Lincolnshire Prescribing and Clinical Effectiveness Forum (PACEF) was founded in 2007. It is the current strategic advisory network to NHS Lincolnshire CCG. PACEF has the responsibility for ensuring the cost-effective use of medicines and other healthcare interventions and their functional integration into healthcare delivery across Lincolnshire.

Representation on the group is comprised of leading professionals from the Lincolnshire Clinical Commissioning Group, primary care, the local Acute Trusts (United Lincolnshire Hospitals Trust and Lincolnshire Partnership Foundation Trust), Lincolnshire Community Health Services, Local Medical Council and Local Pharmaceutical Council. 

PACEF Bulletins

Title
PACE Bulletin Vol 1 No 8 Dec07

Description

New Drug Assessment:

Aliskiren (Rasilez) for teatment of essential hypertension classified AMBER

Rotigotine Transdermal Patch (Neupro) licensed as monotherapy for the treatment of the signs and symptoms of early stage idiopathic Parkinson’s disease and as an adjunct to levodopa with a dopa-decarboxylase inhibitor classified AMBER

Glucosamine (Alateris) relief of symptoms in mild to moderate osteoarthritis of the knee classified RED-RED

Human Papillomavirus Vaccine (Cervarix and Gardasil) prevention of high-grade intraepithelial neoplasia and cervical cancer causally related to HPV types 16 and 18. classified RED-RED

Product Withdrawals Reminder: Co-proxamol and Lumiracoxib (Prexige)

NICE TA129: Bortezomib monotherapy for relapsed multiple myeloma

NICE TA130: Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis

PACE Bulletin Vol 1 No 7 Nov07

Description

Guidance on the Use of Antibacterial Drugs in Lincolnshire Primary Care: Winter 2007/8

NICE CG54: Urinary Tract Infection in Children

PACE Bulletin Vol 1 No 6 Nov07

Description

Paliperidone (Invega) licensed for the treatment of schizophrenia classified RED-RED

Penflurido an unlicensed once weekly oral antipsychotic agent used for the treatment of schizophrenia RED (only to be initiated and prescribed by LPT clinicians)

Tiotropium Bromide (Spiriva Respimat) GREEN (N.B. Take care to prescribe by brand to avoid confusion between the Respimat and the HandiHaler)

Symbicort SMART (SYMBICORT FOR MAINTENANCE AND RELIEF THERAPY)

NICE TA111: Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer’s disease

NICE CG 51 & 52: Drug misuse: psychosocial interventions and opioid detoxification

NICE CG 53: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy)

Shared Care Guidelines: Fulvestrant, Ibandronic acid, Cinacalcet, Lanthanum and Sevelamer

PACE Bulletin Vol 1 No 5 Oct07

Description

Safety concerns associated with rosiglitazone

New Drug Assessment:

Exenatide (Byetta) for treatment of type 2 diabetes in combination with metformin and sulphonylureas classified RED-RED

(N.B. This decision will be reviewed in early 2008 following the publication of the updated NICE Clinical Guideline on the management of type 2 diabetes)

Sitagliptin (Januvia) indicated for use with metformin or a glitazone in type 2 DM inadequately controlled by diet , exercise and either metformin or a glitazone Classified RED-RED

(N.B. This decision will be reviewed in early 2008 following the publication of the updated NICE Clinical Guideline on the management of type 2 diabetes and the launch of vildagliptin)

Lidocaine Medicated Plaster (Versatis) the treatment of postherpetic neuralgia classified AMBER for post-herpetic neuralgia subject to specialist initiation after all other alternatives have been tried. Designated as RED-RED for neuropathic pain (unlicensed).

Rapid Assessments:

Emollin Spray, Sensicare Emollient licensed for topical application to dry, scaly, sensitive or sore skin. Classified GREEN

Beclometasone 5mg tablets (Clipper) Licensed for use in combination with aminosalicylates for mild to moderate ulcerative colitis in patients unresponsive to aminosalicylates Classified RED-RED pending specialist review

NICE TA124: Pemetrexed for non-small cell lung cancer

NICE TA125: Adalimumab licensed for the treatment of active and progressive psoriatic arthritis that has not responded adequately to other disease modifying anti-rheumatic drugs (DMARDs)

NICE TA126: Rituximab for rheumatoid arthritis

NICE TA127: Natalizumab for highly active relapsing-remitting multiple sclerosis

PACE Bulletin Vol 1 No 4 Sep07

Description

Eplerenone (Inspra) for stable patients with left ventricular dysfunction (LVD) with evidence of heart failure (HF) following myocardial infarction classified AMBER (Specialist initiation, but no shared care guideline required)

Ranibizumab (Lucentis) for treatment of neovascular (wet) age-related macular degeneration (AMD) classified RED-RED

Varenicline (Champix) smoking cessation in adults classified GREEN. NB Should be considered as a potential second line alternative to bupropion in patients committed to stopping smoking that have tried and failed to quit using NRT support.

NICE CG49: FAECAL INCONTINENCE

PACE Bulletin Vol 1 No 3 Aug07

Description

DRAFT NICE CLINICAL GUIDELINE ON LIPID MODIFICATION FOR THE PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE

PACE Bulletin Vol 1 No 2 Jul07

Description

Katya tablets oral contraception classified GREEN

Natalizumab inf (Tysabri) for highly active relapsing remitting multiple sclerosis (N.B. It has been agreed that following the imminent publication of a new NICE TA, natalizumab will be reclassified as RED)

Omacor capsules for hypertriglyceridaemia and secondary prevention after MI classified RED-RED

Omalizumab 150mg inj (Xolair) for severe persistent allergic asthma in patients 12 years and over classified RED-RED Subject to a favourable NICE TA, omalizumab is likely to be re-classified as RED later in the year.

Sodium valproate MR capsules (Episenta) are classified as GREEN

Sunya tablets oral contraception classified GREEN

Testosterone 2% gel (Tostran) testosterone replacement in male hypogonadism with confirmed testosterone deficiency classified GREEN

NICE TA122: ALTEPLASE FOR THE TREATMENT OF ACUTE ISCHAEMIC STROKE

NICE CG48: MI: SECONDARY PREVENTION

PACE Bulletin Vol 1 No 1 Jun07

Description

PACEF Decisions: June Update

Exforge tabs (amlodipine/valsartan) for hypertension classified as RED-RED

Natalizumab (Tysabri) for Highly active relapsing remitting multiple sclerosis is classified as RED-RED

Lanthanum Carbonate (Fosrenol) for Hyperphosphataemia in chronic renal failure is classified as AMBER

Sevelamer tabs (Renagel) Hyperphosphataemia in chronic renal failure is classified as AMBER

Testosterone patch (Intrinsa) Women with hypoactive sexual desire disorder classified as RED-RED

Human Papillomavirus Vaccine (Gardasil) Prevention of cervical cancer classified as RED-RED

NICE Update:

CG 46 Venous Thromboembolism

CG 47 FEVERISH ILLNESS IN CHILDREN