netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Search
 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:
Further information on specific drugs available locally and the pathways used is available from the East Midlands Cancer Network.  This includes drugs reviewed as part of NICE technology appraisals


The East Midlands has adopted the Palliative Adult Network Guidelines(PANG) as the single guideline across the region to conform with the requirement for a single guideline within a cancer network.  These are freely available to healthcare professionals.
Chapter Links...
 Details...
08.02.04  Expand sub section  Other immunomodulating drugs
 note  For drugs used in cancer please see EM Cancer Network website.
Glatiramer Acetate (Copaxone®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
BlueTeq

Specialist Neurology prescribing only
High Cost Drug excluded to tariff (NHSE)
See HSC 2002/004 below for conditions of use
Co-paxone 40mg/ml 3 x weekly supported by NHSE and TAS
Blueteq prior approval required before initiation

 
   
Interferon alfa
View adult BNF View SPC online
Restricted Drug Restricted
Red
Specialist prescribing only in Hepatitis B&C
High cost drug excluded to tariff. Commissioned by NHSE in line with NICE TA 75 only
 
Link  NICE TA75: Interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C
   
Interferon beta
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

Specialist Neurology prescribing only
Includes Avonex®,Rebif® and Betaferon ®(Interferon beta-1b)
High cost drug excluded to tariff (NHSE)
Blueteq prior approval required before initiation
See HSC 2002/004 below for conditions of use

 
Link  MHRA Advice: Interferon-beta: risk of thrombotic microangiopathy and risk of nephrotic syndrome
   
Interferon beta-1a (Rebif®)
View adult BNF View SPC online  Track Changes
Formulary
High Cost Medicine
NHS England
BlueTeq

For Multiple sclerosis in adults in line with NICE TA 527

Blueteq prior approval required before initiation

Implementation Date: September 2018

 
   
Peginterferon alfa
View adult BNF View SPC online
Restricted Drug Restricted
Red
Hepatitis B&C treatment
High cost drug excluded to tariff. Commissioned by NHSE in line with NICE TA75, TA96, TA106, TA200, TA 300, CG165
 
Link  NICE CG 165: Hepatitis B (chronic): Chronic hepatitis B in children, young people and adults
Link  NICE TA 106: Peginterferon alfa and ribavirin: mild chronic hepatitis C
Link  NICE TA 200: Peginterferon alfa and ribavirin:chronic hepatitis C
Link  NICE TA 300: Peginterferon alfa and ribavirin:chronic hepatitis C in children and young people
Link  NICE TA 75 Interferon alfa (pegylated and non-pegylated) and ribavirin: chronic hepatitis C
   
Peginterferon beta 1a (Plegridy ®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
Specialist Neurology prescribing only
High cost drug excluded to tariff (NHSE)
Two weekly administration
See HSC 2002/004 for conditions of use  
   
Cladribine (Mavenclad®)
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine
NHS England
BlueTeq

Specialsit neurologist prescribing only. 
For use in line with NICE TA 493
Blueteq prior approval required before initiation
Date decision added to Formulary: March 2018

 
Link  NICE TA 493: Cladribine tablets for treating relapsing–remitting multiple sclerosis
   
Dimethyl Fumarate
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
BlueTeq

Supported in line with NICE TA 320 only.
Specialist neurology prescribing
Blueteq prior approval required before initiation

Date decision added to Formulary: November 2014

 
Link  MHRA Advice: Dimethyl fumarate (Tecfidera): updated advice on risk of progressive multifocal leukoencephalopathy
Link  NICE TA 320: Dimethyl fumarate for Multiple Sclerosis
   
Teriflunomide  (Aubagio®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

Specialist Neurology prescribing only in line with NICE TA 303
High Cost Drug excluded to tariff (NHSE)
Blueteq prior approval required before initiation

Date of entry of decision to Formulary: April 2014

 
Link  NICE TA 303:Teriflunomide for treating relapsing–remitting multiple sclerosis
   
Alemtuzumab
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
BlueTeq

Supported by TAS in line with NICE TA 312.

Blueteq prior approval required before initiation

Date decision added to Formulary: August 14

 
Link  MHRA Advice: Alemtuzumab and serious cardiovascular and immune-mediated adverse reactions
Link  NICE TA 312: Alemtuzumab for Multiple Sclerosis
   
Daclizumab
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
Supported by TAS in line with NICE TA 441

Blueteq prior approval required before initiation

Date decision added to Formulary: July 17  
Link  NICE TA 441: Daclizumab for treating relapsing–remitting multiple sclerosis
   
Natalizumab  (Tysabri®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
NHS England
BlueTeq

Specialist Neurology prescribing only in line with NICE TA 127.
High cost drug excluded to tariff (NHSE)
Blueteq prior approval required before initiation

 
Link  MHRA Advice: Natalizumab (Tysabri▼): progressive multifocal leukoencephalopathy - updated advice to support early detection
Link  NICE TA 127: Natalizumab for the treatment of adults with highly active relapsing–remitting multiple sclerosis
   
Fingolimod (Gilyena®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

Specialist Neurology prescribing only in line with NICE TA 254
High cost drug excluded to tariff (NHSE)
Blueteq prior approval required before initiation

Date of entry of decision to Formulary: July 2012

 
Link  MHRA Advice: Fingolimod (Gilenya▼): risks of progressive multifocal leukoencephalopathy, basal-cell carcinoma, and opportunistic infections
Link  MHRA Advice: Fingolimod (Gilenya): Increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception
Link  NICE TA 254: Fingolimod for the treatment of highly active relapsing–remitting multiple sclerosis
   
Beta-interferon-1a (Avonex®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

For Multiple sclerosis in adults in line with NICE TA 527

Blueteq prior approval required before initiation

Implementation Date: September 2018 

 
Link  NICE TA 527: Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Beta-interferon-1b (Betaferon®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

For Multiple sclerosis in adults in line with NICE TA 527

Blueteq prior approval required before initiation

Implementation Date: September 2018 

 
Link  NICE TA 527: Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Beta-interferon-1b (Extavia®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

For Multiple sclerosis in adults in line with NICE TA 527

Blueteq prior approval required before initiation

Implementation Date: September 2018 

 
Link  NICE TA 527: Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Glatiramer Acetate (Copaxone®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
NHS England
BlueTeq

For Multiple sclerosis in adults in line with NICE TA 527

Blueteq prior approval required before initiation

Implementation Date: September 2018 

 
Link  NICE TA 527: Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Ocrelizumab (Ocrevus®)
View adult BNF View SPC online  Track Changes
Restricted Drug Restricted
Red
High Cost Medicine
NHS England
BlueTeq

For relapsing-remitting multiple sclerosis in line with NICE TA 533. For primary progressive multiple sclerosis in line with NICE TA 585

 

Blueteq prior approval required before initiation

Date decision added to Formulary: October 2018

 
Link  NICE TA 533: Ocrelizumab for treating relapsing–remitting multiple sclerosis
Link  NICE TA 585: Ocrelizumab for treating primary progressive multiple sclerosis
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Black

Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   

Red

Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

Amber SCA

Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

Amber Simple

Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

Green Conditional

Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   

Green

Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.   

netFormulary