Lincolnshire Prescribing and Clinical Effectiveness Forum (PACEF) was founded in 2007. It is the current strategic advisory network to NHS Lincolnshire Integrated Care Board (ICB). 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 NHS Lincolnshire Integrated Care Board, primary care, the local acute trust United Lincolnshire Hospitals NHS Trust, Lincolnshire Partnership NHS Trust, Lincolnshire Community Health Services NHS Trust, Lincolnshire LMC and Community Pharmacy Lincolnshire.
PLEASE NOTE: The publication of PACEF bulletins is currently suspended. We will provide a brief update of formulary decisions and updates following PACEF meetings in the LICB Medicines Optimisation Newsletter and also listed below.
Please allow time for the Lincolnshire Joint Formulary to be updated.
PACEF and Formulary Meeting Updates
PACEF September 2024
Stiripentol - PACEF approved the change of formulary classification to Amber 2, restricting it’s use for the treatment of epilepsy, within its licensed indication, only at the request of an epilepsy specialist from a tertiary centre. In these circumstances Stiripentol is approved for ongoing prescribing in primary care, following approval of a named patient requests. Stiripentol remains as RED/RED for all other uses.
Phytomenadione (unlicensed) – PACEF approved this due to the shortage of Menadiol tablets, which may necessitate the use of unlicensed Phytomenadione. This has been added onto the formulary as a second-line treatment option and will state unlicensed on the formulary too.
Tadalafil (Daily dose) – Following the change in NHSE advice PACEF has approved tadalafil once daily, 5mg and 2.5mg, as a treatment option for those where use of a daily dose is considered clinically appropriate. 2.5mg strength are significantly more expensive than the 5mg strengths and should only be used when 5mg dose is not suitable. Cialis brand should not be used as significantly more expensive than the generic equivalent. Tadalafil remains as second line treatment for erectile dysfunction after sildenafil for patients that meet the SLS criteria.
Formulary meeting August 2024
- Doxazocin is more cost effective to prescribe 2 x 4mg tablets rather than 1 x 8mg tablet. This reflects what is issued at ULHT.
- Removal of Eloquis brand from Apixaban formulary entry as no longer the most cost-effective brand. Removal of Xarelto brand from Rivaroxaban as no longer the most cost-effective brand. Formulary section clarifies to ensure clarity over full course supply issued on discharge from ULHT.
- Nitrofurantoin 50mg/5ml discontinued. 25mg/5ml remains available.
PACEF Bulletins
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| PACE Bulletin Vol 15 No 4 Oct 21 | |
DescriptionFosfomycin (Alexi) 3g sachets - Approved as GREEN. Fixkoh Airmaster DPI (salmeterol / fluticasone) 50/100, 50/250 & 50/500 - Approved as GREEN as a low cost option when a dry powder fixed dose combination of salmeterol and fluticasone is required. Bevespi Aerosphere glycopyrronium (as bromide) 7.2mcg, Formoterol fumarate dehydrate 5 mcg per inhalation MDI - approved as GREEN as an alternative option for the management of COPD when a combination of formoterol and glycopyrronium therapy is indicated. Trixeo Aerosphere MDI Formoterol fumarate 5mcg, budesonide 160mcg, glycopyrronium (as bromide) 72mcg per puff - approved as GREEN. Fobumix Easyhaler 320/9, 160/4.5 , 80/4.5 DPI - approved as GREEN as a lower cost dry powder formulation of formoterol fumarate and budesonide. Tiogiva -18 microgram caps, 30 plus device, Refill 30 cap and Refill 60 cap - approved as GREEN. Trimbow NEXThaler (DPI) 88mcg/5mcg/9 mcg per actuation (beclomethasone diprionate, formoterol fumarate dehydrate, glycopyrronium bromide) - approved as GREEN as an alternative to Trimbow MDI when use of DPI is considered appropriate. Bempedoic acid with ezetimibe - approved as GREEN. |
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| PACE Bulletin Vol 15 No 3 July 21 | |
DescriptionNortriptyline approved as GREEN unlicensed use for management of neuropathic pain. Octasa® brand of mesalazine suppositories approved as AMBER 2 to be used first line when a suppository formulation is required. Accu-Chek Performa Blood Glucose meters. Supply of these meters are being phased out July/ August 2021. Supply of test strips to remain for those already using this meter. Instant Blood Glucose meter and test strips added to Lincolnshire formulary as second line Blood glucose meter as alternative to the Accu-Chek performa meter. Deception® brand of apomorphine –approved as GREY for those patients under the care of external trusts. Steroid containing rectal foams following Colifoam discontinuation only Budenofalk remains on the formulary. Drug Safety Update July 2021 chloramphenicol eye drops containing borax or boric acid can now be administered to children younger than two years of age. |
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| PACE Bulletin Vol 15 No 2 May 21 | |
DescriptionSumatriptan 3mg/0.5ml pre-filled pen (Ranbaxy approved as GREEN. Tinzaparin – low molecular weight heparin approved as GREY for those patients under the care of external trusts. Introduction of the Steroid Emergency Card. |
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| PACE Bulletin Vol 15 No 1 Mar 21 | |
DescriptionSemaglutide 3mg,7mg & 14 mg tablets ( Rybelsus) approved as AMBER 2. Dapagliflozin 10mg tablets (Forxiga) approved as AMBER 2 for the treatment of heart failure. FreeStyle Libre 2® sensors approved as AMBER 2 for use in line with NHS England guidance for Flash Glucose Monitors. Levosert®- Levonorgestrel 20 micrograms/24 hours Intrauterine Delivery System, License change, duration of use for contraception extended to 6 years. Remains as GREEN on formulary, now classed as first choice intrauterine progesterone only contraceptive for women aged under 45 years of age. Kyleena® Levonorgestrel 19.5mg intrauterine delivery system approved as GREEN when a lower dose progesterone only intrauterine device is required. Methotrexate 2mg/ml oral solution (Jylamvo®) approved as AMBER 1. Pilocarpine 5 mg film-coated tablets approved as AMBER 2. Balsalazide sodium 750mg capsules (Colazide) approved as AMBER 2. |
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The current form to request a non-formulary medicine can be viewed here:
Are you a member of our PACEF committee?
If so, please see the forthcoming dates for 2025:
2025 Meeting Dates
Wednesday 22nd January 2025 - 1.15pm start
Wednesday 19th March 2025 - 1.15pm start
Wednesday 21st May 2025 - 1.15pm start
Wednesday 16th July 2025 - 1.15pm start
Wednesday 17th September 2025 - 1.15pm start
Wednesday 19th November 2025 - 1.15pm start
