Prescribed List: Changes as at 1 May 2011

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A decision made on 28 April 2011:

Decision Reference: MD-S-2011-0032
Decision Summary Title :	Prescribed List Changes 1 May 2011		Date of Decision Summary:	27 April 2011
Decision Summary Author:	Policy Principal		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	WR - Prescribed List Changes 1 May 2011		Date of Written Report:	27 April 2011
Written Report Author:	Policy Principal		Written Report : Public or Exempt?	Public
Subject: Changes to be made to the Prescribed List (Jersey) as at 1 May 2011
Decision(s): The Minister approved the changes to the Prescribed List (Jersey) as recommended by the Pharmaceutical Benefit Advisory Committee on 26th April 2011. To be included from 1 May 2011 as a green item: Acenocoumarol (nicoumalone) 1mg tablets
Reason(s) for Decision: The Pharmaceutical Benefit Advisory Committee proposed the recommended change to the Prescribed List (Jersey), following written notification from the Chief Pharmacist of supply issues of the current approved item phenindione. The addition ensures that treatment for a specific medical need is not interrupted and patient safety is not compromised by a national medicine supply problem.
Resource Implications: The addition is an alternative treatment and the net cost to the fund is minimal.
Action required: Policy Principal to issue public notice listing amendments and notify all approved medical practitioners and approved contractors.
Signature:		Position: Chief Minister
Date Signed:		Date of Decision (If different from Date Signed):

Prescribed List: Changes as at 1 May 2011

Recommendations of the Pharmaceutical Benefit Advisory Committee

26th April 2011

1. Summary

On 26th April 2011, the PBAC were asked by the Chief Pharmacist and Consultant Haematologist to consider the item (acenocoumarol) for inclusion onto the Prescribed List. This application was considered as a matter of urgency due to problems of supply both nationally and Island-wide of the current approved item (phenindione).

The addition ensures that treatment for a specific medical need is not interrupted and patient safety is not compromised by a national medicine supply problem. Therefore the PBAC recommended the addition of this item as detailed in this report.

2.0. Item for inclusion

Acenocoumarol (nicoumalone) 1mg tablets

This drug is an oral anticoagulant treatment option for patients unable to take warfarin for reasons other than a hypersensitivity/allergic reaction. It is an alternative to the current approved item phenindione.

Alternatives on the List

Phenindione (10mg, 25mg, 50mg tablets) is an oral anticoagulant predominantly used in patients who have a previous history of warfarin allergy or who develop an allergy on commencement of warfarin.

Confirmed National Supply Problems

The Chief Pharmacist confirmed on 26th April 2011 that the supply of phenindione tablets on the island is fragile and that community pharmacists and the Health and Social Services Department are having difficulties obtaining and supplying phenindione. This is due to confirmed and ongoing national supply difficulties with this item.

Implications for patient care

GPs need to access alternative anticoagulation treatments as any break in phenindione treatment will compromise a patient’s health status.

This item is an urgent addition required to ensure optimal medicine management for specific patients. It is an additional, similarly priced treatment option so the impact to the fund is minimal and patient safety is not compromised by supply problems.

3. Recommendation

The Minister is asked to approve the changes to take effect from 1st May 2011. The total additional net costs to the fund are estimated to be minimal.