Prescribed List (Jersey): Changes as of 1 June 2011

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A decision made 18 April 2011:

Decision Reference: MD-S-2011-0030
Decision Summary Title :	DS - Prescribed List June 2011		Date of Decision Summary:	14 April 2011
Decision Summary Author:	Policy Principal		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	WR - Prescribed List June 2011		Date of Written Report:	14 April 2011
Written Report Author:	Policy Principal		Written Report : Public or Exempt?	Public
Subject: Changes to be made to the Prescribed List (Jersey) as at 1 June 2011
Decision(s): The Minister approved the changes to the Prescribed List (Jersey) as recommended by the Pharmaceutical Benefit Advisory Committee from the meeting held on 6th April 2011. To be included from 1 June 2011 as green items: Calcium carbonate 500mg, colecalciferol 400 units caplets (Calcichew D3 500mg/400units) Doublebase Emollient Wash gel 200g pump (containing isopropyl myristate 15% w/w, liquid paraffin 15% w/w) Betamethasone dipropionate 0.05%, calcipotriol 50mcg/g (Dovobet gel) To be included as amber items (for initiation/stabilisation in secondary care before transfer to primary care) Saxagliptin tablets 2.5mg To give notice that the following items be deleted from 1 July 2011 Xamiol gel
Reason(s) for Decision: The Pharmaceutical Benefit Advisory Committee met on 6th April 2011 and proposed the recommended changes to the Prescribed List (Jersey), effective from 1 June 2011. The changes represent best value amendments for approved medicines and ensure that General Practitioners have the choice available to them of modern, safe and effective medicines.
Resource Implications: The additions represent an estimated net cost to the fund of approximately £2000 per annum.
Action required: Policy Principal to issue 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):

Prescribed List (Jersey): Changes as of 1 June 2011

Recommendations of the Pharmaceutical Benefit Advisory Committee

6th April 2011

1. Summary

The Pharmaceutical Benefit Advisory Committee met on 6th April 2011 to consider the inclusion and/or deletion of certain products from the Prescribed List. The PBAC recommended the inclusion of 4 items (3 green status items, 1 amber status items). The Committee also recommended the deletion of one product as detailed in this report. The additions represent increased treatment options for existing medical conditions and will enhance concordance with medicine treatment and reduce unnecessary medicine waste. The total cost impact to the fund is estimated to be less than £2000 per annum.

2.0. Items for inclusion

2.1. Calcium carbonate 500mg, colecalciferol 400 units caplets (Calcichew D3 500mg/400units) (Green Classification)

Indications and Licensed for:

a) Prevention and treatment of vitamin D and calcium deficiency in the elderly.

b) Vitamin D and calcium supplement as an adjunct to specific osteoporosis treatment of patients who are at risk of vitamin D and calcium deficiency

Cost per patient at recommended dose

Annual cost at recommended dose of one tablet twice daily

Calcichew D3 500/400 £55

Alternatives on the List

Calceos (chewable tablet, lemon), Calcichew D3 Forte (chewable tablet, lemon),Adcal-D3 (chewable tablet, lemon/tutti frutti), Calfovit D3 (powder,lemon)

Cost of existing options

Adcal D3 £51

Calceos £44

Calcichew D3 Forte £53

Calfovit D3 £53

This item is an additional formulation to current treatment options available on the list. The product is the only tablet formulation of high-strength calcium/colecalciferol that is not chewable or effervescent, and so provides increased choice for patients and may increase adherence to treatment. Some patients may prefer plain tablets to other formulations. In addition, Calcichew D3 500/400 caplets may be dispensed in a monitored dosage system, unlike chewable or effervescent products. It is a similar price to existing options and the cost impact will therefore be minimal.

2.2. Doublebase Emollient Wash gel 200g pump (containing isopropyl myristate 15% w/w, liquid paraffin 15% w/w) (Green Classification)

Indications and licensed for:

a) A first line treatment and prophylaxis of dry and chapped skin conditions which may also be itchy or inflamed.

b) May also be used as an adjunct to other topical treatments.

Cost per patient at recommended dose

Doublebase Wash £5.29/200g

Alternatives on the List

Doublebase Bath emollient gel £5.54/500mL

Doublebase shower gel £5.29/200g

This item is an additional formulation to current treatment options available on the list. The product is formulated and packaged specifically for hand washing and therefore provides an additional treatment option for patients already using similarly priced emollients so unlikely to be used by ‘new’ patients .

2.3. Betamethasone dipropionate 0.05%, calcipotriol 50mcg/g (Dovobet gel) (Green Classification)

Indications and licensed for:

a) Topical treatment of scalp psoriasis in adults.

b) Topical treatment of mild to moderate “non-scalp” plaque psoriasis vulgaris in adults.

Cost per patient at recommended dose

Dovobet gel £36.50/60g ; £67.79/2x60g

Alternatives are on the List?

Dovobet ointment £32.99/60g; £61.27/120g

Xamiol gel £36.50/60g (contains betamethasone dipropionate 0.05%, calcipotriol 50mcg/g; licensed for treatment of scalp psoriasis)

This item is an additional formulation to current treatment options available on the list. Its formulation, which is less greasy than Xamiol gel, may be more acceptable to patients. The presentation offers additional choice at the same price as other formulations currently used so unlikely to be used by ‘new’ patients.

2.4 Saxagliptin tablets 2.5mg (Amber Classification)

Saxagliptin 5 mg tablet is an approved item. This is therefore an additional lower strength tablet required to provide appropriate lower dose treatment in patients and prevents unnecessary medicine wastage.

3. Items for deletion

Xamiol gel £36.50/60g (contains betamethasone dipropionate 0.05%, calcipotriol 50mcg/g; licensed for treatment of scalp psoriasis)

Xamiol gel offers no stated advantage as Dovobet gel at the same price. Therefore Xamiol gel should be deleted from the list from 1st July 2011.

Summary of recommendations

Table One Summary of PBAC Recommendations

Item	Reason for change	Status	Net effect on annual expenditure
Calcium carbonate 500mg, colecalciferol 400 units caplets (Calcichew D3 500mg/400units)	New formulation offers additional choice at similar annual cost to other products on the List.	Alternative formulation to current treatment	Minimal less than £500
Doublebase Emollient Wash gel 200g pump (containing isopropyl myristate 15% w/w, liquid paraffin 15% w/w)	New presentation offers additional choice at same price as other products currently used.	Alternative formulation to current treatment	Minimal less than £500
Betamethasone dipropionate 0.05%, calcipotriol 50mcg/g (Dovobet gel)	New presentation offers additional choice at same price as other products currently used.	Alternative formulation to current treatment	Minimal less than £500
Saxagliptin tablets 2.5mg	Additional, lower strength tablet to provide lower dose for use in selected patients.	Addition required to provide lower dose treatment	Minimal less than £500
Xamiol gel (contains betamethasone dipropionate 0.05%, calcipotriol 50mcg/g; licensed for treatment of scalp psoriasis)	No stated advantage to Dovobet gel	Deleted	None

4. Recommendation

The Minister is asked to approve the changes to take effect from 1st June 2011. The total additional costs are estimated to be £2000.