RECOMMENDATIONS OF THE
PHARMACEUTICAL BENEFIT ADVISORY COMMITTEE
15 March 2016
- Summary
The Pharmaceutical Benefit Advisory Committee (PBAC) met on 15 March 2016 to consider applications for changes to the Prescribed List.
1.1 The PBAC recommended the addition of one new medicine to the Prescribed List, as follows:
1.1.1 Cefixime Tablet 200mg
1.2 The following four formulations of medicines already included in the Prescribed List were also recommended:
1.2.1 Levodopa/carbidopa/entacapone 175/43.75/200 (Stalevo 175) tablet
1.2.2 Omeprazole 10mg orodispersible tablets (paediatric use only)
1.2.3 Exenatide modified-release 2mg injection (Bydureon)
1.2.4 Dimeticone 4% Lotion
1.3 The Committee recommended removal from the Prescribed List of the following medicines:
1.3.1 Omega-3 ethyl esters (Omacor)
1.3.2 Permethrin 1% crème rinse
1.3.3 Discontinued items – see appendix 2
1.4 The Committee recommended that the following, patent-expired medicines, should now be included in the Prescribed List as ‘Generic Only’ items:
1.4.1 Morphine Sulphate modified release tablets
1.5 In addition, the Committee recommended minor amendment of existing entries in the Prescribed List for:
1.5.1 Permethrin dermal cream 5% (to specify 5% strength)
1.5.2 Sudocrem cream (to remove erroneous 25mg strength)
1.6 Applications for one product to be added to the Prescribed List was not supported:
1.6.1 Fluticasone propionate 50mcg/Azelastine hydrochloride 137mcg (brand name Dymista)
The overall financial impact of these changes to the Prescribed List was considered to be a reduction in total expenditure of around £80,000, driven largely by the removal of Omacor from the Prescribed List. The addition of the small number of new products was believed to have little impact on total prescription costs.
Mrs Alison Creed
Chair, PBAC
15 April 2016
- Recommendations
- Items to be added to the Prescribed List
2.1.1 | Cefixime Tablet 200mg Cefixime is a cephalosporin-type antibiotic. It is recommended in national guidelines for the management of common infections in primary care as a 2nd line option in children with upper urinary tract infections. . |
2.1.2 | Levodopa/carbidopa/entacapone 175/43.75/200 (Stalevo 175) tablet This combination product for the treatment of Parkinson’s disease is already included in the Prescribed List with a range of strengths except the ‘175’ strength. Addition will ensure that the full range of strengths is available for patients. |
2.1.3 | Omeprazole 10mg orodispersible tablets (paediatric use only) Omeprazole is a proton-pump inhibitor used to reduce the secretion of stomach acid and used to treat acid reflux and gastro-intestinal ulcers. The Committee noted that there is currently no product of this therapeutic type in an easy to swallow form that is licensed for use in children. The Committee agreed that, though more expensive that standard oral forms of omeprazole, restricting use to children only will not cause a substantial increase in expenditure. |
2.1.4 | Exenatide modified-release 2mg injection (Bydureon) Exenatide is used for the treatment of type II diabetes. The Committee noted that this ‘slow-release’ formulation of an injectable product already in the Prescribed List. It is recommended for use by NICE. The cost of the ‘slow-release’ product is marginally more expensive than the standard product, which would be encouraged for use in the first instance. |
2.1.5 | Dimeticone 4% Lotion The Committee accepted the recommendation for this evidence-based treatment for head-lice, which is a more effective replacement for the product currently included in the Prescribed List. |
2.2 Items not recommended for addition to the Prescribed List
2.3.1 | Fluticasone propionate 50mcg/Azelastine hydrochloride 137mcg (brand name Dymista) This nasal spray for the treatment of hayfever has been previously considered and rejected by PBAC. The Committee again considered it to offer no compelling advantage over existing treatments that could justify its additional cost. |
Appendix 1: Estimated financial impact of applications
| | Estimated annual expenditure |
2.1.1 | Cefixime Tablet 200mg. | <£1,000 |
2.1.2 | Levodopa/carbidopa/entacapone 175/43.75/200 (Stalevo 175) tablet | No change |
2.1.3 | Omeprazole 10mg orodispersible tablets (paediatric use only) | <£1,000 |
2.1.4 | Exenatide 2mg injection (Bydureon) | <£5,000 |
2.1.5 | Dimeticone 4% Lotion | No change |
Appendix 2
Discontinued items to be removed from the Prescribed List
- Amphoteracin 10mg lozenges –
- Becodisks
- Benzatropine tablets and injection
- Benzylpenicillin 0.5MU & 1MU
- Betnesol-N eye ointment
- Betnovate-C (all preparations)
- Cabergoline 4mg tablets
- Calcipotriol cream
- Calcium lactate gluconate effervescent tablets
- Calcium polystyrene sulphonate retention enema
- Carbaryl
- Cetomacrogol cream
- Cicatrin (all preparations)
- Cimetidine injection
- Clomipramine liquid
- Clonidine 300mcg tablets
- Co-amoxiclav soluble tablets
- Compound coconut oil ointment
- Cortisone acetate tablets
- Dipivefrine eye drops
- Distigmine tablets
- Domperidone suppositories
- Econazole / hydrocortisone cream
- Edrophonium
- Ergocalciferol injection (IM)
- Estradiol vaginal tablet 25mcg / 0.01% cream
- Estriol pessary
- Estropipate
- Famciclovir 750mg
- Fenbufen
- Flexible collodion
- Flurbiprofen M/R
- Fluticasone diskhaler
- GTN SA tablets
- Haloperidol 500mcg/5ml liquid
- Hydrocortisone / Crotamiton cream
- Hydrous ointment BP
- Ketoprofen 100mg caps
- Levobunolol 1.4% PF eye drops
- Lithium carbonate tablets 200mg & 400mg
- Locorten vioform ear drops
- Megestrol 40mg
- Meloxicam suppositories
- Metolazone
- Mexenone
- Mianserin 20mg tablets
- Nabumentone suspension
- Nalidixic acid suspension
- Neomycin ointment 0.5%
- Nicotinamine
- Nystatin cream & ointment
- Otosporin ear drops
- Pentazocine sup
- Physostigmine eye drops
- Piperazine & senna powder
- Procainamide tablets
- Prontoral
- Salicylic acid collodion & powder
- Salmeterol diskhaler
- Secobarbital
- Senna granules
- Silicone cream
- Slow Fe Folic
- Sodium bicarbonate eye lotion
- Sodium fluoride drops / mouthwash / tablets
- Sulphur BP
- Syrup simplex BP
- Triamcinolone / Gramicidin / neomycin / nystatin otic ointment
- Triclofos
- Trifluoperazine IM
- Vioform
- Zinc sulphate eye drops
- Zinc sulphate injection
- Zinc undecanoate injection