Decisions 24th May 2016

At the meeting that took place on 24th May, the folllowing decisions were agreed.


New Drug Requests


Brivaracetam (TLS Red)

  • Approved for inclusion onto the formulary for patietns with partial onset epilepsy who have tried and failed on adjunctive therapy, inlcuding levetiracetam.

Benepali (Etanercept biosimilar) (TLS Red)

  • Approved for inclusion onto the formulary, in line with NICE.  Etanercept should be prescribed by brand.

Rivastigmine (TLS Amber 1 month)

  • Approved for inclusion onto the formulary for Parkinson's disease dementia.  The current SCP is to be amended to include this indication.


Not Approved

Pliaglis gel for topical anaesthesia

  • There is no evidence to suggest that Pliaglis is clinically better than EMLA or reduces the need for GAs.  There is a significant cost implication by using Pliaglis.  The JFG therefore did not approve the inclusion of Pliaglis onto the formulary at the current time.  The applicant was invited to submit evidence demonstrating superiority over EMLA.  


  • In the absence of any major advantage in terms of efficacy, safety, user acceptability or cost there seems little reason to use Jaydess in preference to Mirena.  The JFG did not currently approve the addition of Jaydess onto the formulary.


  • The JFG acknowledged the difficulties in determining the commissioning arrangements for fulvestrant.  However based on the evidence currently available, fulvestrant does not appear to offer significant clinical benefits over tamoxifen or AIs in the 2nd or 3rd line treatment of breast cancer.  On this basis, the JFG could not approve the addition of fulvestrant to the formulary. 


More information required


  • The JFG acknowledged the lack of robust evidence in this paediatric population leading to the need to extrapolate from adult trials.  The need to prevent thrombi in this patient population is high.  With a lack of evidence to support its use, it is suggested to gain information from other centres already using it and to also determine if there are other adult based trials in this particular cohort.  In addition, we need to ensure that this is a safe treatment in paediatrics.  The JFG agreed to defer the decision until more information is obtained.


Shared Care Protocols/TLS Change in Status


  • TLS Change in status request.  The JFG did not approve the change in status to amber 1 month at this stage.  More work on the whole treatment pathway is required in conjunction with the drug and alcohol service providers.


Azathioprine (Neurology)

  • Updated SCP agreed.

Azathioprine (Paediatric)

  • New SCP.  More work is required to define roles and responsiblities.  To be uploaded once clear.


Mercaptopurine (Dermatology)

  • New SCP.  More work is required to define roles and responsiblities.  To be uploaded once clear.



  • Updated SCP and TLS change in status request agreed to amber 1 month


  • Updated SCP and TLS change in status request agreed to amber 1 month


  • Updated SCP agreed.



  • Current shortage in Antepsin brand.  Supplies are through importing only and therefore costs are significantly increased.  No new patients are to be initiated on Sucralfate and current patients to be reviewed for possible alternatives.


Last updated by: on 19-09-2016 13:27