Changes to be made to the Prescribed List (Jersey) as at 1 January 2008.

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A decision (14/12/2007) regarding: Changes to be made to the Prescribed List (Jersey) as at 1 January 2008.

Decision Reference: MD-S-2007-0084
Decision Summary Title :	Prescribed List (Jersey) 1 January 2008		Date of Decision Summary:	28/11/07
Decision Summary Author:	R. Goulding Policy Principal		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Changes to be made to the Prescribed List (Jersey) as at 1 January 2008		Date of Written Report:	28/11/07
Written Report Author:	R. Goulding Policy Principal		Written Report : Public or Exempt?	Public
Subject: Changes to be made to the Prescribed List (Jersey) as at 1 January 2008
Decision(s): The Minister approved the undermentioned changes to the Prescribed List (Jersey) as recommended by the Pharmaceutical Benefits Advisory Committee from the meeting held on the 20 November 2007. To be included: i. Green classification Lymecycline capsule 408mg Conjugated oestrogens (equine) tablet 300mcg Tiotropium solution for inhalation 2.5mcg Diabact UBT kit. Acarbose 100mg Amantadine hydrochloride syrup 50mg/5ml Carbamazepine suppositories 125mg, 250mg Dexamethasone Minims 0.1% single use eye drops Propylthiouracil tablets 50mg Ranitidine oral solution 75mg/5ml Risedronate sodium tablet 35mg Verapamil S/R tablets 120mg ii. Amber classification Eplerenone tablet 25mg, 50mg (*Inspra – Pfizer) Pramipexole 700mcg Donepezil tablet 10mg Levodopa/carbidopa/entacapone tablets 50mg/12.5mg/200mg; 100mg/25mg/200mg; 150mg/37.5mg/200mg To be included on the dental list Sodium fluoride toothpaste 0.2% w/w Clindamycin 150mg To give notice that the following items will be deleted from the Prescribed List from 1 January 2008 Pylobactell. Co-proxomol Sodium Chloride Infusion 0.18%- 500ml; 1.8% - 500ml; 5% -500ml Trichloroacetic and salicylic Acid paste Weak Iodine solution Digoxin injection 100mcg/ml Calcium syrup 325mg Chlorhexidine with cetrimide Collodion flexible solution Heparanised saline injection 50 iu/ml Levobupivacaine/Adrenaline injection 0.5 %/1ml in 200 000; 1%/1 in 200,000 Lidocaine preservative free injection 0.5% - 20 ml Lidocaine aerosol spray 10% Midazolam buccal solution 10mg/ml Potassium chloride/Dextrose infusion 0.6%/5% 500ml Potassium chloride/Dextrose/sodium chloride infusion 0.15%/4%/0.18% -500ml; 1L. Potassium chloride/Dextrose/sodium chloride infusion 0.3%/4%/0.18% - 500ml; 1L. Potassium chloride/Sodium chloride infusion 0.3%/5% - 1L Potassium chloride/Sodium chloride infusion 0.6%/0.9%, 1L Prilocaine preservative free injection 0.5% Prilocaine/octapressin injection 3%/0.03% units To give notice that the following items will be deleted from the Prescribed List from 1 June 2008 Atorvastatin 10mg; 20mg;40mg To give notice of the following amendments and clarifications to current list Please refer to attached list
Reason(s) for Decision: The Pharmaceutical Benefits Advisory Committee met on 20 November 2007 and provided the Department with the recommended changes to the Prescribed List (Jersey) to become effective from 1 January 2008. The changes include omissions and clarifications to the single Island formulary that was implemented in October 2007.
Resource Implications: The single Island formulary will result in an additional annual cost of £1.3 million (approximate) cost to the Health Insurance fund and the recommendations are part of this cost. The Fund has sufficient resources
Action required: The Minister is asked to approve the recommendations made by the Pharmaceutical Benefits Advisory Committee
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Changes to be made to the Prescribed List (Jersey) as at 1 January 2008.

Recommendations of the Pharmaceutical benefit Advisory Committee

20 November 2007

1. SUMMARY

The Pharmaceutical Benefit Advisory Committee met on 20 November 2008 to consider the inclusion and/or deletion of certain products from the Prescribed List. The PBAC recommended the inclusion of 17 products and the deletion of 26 products detailed in this report. These are to rectify omissions and clarify issues resulting from the implementation of a single Island formulary.

BACKGROUND

Lymecycline capsule 408mg (Tetralysal – Galderma) (GREEN classification).Lymecycline for the treatment of acne is a well established tetracycline antibacterial and is taken once daily without reference to mealtimes. Lymecycline provides a preferred alternative to minocycline and should be added to the Prescribed List for initiation in primary or secondary care.

Eplerenone tablet 25mg, 50mg (*Inspra – Pfizer) (Amber classification).Eplerenone should be added to the Prescribed List for use between 3-14 days after myocardial infarction (MI) in stable patients with left ventricular dysfunction and clinical evidence of heart failure. It should only be initiated by a specialist in secondary care. Prescribing in primary care should not commence until the patient is stable (minimum of 3 months).

Conjugated oestrogens (equine) tablet 300mcg (Premarin – Wyeth). (GREEN classification).This is Hormone replacement therapy for oestrogen deficiency symptoms in postmenopausal women. In view of safety concerns about the long-term effects of hormone replacement therapy, the lowest effective dose of oestrogens should be used for the shortest period of time. The introduction of this low strength preparation of Premarin extends the range of doses currently available.

Tiotropium solution for inhalation 2.5mcg (*Spiriva Respimat) (Green classification).Maintenance treatment of chronic obstructive pulmonary disease

Pramipexole 700mcg (amber classification). Treatment for Parkinson’s disease. Pramipexole 700mcg extends the range of doses currently available

Diabact UBT kit. (Green classification).Test for Helicobacter pylori

Acarbose 100mg (Green Classification) - Treatment for diabetes mellitus – extends the range of doses currently available

Amantadine hydrochloride syrup 50mg/5ml (Green Classification) -Treatment for parkinson’s disease extends the range of formulations

Carbamazepine suppositories 125mg, 250mg (Green Classification) – Short term treatment for epilepsy when oral therapy temporarily not possible.

Dexamethasone Minims 0.1% single use eye drops (Green Classification) – short term local treatment of inflammation

Donepezil tablet 10mg – (Amber classification) – Treatment for Alzheimer’s disease – extends the range of doses currently available

Levodopa/carbidopa/entacapone tablets (Amber classification) treatment for Parkinson’s disease 50mg/12.5mg/200mg; 100mg/25mg/200mg; 150mg/37.5mg/200mg

Propylthiouracil tablets 50mg (Green classification) Treatment for hyperthyroidism

Ranitidine oral solution 75mg/5ml (Green classification) for gastric and duodenal ulceration, gastro-oesophageal disease - extends the formulations currently available.

Risedronate sodium tablet 35mg – (Green classification) treatment of bone disorders

Verapamil S/R tablets 120mg – (Green classification) calcium channel blocker – extends the formulations currently available

Sodium fluoride toothpaste 0.2% w/w (Green classification) - Duraphat – to be added to the dental list to extend the treatment options for prevention of dental caries

Items to be deleted from the Prescribed List

Pylobactell. (Green classification).Test for Helicobacter pylori

Co-proxomol - In 2005, the Medicines and Healthcare products Regulatory Agency (MHRA) recommended that all product licenses for co-proxamol should be withdrawn. This followed a review of the safety of this product, which has been the cause of several deaths in the UK. The MHRA recommended that the withdrawal of co-proxamol should be done gradually, to allow patients to be changed to other painkillers (e.g. paracetamol, co-codamol). By the end of 2007, product licenses for co-proxamol will be withdrawn. The manufacturer of the Distalgesic brand of co-proxamol has indicated that it will continue to produce unlicensed co-proxamol.

Postpone for six months the withdrawal of atorvastatin from Prescribed List (due on 1st January 2008) until further work has been done with GP practices to optimise use of simvastatin 40mg.There has been several requests from GPs and their patients to postpone this deletion. Some patients do not want to switch established therapy for another medicine that may cause unwanted effects. Certainly, not all patients can switch from atorvastatin to simvastatin (because of contraindications or unwanted drug interactions).

Sodium Chloride Infusion 0.18%- 500ml; 1.8% - 500ml; 5% -500ml

Trichloroacetic and salicylic Acid paste

Weak Iodine solution

Digoxin injection 100mcg/ml

Calcium syrup 325mg

Chlorhexidine with cetrimide

Collodion flexible solution

Heparanised saline injection 50 iu/ml

Levobupivacaine/Adrenaline injection 0.5 %/1ml in 200 000; 1%/1 in 200,000

Lidocaine preservative free injection 0.5% - 20 ml

Lithium Carbonate tablets M/R 450mg

Lidocaine aerosol spray 10%

Midazolam buccal solution 10mg/ml

Potassium chloride/Dextrose infusion 0.6%/5% 500ml

Potassium chloride/Dextrose/sodium chloride infusion 0.15%/4%/0.18% -500ml; 1L.

Potassium chloride/Dextrose/sodium chloride infusion 0.3%/4%/0.18% - 500ml;1L.

Potassium chloride/Sodium chloride infusion 0.3%/5%, 1L

Potassium chloride/Sodium chloride infusion 0.6%/0.9%, 1L

Prilocaine preservative free injection 0.5%

Prilocaine/octapressin injection 3%/0.03% units

Development of a single Island formulary

The Committee accepted the attached amendments and clarifications to the current list (appendix A). These arise from the ongoing work to develop a single Island formulary

RECOMMENDATION

The Minister is asked to approve the changes to take effect from 1st January 2008.