Prescribed List: Changes from 1 March 2017

Information about the publication of Ministerial Decisions

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A decision made 3 February 2017:

Decision Reference: MD-S-2017-0011
Decision Summary Title :	Prescribed List Changes 1 March 2017		Date of Decision Summary:	02 February 2017
Decision Summary Author:	Prescribing Advisor		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	Changes to be made to the Prescribed List as at 1 March 2017		Date of Written Report:	02 February 2017
Written Report Author:	Prescribing Advisor		Written Report : Public or Exempt?	Public
Subject: Changes to be made to the Prescribed List (Jersey) as at 1 March 2017
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 2017 as set out in the accompanying report.
Reason(s) for Decision: The Pharmaceutical Benefit Advisory Committee met on 17 January 2017 and has provided the Minister with the recommendations in respect of amendments to the Prescribed List. On considering these recommendations, the Minister would like to make the following amendments. New products to be added to the Prescribed List 1.1 Linagliptin 5mg tablet (brand name Trajenta); linagliptin/metformin 2.5mg/850mg, 2.5mg/1000mg tablets (brand name Jentadueto) for the treatment of type 2 diabetes mellitus 1.2 Tretinoin 250mcg/gram with clindamycin 10mg/gram gel (brand name Treclin) for the treatment of acne 1.3 Insulin degludec 100 IU per ml with liraglutide 3.6mg per ml (brand name Xultophy) for the treatment of type 2 diabetes mellitus 1.4 Adapalene 1mg/gram with benzoyl peroxide 25mg/gram gel (brand name Epiduo) for the treatment of acne 1.5 Docusate sodium oral solution sugar free 50mg/5mL (generic only) Colecalciferol solution (Thorens brand) 25,000 units in 2.5 ml oral solution 2 Additional strengths of products already listed 2.1 Buprenorphine patch 20mcg/hour for the treatment of pain 2.2 Oxycodone m/r tablet 30mg for moderate-severe pain 2.3 Beclometasone 200mcg/dose with formoterol 6mcg/dose metered dose inhaler and dry powder inhaler (brand names Fostair and Fostair NEXThaler) 2.4 Levothyroxine tablets 75mcg (generic only) 2.5 Estradiol with dydrogesterone tablets 0.5mg/2.5mg (brand name Femoston-conti) Items to be removed from the Prescribed List 3.1 Hypromellose preservative-free eye drops 0.32% as lower cost alternatives are available. 3.2 Betamethasone valerate 0.1% with neomycin 0.5% cream and ointment following discontinuation of Betnovate N brand 3.3 The Committee supported the removal of Erythromycin 40 mg, zinc acetate 12 mg/mL (brand name Zineryt) for the treatment subject to wider consultation due to the extensive use of this product at present 4 Other amendments to the Prescribed List 4.1 Buprenorphine patch 5mcg, 10mcg, 20mcg to be reimbursed for both branded and generic products 4.2 Oral contraceptives to be reimbursed for both branded and generic products currently included in the Prescribed List 4.3 Glycopyrronium bromide entry to be amended entries in the Prescribed List to specify strength as 55mcg per dose not 50mcg The changes 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 at a proportionate cost to the Fund.
Resource Implications: The overall impact of the changes is expected to be cost neutral
Action required: Business Manager 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: Changes from 1 March 2017

RECOMMENDATIONS OF THE

PHARMACEUTICAL BENEFIT ADVISORY COMMITTEE

17 January 2017

Summary

The Pharmaceutical Benefit Advisory Committee (PBAC) met on 17 January 2017 to consider applications for changes to the Prescribed List.

The PBAC recommended the following changes to the Prescribed List:

1 New products to be added to the Prescribed List

1.1 Linagliptin 5mg tablet (brand name Trajenta); linagliptin/metformin 2.5mg/850mg, 2.5mg/1000mg tablets (brand name Jentadueto) for the treatment of type 2 diabetes mellitus

1.2 Tretinoin 250mcg/gram with clindamycin 10mg/gram gel (brand name Treclin) for the treatment of acne

1.3 Insulin degludec 100 IU per ml with liraglutide 3.6mg per ml (brand name Xultophy) for the treatment of type 2 diabetes mellitus

1.4 Adapalene 1mg/gram with benzoyl peroxide 25mg/gram gel (brand name Epiduo) for the treatment of acne

1.5 Docusate sodium oral solution sugar free 50mg/5mL (generic only)

1.6 Colecalciferol solution (Thorens brand) 25,000 units in 2.5 ml oral solution

2 Additional strengths of products already listed

2.1 Buprenorphine patch 20mcg/hour for the treatment of pain

2.2 Oxycodone m/r tablet 30mg for moderate-severe pain

2.3 Beclometasone 200mcg/dose with formoterol 6mcg/dose metered dose inhaler and dry powder inhaler (brand names Fostair and Fostair NEXThaler)

2.4 Levothyroxine tablets 75mcg (generic only)

2.5 Estradiol with dydrogesterone tablets 0.5mg/2.5mg (brand name Femoston-conti)

3 Items to be removed from the Prescribed List

3.1 Hypromellose preservative-free eye drops 0.32% as lower cost alternatives are available.

3.2 Betamethasone valerate 0.1% with neomycin 0.5% cream and ointment following discontinuation of Betnovate N brand

3.3 The Committee supported the removal of Erythromycin 40 mg, zinc acetate 12 mg/mL (brand name Zineryt) for the treatment subject to wider consultation due to the extensive use of this product at present

4 Other amendments to the Prescribed List

4.1 Buprenorphine patch 5mcg, 10mcg, 20mcg to be reimbursed for both branded and generic products

4.2 Oral contraceptives to be reimbursed for both branded and generic products currently included in the Prescribed List

4.3 Glycopyrronium bromide entry to be amended entries in the Prescribed List to specify strength as 55mcg per dose not 50mcg

5 Applications deferred

5.1 Atomoxetine capsules 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg for the treatment of ADHD pending views from the Child and Adolescent Mental Health (CAMHs) Team

5.2 Methylphenidate tablet 5mg, 10mg, 20mg; modified-release tablets 18mg, 27mg, 36mg, 54mg; modified-release capsules 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg for the treatment of ADHD pending views from the CAMHs team

5.3 Prednisolone oral solution 10mg/mL (generic only) pending further information on pack sizes and shelf-life

6 Rejected applications

Applications for two products to be added to the Prescribed List were not supported:

6.1 Aclidinium bromide/ formoterol fumarate dihydrate 396mcg/11.8mcg per dose (brand name Duaklir) for the treatment of chronic obstructive pulmonary disease (COPD) due to lack of evidence of signigicant clinical advantage over existing medicines on the Prescribed List

6.2 Empagliflozin tablets 10mg, 25mg; with metformin 5mg/1000mg, 12.5mg/1000mg, 5mg/850mg, 12.5mg/850mg for the treatment of type 2 diabetes due to lack of evidence of signigicant clinical advantage over existing medicines on the Prescribed List

7 Financial impact

The proposed changes to the Prescribed List are estimated to be cost neutral. The additions to the List provide alternative options for treatment at a similar price to products already included in the List.

Mrs Alison Creed

Chair, PBAC

19 January 2017

Recommendations

Items to be added to the Prescribed List

1.1	Linagliptin 5mg tablet (brand name Trajenta); linagliptin/metformin 2.5mg/850mg, 2.5mg/1000mg tablets (brand name Jentadueto) for the treatment of type 2 diabetes mellitus This product is similar to three others on the Prescribed List but has the clinical advantage of not requiring dose adjustment in patients with impaired kidney function. It is the same price as alternatives so use will not increase treatment costs.
1.2	Tretinoin 250mcg/gram with clindamycin 10mg/gram gel (brand name Treclin) for the treatment of acne This is one of two products for the treatment of acne that were recommended for addition to the Prescribed List following a local review with GPs of treatment guidelines. Both new products support the aim of limiting the use of topical antibiotics and minimising the risk of developing bacteria that are resistant to commonly used antibiotics. They are similarly priced to existing treatment options and so are not expected to present a cost pressure.
1.3	Insulin degludec 100 IU per ml with liraglutide 3.6mg per ml (brand name Xultophy) for the treatment of type 2 diabetes mellitus Both insulin degludec and liraglutide are listed in the Prescribed List as separate products. This new combination product provides a lower cost and more convenient option for patients who require both medicines. It will be used under the advice of the local specialist in diabetes.
1.4	Adapalene 1mg/gram with benzoyl peroxide 25mg/gram gel (brand name Epiduo) for the treatment of acne This is one of two products for the treatment of acne that were recommended for addition to the Prescribed List following a local review with GPs of treatment guidelines. Both new products support the aim of limiting the use of topical antibiotics and minimising the risk of developing bacteria that are resistant to commonly used antibiotics. They are similarly priced to existing treatment options and so are not expected to present a cost pressure.
1.5	Docusate sodium oral solution sugar free 50mg/5mL (generic only) This product provides a liquid alternative to docusate capsules that are included in the Prescribed List.
1.6	Colecalciferol solution (Thorens brand) 25,000 units in 2.5 ml oral solution This product is a licensed oral solution containing vitamin D (colecalciferol) for patients who need high doses. It replaces unlicensed products that are more volatile in price.