New consultation: CRG actions April 2024

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the April 2024 CRG meeting. Actions in this consultation include:

  • Lamotrigine tablets – green specialist advice for bipolar disorder
  • Doxylamine / pyridoxine for nausea and vomiting in pregnancy – removed from grey list and made a first choice option alongside cyclizine and prochlorperazine
  • Levemir InnoLet and Insulatard InnoLet – remove from formulary following discontinuation of the products
  • Buprenorphine prolonged release solution for injection (Buvidal) – add to formulary as alternative to methadone and oral buprenorphine
  • Fluocinolone intravitreal implant – RED
  • Dupilumab for prurigo nodularis – DNP
  • Etrasimod for ulcerative colitis – RED
  • Ritlecitinib for alopecia areata – RED
  • Satralizumab for neuromyelitis optica spectrum disorders – DNP
  • Sebelipase alfa for lysosomal acid lipase deficiency – DNP

All links to NICE clinical guidelines and MHRA drug safety updates will be added to formulary as appropriate.

This consultation will run for six weeks and closes at 5pm on Friday 24th May 2024. To take part, visit the consultations page.


Decisions approved by GM ICB Executive

The decisions made at the Greater Manchester Medicines Management Group (GMMMG) March 2024 meeting have now been reviewed by GM Executive and can be found at https://gmmmg.nhs.uk/meetings/decision-summaries/. This includes the recommendations made by GMMMG in March 2024 and NICE Technology appraisals published in November 2023.

The following decisions were approved and can be found at:

Colleagues are asked disseminate for implementation within your organisations.

Drugs with a NICE recommendation published in December 2023 have been considered by CRG at its March 2024 meeting, and will be considered for approval by GMMMG and CEGC at their April 2024 meetings.

All approved CRG and GMMMG meeting minutes can be found at: https://gmmmg.nhs.uk/meetings/clinical-reference-group/ and https://gmmmg.nhs.uk/meetings/gmmmg-meetings/.


New consultation: salbutamol inhaler switch

On behalf of the NHS Greater Manchester Green Plan Oversight Group, we now seek comments on a proposal for an active switch from Ventolin Metered-Dose Inhaler (MDI) or generic salbutamol MDI to Salamol MDI in primary care.

This consultation will run for six weeks and is open until 5pm on Thursday 16th May 2024. To take part, visit the consultations page.


GMMMG updates – March 2024

Following the March meetings of GMMMG and CEGC, the following actions have been published to the GMMMG website.

Updates to guidelines include:

  • Gabapentinoid resource pack re-published
  • Pathway guidance for managing GLP-1 agonist shortages in adults updated
  • Advice on use on tirzepatide published

Formulary and RAG updates include:

  • Foslevodopa with foscarbidopa added as red

Links to NICE guidance and MHRA safety advice added as appropriate. For full details of formulary and RAG updates, see the formulary change log available on the formulary page.

The following decisions await approval by the GM ICB Executive:

  • Cytisine 1.5mg tablets for smoking cessation – Green first line option
  • Empagliflozin for treating chronic heart failure
  • Riluzole shared care protocol (update)
  • Slenyto rebate scheme

GMMMG updates – January & February 2024

Following the February meetings of GMMMG and CEGC, the following actions have been reviewed by the GM ICB Executive and published to the GMMMG website.

Formulary and RAG updates include:

  • Mirikizumab for ulcerative colitis added as RED
  • Acetylcysteine 600mg effervescent tablets added as GREEN, first choice and carbocisteine tablets made GREEN alternative for use as mucolytics in COPD
  • Tirzepatide for type 2 diabetes added as GREEN, as an alternative to GLP-1 mimetics
  • Carbimazole 10mg & 15mg tablets added to DNP list
  • Gepretix 100mg micronised progesterone added as an additional option for women requiring progesterone for HRT
  • Tofacitinib for active ankylosing spondylitis added as RED
  • Bimekizumab for active psoriatic arthritis and axial spondyloarthritis added as RED

Links to NICE guidance and MHRA safety advice added as appropriate. For full details of formulary and RAG updates, see the formulary change log available on the formulary page.

More details of the published decisions are available from the decision summaries page.


New consultation: CRG actions March 2024

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the March 2024 CRG meeting. Actions in this consultation include:

  • Doxazosin 8mg immediate-release tablets – DNP
  • Atropine 1% eye drops and minims for hypersalivation – GREEN (following specialist advice)
  • Paliperidone palmitate 700mg & 1000mg prolonged-release suspension for injection – add to formulary as AMBER (see also separate consultation on updated shared care protocol)
  • Add belumosudil as RED

All links to NICE clinical guidelines and MHRA drug safety updates will be added to formulary as appropriate.

This consultation will run for six weeks and closes at 5pm on Thursday 28th March 2024. To take part, visit the consultations page.


New consultations: asthma, tobacco, and paliperidone

Three new consultations have opened on the GMMMG website:

  • Asthma Guideline – update for 2024, to include AIR therapy
  • Medical Management of Tobacco Dependency guidelines – update for 2024, to include cytisine
  • Shared care protocol for paliperidone long-acting injection – update

All three consultations will run for six weeks, and close at 5pm on Wednesday 24th April. To take part in these or any other consultations, visit https://gmmmg.nhs.uk/consultations/.


New consultation: statins for primary CV prevention in HIV

Following discussion at the February 2024 meeting of CRG, we now seek comments on a draft position statement on prescribing statins for primary prevention in HIV.

This consultation will run for six weeks and closes at 5pm on Friday 12th April 2024. To take part, visit the consultations page.


New consultation: updated Primary Care Rebate Scheme ethical framework

On behalf of the GMMMG Medicines Value Group, we now seek comments on an update to the GMMMG Ethical Framework for Considering Rebate Applications from Pharmaceutical, Nutrition and Device Companies in primary care.

Please note this consultation includes two documents, provided in a zipped folder.

This consultation will run for six weeks and closes at 5pm on Wednesday 3rd April 2024. To take part, visit the consultations page.


New consultation: DOAC switching guide

On behalf of the GMMMG Clinical Reference Group, we now seek comments on a draft guide on DOAC review and switch to apixaban for NVAF patients.

This consultation period is open until 5pm on Friday 29th March 2024. To take part, visit the consultations page.