Budget impact of metformin 1g immediate release tablet prescribing

The purpose of this bulletin is to highlight the rapid increase in price of metformin 1g tablets over the last year, and to raise awareness of the difference in price of metformin 1g immediate release (IR) tablets compared with 500mg IR tablets. It considers the potential budget impact to primary care of prescribing metformin 1g IR tablets across the ICSs in the North East & Yorkshire region and Greater Manchester.

This publication was updated in May 2024 – First published in February 2023

Inhaler Carbon Impact Assessment Tool

Overview

The NHS Long Term Plan outlines that 4% of the total NHS carbon footprint savings are expected to be realised through a ‘shift to lower carbon inhalers’ equivalent to a 50% reduction in the inhaler carbon footprint. 1,2 The RDTC has developed an inhaler carbon impact assessment tool in response to these targets. It is intended to be used at a commissioning level to estimate the impact of respiratory pathway choices made following a clinical decision making process.

This is not a clinical switch tool and should only be used as a calculator to estimate the impact of respiratory pathway choices already made following a clinical decision making process.

We have provided an open access version of the inhaler carbon impact assessment tool for download with national and regional level data. In order to access the full version of the tool which has stakeholder ICB and Sub-ICB level data either login to your account or you can request an account be set up by registering your details.

References

1. NHSE. NHS Long Term Plan.

2. Faculty of public health special interest group – sustainable development. The NHS: Carbon Footprint.

Data Period

October 2022 to September 2023

Frequency

Annually

Comparison of DOACs for Atrial Fibrillation

Comparison tables are produced for prescribers and medicines management teams. They are designed to assist in prescribing and decision-making within a specific therapeutic area.

Several direct oral anticoagulants (DOACs) are licensed for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF). This comparison table allows prescribers and other healthcare professionals to easily compare the characteristics of these medicines.

This publication was updated in January 2024 to reflect the latest NHSE operational note on choice of DOAC, and recently published guidance from SPS around drug interactions with DOACs

Monthly Formulary Amendments – March 2023

Monthly Formulary Amendments Documents list any NICE Technology Appraisals, NICE Guidelines, RMOC Guidance, MHRA Drug Safety Updates, and National Patient Safety Alerts published in the previous calendar month which may have an impact on local formularies and guidelines.  This document is for APCs, and formulary committees to ensure formularies remain up to date, and in line with latest NICE guidance and safety information.

This edition covers guidance and alerts published in March 2023.

It includes a suggested formulary position for APCs/formulary committees, together with a summary of any financial/commissioning implications. The purpose of the document is to support consistent decision making by APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Transfer of prescribing from private provider to NHS GP

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

This publication aims to provide guidance on what NHS prescribers need to be aware of when they are asked by a private healthcare provider, and/or patient, to take on the regular prescribing of a medication for a patient, including medicines supplied under formal shared care agreements. Based on suggested best practice it discusses the principles which underpin the transfer of patients from private to NHS provision and highlights Shared Care specific, and ethical considerations.

This publication is open access.

Monthly Horizon Scanning Report – March 2023

Monthly horizon scanning reports are designed to inform the NHS about new products, significant changes to product licenses, significant new guidance, and decisions that have been made by recognised bodies. 

This information is produced for use by NHS healthcare professionals. 

Considerations for Sustainable Inhaler Prescribing

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

Inhalers account for approximately 3% of all NHS carbon emissions. Reducing the carbon impact from inhaler prescribing has been identified as a significant area of focus for delivering a net zero NHS. This document aims to outline strategies that can be considered to promote optimal respiratory care, while minimising the environmental impact from inhalers and consequences of suboptimal disease management

NICE TA875; Semaglutide for managing obesity: A briefing for ICSs  

In March 2023 NICE published TA875: Technology Appraisal guidance for semaglutide (Wegovy®) for managing overweight and obesity. The guidance recommends semaglutide as an option for weight management when prescribed by a specialist service alongside a reduced-calorie diet and increased physical activity in adults if they meet the criteria specified. This briefing aims to provide advice to prescribers on how the treatment can be accessed and which patient groups are eligible to receive Wegovy®. The document explains some of the limitations of the treatment and the evidence base, as described by NICE and may help to manage patient expectations.

At the time of publication the product is not yet available in the UK.

Formulary assessment – Tacalcitol (Curatoderm) Lotion and Ointment

Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.

The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Problematic Polypharmacy:  Prescribing Cascades Evidence Evaluation

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

Problematic polypharmacy is a significant concern with overprescribing and occurs where the prescribing of multiple medicines is either inappropriate or where the intended benefit of the medication is not realised. Prescribing cascades contribute to problematic polypharmacy because they can lead to inappropriate medication use, adverse drug reactions, poor outcomes and increased healthcare resource use that could be avoided.

The publication aims to raise awareness of potential prescribing cascades and to highlight resources, tools, and strategies to help identify, prevent, and resolve inappropriate cascades.

This publication is part of our Strategic Support and Planning contract. To gain access please email us at nuth.nyrdtc.rxsupp@nhs.net.