NHS Dudley Health Economy Medicines Formulary
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Area Clinical Effectiveness Committee (ACE, formerly AMMC)

The Dudley Area Clinical Effectiveness Committee (ACE) meets every two months to discuss issues concerning prescribing across the health economy. This page of the website will keep local clinicians up to date with discussions around choice of drugs. If there are any issues you wish raised with the ACE please call 01384 321979 or email Joanne.turner2@dudleyccg.nhs.uk

Dates of ACE meetings 2019 are:

  • Thursday 24 January 2019

  • Thursday 21 March 2019

  • Thursday 23 May 2019

  • Thursday 18 July 2019

  • Thursday 19 September 2019

  • Thursday 21 November 2019

Click here for a New Drug Application Form.

Click here for the ACE Sub Committee Terms of Reference

Q. Which documents need to be approved by ACE?
A. Any document produced by or for the CCG by individuals or groups of clinicians which direct the clinical management of patients and is expected to be used in a primary care setting by primary care contractors and /or their employees.
Please read the 'Assurance Framework for managing clinical policies and guidelines' for further information:

Please see below for ACE decisions made from April 2011.  Click on drug name to take you to relevent section of formulary. We aim to put decisions from ACE meetings onto this site within two weeks of each meeting.

Drug 

 

Date of Application

Indication 

Decision 

Comments 

  May 2019     PKG Commissioning statement: At the Prescribing and Medicines Management Sub Committee [PSC] approved to fund 50 reports during the course of this financial year. ACE noted the approval for 50 reports by the CCG PSC
Flutiform K-haler May 2019 Asthma Approved Option for adolescents using the Easibreathe device
Aerochamber Flo-VU May 2019   Approved Preferred formulary choice, replacing all other spacer devices noting that only one would need to be prescribed per year
Verkazia May 2019 Severe vernal keratoconjunctivitis Approved For children from 4 years of age and adolescents where ciclosporin A 0.1% is required
Mexiletine  April 2019 Arrhythmia Hospital use ONLY Mexiletine is no longer prescribed in primary care. Mexiletine should be prescribed and dispensed by the hospital
Brand optimisation - Metoject (methotrexate s/c)  January 2019 All licensed indications Approved Brand Optimisation
Desunin 800 international units tablets (colecalciferol [vitamin D3]) November 2018 Vitamin D deficiency Approved Click here for Vitamin D deficiency guidance
Acidex  November 2018 indigestion  Approved Replaces Gaviscon Advance.
Sukkarto MR (Metformin MR tabs) November 2018 Diabetes Approved Preferred brand of Metformin MR
Relvar November 2018 Asthma  Approved Relvar for inclusion in the adult asthma guidelines.
Butec patches November 2018 Pain Approved Existing patients prescribed buprenorphine patch to be switched to Butec brand.
Stexterol 25,000 units  November 2018 Vitamin D deficiency Approved Optional treatment dose for vitamin D deficiency where Invita D3 liquid is not an option
Semaglutide November 2018 Type 2 diabetes  Approved Replacing exenatide twice daily injection
Thorens liquid May 2018 Vitamin D deficiency Approved Approved for formulary listing
Invita D3 solution May 2018 Vitamin D deficiency Removal Removed from formulary
Quinine sulphate  May 2018 Nocturnal leg cramps Approved Approved for formulary listing
Quinine Bisulphate  May 2018 Nocturnal leg cramps Removal Removed from formulary
HydroTac dressings March 2018 Wound care dressings Approved Approved for formulary listing
Lyofoam & Biatain dressings March 2018 Wound care dressings Removal Removed from formulary
Sialanar (glycopyrronium) oral solution March 2018

Symptomatic treatment of severe sialorrhoea (chronic pathological drooling) in children and adolescents aged 3 years and older with chronic neurological disorders.

Approved Preferred brand of glycopyrronium oral solution
ProCal March 2018 Disease-related malnutrition or other ACBS indication Removal Removed from formulary 
Calogen-Extra  March 2018 Disease-related malnutrition or other ACBS indication Approved To remain on the formulary for use in secondary care and for those patients prescribed smaller daily volumes in primary care
Altrashot March 2018 Disease-related malnutrition or other ACBS indication Approved Approved for formulary listing

Anoro Ellipta 

 

January 2018 COPD Approved Approved in line with the updated COPD guidelines

Incruse Ellipta 

 

January 2018 COPD Approved Approved in line with the updated COPD guidelines

Trelegy Ellipta 

 

January 2018 COPD Approved Approved in line with the updated COPD guidelines

Trimbow 

 

January 2018 COPD Approved Approved in line with the updated COPD guidelines

Spiolto Respimat 

 

January 2018 COPD Approved Approved in line with the updated COPD guidelines

Dymista

 

January 2018 Allergic Rhinitis Approved Restricted use, third line

FreeStyle Libre® Glucose Monitoring System

 

January 2018 Diabetes Approved As per conditions in the commissioning statement

Brand optimisation - Foodlink Complete  (and with fibre)

 

November 2017 Oral nutritional supplement Approved New product application and brand optimisation form Approved 

Vesomni

 

November 2017 Urinary storage symptoms and voiding symptoms associated with BPH Non-formulary

Vesomni is no longer formulary, however whilst the guidance is being updated, the current guidance remains active except for the section on Versomni

 

Brand optimisation - Pipexus prolonged-release tablets

 

September 2017 Parkinson's disease Approved This product is a cost effective option compared to generic pramipexole prolonged release tablets

Brand optimisation - Ipinnia XL 

 

September 2017 Parkinson's disease Approved

This product is a cost effective option compared to generic pramipexole prolonged release tablets. Requip and Repinex to be removed 

 

Brand optimisation - Stanek 

 

September 2017 Parkinson's disease Approved

Approved for inclusion in the formulary as the preferred brand of levodopa/carbidopa and entacapone

 

Brand optimisation - Axalid and Alzain

 

July 2017 Neuropathic pain Approved Approved for inclusion in the formulary- to be prescribed by brand in place of Lyrica for neuropathic pain 

Brand optimisation - Vencarm

 

July 2017 Anxiety, depressions and panic disorder, with or without agoraphobia Approved Cost effective option for prescribing for Venlafaxine modified release

Brand optimisation - Meatal Dilators 

 

July 2017   Approved Prescribed following the recommendation of Continence Team
Brivaracetam  July 2017 Epilepsy Approved

Use as 2nd line treatment as per SMC guidance for treatment failure. Only licensed in Adults.  Specialist review for a period of 1 year. Specialist initiation and stabilisation. Approval to formulary focus epilepsy without secondary generalisation for second adjunctive therapy 

 

Opicapone  July 2017 Parkinson Disease  Approved

Once daily, before or after levodopa combinations. Specialist initiation

 

Safinamide  July 2017 Parkinson Disease Approved

Specialist initiation

 

Brand optimisation - Spiriva Respimat  July 2017 COPD Approved

Cost effective option in primary care in place Spiriva Handihaler 

 

Brand optimisation - Sodium hyaluronate Eye drops - Optive Fusion May 2017 Dry eye Approved

Approved for inclusion in the formulary- to be prescribed by brand. Optive and Optive plus removed.

 

Brand optimisation - Macrogol sachets - Cosmocol May 2017 Constipation Approved

Approved for inclusion in the formulary- to be prescribed by brand. Movicol and Laxido remove from formulary 

 

Brand optimisation - Co-Codamol 30/500 mg tablets and capsuls - Zapain  May 2017 Pain Approved

Approved for inclusion in the formulary- to be prescribed by brand

 

Thealoz Duo May 2017 severe dry eye  Approved

Thealoz Duo replaces carmellose Optive in severe dry eye on the previous pathway. This replaces Sodium hyaluronidate 0.2%, clinitas 0.4% as a more cost effective option 

 

Trivalent influenza vaccine  February 2017 Influenza prophylaxis Approved

Approved for inclusion in the formulary as the preferred choice of vaccine over quadrivalent vaccine

 

Marol (Tramadol) Prolonged Release tablets 100mg, 150mg, 200mg February 2017

Treatment of moderate to severe pain 

Approved  
Prednisolone soluble tablets October 2016

Prednisolone soluble tablets reintroduced on childrens wards, liquid preferred over crushing tablets as per previous ACE decision in primary care

 

Approved  
Thickeners formulary application October 2016

Approved for Resource Thicken Up Clear to be used in Primary Care and Nutilis Clear in hospital 

 

Approved  
Zlatal (Methotrexate) October 2016

Zlatal is indicated for the treatment of
-active rheumatoid arthritis in adult patients,
-polyarthritic forms of severe, active juvenile idiopathic arthritis, when the response to nonsteroidal anti- inflammatory drugs (NSAIDs) has been inadequate,
-severe recalcitrant disabling psoriasis, which is not adequately responsive to other forms of therapy such as phototherapy, PUVA, and retinoids, and severe psoriatic arthritis in adult patients.

 

Approved Note: Device is a Prefilled syringe and different to Metoject 
Binosto (Alendronate) October 2016

Treatment of postmenopausal osteoporosis. Binosto 70 mg reduces the risk of vertebral and hip fractures.

 

Approved Proposed switch from liquid to effervescent tablets which will be written generically

Vitamin B Co strong 

 

October 2016 To be removed from DWMHT formulary
ACE decision – Non formulary 
Non-formulary  
Brand optimisation - oxycodone prolonged release tablets - Longtec      September 2016 Pain Approved

Approved for inclusion in the formulary- to be prescribed by brand, switching endorsed

 

Brand optimisation - buprenorphine transdermal patches - Butec     September 2016 Pain Rejected

Primary Care pain guidelines state Butrans is not appropriate, therefore unable to review and support BuTrans at this moment. 

 

Brand optimisation Cilique

September 2016

Hormonal contraception

Approved

Approved for inclusion in the formulary for new patients, practices to consider whether to switch patients

 

Brand optimisation Levest/ Rigivedon September 2016 Hormonal contraception Approved

Approved for inclusion in the formulary for new patients, practices to consider whether to switch patients

 

Brand optimisation Yacella/Lucette September 2016 Hormonal contraception Approved

Approved for inclusion in the formulary for new patients, practices to consider whether to switch patients

 

Brand optimisation- Symbicort 200/6 MDI September 2016 Asthma and COPD Approved

Approved for inclusion in the formulary for new patients, practices to consider whether to switch patients

 

Contiform Only and Pelvic Toner - after review by specialist physiotherapist (Dudley Continence Service)
UgoFix Gentle Clip for Catheters 
Bladder Infusion Kit
Prosys All silicone Catheter

 

September 2016 Continence services Approved  
Entresto (Sacubitril / valsartan) June 2016

Adult patients for treatment of symptomatic chronic heart failure with reduced ejection fraction

 

Approved See Dudley Health Economy guidance on implementation - click here

Abasaglar 

May 2016

Treatment of diabetes mellitus in adults, adolescents and children aged 2 years and above.

 

Approved Approved for inclusion in the formulary
Guanfacine May 2016 ADHD Approved

To be included in the formulary in line with the proposed ESCA for initiation by DWMHT CAMHS consultants

 

 

Fostair 200/6 pMDI inhaler

 

March 2016 Asthma in adults Approved Only to be used in adults with asthma

Fostair 200/6 Nexthaler DPI

 

March 2016 Asthma in adults Approved Only to be used in adults with asthma

Fostair 100/6 Nexthaler DPI

 

March 2016 COPD in adults Approved Additional use in adults with COPD
Microgynon 30 / Maexini tablets March 2016 Contraception Approved

Maexini approved for inclusion in the formulary for CASH, Microgynon 30 to remain as formulary choice in primary care

 

Desogestrel / Feonolla / Cerelle tablets March 2016 Contraception Approved

Feonolla approved for inclusion in the formulary for CASH, Cerelle to remain as formulary choice for primary care

 

Lisdexamfetamine dimesylate 30 mg

 

Feb 2014

Attention deficit hyperactivity disorder refractory to methylphenidate (initiated by a specialist)

Approved

Shared care guidelines available

Quetiapine XL (Biquelle XL) - Brand of choice 

 

Feb 2017

Schizophrenia

Approved

 

Duaklir Genuair (Aclidinium / Formoterol

 

March 2015

COPD

Approved

 

Repinex XL (Ropinirole XL)

 

January 2015         

Brand optimisation of ropinirole modified release for Parkinson’s Disease

Approved

As directed by specialist initiation or review

Fluticasone/formoterol  (Flutiform®)

 

November 2014   Asthma Approved For patients over 12 years

Alogliptin 6.25 mg, 12.5 mg, 25 mg tablets 

 

November 2014

Type 2 diabetes as dual therapy in combination with either metformin, pioglitazone, a sulfonylurea, or insulin (when treatment with these drugs alone fails to achieve adequate glycaemic control), or as triple therapy in combination with metformin and either pioglitazone or insulin

Approved

 

Beclometasone/Formoterol (Fostair®) inhaler 100/6        

 

July 2014            COPD Approved Now licensed for COPD

Fluticasone/Vilanterol (Relvar Ellipta®) inhaler 92/22          

 

September 2014     COPD Approved but see comments     For Respiratory Consultant Initiation ONLY at present 

Prasterone 

September 2014

Treatment of adrenal insufficiency

Approved

The committee agreed that this be added to the formulary for use by specialists only. It was acknowledged that since the affected cohort was a small number of patients, the patient pathway would involve an annual consultant appointment in addition to three specialist nurse outpatient appointments each year; prescriptions for Prasterone would be issued by the specialist at each of these appointments. There would be no prescribing of Prasterone in primary care.

 

Magnesium –L aspartate (Magnaspartate®) sachets

September 2014

 

Approved

Use of Magnaspartate ® classified as a food for special medical purposes to replace the unlicensed magnesium glycerophosphate tablets would reduce costs in both sectors.

Fesoterodine fumarate modified-releate tablets 4 mg, 8 mg 

September 2014

Urinary frequency, urinary urgency, urge incontinence

Approved

To be used 2nd line if unsuccessful with tolterodine in line with local guidelines 

Bimatoprost (Lumigan 0.03%) Single-dose eye drops

 

Dec 2013 Glaucoma and ocular hypertension Approved For patients requiring preservative free eye drops

Fluticasone furoate (Avamys nasal spray)

 

October 2012

Nasal allergy 

Approved

Third line choice

Dovobet Gel

 

April 2012

Psoriasis 

Approved

 

Fentanyl (Fenico brand patches)

 

April 2012 

Analgesia

Not approved

Not approved due to problems with adherence

Fultium D3

 

April 2012

Vitamin D deficiency

Approved

Click here for Vitamin D deficiency guidance

Linagliptin

 

April 2012 

Diabetes 

Approved 

 

Adrenaline (EpiPen)

 

February 2012

Allergic emergencies

Approved

EpiPen preferred brand

Dabigatran

 

December 2011 

Anticoagulant 

Approved 

Secondary care for first 6 months 

Ranolazine

 

October 2011

Angina

Approved 

 

Saxagliptin

 

October 2011

Diabetes

Approved 

For patients where renal function is a concern

Testosterone 2% Gel

 

October 2011

Male Hypogonadism

Approved

 

Cannabis Extract (Sativex)

 

April 2011

Moderate to severe spasticity to multiple sclerosis 

Not Approved 

Lack of Evidence of efficacy

Duloxetine

 

April 2011 

Diabetic neuropathy 

Approved 

 

Leuprorelin acetate (Prostap 3 / Prostap SR)

 

April 2011

Prostate cancer

Approved

 

Methoxy Polyethylene Glycolepoetin Beta (Mircera)

 

April 2011

Symptomatic anaemia associated with chronic kidney disease

Approved

Supported by an ESCA 

Bimatoprost 0.01% (Lumigan)

 

December 2010

Glaucoma

Not Approved

Minimal patients. 0.03% already on formulary

Cabergoline

 

April 2010

Parkinson's Disease

Removed 

 

Pergolide

 

February 2010

Parkinson's Disease 

Removed 

 

Targinact

February 2010 

Severe pain 

Not approved 

Not approved due to lack of evidence over products already on formulary 

 

Approved for inclusion in the formulary- to be prescribed by brand. Optive and Optive plus removed.
Removed from formular
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