened on the GMMMG consultations page. The topics include:

  • Actions from the December meeting of CRG
  • Updated rheumatoid arthritis high cost drugs pathway
  • Updated neuropathic pain pathway
  • Updated headache pathway
  • Updated primary care rebate scheme ethical framework

Each of these consultations will be open until 5pm on Monday 14th February, and comments are invited from all stakeholders.

GMMMG are mindful of additional service pressures at present, therefore these consultations will run for eight weeks instead of the usual six. Every effort has been made to allow sufficient time for appropriate clinical input to these documents, but if you foresee any problems or have any questions please contact the secretariat at nuth.enquires.gmmmg@nhs.net.

Consultation: actions from November meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the November 2021 CRG meeting.

Actions in this consultation include:

  • Insulin aspart Sanofi (Trurapi) to be added to formulary as a GREEN drug and first line option for rapid acting insulin.
  • Haloperidol 500 microgram tablets to be DNP (criterion 2)
  • Berotralstat for hereditary angioedema to be added to the RAG list as a RED drug
  • Casirivimab/imdevimab (Ronapreve)® to be added to formulary as a RED drug, with link to NG191

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Thursday 23rd December 2021.

Consultation: actions from October meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the October 2021 CRG meeting.

Actions in this consultation include:

  • Inhaled colistimethate, dornase alfa and tobramycin for cystic fibrosis in children – RED. Repatriation should not be sought until a request to do so has been received from the specialist.
  • Bimekizumab for moderate to severe plaque psoriasis – RED.
  • Link to NG191, Managing COVID-19, to be added to formulary in chapter 2

To take part in this consultation, visit the consultations page. This consultation period is open until 5pm Tuesday 30th November 2021.

Consultation: actions from September meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the September 2021 CRG meeting.

Actions in this consultation include:

  • Insulin degludec for T1DM and T2DM: to be GREEN following specialist initiation and GREY (criterion 3)
  • Dapsone 50mg & 100mg tablets as second line option for Pneumocystis carinii pneumonia (PCP) prophylaxis to be GREEN following specialist initiation
  • Isoniazid 100mg tablets for TB prophylaxis in renal patients considered to be at high risk of developing TB to be GREEN following specialist initiation
  • Duloxetine 90mg & 120mg capsules to be GREEN and GREY (criterion 2), only to be used where the prescriber believes that patient’s pill burden is high enough to justify the extra cost associated with the use of these formulations.
  • The following NICE guidelines will be added to formulary:
    • NICE NG201: antenatal care
    • NICE NG202: obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s
    • NICE NG203: Chronic kidney disease: assessment and management

To take part in this consultation, visit the consultations page. This consultation period is open until 5pm Tuesday 2nd November 2021