Consultation: DOAC switch to edoxaban for NVAF patients

Following development by a working group of healthcare professionals from Manchester and Trafford, we now seek comments on the draft document: ‘DOAC switch to edoxaban for NVAF patients – protocol’.

Please note that this consultation will run for 3 weeks; please visit the consultations page to take part. The consultation will run until 5pm on Monday 9th October 2023.


Formulary and RAG updates – August 2023

Following approval by CRG, the July meetings of GMMMG and the Greater Manchester ICS Clinical Effectiveness and Governance Committee, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

The formulary has also been updated to reflect relevant safety alerts and NICE guidelines. For full details, see the GMMMG decision summary for August 2023, or the formulary change log available on the formulary page.


Formulary update – CGM

Following approval by the GM Executive, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

  • FreeStyle Libre 2 and Dexcom ONE added to formulary.

For full details, see the formulary change log available on the formulary page.


Consultation: steroid eye drop information for primary care prescribers

Following development by Manchester Royal Eye Hospital we now seek comments on the draft document: ‘Prescribing Information for Primary Care: Steroid Eye Drops for Ophthalmic Indications’.

The consultation will run for 6 weeks; please visit the consultations page to take part. The consultation will run until 5pm on Wednesday 27th September 2023.

Please note: the RAG status of the steroid eyedrops is currently undergoing a separate consultation, with a proposed change from RED to GREEN (following specialist initiation). Please see the proposed actions from the August 2023 meeting of the Clinical Reference Group for more details.


Formulary and RAG updates – July 2023

Following approval by CRG, the July meetings of GMMMG and the Greater Manchester ICS Clinical Effectiveness and Governance Committee, and review by the GM Executive, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

  • Finerenone for CKD in type 2 diabetes added as GREEN (specialist advice)
  • Semaglutide for overweight and obesity added as RED
  • Orodispersible morphine added as GREEN and GREY, only for use when specified criteria are met
  • Eptinezumab for preventing migraine added as RED
  • Hydrocortisone modified release capsules (Efmody) added as GREEN (following specialist initiation), only for patients not well controlled on standard release preparations and where specified criteria are met
  • Dapagliflozin for CKD in children added to paediatric RAG list as RED
  • Chloral hydrate and cloral betaine added to the RAG list only as RED
  • Asfotase alfa added to the RAG list only as RED

The formulary has also been updated to reflect relevant safety alerts and NICE guidelines. For full details, see the GMMMG decision summary for July 2023, or the formulary change log available on the formulary page.


High cost drugs pathways updated

The GMMMG high cost drugs pathways for rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis have been updated. The updates follow a technical review to add information on the MHRA safety alert for JAK inhibitors, and links to NICE TA861 for upadacitinib for treating active non-radiographic axial spondyloarthritis.

GMMMG high cost drugs pathways are available on the Clinical Guidance and Pathways page.


Inclisiran prescribing information

The GMMMG information leaflet on inclisiran prescribing, ordering and cost information has been updated. The updated version reflects revised Drug Tariff reimbursement prices and includes information about longer term use.

All GMMMG information for prescribers is available on the Information Leaflets for Primary Care Prescribers page.


Links to immunisation PGDs

Patient Group Directions (PGDs) for immunisations are hosted on the Greater Manchester Integrated Care website. A link to these PGDs has been added to the GMMMG site on the Prescribing Policies page.


New Consultation: GM guidance on long-term azithromycin in adults with chronic respiratory disease

Following development in Bury and adaptation for implementation across the ICB, we now seek comments on draft guidance for long-term azithromycin for chronic respiratory conditions.

We now seek comments on the draft pathway; please visit the consultations page to take part. The consultation will run until 5pm on Wednesday 7th June 2023.


New consultation: draft hypertension pathway

The Greater Manchester Strategic Clinical Network (SCN) have developed an Adult Hypertension Medication Pathway for use in GM. We now seek comments on the draft pathway; please visit the consultations page to take part.

The consultation will run until 5pm on Tuesday 6th June 2023.