1. Summary and Next Steps Linda Lord – Chief Pharmacist

2. FreeStyle Libre (1)
For now, continue to adhere to the WSCCG Prescribing Policy (holding statement):
No prescribing
Policy is in your pack
Promote DAFNE and DESMOND
DAFNE = Dose Adjustment For Normal Eating (T1D)
DESMOND = Diabetes Education and Self Management for Ongoing and Newly Diagnosed (T2D)
DAFNE and DESMOND are freely available for all diabetic patients in West Suffolk - availability recently enhanced
Adhere to the revised WSCCG Prescribing Policy, available soon, which will clarify criteria for prescribing
Waiting for final EoE recommendations

3. FreeStyle Libre (2) And also…
Continue to adhere to WSCCG-WSFT prescribing policies for blood glucose testing strips, lancets and needles
Continue to adhere to WSCCG-WSFT Type 2 Diabetes Mellitus Adult Treatment Pathway
Further copies of all these documents available tonight

4. Liothyronine (1) ePACT, October 2017
Projected full year cost for WSCCG (2017) = £180k
Approximately 50 patients

5. Liothyronine (2) Costs, Drug Tariff January 2018 The issue!
Cost per patient per 12 months
Liothyronine tablets 20mcg tds: £10,097
Levothyroxine tablets 100mcg od: £14.21

6. Liothyronine (3)
Do not initiate any new patients on liothyronine or Armour Thyroid
Switch existing patients from liothyronine, combination therapy or Armour Thyroid to levothyroxine if at all possible
Refer to the WSCCG Liothyronine Policy for
Risks associated with T3
Equivalent doses of levothyroxine
Exceptional circumstances
Supporting statements from national organisations, e.g. Royal College of Physicians, British Thyroid Association, NHSE/NHSCC.
Policy is in your pack
EoE Priorities Advisory Committee recommendations due soon - WSCCG Policy will be updated if needed

7. Quetiapine (1) ePACT, October 2017
Projected full year cost for WSCCG (2017) = £212k
Estimated savings from switching to IR (2017) = £150k

8. Quetiapine (2) Do not initiate quetiapine XL
Quetiapine costs are being monitored by the Medicines Management Team
Switch from XL to IR if at all possible when advised by the Medicines Management Team
Follow NSFT switching protocol
Protocol is in your pack

9. Trimipramine (1) ePACT, October 2017
Projected full year cost for WSCCG (2017) = £144k
Approximately 30 patients

10. Trimipramine (2) Discontinue if possible
Switch to an SSRI if on-going prescribing genuinely indicated, or to a TCA
Adhere to PrescQIPP bulletin recommendations
Bulletin is in your pack

11. And Finally…
All sorts of supporting documents available at the back. Please take what you need!
Antibiotic Formulary
Antibiotic not required ‘prescription’
Treating your infection leaflets
Pain Ladders
Pain Toolkit
Diabetes Treatment Guidelines
BGTS, Lancet and Needle Policies
COPD Guidelines
COPD Placebo Inhaler Device Kits
Other things too

12. Thank you