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 2022 CRG meeting.

Actions in this consultation include:

  • Ozanimod for moderately to severely active ulcerative colitis – RED
  • Relugolix / estradiol / norethisterone for moderate to severe symptoms of uterine fibroids – GREEN (following specialist advice)
  • Remove fostamatinib from DNP list and assign a RED status
  • Replace links to superseded NICE clinical guideline CG177 with links to NG226: Osteroarthritis in over 16s. Formulary note regarding glucosamine updated to read “Do not offer glucosamine products or strong opioids for the management of osteoarthritis.”

All links to MHRA drug safety updates will be added to formulary as appropriate.

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Friday 23rd December 2022.


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 2022 CRG meeting.

Actions in this consultation include:

  • Estradiol and testosterone for gender dysphoria (when under NHS care) – GREEN (following specialist initiation)
  • Dexcom One real-time CGM system – to be available as an alternative first-line option to FreeStyle Libre.
  • Chloral hydrate & chloral betaine – RED
  • Dexamethasone intravitreal implant for diabetic macular oedema – update links to reflect latest NICE technology appraisal
  • Avacopan for severe active granulomatosis with polyangitis or microscopic polyangitis – added to RAG list only as RED
  • Upadacitinib for active ankylosing spondylitis – RED

All links to MHRA drug safety updates will be added to formulary as appropriate.

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


Consultation: actions from July meeting of CRG

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

Actions in this consultation include:

  • Ranibizumab biosimilar to be added to formulary as RED, and ranibizumab to be first choice anti-VEGF therapy for NICE-approved indications.
  • Melatonin (Adaflex) to be added to formulary as AMBER (children) and GREEN (specialist advice) for adults with REM sleep behaviour disorder in Parkinson’s disease.
  • Mexiletine – RED for life-threatening ventricular arrhythmias
  • Filgotinib – RED for moderately to severely active ulcerative colitis
  • Faricimab – RED for diabetic macular oedema and wet age-related macular degeneration
  • Diroximel fumarate – RED for relapsing-remitting multiple sclerosis
  • Teduglutide – RED for short bowel syndrome
  • NICE clinical guideline for gout, NG219, to add to formulary.

All links to MHRA drug safety updates will be added to formulary as appropriate.

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


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.