Prescribing Bulletin: 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.

Formulary assessment tool: Morphine sulfate (Actimorph) orodispersible tablets

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.

The Formulary assessment tool for morphine sulfate orodispersible tablets (Actimorph) can be found here.

December 2022 Newsletter

Prescribing support newsletters aim to inform readers of work done by the unit and work in progress, to help tailor local work plans and highlight any ‘topical’ issues in prescribing or medicines management.

If you have any suggestions for future topics for the newsletter, then please contact nuth.nyrdtc.rxsupp@nhs.net

This month’s edition focuses on polypharmacy, influenza in the community – prescribing antivirals, group A streptococcus in children – advice for clinicians, and the MHRA review on the safe use of valproate. We also include recent publications from the RDTC and another in the series of “Meet the Team” where you can get to know the people behind the work we do. There is also information on some key medicines availability issues and serious shortage protocols.

Strategic Insight: Polypharmacy and overprescribing: an overview

Strategic Insight reports are designed to support strategic objectives and planning by Integrated Care System leaders. Through the analysis of data and communication with key stakeholders across the ICS, interventions to be undertaken by the ICS are proposed to Integrated Care Boards or associated committees.

This report provides an update on key primary care prescribing trends in the North of England with respect to polypharmacy, in order to support primary care teams in identifying key groups who may benefit from a structured medicines review.

Formulary assessment tool: Trifarotene (Aklief)

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.

The Formulary assessment tool for trifarotene (Aklief) can be found here.

Comparison table: DPP-4 inhibitors (Gliptins)

Comparison table documents are designed to support prescribers and medicines management teams to maximise health gains through the optimum use of medicines within a specific therapeutic area.

There are currently five dipeptidyl peptidase-4 (DPP-4) inhibitors (or gliptins) available in the UK for the management of type 2 diabetes mellitus. There are a number of differences between the DPP-4 inhibitors in terms of licensing, interactions, renal impairment dose adjustment, hepatic impairment dose adjustment, and cost. This comparison table allows prescribers and other healthcare professionals to easily compare the characteristics of these medicines.

October 2022 Newsletter

Prescribing support newsletters aim to inform readers of work done by the unit and work in progress, to help tailor local work plans and highlight any ‘topical’ issues in prescribing or medicines management.

If you have any suggestions for future topics for the newsletter, then please contact nuth.nyrdtc.rxsupp@nhs.net

This month’s edition covers the RDTC’s Climate Emergency declaration, Pill Swallowing – a skill for life, Metolazone preparations and safety considerations, and the second in the series of “Meet the Team” where you can get to know the people behind the work we do. We also cover the Price concessions and the Discount Deduction scheme, World Antimicrobial Awareness Week, and a guide to the COVID-19 autumn booster. There is also information on the changes to the Medicines Information Service, and some key medicines availability issues.

Formulary assessment tool: Glucagon (Ogluo)

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.

The Formulary assessment tool for Glucagon (Ogluo) can be found here.

Formulary assessment tool: metolazone (Xaqua)

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.

The Formulary assessment for metolazone (Xaqua) can be found here.

Medicines in Practice: Optimising the use of morphine 10mg/5mL oral solution in primary care (Update)

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.

Opioids are effective for acute pain and pain at the end of life, but there is little evidence of their effectiveness for long term pain. This document supports primary care teams to review patients receiving regular large quantities of morphine 10mg/5mL oral solution and includes advice on how these patients could be managed.

This update includes:

  • opioid equivalence information to align with the updated Opioids Aware information
  • information on safety issues identified with morphine oral solution 10mg/5mL.
  • details regarding the NHSBSA Epact2 opioid dashboard which can be used to identify patients for review.