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Changes to prescribed list as of 1 January 2019

A formal published “Ministerial Decision” is required as a record of the decision of a Minister (or an Assistant Minister where they have delegated authority) as they exercise their responsibilities and powers.

Ministers are elected by the States Assembly and have legal responsibilities and powers as “corporation sole” under the States of Jersey Law 2005 by virtue of their office and in their areas of responsibility, including entering into agreements, and under any legislation conferring on them powers.

An accurate record of “Ministerial Decisions” is vital to effective governance, including:

  • demonstrating that good governance, and clear lines of accountability and authority, are in place around decisions-making – including the reasons and basis on which a decision is made, and the action required to implement a decision

  • providing a record of decisions and actions that will be available for examination by States Members, and Panels and Committees of the States Assembly; the public, organisations, and the media; and as a historical record and point of reference for the conduct of public affairs

Ministers are individually accountable to the States Assembly, including for the actions of the departments and agencies which discharge their responsibilities.

The Freedom of Information Law (Jersey) Law 2011 is used as a guide when determining what information is be published. While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.

A decision made on 13 December 2018:

Decision Reference: MD-S-2018-0072

Decision Summary Title :

DS_Changes to Prescribed List as of 1 Jan 2019

Date of Decision Summary:

12 December 2018

Decision Summary Author:

Prescribing Advisor

Decision Summary:

Public or Exempt?

Public

Type of Report:

Oral or Written?

Written

Person Giving

Oral Report:

N/A

Written Report

Title :

WR_Changes to Prescribed List as of 1 Jan 2019

Date of Written Report:

12 December 2018

Written Report Author:

Prescribing Advisor

Written Report :

Public or Exempt?

Public

Subject: Changes to be made to the Prescribed List (Jersey) as of 1 January 2019

Decision(s): Further to Article 15, paragraphs (11) and (12), of the Health Insurance (Jersey) Law 1967, and having consulted with the Pharmaceutical Benefit Advisory Committee, the Minister decided to make amendments to the Prescribed List with effect from 1 January 2019  as set out in the accompanying report.

Reason(s) for Decision:  The Pharmaceutical Benefit Advisory Committee met on 6 September 2018 and has provided the Minister with recommendations and the accompanying written report regarding amendments to the Prescribed List.

 

Items to be added to the Prescribed List

  • Mesalazine 2g enema
  • Sodium chloride 5% eye drops (non-preservative free)
  • Quetiapine 300mg tablet
  • Xailin Night lubricating eye ointment (contains White soft paraffin 57.3% w/w, White Mineral Oil 42.5% w/w and Lanolin Alcohols 0.2% w/w)
  • Addition of items to ensure consistency with the Dental Practitioners’ Formulary of England and Wales

 

Items to be listed as generic only

  • Items detailed in the written report

 

Other amendments to the Prescribed List

  • Lidocaine topical to be amended to read Lidocaine cream 4%

 

 

Additionally, instructions regarding instalment dispensing are amended, removing conflicting advice regarding prescriptions for benzodiazepines

 

The changes reflect current evidence and expert advice, and ensure that patients in Jersey have access to an appropriate range of modern, safe and effective treatments from their GPs at a proportionate cost to the Fund.

 

Resource Implications:  The overall impact of the changes is expected to be cost neutral.  

Action required:  Customer and Local Services to issue public notice listing amendments and notify all approved medical practitioners and approved contractors.

Signature:

 

 

 

Position:

Minister

Date Signed:

 

 

 

Date of Decision (If different from Date Signed):

 

Changes to prescribed list as of 1 January 2019

RECOMMENDATIONS OF THE

PHARMACEUTICAL BENEFIT ADVISORY COMMITTEE

 

29 November 2018

 

Summary

 

The Pharmaceutical Benefit Advisory Committee (PBAC) met on 29 November 2018 to consider applications for changes to the Prescribed List.

 

The PBAC was unanimous in its recommendations for the following changes to the Prescribed List.

 

  1. Items to be added to the Prescribed List

 

  1. Mesalazine 2g enema

 

  1. Sodium chloride 5% eye drops (non-preservative free)

 

  1. Quetiapine 300mg tablet

 

  1. Xailin Night lubricating eye ointment (contains White soft paraffin 57.3% w/w, White Mineral Oil 42.5% w/w and Lanolin Alcohols 0.2% w/w)

 

  1. Addition of items to ensure consistency with the Dental Practitioners’ Formulary

 

 

  1. Items to be listed as generic only

 

  1. See Appendix 1

 

  1. Other amendments to the Prescribed List

 

  1. Lidocaine topical to be amended to read Lidocaine cream 4%

 

 

Financial impact

 

The overall financial impact of the above changes is estimated to be cost neutral.

 

Mrs Alison Creed

Chair, PBAC

 

3 December 2018

Recommendations

 

  1. Items to be added to the Prescribed List

 

  1. Mesalazine 2g enema

The Prescribed List already includes mesalazine rectal foam for the treatment of inflammatory bowel disease. However, a small number of patients find the enema formulation of the drug to be more effective. Both the rectal foam and enema have a similar treatment cost at recommended doses so the change is expected to be cost neutral.

 

  1. Sodium chloride 5% eye drops (non-preservative free)

The Prescribed List already includes sodium chloride 5% preservative-free eye drops but this product has been unavailable to community pharmacies. Adding the non-preservative free eye drops will ensure continuity in supply for those patients who need sodium chloride 5% eye drops and who are not sensitive to preservatives. Both formulations of eye drops are similarly priced so this change is expected to be cost neutral.

 

  1. Quetiapine 300mg tablet

All other strengths of quetiapine tablets are included in the Prescribed List so addition of the 300mg strength ensures that patients have access to the full range. This change is expected to be cost neutral.

 

  1. Xailin Night lubricating eye ointment (contains White soft paraffin 57.3% w/w, White Mineral Oil 42.5% w/w and Lanolin Alcohols 0.2% w/w)

Xailin Night eye ointment is the nearest equivalent to Lacri-Lube eye ointment, which is already included in the Prescribed List but currently out of stock for all pharmacies. Inclusion of the lower cost Xailin Night eye ointment will ensure that patients can continue to access an equivalent, effective treatment. This change is expected to provide a small cost saving.

 

  1. Products to be added to the List to ensure consistency with the Dental Practitioner’s Formulary

Following consultation with the Jersey Dental Association and dental practitioners in Jersey, PBAC recommends that the Jersey Dental List is replaced by the Dental Practitioner’s Formulary (DPF) with effect from 1 January 2019. This change will ensure that Jersey dental practitioners have access to the same range of medicines for their patients as in England and Wales. To facilitate this change, a small number of medicines will need to be added to the Prescribed List, as follows:

 

Product

Additional information

Artificial Saliva Gel, DPF

e.g. Biotene Oralbalance

Artificial Saliva Oral Spray, DPF

e.g. Xerotin

Artificial Saliva Pastilles, DPF

e.g. Salivix

Artificial Saliva Protective Spray, DPF

e.g. Aquoral

Artificial Saliva Substitutes as listed below:

to be prescribed ONLY for indications approved by ACBS (patients suffering from dry mouth as a result of having or, having undergone, radiotherapy or sicca syndrome

BioXtra® Gel Mouthspray

BioXtra® Moisturising Gel

Glandosane®

Saliveze®

Artificial Saliva Substitute Spray, DPF

e.g. AS Saliva Orthana Spray

Azithromycin Capsules, 250 mg, DPF

 

Cefalexin Tablets, BP

 

Cefradine Capsules, BP

 

Chlorhexidine Gluconate Gel, BP

 

Hydrogen Peroxide Mouthwash, BP, 6%

 

Lidocaine Spray 10%, DPF

e.g. Xylocaine Spray

Menthol and Eucalyptus Inhalation, BP 1980

 

Saliva Stimulating Tablets, DPF

e.g. SST brand

Sodium Chloride Mouthwash, Compound, BP

 

Temazepam Oral Solution, BP

 

 

 

2        Other changes to the Prescribed List

 

  1. Lidocaine topical to be amended to read Lidocaine cream 4%

 

  1. Items to be listed as ‘Generic Only’

Following a review of the Prescribed List, a number of medicines are recommended for listing as ‘Generic Only’ medicines that should only be prescribed by generic name and reimbursed in accordance with Part VIII of the Drug Tariff. This change to the medicines listed in Appendix 1 will ensure that Jersey continues to reimburse for them at the lowest price.

 

  1. Reimbursement for instalment dispensing – proposed amendment to text in the Prescribed List

The preface to the Prescribed List includes the following paragraph with relation to prescribing in instalments: “When a doctor has requested dispensing at stipulated intervals, instalment-dispensing fees may be claimed if the medicine is listed in Part I, II or III of the second schedule to the Misuse of Drugs (Jersey) Law 1978. NB Benzodiazepines are not a notifiable product under the Misuse of Drugs Law.  Therefore, no instalment dispensing fees can be paid for someone addicted only to benzodiazepines.”

 

Since Part III of the second schedule contains benzodiazepines, the second sentence in this paragraph appears to contradict the first. In addition, it is clinically appropriate for clinicians to choose to prescribe benzodiazepines for dispensing in instalments for selected patients.

 

PBAC, therefore, recommends amendment of the above paragraph, to remove the second sentence. The paragraph should now read “When a doctor has requested dispensing at stipulated intervals, instalment-dispensing fees may be claimed if the medicine is listed in Part I, II or III of the second schedule to the Misuse of Drugs (Jersey) Law 1978.”


 

  1. Applications not supported by PBAC

 

  1. Ciclesonide 80mcg, 160mcg pressurised inhaler

 

The Committee considered an application for ciclesonide, an inhaled corticosteroid, to be added to the Prescribed List but did not support its recommendation for the following reasons:

  • There are three other inhaled corticosteroids included in the List, some of which are much less expensive that ciclesonide.
  • There is no evidence of a significant clinical advantage of ciclesonide over other available inhaled corticosteroids
  • Unlike the other inhaled corticosteroids, ciclesonide is not available as a combination product.

 

  1. Liquid paraffin 500mg per gram/white soft paraffin 500mg per gram ointment

 

The Committee considered an application for 50/50 liquid paraffin/WSP, an emollient, to be added to the Prescribed List but did not support its recommendation for the following reasons:

  • Other paraffin-based emollients are already available and there is no clinical evidence to support the preferential use of any one.
  • Paraffin-based products present a fire-hazard and this product has a higher proportion of paraffin than other products on the List

 

 


Appendix 1: Medicines to be prescribed only by generic name and reimbursed in accordance with Part VIII of the Drug Tariff (category M)

 

This list is based on the current list of Category M medicines included in the Drug Tariff. Most are already extensively prescribed by generic name but the proposed changes will ensure consistent reimbursement at the lowest price.

Drug Name

Pack size

 

Acetazolamide 250mg tablets

112

tablet

Alfuzosin 2.5mg tablets

60

tablet

Alverine 60mg capsules

100

capsule

Amisulpride 100mg tablets

60

tablet

Amisulpride 200mg tablets

60

tablet

Amisulpride 50mg tablets

60

tablet

Amoxicillin 125mg/5ml oral suspension

100

ml

Amoxicillin 125mg/5ml oral suspension sugar free

100

ml

Amoxicillin 250mg/5ml oral suspension

100

ml

Amoxicillin 250mg/5ml oral suspension sugar free

100

ml

Aqueous cream

500

gram

Aqueous cream

100

gram

Aspirin 300mg dispersible tablets

100

tablet

Aspirin 300mg dispersible tablets

32

tablet

Aspirin 75mg dispersible tablets

28

tablet

Aspirin 75mg dispersible tablets

100

tablet

Azithromycin 250mg capsules

6

capsule

Baclofen 5mg/5ml oral solution sugar free

300

ml

Beclometasone 50micrograms/dose nasal spray

200

dose

Benzydamine 0.15% mouthwash sugar free

300

ml

Benzydamine 0.15% oromucosal spray sugar free

30

ml

Betamethasone valerate 0.1% cream

100

gram

Betamethasone valerate 0.1% cream

30

gram

Betamethasone valerate 0.1% ointment

30

gram

Betamethasone valerate 0.1% ointment

100

gram

Bezafibrate 200mg tablets

100

tablet

Bisoprolol 1.25mg tablets

28

tablet

Bisoprolol 10mg tablets

28

tablet

Bisoprolol 2.5mg tablets

28

tablet

Bisoprolol 3.75mg tablets

28

tablet

Bisoprolol 5mg tablets

28

tablet

Bisoprolol 7.5mg tablets

28

tablet

Brimonidine 0.2% eye drops

5

ml

Brinzolamide 10mg/ml eye drops

5

ml

Buspirone 10mg tablets

30

tablet

Buspirone 5mg tablets

30

tablet

Carbimazole 20mg tablets

100

tablet

Carbimazole 5mg tablets

100

tablet

Carbocisteine 375mg capsules

120

capsule

Cefalexin 250mg tablets

28

tablet

Cefalexin 250mg/5ml oral suspension

100

ml

Cefalexin 500mg tablets

21

tablet

Cefradine 250mg capsules

20

capsule

Cefradine 500mg capsules

20

capsule

Celecoxib 100mg capsules

60

capsule

Celecoxib 200mg capsules

30

capsule

Chlorpromazine 100mg tablets

28

tablet

Chlorpromazine 25mg tablets

28

tablet

Chlorpromazine 50mg tablets

28

tablet

Cinnarizine 15mg tablets

84

tablet

Citalopram 40mg/ml oral drops sugar free

15

ml

Clarithromycin 125mg/5ml oral suspension

70

ml

Clarithromycin 250mg/5ml oral suspension

70

ml

Clindamycin 150mg capsules

24

capsule

Clotrimazole 1% cream

20

gram

Clotrimazole 1% cream

50

gram

Clotrimazole 500mg pessaries

1

pessary

Co-amoxiclav 125mg/31mg/5ml oral suspension sugar free

100

ml

Co-amoxiclav 250mg/62mg/5ml oral suspension sugar free

100

ml

Co-codamol 30mg/500mg effervescent tablets

100

tablet

Co-codamol 30mg/500mg effervescent tablets

32

tablet

Co-codamol 30mg/500mg tablets

30

tablet

Co-codamol 30mg/500mg tablets

100

tablet

Co-codamol 8mg/500mg effervescent tablets

100

tablet

Co-codamol 8mg/500mg effervescent tablets

32

tablet

Cyclizine 50mg tablets

100

tablet

Dapsone 50mg tablets

28

tablet

Desmopressin 10micrograms/dose nasal spray

60

dose

Desmopressin 200microgram tablets

30

tablet

Dexamethasone 2mg tablets

50

tablet

Dexamethasone 500microgram tablets

28

tablet

Diamorphine 10mg powder for solution for injection ampoules

5

ampoule

Diamorphine 30mg powder for solution for injection ampoules

5

ampoule

Duloxetine 30mg gastro-resistant capsules

28

capsule

Duloxetine 60mg gastro-resistant capsules

28

capsule

Eplerenone 25mg tablets

28

tablet

Eplerenone 50mg tablets

28

tablet

Erythromycin ethyl succinate 125mg/5ml oral suspension sugar free

100

ml

Erythromycin ethyl succinate 250mg/5ml oral suspension sugar free

100

ml

Exemestane 25mg tablets

30

tablet

Fenofibrate micronised 160mg tablets

28

tablet

Fenofibrate micronised 200mg capsules

28

capsule

Fenofibrate micronised 267mg capsules

28

capsule

Ferrous gluconate 300mg tablets

28

tablet

Ferrous sulfate 200mg tablets

28

tablet

Flucloxacillin 125mg/5ml oral solution

100

ml

Flucloxacillin 125mg/5ml oral solution sugar free

100

ml

Flucloxacillin 250mg/5ml oral solution sugar free

100

ml

Fluoxetine 20mg/5ml oral solution

70

ml

Fluvastatin 20mg capsules

28

capsule

Fluvastatin 40mg capsules

28

capsule

Frovatriptan 2.5mg tablets

6

tablet

Glyceryl trinitrate 400micrograms/dose pump sublingual spray

180

dose

Glyceryl trinitrate 400micrograms/dose pump sublingual spray

200

dose

Glyceryl trinitrate 500microgram sublingual tablets

100

tablet

Hydrocortisone 10mg tablets

30

tablet

Hydroxocobalamin 1mg/1ml solution for injection ampoules

5

ampoule

Hydroxychloroquine 200mg tablets

60

tablet

Hypromellose 0.3% eye drops

10

ml

Ibuprofen 100mg/5ml oral suspension sugar free

100

ml

Ibuprofen 5% gel

100

gram

Ibuprofen 5% gel

50

gram

Ipratropium bromide 500micrograms/2ml nebuliser liquid unit dose vials

20

unit dose

Ivabradine 5mg tablets

56

tablet

Ivabradine 7.5mg tablets

56

tablet

Ketoprofen 2.5% gel

50

gram

Ketoprofen 2.5% gel

100

gram

Labetalol 100mg tablets

56

tablet

Labetalol 200mg tablets

56

tablet

Lactulose 3.1-3.7g/5ml oral solution

500

ml

Lercanidipine 10mg tablets

28

tablet

Lercanidipine 20mg tablets

28

tablet

Losartan 100mg tablets

28

tablet

Losartan 12.5mg tablets

28

tablet

Losartan 25mg tablets

28

tablet

Losartan 50mg tablets

28

tablet

Lymecycline 408mg capsules

28

capsule

Memantine 10mg tablets

28

tablet

Memantine 20mg tablets

28

tablet

Metoprolol 100mg tablets

28

tablet

Morphine sulfate 10mg/5ml oral solution

300

ml

Naftidrofuryl 100mg capsules

84

capsule

Nefopam 30mg tablets

90

tablet

Nicorandil 10mg tablets

60

tablet

Nicorandil 20mg tablets

60

tablet

Nitrofurantoin 100mg tablets

28

tablet

Nitrofurantoin 50mg tablets

28

tablet

Norethisterone 5mg tablets

30

tablet

Nortriptyline 10mg tablets

100

tablet

Nortriptyline 25mg tablets

100

tablet

Nystatin 100,000units/ml oral suspension

30

ml

Paracetamol 250mg/5ml oral suspension

100

ml

Phenoxymethylpenicillin 125mg/5ml oral solution

100

ml

Phenoxymethylpenicillin 125mg/5ml oral solution sugar free

100

ml

Phenoxymethylpenicillin 250mg/5ml oral solution

100

ml

Phenoxymethylpenicillin 250mg/5ml oral solution sugar free

100

ml

Prednisolone 5mg soluble tablets

30

tablet

Pregabalin 100mg capsules

84

capsule

Pregabalin 150mg capsules

56

capsule

Pregabalin 200mg capsules

84

capsule

Pregabalin 225mg capsules

56

capsule

Pregabalin 25mg capsules

56

capsule

Pregabalin 300mg capsules

56

capsule

Pregabalin 50mg capsules

84

capsule

Pregabalin 75mg capsules

56

capsule

Propylthiouracil 50mg tablets

56

tablet

Quetiapine 100mg tablets

60

tablet

Quetiapine 150mg tablets

60

tablet

Quetiapine 200mg tablets

60

tablet

Quetiapine 25mg tablets

60

tablet

Quetiapine 300mg tablets

60

tablet

Raloxifene 60mg tablets

28

tablet

Ranitidine 75mg/5ml oral solution sugar free

300

ml

Rasagiline 1mg tablets

28

tablet

Rosuvastatin 10mg tablets

28

tablet

Rosuvastatin 20mg tablets

28

tablet

Rosuvastatin 40mg tablets

28

tablet

Rosuvastatin 5mg tablets

28

tablet

Senna 7.5mg tablets

60

tablet

Sotalol 80mg tablets

28

tablet

Sulfasalazine 500mg tablets

112

tablet

Tadalafil 10mg tablets

4

tablet

Tadalafil 20mg tablets

4

tablet

Tadalafil 5mg tablets

28

tablet

Telmisartan 20mg tablets

28

tablet

Telmisartan 40mg tablets

28

tablet

Telmisartan 80mg tablets

28

tablet

Temazepam 10mg tablets

28

tablet

Temazepam 20mg tablets

28

tablet

Thiamine 100mg tablets

100

tablet

Thiamine 50mg tablets

100

tablet

Timolol 0.25% eye drops

5

ml

Timolol 0.5% eye drops

5

ml

Tolterodine 1mg tablets

56

tablet

Tolterodine 2mg tablets

56

tablet

Tranexamic acid 500mg tablets

60

tablet

Trazodone 50mg/5ml oral solution sugar free

120

ml

Ursodeoxycholic acid 250mg capsules

60

capsule

Valaciclovir 500mg tablets

10

tablet

Vitamin B compound strong tablets

28

tablet

Warfarin 1mg tablets

28

tablet

Warfarin 3mg tablets

28

tablet

Warfarin 500microgram tablets

28

tablet

Warfarin 5mg tablets

28

tablet

 

1

 

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