Sheffield Health & Social Care Formulary Statement

Prescribing and the choice of medication used within the Trust is based on the individual service users clinical needs and in line with NICE guidance (http://www.nice.org.uk/).  The British National Formulary (http://www.bnf.org/bnf/index.htm) contains information to guide clinicians in the safe and effective use of medication.  Formularies produced by NHS Sheffield Clinical Commissioning Group and Sheffield Teaching Hospitals NHS Foundation Trust are also supported.

Medicines that do not have sufficient justification of cost effectiveness to be made routinely availability are classed as non approved for use within the Trust.  Unless NICE approved, all new psychiatric drugs are classed as non approved unless approved by the Medicines Management Committee.

In cases where there is felt to be an overwhelming clinical need for a service user to receive a non approved medicine, clinicians should contact their Clinical Director and  Chief Pharmacist.

Non Approval List April 2014

Drug Rationale
Agomelatine

High acquisition costs

No evidence to support a role in treatment resistance

No evidence of a unique role, many other antidepressants available

Aripiprazole Abilify Maintena

Insufficient justification.

Further review possible if more information becomes available

Lisdexamfetamine

High cost

Insufficient justification

Other drugs available

Loxapine (ADUSUVE)

High cost

Insufficient justification

Lurasidone

High cost

Other drugs available

Olanzapine Depot(ZypAdhera)

High acquisition cost

Intensive monitoring required following each injection

Other depot formulations available

Paliperidone

High acquisition cost active metabolite of risperidone (9 hydroxy risperidone)

Many other antipsychotics available

Quetiapine slow release (XL)

Long term high costs – avoiding generic update

Little clinical advantage in majority of cases

Licensed indication for standard and XL formulations vary

Reboxetine – for new patients

Significant doubt about the benefit verses safety profile

Many other antidepressants available

Venlafaxine slow release (XL)

High Drug Tariff cost in relation to standard release

Little clinical advantage in majority of cases

 

J. Peter Pratt

Chief Pharmacist