LANARKSHIRE AREA DRUG & THERAPEUTICS COMMITTEE. 2014/116 Apologies Mr John Milne, Mrs Victoria Mackinnon, Mr Smith Mr George Lindsay

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LANARKSHIRE AREA DRUG & THERAPEUTICS COMMITTEE Minute of the meeting held on Wednesday 17 th September 2014 at 10am in the Boardroom, NHS Lanarkshire HQ, Kirklands, Bothwell PRESENT: Dr Mehrdad

1 LANARKSHIRE AREA DRUG & THERAPEUTICS COMMITTEE Minute of the meeting held on Wednesday 17 th September 2014 at 10am in the Boardroom, NHS Lanarkshire HQ, Kirklands, Bothwell PRESENT: Dr Mehrdad Malekian [Chair] Ms Ann Auld Dr Caroline Delahunty Dr Stephanie Dundas Mrs Christine Gilmour Dr Harpreet Kohli Mr Billy Lang Dr Alwaly Majumdar Dr Philip McMenemy Dr Colin Ooi Mrs Karen Patterson Mrs Gail Richardson Dr Vijay Sonthalia 2014/116 Apologies Mr John Milne, Mrs Victoria Mackinnon, Mr Smith Mr George Lindsay Action 2014/117 Presentation: Treatments for Hepatitis C Dr Nick Kennedy attended the meeting and gave a presentation on recent advances in the treatment options for hepatitis C. This is a rapidly evolving area with further developments expected within the next few months. 2014/118 Matters arising from the previous minute (a) Confirmation of Publication of 16 th July 2014 Minutes It was confirmed that these minutes have been published on the website. (b) Minute of previous meeting held on 20 th August 2014 The minute was accepted as a true record. (c) Remote Prescribing Policy Mrs Gilmour to arrange for SOP to be cascaded to relevant nursing and medical staff. Action: Mrs Gilmour. (d) Information Sheet for GPs to aid the recording but not the prescribing of hospital supply medicines Carried forward to next meeting Action: Ms Auld (e) Update on AEDs Carried forward to next meeting Action: Mrs Mackinnon (f) Update on Unlicensed Medicines Policy 1

2 Carried forward to next meeting Action: Mrs Gilmour (g) Remit and Constitution Members were asked to send any comments to Mrs Gilmour so that draft revised remit and constitution can be discussed at next meeting. Dr Malekian & Mrs Gilmour updated members of work that has commenced to review all existing groups and committees which have a responsibility for medicine governance. Whilst it is acknowledged that this will impact on the ADTC it was agreed that this could take some time and that the ADTC should review its existing remit and constitution as planned. It was agreed that there should be clarity on where the ADTC reports into the NHSL governance structure. Action: All (h) Feedback from SMC A query had been raised with SMC regarding changes in budget impact information presented at SMC and that appearing in the final detailed advice document. It was reported that although this was unusual it was a matter of routine. Subsequent to the August ADTC meeting an approach was made to SMC enquiring if consideration would be given to evaluating those medicines which were SMC no as a consequence of non-submission where the drug was considered to be of public interest. It was reported that SMC welcomed that they are going to be able to do this but were not in a position to provide dates for when this would be able to be undertaken. 2014/119 SMC Decisions 1. Empagliflozin (Jardiance ) empagliflozin (Jardiance) FINAL Sep Mrs Mackinnon to seek comment from the Diabetes MCN 2. Lurasidone (Latud ) lurasidone (Latuda) FINAL Sept 2014.doc. Mr Lang to seek comment from Mental Health D&T Committee 2

3 3. Dabigatran (Pradaxa ) dabigatran etexilate (Pradaxa) FINAL Sept Mrs Mackinnon to seek comment from Dr Hung lead clinician for anticoagulant services 4. Misoprostol (Mysodelle ) misoprostol (Mysodelle) FINAL Sep Mrs Mackinnon to seek comment from Clinical Director for Obstetrics 5. Brentuximab (Adcetris ) Brentuximab vedotin (Adcetris) FINAL Sept Mrs Mackinnon to seek comment from Lead Clinician for Haematology 6. Trastuzumab emtansine (Kadcyla ) Trastuzumab(Kadcyl a) FINAL Sept 2014.d This was noted by the committee 7. Capsacin (Qutenza ) capsaicin (Qutenza) RESUBMISSION Final Mrs Mackinnon to seek comment from Lead Clinician for Pain Services 8. Alogliptin (Vipdomet ) alogliptin plus metformin (Vipdomet) Mrs Mackinnon to seek comment from the Diabetes MCN 3

4 9. Posaconazole (Noxafil ) posaconazole (Noxafil) Abbreviated This was noted by the committee. It is a change in formulation of an existing therapy. 10. Azelastine hydrochloride + Fluticasone propionate (Dymista ) azelastine hydrochloride (Dymist This was noted by the committee. It will not be added to the formulary 2014/120 AMENDED SMC ADVICE The amendment to the SMC Detailed Advice Document for fingolimod, 0.5mg, hard capsules (Gilenya ) SMC No. (992/14) Novartis Pharmaceuticals UK was noted. 2014/121 SMC Follow-up The document was noted by the committee. 2014/122 Lanarkshire Formulary No matters arising 2014/123 Clinical Protocols a. Synergistic Gentamicin Dr Dundas spoke to the protocol. The protocol was accepted and welcomed by the committee. b. Tociluzimab The protocol was considered not to be complete and so could not be accepted by the committee. The protocol to be returned to rheumatology for submission at a later date. KP c. Rivaroxaban / Enoxaparin The committee requested that the orthopaedic service consider which agent is to be used first line and that the protocol be resubmitted as separate documents for each individual medicine detailing their place in therapy and MM 4

5 duration of treatment. Dr Malekian will discuss this with Mr Khan. d. Acute management of Parkinson s patients who are nil by mouth or who have a compromised swallow The committee welcomed this document and praised its clarity and content which was considered to be very helpful. KP The document was accepted subject to some presentational changes. Mrs Patterson agreed to take these comments back to the service. 2014/124 ADTC Bulletin No 83 July 2014 This was noted by the committee. 2014/125 a. b. c. d. e. Unlicensed Medicines Etoposide no further update Demeclocycline Accepted by the committee. Confirmation was sought that this had been communicated to community pharmacies. Artesunate for malaria. Accepted by the committee Yellow Fever Vaccine Accepted by the committee Zoledronic Acid 5mg/100ml The committee were asked to consider whether they would support continued use of the generic product when the current batch covering both therapeutic indications is exhausted. It was acknowledged that there is precedent for using a generic product off-label when clinical equivalence is assumed, however the committee asked that further details be obtained. CG agreed to lead on this and report back CG 2014/126 NICE/HIS Guidance There was nothing new to discuss at this meeting. 2014/127 Medication and Clinical Risk in Lanarkshire The MHRA information was noted. 2014/128 Regional Cancer Prescribing Advisory Network There was nothing new to discuss at this meeting. 5

6 2014/129 Correspondence a. Letter from Dr A Manchip Dr Manchip s letter confirmed that health services within Shotts Prison have been made aware of the communication from the national prisoner Healthcare Network Advisory Group and have processes in place to ensure compliance. The letter was noted by the committee 2014/130 5Date of next meeting The next meeting will be Wednesday the 15 th October 2014 at 10 am in the board room NHS Lanarkshire HQ Kirklands Bothwell 6

LANARKSHIRE AREA DRUG & THERAPEUTICS COMMITTEE. PRESENT: Anne Buchanan [Admin Support] Dr Mehrdad Malekian [Chair]

LANARKSHIRE AREA DRUG & THERAPEUTICS COMMITTEE Minute of the meeting held on Wednesday 18 th September 2013 at 10am in the Boardroom, NHS Lanarkshire HQ, Kirklands, Bothwell PRESENT: Anne Buchanan [Admin