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Formulary Adherence Checklist for NICE Technology Appraisals About Medicines

Developed for the NHS by: East and South East England

Specialist Pharmacy Services

This spreadsheet is updated monthly and enables self-audit of a medicines formulary for adherence to current NICE Technology Appraisals. Version 5.5 September 2014.

All guidelines refer to adults unless indicated. No copyright is asserted on this material if used for non-commercial purposes within the NHS.

Technology appraisal (TA) Titles are hyperlinks to full guidance

Date of TA

Release

Availability of medicine for NHS patients with this

medical condition, as indicated by NICE

Yes

(mark 'x' if

applicable)

N/A

(mark 'x' if

applicable)

Date of local

decision

(DD/MM/YY)

Time to

implement

(days)

Notes (e.g. rationale, method of

making available)

2014-15Lenalidomide for treating myelodysplastic

syndromes associated with an isolated

deletion 5q cytogenetic abnormality

(TA322)

30/09/2014 Lenalidomide - an option for treating transfusion-dependent

anaemia caused by low or intermediate-1 risk

myelodysplastic syndromes associated with an isolated

deletion 5q cytogenetic abnormality when other options are

insufficient or inadequate, with the proviso that the cost of

the drug (excluding any related costs) for people who remain

on treatment for more than 26 cycles will be met by the

company.

x

17/10/2014 17 Formulary entry updated

Dimethyl fumarate for treating

relapsing‑remitting multiple sclerosis

(TA320)

29/08/2014 Dimethyl fumarate - an option for treating adults with active

relapsing-remitting multiple sclerosis (normally defined as 2

clinically significant relapses in the previous 2 years), only if

they do not have highly active or rapidly evolving severe

relapsing-remitting multiple sclerosis and the manufacturer

provides the medicine with the discount agreed in the patient

access scheme.

x

17/10/2014 49 Disease-modifying drugs for MS are not

provided at PHT - patients are treated

at UHS.

Ipilimumab for previously untreated

advanced (unresectable or metastatic)

melanoma (TA319)

31/07/2014 Ipilimumab - an option, within its marketing authorisation,

for treating adults with previously untreated advanced

(unresectable or metastatic) melanoma, only if the

x15/08/2014 15 Formulary entry updated

Lubiprostone for treating chronic

idiopathic constipation (TA318)

31/07/2014 Lubiprostone - an option for adults with chronic idiopathic

constipation in whom treatment with at least 2 laxatives from

different classes, at the highest tolerated recommended

doses for at least 6 months, has failed to provide adequate

x

15/08/2014 15

Prasugrel with percutaneous coronary

intervention for treating acute coronary

syndromes (review of technology appraisal

guidance 182) (TA317)

31/07/2014 Prasugrel 10mg - an option, in combination with aspirin, for

preventing atherothrombotic events in adults with acute

coronary syndrome (unstable angina, non-ST segment

elevation myocardial infarction or ST segment elevation

x


Adherence of local formulary to NICE

http://www.nice.org.uk/guidance/ta322




http://www.nice.org.uk/guidance/TA320



http://www.nice.org.uk/Guidance/TA319









Enzalutamide for metastatic

hormone‑relapsed prostate cancer

previously treated with a

docetaxel‑containing regimen (TA316)

31/07/2014 Enzalutamide - an option, within its marketing authorisation,

for metastatic hormone-relapsed prostate cancer in adults

whose disease has progressed during or after docetaxel-

containing chemotherapy, only if the manufacturer provides

enzalutamide with the discount agreed in the patient access

scheme.

x

15/08/2014 15

Canagliflozin in combination therapy for

treating type 2 diabetes (TA315)

30/06/2014 Canagliflozin - an option in combination with other

treatments for some patients with type 2 diabetes.

x

15/08/2014 46

Psoriatic arthritis (active) - ustekinumab

(TA313)

30/05/2014 Ustekinumab - not recommended alone or with

methotrexate for adults when the response to previous non-

biological disease-modifying antirheumatic drug therapy has

been inadequate.

x

13/06/2014 14

Multiple sclerosis (relapsing-remitting) -

alemtuzumab (TA312)

30/05/2014 Alemtuzumab - an option for adults with active

relapsing–remitting multiple sclerosis. x13/06/2014 14 Disease-modifying drugs for MS are not

provided at PHT - patients are treated

at UHSMultiple myeloma - bortezomib (induction

therapy) (TA311)

30/04/2014 Bortezomib - an option, in combination with dexamethasone,

or with dexamethasone and thalidomide, for the induction

treatment of adults with previously untreated multiple

myeloma, who are eligible for high-dose chemotherapy with

haematopoietic stem cell transplantation.

x


Lung cancer (non small cell, EGFR mutation

positive) - afatinib (TA310)

30/04/2014 Afatinib - an option for adults with locally advanced or

metastatic non-small-cell lung cancer if they have the EGFR-

TK mutation and have not had a EGFR-TK inhibitor previously

and the drug is provided at the discount agreed in the patient

access scheme.

x

13/06/2014 44

Lung cancer (non small cell, non

squamous) - pemetrexed (TA309)

30/04/2014 Pemetrexed - not recommended as maintenance treatment

for locally advanced or metastatic non-squamous non-small-

cell lung cancer after induction therapy with pemetrexed and

cisplatin.

x

13/06/2014 44

8 4

% "Yes" % "N/A" _Average

implement

time (days)

Adherence statistics for 2014-15 67% 33% 28







http://guidance.nice.org.uk/TA313










NICE Technology Appraisals About Medicines: Formulary Adherence Checklist



This spreadsheet is updated monthly and enables self-audit of a medicines formulary for adherence to current NICE Technology Appraisals. Version 4.9 March 2014



Date of TA

Release


medical condition, as indicated by NICEYes

(mark 'x' if

applicable)

N/A

(mark 'x' if

applicable)

Date of local

decision

(DD/MM/YY)

Time to

implement

(days)

Notes (e.g. rationale, method of making available)

2013-14

Vasculitis (anti-neutrophil cytoplasmic antibody-

associated) - rituximab (with glucocorticoids)

(TA308)

31/03/2014 Rituximab - recommended as an option with

glucocorticoids for adults with anti-neutrophil

cytoplasmic antibody-associated vasculitis only if further

treatment with cyclophosphamide would exceed the

maximum cumulative cyclophosphamide dose or

cyclophosphamide is contraindicated or not tolerated or

they want to have children and treatment with

cyclophosphamide may materially affect their fertility or

the disease has stayed active or progressed despite a

course of cyclophosphamide lasting 3 to 6 months or the

person has had uroepithelial malignancy.

x

11/04/2014 11 NHSE commissioned

Colorectal cancer (metastatic) - aflibercept

(TA307)

31/03/2014 Aflibercept - not recommended in combination with

irinotecan and fluorouracil-based therapy for metastatic

colorectal cancer that is resistant to or has progressed

after chemotherapy that includes oxaliplatin.x

11/04/2014 11

Lymphoma (non Hodgkin's, relapsed, refractory)

- pixantrone monotherapy (TA306)

28/02/2014 Pixantrone – recommended as a possible monotherapy

for multiply relapsed or refractory aggressive disease if

patients: have previously been treated with rituximab

and they are receiving 3rd

or 4th

-line treatment and the

drug is provided at the discount agreed in the patient

access scheme.

x

11/04/2014 42

Macular oedema (central retinal vein occlusion) -

aflibercept solution for injection (TA305)

28/02/2014 Aflibercept – recommended as an option for visual

impairment caused by macular oedema secondary to

central retinal vein occlusion only if the manufacturer

provides it with the discount agreed in the patient

access scheme.

x

11/04/2014 42 Formulary entry updated.

Multiple sclerosis (relapsing) - teriflunomide

(TA303)

31/01/2014 Teriflunomide – recommended as a possible treatment

under a patient access scheme for active relapsing-

remitting MS that isn’t highly active or rapidly evolving. x

14/02/2014 14 MS services are commissioned by NHSE and MS

patients are not treated in Portsmouth. Teriflunomide

will not be added to the Portsmouth and South East

Hampshire formulary at present as it will not be

supplied locally.






















This spreadsheet is updated monthly and enables self-audit of a medicines formulary for adherence to current NICE Technology Appraisals.



Date of TA

Release


medical condition, as indicated by NICEYes

(mark 'x' if

applicable)

N/A

(mark 'x' if

applicable)

Date of local

decision

(DD/MM/YY)

Time to

implement

(days)


2012-13

Methylnaltrexone for treating opioid-induced

bowel dysfunction in people with advanced

illness receiving palliative care (terminated

appraisal) (TA277)

27/03/2013 Methylnaltrexone-unable to recommend NHS use for

treating opioid-induced bowel dysfunction in people

with advanced illness receiving palliative care because

no evidence submission was received from the

manufacturer.

x 19/04/2013 23

Cystic fibrosis (pseudomonas lung infection) -

colistimethate sodium and tobramycin (TA276)

27/03/2013 Tobramycin and colistimethate sodium dry powders for

inhalation - recommended as possible treatments for

chronic pseudomonas lung infection in some people

with cystic fibrosis, only as part of agreed patient access

schemes. NB At time of publication, implementation

guidance applies only to tobramycin as colistimethate is

not available.

x 19/04/2013 23

Macular oedema (diabetic) - ranibizumab

(TA274) Review of TA237

27/02/2013 Ranibizumab - possible treatment for problems with

sight due to diabetic macular oedema if the eye has a

central retinal thickness of 400 micrometres or more at

the start of treatment, only as part of an agreed patient

x 19/04/2013 51

Stroke and systemic embolism (prevention, non-

valvular atrial fibrillation) - apixaban (TA275)

27/02/2013 Apixaban - recommended as a option for prevention of

stroke and systemic embolism in people with atrial

fibrillation and one or more risk factors, but without

underlying heart valve disease.

x 19/04/2013 51

Diabetic macular oedema - fluocinolone

acetonide intravitreal implant (TA271)

31/01/2013 Fluocinolone acetonide impant – Not recommended

when other treatments have not worked well enough.

x 15/02/2013 15

Urothelial tract carcinoma (transitional cell;

advanced or metastatic) - vinflunine (TA272)

31/01/2013 Vinflunine – Not recommend for this cancer if treated

previously with platinum-containing drugs.

x 15/02/2013 15

Hyperplasia (benign prostatic) - tadalafil

(terminated appraisal) (TA273)

31/01/2013 Tadalafil – Unable to recommend NHS use because no

evidence received from manufacturer.

x 15/02/2013 15

Melanoma (BRAF V600 mutation positive,

unresectable or metastatic) - vemurafenib

(TA269)

31/12/2012 Vemurafenib – recommended for this indication only as

part of agreed patient access scheme.

x 14/12/2012 -17

Leukaemia (acute myeloid ) - decitabine


31/12/2012 Decitabine – unable to make recommendation about

NHS use due to lack of evidence submission.

x 14/12/2012 -17








































Developed for the NHS by: East and

South East England


This spreadsheet enables self-audit of a medicines formulary for adherence to NICE Technology Appraisals. No copyright is asserted if used for non-commercial purposes within the NHS.


Date of TA

Release



Yes N/A Date of local

decision

(DD/MM/YY)

Time to

implement

(days)


2011-12

Atrial fibrillation - dabigatran etexilate (TA249) 31/03/2012 Dabigatran – a recommended option for atrial

fibrillation patients with risk factors to prevent stroke

and embolism.

x20/04/2012 20

Rheumatoid arthritis - tocilizumab (TA247)

Update to TA198

29/02/2012 Tocilizumab (with methotrexate) – a recommended

option (in the same circumstances as TA130) after other

specified treatments have failed or not been tolerated.x

20/04/2012 51

Diabetes (type 2) - exenatide (prolonged

release) (TA248)

29/02/2012 Exenatide prolonged release – a recommended option in

combination with oral drugs for selected patients with

type 2 diabetes

x20/04/2012 51

Venom anaphylaxis - immunotherapy

pharmalgen (TA246)

29/02/2012 Pharmalgen – a recommended treatment for bee or

wasp venom allergy after a severe reaction, or moderate

reaction in certain circumstances.

x20/04/2012 51

PHT not a specialist centre - patients will be referred

to UHS

Venous thromboembolism (hip and knee

surgery) - apixaban (TA245)

31/01/2012 Apixaban – a recommended option to reduce

thromboembolism after knee/hip replacement.x

24/02/2012 24

Rivaroxaban currently used for this indication at PHT

Chronic obstructive pulmonary disease -

roflumilast (TA244)

31/01/2012 Roflumilast – only recommended as part of a clinical

trial.x

24/02/2012 24

Colorectal cancer (metastatic) 2nd line -

cetuximab, bevacizumab and panitumumab

(TA242)

Review of TA150 and part review of TA118

31/01/2012 Cetuximab – not recommended alone or in combination.

Bevacizumab – not recommended with

fluoropyrimidines.

Panitumumab – not recommended.x

24/02/2012 24

Follicular lymphoma - rituximab (TA243)

Update to TA110

31/01/2012 Rituximab – recommended in combination for first line

treatment of stage III–IV disease.x

24/02/2012 24


































Leukaemia (chronic myeloid) - dasatinib,

nilotinib, imatinib (intolerant, resistant) (TA241)

31/01/2012 Dasatinib – not recommended.

Nilotinib – recommended for Philadelphia-chromosome-

positive CML if standard dose imatinib unsuccessful or

unsuitable.

Imatinib high dose – not recommended if disease has

progressed after standard dose.

x

24/02/2012 24

Arthritis (juvenile idiopathic, systemic) -

tocilizumab (TA238)

31/12/2011 Tocilizumab – recommended if NSAIDs, steroids and

methotrexate have failed.x

24/02/2012 55

Breast cancer (metastatic) - fulvestrant (TA239) 31/12/2011 Fulvestrant – not recommended post-menopause in

oestrogen dependent metastatic disease, or if disease

returned/worsened after anti-oestrogens.x

24/02/2012 55

Colorectal cancer (metastatic) - panitumumab


31/12/2011 Panitumumab – unable to recommend NHS use. TA

terminated due to lack of evidence submission. x24/02/2012 55

Macular oedema (diabetic) - ranibizumab

(TA237)

30/11/2011 Ranibizumab – not recommend for people with diabetic

macular oedema.x

16/12/2011 16

Osteosarcoma - mifamurtide (TA235) 31/10/2011 Mifamurtide – recommended as a treatment for

specified children, adolescents and young adults with

osteosarcoma.

x16/12/2011 46

Unlikely to be prescribed at PHT - pts will be under

care of UHS

Acute coronary syndromes - ticagrelor (TA236) 31/10/2011 Ticagrelor – recommended combined with low-dose

aspirin for up to a year as a treatment for specified

people with acute coronary syndromes.

16/12/2011 46

Ankylosing spondylitis - golimumab (TA233) 31/08/2011 Golimumab – a recommended option for severe, active

ankylosing spondylitis in the same circumstances as

TA143 when NSAIDs unsuccessful.x

21/10/2011 51

Rheumatoid arthritis - abatacept (2nd line)

(TA234)

31/08/2011 Abatacept – not recommended with methotrexate in

moderate to severe RA if DMARDs ineffective. x21/10/2011 51

Macular oedema (retinal vein occlusion) -

dexamethasone (TA229)

31/07/2011 Dexamethasone intravitreal implant – recommended

for specified people with macular oedema due to retinal

vein occlusion.

x19/08/2011 19

Depression - agomelatine (terminated

appraisal) (TA231)

31/07/2011 Agomelatine – unable to recommend NHS use for major

depressive episodes. TA terminated due to lack of

evidence submission.

x19/08/2011 19

Epilepsy (partial) - retigabine (adjuvant) (TA232) 31/07/2011 Retigabine – a recommended adjunctive option for

partial onset seizures with or without secondary

generalisation in some people with epilepsy.

01/10/2011 62

Awaiting advice from neurologists at UHS

Multiple myeloma (first line) - bortezomib and

thalidomide (TA228)

31/07/2011 Thalidomide – a recommended option for specified

people with multiple myeloma.

Bortezomib – a recommended option only if thalidomide

not tolerated or suitable.

x

19/08/2011 19

Myocardial infarction (persistent ST-segment

elevation) - bivalirudin (TA230)

31/07/2011 Bivalirudin – recommended as a possible treatment for

adults with STEMI having percutaneous coronary

intervention.

x19/08/2011 19




















































Lung cancer (non-small-cell, advanced or

metastatic maintenance treatment) - erlotinib

(monotherapy) (TA227)

30/06/2011 Erlotinib – not recommended as maintenance after

platinum-chemotherapy. x19/08/2011 50

Lymphoma (follicular non-Hodgkin's) - rituximab

(TA226)

30/06/2011 Rituximab – recommended as a possible treatment to

maintain remission.x

19/08/2011 50

Rheumatoid arthritis (after failure of previous

anti-rheumatic drugs) - golimumab (TA225)

30/06/2011 Golimumab – a recommended option (in the same

circumstances as TA130) after other specified

treatments have failed or not been tolerated.x

19/08/2011 50

Rheumatoid arthritis (methotrexate-naïve) -

golimumab (terminated appraisal) (TA224)

30/06/2011 Golimumab – unable to recommend NHS use. TA

terminated due to lack of evidence submission. x

19/08/2011 50

Peripheral arterial disease - cilostazol,

naftidrofuryl oxalate, pentoxifylline and inositol

nicotinate (TA223)

31/05/2011 Naftidrofuryl oxalate – a recommended option for

intermittent claudication in peripheral arterial disease.

Cilostazol, pentoxifylline and inositol nicotinate – not

recommended.

x

17/06/2011 17

Thrombocytopenic purpura - romiplostim

(TA221)

30/04/2011 Romiplostim – recommended for specified people with

chronic, severe, and refractory ITP.x

19/08/2011 111 Delayed while awaiting advice from haematology on

implementation

Ovarian cancer (relapsed) - trabectedin (TA222) 30/04/2011 Trabectedin – not recommended with pegylated

liposomal doxorubicin for relapsed platinum-sensitive

ovarian cancer.

x17/06/2011 48

Psoriatic arthritis - golimumab (TA220) 30/04/2011 Golimumab – recommended as a possible treatment

after trying other DMARDs in the same circumstances as

TA199.

x17/06/2011 48

Everolimus for the second-line treatment of

advanced renal cell carcinoma (TA219)

30/04/2011 Everolimus – not recommended.x

17/06/2011 48

16 13


implement time

(days)











































Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2010-11

Alzheimer's disease - donepezil, galantamine,

rivastigmine and memantine (TA217)

31/03/2011 Donepezil, galantamine, rivastigmine – recommended

options for mild and moderate disease.

Memantine – a recommended option for moderate

disease if people cannot take AChE inhibitors, and for

managing severe disease.

x

08/04/2011 8

Myelodysplastic syndromes - azacitidine

(TA218)

31/03/2011 Azacitidine – a recommended option for specified adults

not eligible for haematopoietic stem cell transplantation. x08/04/2011 8

Renal cell carcinoma (first line metastatic) -

pazopanib (TA215)

28/02/2011 Pazopanib – a recommended option for some people

with renal cell carcinoma.x

08/04/2011 39

Breast cancer - bevacizumab (in combination

with a taxane) (TA214)

28/02/2011 Bevacizumab – not recommended with a taxane first line

for metastatic breast cancer.x

08/04/2011 39

Leukaemia (lymphocytic) - bendamustine

(TA216)

28/02/2011 Bendamustine – a recommended option for untreated

chronic lymphocytic leukaemia of Binet stage B or C

where fludarabine cannot be used.

x

08/04/2011 39

Schizophrenia - aripiprazole (TA213) 31/01/2011 Aripiprazole – a recommended option in 15 to 17 year

olds with schizophrenia if risperidone unresponsive/

unsuitable.x

18/02/2011 18

Osteoporosis - primary prevention (TA160) 31/01/2011 As an option to prevent fractures in postmenopausal

women with osteoporosis but no fractures:

Alendronate – recommended.

Risedronate, etidronate – recommended if alendronate

not suitable.

Strontium ranelate – recommended if bisphosphonates

not suitable.

Raloxifene – not recommended

x

18/02/2011 18

Osteoporosis - secondary prevention including

strontium ranelate (TA161)

31/01/2011 As an option to prevent fractures in postmenopausal

women with osteoporosis who have had fractures:

Alendronate – recommended.

Risedronate, etidronate – recommended if alendronate

not suitable.

Strontium ranelate, raloxifene – recommended if

bisphosphonates not suitable.

Teriparatide – If above options not suitable, or fracture

sustained while on bisphosphonates.

x

18/02/2011 18





































Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2009-10

Rheumatoid arthritis - certolizumab pegol

(TA186)

28/02/2010 Certolizumab pegol – a recommended option for severe

'active' disease if methotrexate and another DMARD

unsuccessful. Usually given with methotrexate, but

monotherapy if methotrexate not tolerated. Use as per

TA130.

x

10/04/2010 41

Soft tissue sarcoma - trabectedin (TA185) 28/02/2010 Trabectedin – a recommended option for advanced

disease where treatment with anthracyclines and

ifosfamide is unsuitable, has failed, or is not tolerated.x

10/04/2010 41 Not treated at PHT

Lung cancer (small-cell) - topotecan (TA184) 30/11/2009 Oral topotecan – a recommended option for relapsed

small-cell lung cancer in specified circumstances.

IV topotecan – not recommended.x

18/12/2009 18

Cervical cancer (recurrent) - topotecan (TA183) 31/10/2009 Topotecan – a recommended option for recurrent or

stage IVB cervical cancer with cisplatin, if cisplatin not

given before. x

18/12/2009 48

Acute coronary syndrome - prasugrel (TA182) 31/10/2009 Prasugrel – a recommended option with aspirin for

patients undergoing PCI in specific circumstances. x

18/12/2009 48

Lung cancer (non-small-cell, first line treatment)

- pemetrexed (TA181)

30/09/2009 Pemetrexed – a recommended first line option for

locally advanced or metastatic adeno-or large-cell

carcinoma types of non-small-cell lung cancer.x

18/12/2009 79

Gastrointestinal stromal tumours - sunitinib

(TA179)

30/09/2009 Sunitinib – a recommended option for unresectable or

metastatic malignant GIST if imatinib unsuccessful or

unsuitable. x

18/12/2009 79


























Psoriasis - ustekinumab (TA180) 30/09/2009 Ustekinumab – a recommended option for severe

plaque psoriasis when other treatments unsuccessful or

unsuitable. x

23/10/2009 23

Colorectal cancer (first line) - cetuximab (TA176) 31/08/2009 Cetuximab – recommended in combination with FOLFOX

as first line option for metastatic colorectal cancer in

specific circumstances. Use with FOLFIRI, if FOLFOX

unsuitable.

x

23/10/2009 53

Eczema (chronic) - alitretinoin (TA177) 31/08/2009 Alitretinoin – a recommended option for severe chronic

hand eczema unresponsive to potent topical steroids. x23/10/2009 53

Renal cell carcinoma (TA178) 31/08/2009 Bevacizumab, sorafenib, temsirolimus – not

recommended first line for advanced and/or metastatic

renal cell carcinoma.

Sorafenib, sunitinib – not recommended second line.

x

23/10/2009 53

Hepatitis B - tenofovir disoproxil fumarate

(TA173)

31/07/2009 Tenofovir disoproxil – a recommended option for

chronic hepatitis B.

x

08/04/2011 616 Before 2011 there was no hepatology service in

Portsmouth and no hepatitis B or C medicines were

prescribed locally. When a new service was set up all

the NICE-recommended medicines were added to the

formulary.

Leukaemia (chronic lymphocytic, first line) -

rituximab (TA174)

31/07/2009 Rituximab – a recommended first line option for chronic

lymphocytic leukaemia only in combination with

fludarabine and cyclophosphamide.x

23/10/2009 84

Lung cancer (non-small-cell, second line) -

gefitinib (terminated appraisal) (TA175)

31/07/2009 Gefitinib – unable to recommend NHS use. TA

terminated due to lack of evidence submission.x

21/08/2009 21

Head and neck cancer (squamous cell

carcinoma) - cetuximab (TA172)

30/06/2009 Cetuximab – not recommended with platinum drugs for

recurrent and/or metastatic squamous cell cancer of the

head and neck.

x21/08/2009 52

Multiple myeloma - lenalidomide (TA171) 30/06/2009 Lenalidomide – a recommended option with

dexamethasone for multiple myeloma after failure of

two previous treatments.

x21/08/2009 52

Venous thromboembolism - rivaroxaban

(TA170)

30/04/2009 Rivaroxaban – a recommended option for

thromboembolism prophylaxis arising from elective total

hip or knee replacement surgery. x

21/08/2009 113

13 4


implement time

(days)










































Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2008-09

Renal cell carcinoma - sunitinib (TA169) 31/03/2009 Sunitinib – a recommended first line option for mobile

people with advanced and/or metastatic disease if

immunotherapy suitable.

x30/06/2009 91

Influenza (treatment) - zanamivir, amantadine

and oseltamivir (review) (TA168)

28/02/2009 Note national guidance on flu jabs.

For flu that is not a widespread epidemic:

Oseltamivir, zanamivir – a recommended option in ‘at

risk’ people in specified circumstances.

Amantadine – not recommended to treat flu.

x

31/05/2009 92

Hyperuricaemia - febuxostat (TA164) 31/12/2008 Febuxostat – recommended option for chronic

hyperuricaemia in gout if allopurinol unsuitable or not

tolerated.

x31/03/2009 90

Ulcerative colitis (acute exacerbations) -

infliximab (TA163)

31/12/2008 Infliximab – a recommended option in severely active

ulcerative colitis if ciclosporin inappropriate, or as part

of a clinical trial.

x31/03/2009 90

Lung cancer (non-small-cell) - erlotinib (TA162) 30/11/2008 Erlotinib – recommended if one previous chemotherapy

regimen ineffective, as cost neutral alternative to

docetaxel. Not recommended in locally advanced or

metastatic NSCLC after one prior unsuccessful regimen

when docetaxel unsuitable. Not recommended after two

prior unsuccessful regimens, including docetaxel.

x

28/02/2009 90

Influenza (prophylaxis) - amantadine,

oseltamivir and zanamivir (TA158) Including

review of TA67

30/09/2008 Note national guidance on flu jabs.

For flu that is not a widespread epidemic:

Oseltamivir, zanamivir – a recommended option in non-

vaccinated, flu-exposed, ‘at risk’ people in specified

circumstances.

Amantadine – not recommended to prevent flu.

x

31/12/2008 92

Venous thromboembolism - dabigatran (TA157) 30/09/2008 Dabigatran etexilate – recommended option to reduce

VTE risk after hip or knee replacement surgery. x31/12/2008 92 Rivaroxaban currently used for this indication at PHT































Macular degeneration (age-related) -

ranibizumab and pegaptanib (TA155)

31/08/2008 Ranibizumab – a recommended option for

deteriorating wet AMD in specified circumstances.

Pegaptanib – not recommended for wet AMD. x

30/11/2008 91

Pregnancy (rhesus negative women) - routine

anti-D (review) (TA156)

31/08/2008 Anti-D immunoglobulin – a recommended antenatal

option for RhD negative pregnant women who are not

known to be 'sensitised'.

x

30/11/2008 91

Hepatitis B - telbivudine (TA154) 31/08/2008 Telbivudine – not recommended for chronic hepatitis B.x

30/11/2008 91

Hepatitis B - entecavir (TA153) 31/08/2008 Entecavir – a recommended option for chronic hepatitis

B.

x





formulary.

Head and neck cancer - cetuximab (TA145) 30/06/2008 Cetuximab – a recommended option with radiotherapy

for locally advanced squamous cell disease with

Karnofsky score 90% or more, and if platinum-based

chemotherapy inappropriate.

x

30/09/2008 92

Psoriasis - adalimumab (TA146) 30/06/2008 Adalimumab – a recommended option for severe plaque

psoriasis if other treatments are unsuitable,

unsuccessful or not tolerated.

x30/09/2008 92

Glioma (recurrent) - carmustine implants


30/06/2008 Gefitinib – unable to recommend NHS use as an adjunct

to surgery. TA terminated due to lack of evidence

submission.

x30/09/2008 92

Lung cancer (non-small-cell) - bevacizumab


30/06/2008 Bevacizumab – unable to recommend NHS use with

platinum-based chemotherapy for unresectable non-

small-cell lung cancer (other than predominantly

squamous cell histology). TA terminated due to lack of

evidence submission.

x

30/09/2008 92

Anaemia (cancer-treatment induced) -

erythropoietin (alpha and beta) and

darbepoetin (TA142)

31/05/2008 Erythropoietin analogues with iron injections – a

recommended option for profound anaemia after

chemotherapy if blood transfusions cannot be given; and

after platinum-based chemotherapy for ovarian cancer if

haemoglobin is 8 g/100 ml or less.

x

31/08/2008 92

Ankylosing spondylitis - adalimumab,

etanercept and infliximab (TA143)

31/05/2008 Adalimumab, etanercept – recommended options for

severe ankylosing spondylitis if at least 2 NSAIDs

ineffective. The other drug may be tried if the first is not

tolerated, but not if it is ineffective.

Infliximab – not recommended.

x

31/08/2008 92

Ulcerative colitis (subacute manifestations) -

infliximab (TA140)

30/04/2008 Infliximab – not recommended for subacute, moderate

to severely active ulcerative colitis as specified. x31/07/2008 92

14 4











































implement time

(days)







Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2007-08

Chronic asthma (in adults) - corticosteroids

(TA138)

31/03/2008 Inhaled corticosteroids – the least costly suitable

product is recommended when indicated.

Inhaled corticosteroid with long-acting beta-2 agonist –

a combination device is a recommended option; use the

least costly. Separate inhalers may be suitable on an

individual basis.

30/06/2008 91 A range of corticosteroid and combination inhalers

are available for prescribing.

Lymphoma (follicular non-Hodgkin's) - rituximab

(TA137)

Review of TA37

29/02/2008 Rituximab – a recommended option with chemotherapy

to induce remission, or alone as maintenance therapy

during remission. Monotherapy also an option for

relapsed or refractory disease when other options

exhausted.

x

30/05/2008 91

Mesothelioma - pemetrexed disodium (TA135) 31/01/2008 Pemetrexed – a recommended option for specified

people with advanced or unresectable malignant pleural

mesothelioma.

x

30/04/2008 90

Psoriasis - infliximab (TA134) 31/01/2008 Infliximab – a recommended option for severe plaque



x30/04/2008 90

Chronic asthma (in children) - corticosteroids

(TA131)

30/11/2007 Inhaled corticosteroids – when indicated, use the least

costly suitable product.

Inhaled corticosteroid with long-acting beta-2 agonist –

when both indicated, a combination device may be used;

use the least costly suitable option.

x

29/02/2008 91 A range of corticosteroid and combination inhalers

are available for prescribing.

Asthma (uncontrolled) - omalizumab (TA133) 30/11/2007 Omalizumab – recommended option for specified non-

smokers with severe persistent allergic asthma, despite

using other asthma medicines.x

29/02/2008 91
























Hypercholesterolaemia - ezetimibe (TA132) 30/11/2007 Ezetimibe – a recommended option for heterozygous-

familial and non-familial hypercholesterolaemia with a

statin if cholesterol not low enough, or as monotherapy

if a statin unsuitable.

x

29/02/2008 91

Multiple myeloma - bortezomib (TA129) 31/10/2007 Bortezomib – a recommended monotherapy for

progressive multiple myeloma at first relapse after one

prior therapy in people who have undergone, or are

unsuitable for, bone marrow transplant.

x

31/01/2008 92

Rheumatoid arthritis - adalimumab, etanercept

and infliximab (TA130)

Partially updates TA36

31/10/2007 Adalimumab, etanercept, infliximab – recommended

options for rheumatoid arthritis after trying

methotrexate and another DMARD. Usually with

methotrexate, but monotherapy if methotrexate

unsuitable.

x

31/01/2008 92

Lung cancer (non-small-cell) - pemetrexed

(TA124)

(See TA181 for first line use)

31/08/2007 Pemetrexed – not recommended for locally advanced or

metastatic non-small-cell lung cancer after prior

chemotherapy.

x

30/11/2007 91

Multiple sclerosis - natalizumab (TA127) 31/08/2007 Natalizumab – a recommended option for rapidly

evolving severe relapsing-remitting MS.x

30/11/2007 91 MS patients treated at UHS.

Smoking cessation - varenicline (TA123) 31/07/2007 Varenicline – a recommended option for smokers who

want to stop, normally as part of a cessation

programme.

x31/10/2007 92

Glioma (newly diagnosed and high grade) -

carmustine implants and temozolomide (TA121)

30/06/2007 Carmustine implants – a recommended option for newly

diagnosed high-grade glioma if more than 90% of the

tumour has been removed.

Temozolomide – a recommended option for newly

diagnosed glioblastoma multiforme in specified

circumstances.

x

30/09/2007 92 Temozolomide is available on the formulary

(carmustine implants via specialist centres only).

Ischaemic stroke (acute) - alteplase (TA122) 30/06/2007 Alteplase – a recommended option for acute ischaemic

stroke.x

30/09/2007 92

11 2


implement time

(days)




































Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2006-07

Leukaemia (lymphocytic) - fludarabine (TA119) 28/02/2007 Fludarabine – monotherapy not recommended as initial

treatment for chronic lymphocytic leukaemia. x

30/05/2007 91

Breast cancer - gemcitabine (TA116) 31/01/2007 Gemcitabine with paclitaxel – a recommended option

for metastatic breast cancer only when docetaxel

monotherapy or docetaxel plus capecitabine are also

appropriate.

x

30/04/2007 89

Colorectal cancer (metastatic) - bevacizumab

and cetuximab (TA118) (partially updated by

TA242)

31/01/2007 Bevacizumab with 5-fluorouracil plus folinic acid, with

or without irinotecan – not recommended first line.

Cetuximab with irinotecan – not recommended if

previous treatment included irinotecan.

x

30/04/2007 89

Hyperparathyroidism - cinacalcet (TA117) 31/01/2007 Cinacalcet – recommended for people on dialysis with

hyperparathyroidism only if unresponsive to other

treatments or if parathyroidectomy unsuitable. x

30/04/2007 89

Drug misuse - methadone and buprenorphine

(TA114)

31/01/2007 Methadone, buprenorphine (oral) – recommended

options for opioid dependence as part of a support

programme, with supervised administration for at least

the first 3 months.

x

30/04/2007 89

Drug misuse - naltrexone (TA115) 31/01/2007 Naltrexone – a recommended option for opioid

dependent people who have stopped opioids, but are

highly motivated to stay free from the drugs in an

abstinence programme.

x

30/04/2007 89

Breast cancer (early) - hormonal treatments

(TA112)

30/11/2006 Anastrozole, exemestane, letrozole – recommended

adjuvant options after surgery for early oestrogen-

receptor-positive breast cancer post-menopause.x

31/01/2007 62 Anastrazole, exemestane, letrozole available on the

formulary.



























Breast cancer (early) - paclitaxel (TA108) 30/09/2006 Paclitaxel – not recommended for the adjuvant

treatment of women with early node-positive breast

cancer. Updated by CG80x

31/12/2006 92

Breast cancer (early) - docetaxel (TA109) 30/09/2006 Docetaxel – a recommended adjuvant option with

doxorubicin and cyclophosphamide for early node-

positive breast cancer. Updated by CG80x

31/12/2006 92

Breast cancer (early) - trastuzumab (TA107) 31/08/2006 Trastuzumab – a recommended option for early-stage

HER2-positive breast cancer after surgery,

chemotherapy, and radiotherapy if applicable. Updated

by CG80.

x

30/11/2006 91

Hepatitis C - peginterferon alfa and ribavirin

(TA106)

Extension of TA75 and partially updated by

TA200

31/08/2006 Peginterferon alfa and ribavirin – a recommended

option for mild chronic hepatitis C. If ribavirin is

unsuitable, use peginterferon monotherapy. No

recommendation on use in the under 18s, or after liver

transplant, due to lack of evidence.

x





formulary.

Psoriasis - efalizumab and etanercept (TA103) 31/07/2006 Etanercept – a recommended option for severe plaque



Efalizumab – drug withdrawn.

x

31/10/2006 92

Prostate cancer (hormone-refractory) -

docetaxel (TA101)

30/06/2006 Docetaxel – a recommended option for hormone-

refractory metastatic prostate cancer with Karnofsky

score 60% or more. Not recommended if the disease

recurs after a first course.

x

30/09/2006 92

Colon cancer (adjuvant) - capecitabine and

oxaliplatin (TA100)

30/04/2006 Recommended options after surgery for stage III (Dukes’

C) colon cancer:

Capecitabine – as monotherapy.

Oxaliplatin – with 5-fluorouracil and folinic acid.

x

31/07/2006 92

Renal transplantation - immunosuppressive

regimens for children and adolescents (TA99)

30/04/2006 Basiliximab, daclizumab – consider for induction therapy

with combinations that include ciclosporin.

Tacrolimus – an alternative to ciclosporin for initial

therapy or maintenance.

Mycophenolate mofetil – Only consider when intolerant

of calcineurin inhibitors (ciclosporin-like drugs).

Mycophenolate sodium – not recommended.

Sirolimus – not recommended unless intolerant of

calcineurin inhibitors.

x

31/07/2006 92 Basiliximab, ciclosporin, tacrolimus, mycophenolate

mofetil available on the formulary.

12 3


implement time

(days)





http://www.nice.org.uk/guidance/index.jsp?action=byID&o=12132
















































Date of TA

Release




decision

(DD/MM/YY)

Time to

implement

(days)


2000-06

Attention deficit hyperactivity disorder (ADHD) -

methylphenidate, atomoxetine and

dexamfetamine (review) (TA98)

31/03/2006 Methylphenidate, atomoxetine, dexamfetamine –

recommended options for ADHD; if more than one is

appropriate, choose the cheapest.

x

27/10/2006 210 TA 98 discussed at APC 27/10/2006 but medicines

available on the formualry prior to the publication of

the TA by local agreement.

Hepatitis B (chronic) - adefovir dipivoxil and

pegylated interferon alpha-2a (TA96)

28/02/2006 Peginterferon alfa-2a – a recommended first line option

for chronic hepatitis B.

Adefovir dipivoxil – recommended option if

peginterferons unsuccessful or not tolerated. Given as

monotherapy or with lamivudine depending on

lamivudine resistance.

x





formulary.

Cardiovascular disease - statins (TA94) 31/01/2006 Statin therapy is recommended for adults with specified

clinical evidence of CVD or at specified risk of CVD. x

30/04/2006 89 A choice of statins is available on the formulary.

Ovarian cancer (advanced) - paclitaxel,

pegylated liposomal doxorubicin hydrochloride

and topotecan (review) (TA91)

31/05/2005 Paclitaxel, liposomal doxorubicin, topotecan –

recommended options in advanced disease depending

largely upon platinum sensitivity, resistance, tolerance,

and allergy.

x

31/08/2005 92

Gastrointestinal stromal tumours - imatinib

(TA86) Partially updated by TA209

31/10/2004 Imatinib – recommended first-line for management of

people with KIT (CD117)-positive unresectable and/or

metastatic GISTs.

x

31/01/2005 92

Renal transplantation - immuno-suppressive

regimens (adults) (TA85)

30/09/2004 Basiliximab, daclizumab – consider for induction therapy

with combinations that include ciclosporin.

Tacrolimus – an alternative to ciclosporin for initial

therapy or maintenance.

Mycophenolate mofetil – Only consider when intolerant

of calcineurin inhibitors (ciclosporin-like drugs).

Sirolimus – not recommended unless intolerant of

calcineurin inhibitors.

x

31/12/2004 92 Basiliximab, ciclosporin, tacrolimus, mycophenolate

mofetil are available on the formulary.



























Atopic dermatitis (eczema) - topical steroids

(TA81)

31/08/2004 Topical corticosteroid – the cheapest suitable option for

atopic eczema should be used and applied no more than

twice daily.x

30/11/2004 91 A range of topical steroids is available on the

formulary.

Atopic dermatitis (eczema) - pimecrolimus and

tacrolimus (TA82)

31/08/2004 Not recommended for first line use or mild disease. If

maximum topical steroids ineffective or threaten

important side effects, consider:

Tacrolimus – for moderate to severe disease in patients

over 2 years.

Pimecrolimus – for moderate disease on face and neck

for those between 2 and 16 years.

x

30/11/2004 91

Insomnia - newer hypnotic drugs (TA77) 30/04/2004 Zaleplon, zolpidem, zopiclone – prescribe the cheapest

of these or a shorter-acting benzodiazepine, for a short

period, if non-drug treatments don’t work. x

31/07/2004 92 Zopiclone is available on the formualry

Hepatitis C - pegylated interferons, ribavirin and

alfa interferon (TA75)

Partially updated by TA200; replaces TA14

31/01/2004 Peginterferon alfa with ribavirin – recommended for

moderate to severe chronic hepatitis C as specified

within this TA . x





formulary.

Leukaemia (chronic myeloid) - imatinib (TA70)

(partially updated by TA241 and TA251)

31/10/2003 Imatinib – a recommended option for those who present

in the accelerated phase or with blast crisis, or those in

chronic phase who progress to these stages without

prior imatinib.

x

31/01/2004 92

Macular degeneration (age-related) -

photodynamic therapy (TA68)

30/09/2003 Verteporfin – recommended for wet ARMD in specified

people if classic subfoveal choroidal neovascularisation

(CNV), with no sign of occult CNV. Not recommended for

wet ARMD with mostly classic and some occult CNV

unless in a clinical trial. No recommendation about PDT

for ARMD with occult CNV since product unlicensed.

x

31/12/2003 92 Verteporfin infection added to the formulary Febrary

2014 as photodyamic therapy can now be provided in

PHT.

Non-Hodgkin's lymphoma - rituximab (TA65) 30/09/2003 Rituximab with CHOP – recommended first line for

diffuse large-B-cell lymphoma at stage 2, 3 or 4; in stage

1 only in a clinical trial. Rituximab not recommended

without CHOP.

x

31/12/2003 92

Growth hormone deficiency (adults) - human

growth hormone (TA64)

31/08/2003 Human growth hormone – recommended only where

severe growth hormone deficiency severely affects

quality of life. x

30/11/2003 91

Colorectal cancer - capecitabine and tegafur

uracil (TA61)

30/05/2003 Capecitabine or tegafur with uracil (and folinic acid) –

recommended among first options for metastatic

colorectal cancer.

x31/08/2003 93

Ovarian cancer - paclitaxel (review) (TA55)

Partially updated by TA91

31/01/2003 Cisplatin or carboplatin, with or without paclitaxel –

recommended as alternatives for first-line use (usually

following surgery) in ovarian cancer.x

30/04/2003 89








































Diabetes (types 1 and 2) - long acting insulin

analogues (TA53)

31/12/2002 Insulin glargine – a recommended option for type 1

diabetes. Guidance in type 2 diabetes is contained in the

CG66 Update.

31/03/2003 90 Insulin glargine and insulin detemir are available on

the formualry.

Myocardial infarction - thrombolysis (TA52) 31/10/2002 Alteplase, reteplase, streptokinase, tenecteplase –

suggestions made on how to choose the most

appropriate agent in hospitals. Reteplase or

tenecteplase recommended for use outside hospitals.

x

31/01/2003 92 Alteplase, streptokinase and tenecteplase are avialble

on the formualry

Acute coronary syndromes - glycoprotein IIb/IIIa

inhibitors (review) (TA47)

Partially updated by CG94

30/09/2002 A GP IIb/IIIa inhibitor should be considered as an

elective PCI adjunct in patients with diabetes, and in

patients undergoing specified complex procedures. Not

recommended in procedurally uncomplicated elective

PCI unless specified complications occur.

x

31/12/2002 92 Abciximab is available on the formulary.

Arthritis (juvenile idiopathic) - etanercept

(TA35)

31/03/2002 Etanercept – recommended for 4–17 year olds with

active disease where methotrexate unsuccessful or not

tolerated.x

30/06/2002 91

Asthma (older children) - inhaler devices (TA38) 31/03/2002 Inhaler choice should reflect patient needs:

Steroids – press-and-breathe inhalers with a spacer

recommended first line.

Bronchodilators – a wider choice of inhalers, including

easily portable ones.

x

30/06/2002 91 A range of inhaler devices and spacers are available

for prescribing.

Breast cancer - trastuzumab (TA34) 31/03/2002 In metastatic breast cancer with HER2 at 3+:

Trastuzumab with paclitaxel – recommended if no prior

chemo and anthracyclines inappropriate.

Trastuzumab monotherapy – recommended after at

least two other regimens tried including at least one

anthracycline, taxane, and hormonal treatment if

appropriate.

x

30/06/2002 91

Multiple sclerosis - beta interferon and

glatiramer acetate (TA32)

31/01/2002 Beta interferon, glatiramer – recommendation to use

these medicines not justified. x30/04/2002 89 MS patients treated at UHS

Leukaemia (lymphocytic) - fludarabine (TA29) 31/01/2002 Fludarabine – recommended option orally instead of

CHOP, VAP or CVP regimens in B-cell CLL if first chemo

regimen unsuccessful or not tolerated. Use infusion only

if oral route not suitable.

x

30/04/2002 89

Pancreatic cancer - gemcitabine (TA25) 30/05/2001 Gemcitabine – a first line option for advanced or

metastatic disease if Karnofsky score 50 or more, if

curative surgery not an option. Not for second line use.x

31/08/2001 93

Brain cancer - temozolomide (TA23) 30/04/2001 Temozolomide – consider for specified people with

recurrent brain cancer if initial chemo failed or not

tolerated. Only for first line use in a clinical trial.x

31/07/2001 92

Motor neurone disease - riluzole (TA20) 31/01/2001 Riluzole – should be available for MND. x 30/04/2001 89












































Asthma (children under 5) - inhaler devices

(TA10)

31/08/2000 Steroids, bronchodilators – deliver by a pressurised

metered dose inhaler with spacer, using a facemask if

necessary. If this not suitable, consider a nebuliser, or a

dry powder inhaler in the over 3s.

x

30/11/2000 91 A range of inhaler devices and spacers are available

for prescribing.

26 1


implement time

(days)






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