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
| Title | |
|---|---|
| PACE Bulletin Vol 16 No 6 November 2022 | |
DescriptionDicloverine Liquid approve as AMBER 2 Antacid and Oxetacaine Oral Suspension. This is an unlicensed medicine approved as AMBER 2 for the treatment of mucositis associated with Systematic Anti-Cancer Therapy (SACT) or radiotherapy. Ryego- recommended by NICE TA 832 for the treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age. Approved as AMBER 2. Ryaltris nasal spray approved as AMBER 2 for the treatment of moderate to severe nasal symptoms associated with allergic rhinitis. Tacrolimus Modified release tablets (Envarsus) added to the formulary as AMBER 1. All tacrolimus must be prescribed by brand name Trimbow pMDI 172 micrograms/5 micrograms/9 micrograms pressurised inhalation, solution. Approved as GREEN GlucoRX dual - Safety needles 5mm approved for use on the formulary as GREEN when use of safety needles is clinically appropriate. Fuzatal® XL approved as preferred low cost Alfuzosin10mg modified release formulation. Approved as GREEN. Emeside® 250mg capsules and 250mg/5ml Oral Solution approved as preferred low cost Ethosuximide formulations. Approved as AMBER 2. Review of formulary recommended food thickeners |
|
| PACE Bulletin Vol 16 No 5 September 2022 | |
DescriptionCalfovit D3 sachets and Adcal D3 Dissolve (effervescent tablets) have been added to the formulary both classed as GREEN. Otigo® 40mg/10mg/g ear drop solution approved as GREEN Page 2 AccuChek Guide test strips approved to be used for patients on Medtronic 780G) insulin pump system Contour Plus test strips and Contour Plus Blue meter approved as an alternative to Contour Next test strips and metre. To be used for those with gestational diabetes. |
|
| PACE Bulletin Vol 16 No 4 July 2022 ONS | |
DescriptionThis guidance is aimed at adults and does not include children under the age of 16 years. Children who require nutritional assessment or intervention should be referred to the Dietetics Service |
|
| PACE Bulletin Vol 16 No 3 July 2022 Asthma | |
DescriptionThis bulletin details the Guide on inhaler selection in the management of Asthma approved by PACEF meeting held in May 2022. |
|
| PACE Bulletin Vol 16 No 2 May 2022 | |
DescriptionSativex® Oromucosal Spray approved as RED for treatment of moderate to severe spasticity associated with Multiple Sclerosis. Buprenorphine Long-acting injection Buvidal® –approved as RED for use only by “We are with you” service. HRT products – temporary removal of formulary restrictions to manage current supply disruption. Liothyronine Sodium Capsules (ROMA Pharmaceuticals) approved as AMBER 2. Atorvastatin 4mg/ml liquid (Rosemount Pharmaceuticals) approved as GREEN to be used when standard tablets or chewable tablets are not appropriate. Mexiletine Hydrochloride hard capsules 50mg,100mg,200mg (Clinigen Healthcare Ltd) approved as AMBER 2 for use for their licensed indication for the treatment of life-threatening ventricular arrhythmias. Camouflagers (Covermark®, Dermacolor®, Keromask® & Veil®) approved as AMBER 2 NICE TA 773 Empagliflozin for heart failure – Empagliflozin approved as AMBER 2 for this indication. NICE TA 775 Dapagliflozin for CKD – Dapagliflozin approved as AMBER 2 for this indication. |
|
| PACE Bulletin Vol 16 No 1 Mar 2022 | |
DescriptionSolaraze® (Diclofenac)3%Gel changed from amber 2 to GREEN for the treatment of actinic keratosis. Solacutan® (Diclofenac )3% gel approved as GREEN for the treatment of actinic keratosis. Efudix® (Fluorouracil )5% cream changed from amber 2 to GREEN on formulary for the treatment of non-malignant skin conditions. Tirbanibulin (Klisyri®) 10mg/g ointment approved as AMBER 2 for the treatment of actinic keratosis. Lidocaine plasters 5% approved as AMBER 2 for the management of localised neuropathic pain in patients reviewed by the chronic pain service. Artificial Salvia review of formulary advice all products classed as GREEN Semaglutide tablets (Rybelsus®) changed from Amber 2 to green when the use of an oral formulation is indicated. Sodium cromoglicate 100mg capsules (Nalcrom®) approved as AMBER 2 for unlicensed use for treatment of mast cell disorders Gonadorelin analogues therapy requested for patients who are under of gender dysphoria services. |
|
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
