Consultation on medicines which should not routinely be prescribed

NHS England have published a new consultation proposing further national guidance for CCGs on medicines which should not routinely be prescribed in primary care. The consultation, running to 28 February 2019, is:

The items considered for inclusion were:

  • medicines that do not work very well or are not very safe for patients to take;
  • more expensive when compared to other medicines that work as well;
  • medicines that the NHS should not spend money on because they do not treat serious illnesses.

A lot of the action advice within the consultation is already current practice in Camden and therefore the impact upon Camden patients is not expected to be significant.

The new consultation is for 8 drugs and medical products and an amendment to 1 set of previous advice. Recommendations are for the following:

  • Aliskiren (usually prescribed on its own or together with other medicines to lower high blood pressure) should not be prescribed to new patients; patients who are prescribed aliskiren will be supported to start using different medicines instead.
  • Amiodarone (medicine used to treat and prevent a number of medical conditions that give you irregular heartbeats) should not be prescribed to new patients and should be prescribed only by a specialist or in cases when other treatment cannot be used or didn’t work.
  • Dronedarone (medicine used to keep the heartbeat normal in patients who cannot have other treatments or medicines for this) should not be prescribed for new patients and should be prescribed only by a specialist and in very special cases, for example when other treatment cannot be used or didn’t work.
  • Minocycline (type of antibiotic that can be used for many things, but is usually used by primary care to treat acne) should not be prescribed for new patients; patients who are prescribed minocycline will be supported to use different medicines.
  • Silk garments, (prescribed to patients who have very bad eczema or allergic reactions on their skin), should not be prescribed to new patients; patients should not be prescribed silk garments anymore, and that they are supported in this change.
  • That for bath and shower preparations for dry or itchy skin; gels and soaps should not be prescribed to new patients; patients who get these gels and soaps on prescription at the moment will be supported to start using leave-on lotions instead.
  • Recommending that prescribers choose less expensive blood glucose testing strips for Type 2 Diabetes; patients who are being prescribed more expensive strips will be supported to start using test strips that cost under 10 pounds for a set of 50.
  • Recommending prescribers choose less expensive items for insulin pen needles; patients who are prescribed more expensive insulin pen needles should be moved onto needles costing less than 5 pounds for a set of 100, and that they get the help they need to make this change.
  • The update to rubefacients proposes allowing capsaicin cream to be prescribed if appropriate in line with NICE guidance.

During the consultation a range of events, including meetings and webinars (online meetings) will take place to gather feedback on the proposals. You can register for these here:  https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed-update/

The Camden Medicines Management Committee will submit a response to the consultation on behalf of Camden CCG.