Recommendations
This section contains a list of the policy recommendations of the Pan Mersey Area Prescribing Committee.
Reviews of the new medicines have been conducted by our pharmacists using a number of resources including National Institute for Health and Clinical Excellence (NICE) which is a Special health Authority (SHA) set up in 1999. It is used to give advice to the NHS on best clinical practice including the clinical and cost effectiveness of drugs and other treatments.
Definitions and Criteria for Categorisation of Medicines
Coronavirus guidance
Guidance to support primary care prescribers and pharmacists is available from the MLCSU Coronavirus guidance resource page. Links are provided to national resources and regional documents produced by MLCSU, RDTC, and SPS for use by Pan Mersey APC, LSCMMG, and GMMMG.
The list of resources will be updated as new material becomes available so please check back regularly for updates.
The Pan Mersey APC supports the use of COVID-specific guidance issued by NICE, and NHS England and NHS Improvement. During the COVID pandemic this will supersede any APC advice.
Documents
The Pan Mersey Area Prescribing Committee recommends the prescribing of CANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as COMBINATION THERAPIES as options for treating type 2 diabetes in adults in accordance with NICE guidance.
The Pan Mersey Area Prescribing Committee recommends the prescribing ofCANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as
MONOTHERAPIES as options for treating type 2 diabetes in adults in accordance with NICE TA390 and TA572.
The Pan Mersey Area Prescribing Committee recommends the prescribing of DAPAGLIFLOZIN tablets (Forxiga®) WITH INSULIN, for the treatment of type 1 diabetes mellitus in accordance with NICE TA597.
Pathway for addition of SGLT2 inhibitors to insulin therapy for patients with type 1 diabetes
The Pan Mersey Area Prescribing Committee recommends the prescribing ofCANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as
MONOTHERAPIES as options for treating type 2 diabetes in adults in accordance with NICE TA390 and TA572.
The Pan Mersey Area Prescribing Committee recommends the prescribing of CANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as COMBINATION THERAPIES as options for treating type 2 diabetes in adults in accordance with NICE guidance.
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of DENOSUMAB solution for injection (Prolia®) for the treatment of bone loss associated with long-term systemic glucocorticoid therapy.
The Pan Mersey Area Prescribing Committee recommends the prescribing ofCANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as
MONOTHERAPIES as options for treating type 2 diabetes in adults in accordance with NICE TA390 and TA572.
The Pan Mersey Area Prescribing Committee recommends the prescribing of CANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as COMBINATION THERAPIES as options for treating type 2 diabetes in adults in accordance with NICE guidance.
The Pan Mersey Area Prescribing Committee recommends the prescribing of CANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as COMBINATION THERAPIES as options for treating type 2 diabetes in adults in accordance with NICE guidance.
The Pan Mersey Area Prescribing Committee recommends the prescribing ofCANAGLIFLOZIN, DAPAGLIFLOZIN, EMPAGLIFLOZIN and ERTUGLIFLOZIN as
MONOTHERAPIES as options for treating type 2 diabetes in adults in accordance with NICE TA390 and TA572.
The Pan Mersey Area Prescribing Committee recommends the prescribing on the NHS of flash glucose monitor sensors (FreeStyle Libre®) only within the criteria outlined.
These templates should be used by Pan Mersey organisations for incorporation into their specialist diabetes service clinic documentation that informs primary care prescriber that Freestyle Libre prescribing has been initiated in an individual patient according to the agreed criteria in the Pan Mersey statement, when confirming to primary care prescriber whether the patient has met continuation criteria after review, and into patient information/ contract documentation given to each patient on commencement of prescribing. There is also a template for use by a specialist when informing primary care prescribers that an individual has been switched to Freestyle Libre 2.
Background information is provided to support primary care prescribers in switching existing Freestyle Libre users to Freestyle Libre 2.
The Pan Mersey Area Prescribing Committee recommends the prescribing of FreeStyle Optium® blood glucose and FreeStyle Optium® ß-ketone test strips only for use with FreeStyle Libre® specifically in patients who are using carbohydrate counting/ bolus advice.
The Pan Mersey Area Prescribing Committee recommends the prescribing of GLP-1 mimetics in combination with insulin for type 2 diabetes, only with specialist care advice and ongoing support from a consultant-led MDT.
The Pan Mersey Area Prescribing Committee recommends the prescribing of INSULIN DEGLUDEC 100units/mL and 200 units/mL solution for subcutaneous injection (Tresiba®), initiated by specialists only, for type 1 and type 2 diabetes for specific patient groups, taking into account NICE guidance
The Pan Mersey Area Prescribing Committee recommends the prescribing of LIRAGLUTIDE injection (Saxenda®), by specialists only, for managing overweight and obesity within a Tier 3 secondary care weight management service, in accordance with NICE TA664.
The Pan Mersey Area Prescribing Committee does not recommend the prescribing of CONJUGATED OESTROGENS and BAZEDOXIFENE 0.45mg/20mg modified release tablets (Duavive®) for the treatment of oestrogen deficiency in postmenopausal women with a uterus.
The Pan Mersey Area Prescribing Committee does not recommend the prescribing of PREDNISOLONE ENTERIC COATED 2.5 mg and 5 mg tablets.