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Information and public services for the Island of Jersey

L'înformâtion et les sèrvices publyis pouor I'Île dé Jèrri

Prescribed list (Jersey) as of 1 March 2021

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A decision made on 2 February 2021

Decision Reference:  MD-S-2021-0008

Decision Summary Title :

DS Prescribed list as of 1 March 2021

Date of Decision Summary:

25 January 2021

Decision Summary Author:

Prescribing Advisor

Decision Summary:

Public or Exempt?

Public

Type of Report:

Oral or Written?

Written

Person Giving

Oral Report:

NA

Written Report

Title :

WR report PBAC 26 November 2020

Date of Written Report:

25 January 2021

Written Report Author:

Prescribing Advisor

Written Report :

Public or Exempt?

 

Public

Subject: Changes to be made to the Prescribed List (Jersey) as of 1 March  2021

Decision(s): Further to Article 15, paragraphs (11) and (12), of the Health Insurance (Jersey) Law 1967, and having consulted with the Pharmaceutical Benefit Advisory Committee, the Minister decided to make amendments to the Prescribed List with effect from 1 March 2021 as set out in the accompanying report and supporting document.

Reason(s) for Decision: The Pharmaceutical Benefit Advisory Committee met to consider applications for changes to the Prescribed List and made the following recommendations:  

1.      Items to be added to the Prescribed List

1.1  Tacalcitol 4micrograms/g ointment

1.2  Calcitriol 3micrograms/g ointment

1.3  Famotidine 20mg tablets; Famotidine 40mg tablets; Nizatidine 300mg capsules

1.4  Semaglutide 3mg tablets; 7mg tablets; 14mg tablets

1.5  Diltiazem modified-release products – to increase range of allowed products

1.6  Calcium and vitamin D – increase range of allowed products to include Accrete D3 tablets/Accrete D3 One a Day tablets

 

The above recommendations reflect current evidence and expert advice and ensure that patients in Jersey have access to an appropriate range of modern, safe and effective treatments from their GPs and community prescribers at a proportionate cost to the Fund.

 

Resource Implications: The overall financial impact of the above changes is expected to be an increase in expenditure. This may be up to an additional £57,000 pa, largely due to the price volatility of generic famotidine/nizatidine. However, prices of similar medicines in the Prescribed List have increased due to stock shortages so the actual impact of the changes is expected to be much less.

Action required: Health Zone Manager at Customer and Local Services to issue a public notice listing amendments and notify all approved medical practitioners and approved contractors.

Signature:

 

 

Position:

Minister

 

Date Signed:

 

 

Date of Decision (If different from Date Signed):

 

Hide report
Prescribed list (Jersey) as of 1 March 2021

RECOMMENDATIONS OF THE

PHARMACEUTICAL BENEFIT ADVISORY COMMITTEE

 

Summary

 

The Pharmaceutical Benefit Advisory Committee (PBAC) met on 26 November 2020 to consider applications for changes to the Prescribed List.

The PBAC was unanimous in its recommendations for the following changes to the Prescribed List to be implemented from 1 March 2021, unless stated otherwise.

 

1.      Items to be added to the Prescribed List

 

1.1  Tacalcitol 4micrograms/g ointment

1.2  Calcitriol 3micrograms/g ointment

1.3  Famotidine 20mg tablets; Famotidine 40mg tablets; Nizatidine 300mg capsules

1.4  Semaglutide 3mg tablets; 7mg tablets; 14mg tablets

1.5  Diltiazem modified-release products – to increase range of allowed products

1.6  Calcium and vitamin D – increase range of allowed products to include Accrete D3 tablets/Accrete D3 One a Day tablets

 

2.      Items to be removed from the Prescribed List

 

2.1 None recommended

1

 


 


 

 

Financial impact

 

The overall financial impact of the above changes is expected to be an increase in expenditure. This may be up to an additional £57,000 pa, largely due to the price volatility of generic famotidine/nizatidine. However, prices of similar medicines in the Prescribed List have increased due to stock shortages so the actual impact of the changes is expected to be much less.

 

Mrs Alison Creed, PBAC Chair

26 November 2020

 


Recommendations

 

  1. Items to be added to the Prescribed List

 

1.1 Tacalcitol 4micrograms/g ointment

1.2 Calcitriol 3micrograms/g ointment

 

Tacalcitol and calcitriol are two vitamin D analogues applied topically to the skin for the treatment of psoriasis. Both are effective treatments already available through Jersey General Hospital. This group of medicines is recommended as part of the NICE Clinical Guideline for the management of psoriasis (Sept 2017).

Inclusion of both products, for initiation and ongoing prescribing in primary care, is likely to have a modest impact on HIF expenditure with an estimated £10,000 increase per annum.

 

1.3 Famotidine 20mg tablets; Famotidine 40mg tablets; Nizatidine 300mg capsules

 

Famotidine and nizatidine are histamine (H2) blockers that reduce the production of gastric acid and so are used in the treatment of dyspepsia and associated conditions. A number of similar products are already included in the Prescribed List, including cimetidine, ranitidine and a lower strength of nizatidine, but their supply and prices are very volatile resulting in treatment shortages. The inclusion of further options from this group of medicines will provide greater flexibility for prescribers and community pharmacists in ensuring patients get some treatment.

Around £47,000 pa is currently spent on H2-blockers in the community and this could increase 2-3 fold with the inclusion of these additional products. However, accurate estimates are difficult due to the volatility of the current market.

 

1.4 Semaglutide 3mg tablets; 7mg tablets; 14mg tablets

 

Semaglutide is used for the treatment of adults with insufficiently controlled type 2 diabetes mellitus to improve glycaemic control as an adjunct to diet and exercise. It can be used as monotherapy when metformin is considered inappropriate due to intolerance or contraindications, or in combination with other medicinal products for the treatment of diabetes.

 

Semaglutide injection is already included in the Prescribed List. This oral (tablet) product is more recently licensed and provides an alternative.

 

The addition of semaglutide tablets to the Prescribed List is expected to be cost-neutral as it will provide an alternative for similarly priced products.

 

1.5  Diltiazem modified-release products – to increase range of allowed products

 

There are a wide range of diltiazem products available of the market. Choice of product has been restricted in the Prescribed List to try to ensure consistency in prescribing and minimise stockholding for community pharmacies. However, pharmacies have experienced difficulties in accessing supplies of some diltiazem products resulting in delays for patients. Ensuring that the full range of products is included in the List will provide flexibility for prescribers and their patients with minimal impact on overall expenditure.

 

 

 

 

1.6 Calcium and vitamin D – increase range of allowed products to include Accrete D3 tablets/Accrete D3 One a Day tablets

 

A number of products containing calcium and vitamin D, for the improvement of bone health and prevention of osteoporosis, are included in the Prescribed List but new products continue to be released. Accrete D3 and Accrete D3 One a Day are amongst the lowest cost of these products. Their inclusion in the List would, therefore, increase choice for prescribers and their patients, and introduce competition to the market and, potentially, reduce overall expenditure.

to the Prescribed List.

1

 

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