Changes to be made to the Prescribed List (Jersey) as at 1 January 2009.

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A decision made (05/12/2008) regarding: Changes to be made to the Prescribed List (Jersey) as at 1 January 2009.

Decision Reference: MD-S-2008-0087
Decision Summary Title :	Prescribed List (Jersey) 1 January 2009		Date of Decision Summary:	18 November 2008
Decision Summary Author:	Rosie Goulding Policy Principal		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	Changes to be made to the Prescribed List (Jersey) as at 1 January 2009		Date of Written Report:	18 November 2008
Written Report Author:	Rosie Goulding Policy Principal		Written Report : Public or Exempt?	Public
Subject: Changes to be made to the Prescribed List (Jersey) as at 1 January 2009
Decision(s): The Minister approved the changes to the Prescribed List (Jersey) as recommended by the Pharmaceutical Benefits Advisory Committee from the meeting held on the 11th November 2008. To be included: Dermol cream (brand name). Doublebase shower gel (brand name) Aspirin e/c tablet 75mg (generic only) Salbutamol m/r capsules (Ventmax SR) 4mg, 8mg (open order) Mycophenolic acid (Myfortic) tablet e/c 180mg, 360mg (brand name) Potassium permanganate solution tablet 400mg (open order) Dexamethasone oral solution 2mg/5mL (open order) Hydrocortisone inj 25mg/mL Cabergoline tablet 1mg, 2mg, 4mg (generic only)
Reason(s) for Decision: The Pharmaceutical Benefits Advisory Committee met on 11th November 2008 and provided the Minister with the recommended changes to the Prescribed List (Jersey), effective from 1 January 2009. The changes represent additional formulations of approved medicines to ensure that General Practitioners have the choice available to them of modern, safe and effective medicines.
Resource Implications: The cost to the fund is an estimated £30, 000 per annum and the fund has sufficient resources.
Action required: The Minister approved the recommendations made by the Pharmaceutical Benefits Advisory Committee
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Changes to be made to the Prescribed List (Jersey) as at 1 January 2009.

Recommendations of the Pharmaceutical benefit Advisory Committee

11 th November 2008

1. SUMMARY

The Pharmaceutical Benefit Advisory Committee met on 11th November 2008 to consider the inclusion and/or deletion of certain products from the Prescribed List. The PBAC recommended the inclusion of 10 products detailed in this report.

The Committee also reviewed their recommendation on all contraception to be placed on the Prescribed List. Following consideration of the Public Health Position Paper, the Committee are to revise their previous recommendation (19th March 2008) to the Minister, a report will follow in due course.

BACKGROUND

Items for inclusion

2.1. Contraception update including report on sexual health strategy – (Postponed pending report for the Minister)

Mr A Heaven presented the Public Health Department position paper on Contraceptive Services in Jersey. The purpose of this paper was to provide Public Health guidance to the Minister for Social Security on the Committee’s recommendation (19th March 2008) to place all contraceptives on the Health Insurance formulary (the Prescribed List).

Mr Heaven stated that the key principles of the Jersey sexual health strategy were to reduce unintended pregnancies and sexually transmitted infections by providing accessible community services. The paper made several recommendations, which included the need for quality assurance and governance mechanisms. This would ensure that women attending a GP led service would receive appropriate contraception from a competent clinician. It also recommended the development of educational links between Family Planning Clinics and GPs.

After some discussion about the content of the paper and its recommendations, the Committee agreed that the range of contraceptive products previously recommended for addition to the Prescribed List was too broad for inclusion at this time. The Committee supported the addition of the oral contraceptives (excluding Yasmin) and the depot injection of medroxyprogesterone (Depo-Provera) but identified the need to revise the March 2008 recommendations and work in conjunction with Public Health. A joint PBAC and Public Health report would therefore be prepared for the Minister’s consideration at the earliest opportunity.

Dermol cream (brand name).

Extends the range of formulations available to patients and not expected to increase costs as prescribing will shift from other products (GREEN drug for initiation in primary and secondary care).

2.3. Doublebase shower gel (brand name)

Extends the range of formulations available to patients and not expected to increase costs as prescribing will shift from other products (GREEN drug for initiation in primary and secondary care).

2.4. Aspirin e/c tablet 75mg (generic only)

Extends the range of formulations available to patients. Also, the approval of aspirin e/c 75mg provides an alternative to dispersible tablets and in such patients could prevent use of the much more expensive clopidogrel (GREEN drug for initiation in primary and secondary care). Estimated annual cost is £1000 but overall impact is expected to reduce costs as it provides an alternative to clopidogrel (£400 per patient)

2.5. Salbutamol m/r capsules (Ventmax SR) 4mg, 8mg (open order)

Salbutamol m/r tablets (Volmax) are discontinued from 1st October 2008. This formulation provides an alternative for patients (GREEN drug for initiation in primary and secondary care). No increase in cost expected

2.6. Mycophenolic acid (Myfortic) tablet e/c 180mg, 360mg (brand name)

Extends the range of formulations available to patients (AMBER drug for shared-care following initiation by a specialist only). Estimated cost is £10,000 per annum, shared care medicine.

2.7. Potassium permanganate solution tablet 400mg (open order)

Extends the range of formulations available to patients and not expected to increase costs as prescribing will shift from other product (GREEN drug for initiation in primary and secondary care).

2.8. Dexamethasone oral solution 2mg/5mL (open order)

Extends the range of formulations available to patients (GREEN drug for initiation in primary or secondary care). Estimated cost is £2000 per annum,

2.9. Hydrocortisone inj 25mg/mL

Extends the range of formulations available to patients and not expected to increase costs as prescribing will shift from other product (GREEN drug for initiation in primary or secondary care).

2.10. Cabergoline tablet 1mg, 2mg, 4mg (Generic only)

Extends the range of doses available to patients ((AMBER drug for shared-care following initiation by a specialist only). Estimated cost is £20,000 per annum, shared care medicine.

RECOMMENDATION

The Minister is asked to approve the changes to take effect from 1st January 2009.

The cost is an estimated £30,000