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A new Tag has been created in the chemotherapy section called ‘Chemotherapy – Oral’ which includes all of the tablets, capsules and oral solutions with a cytotoxic indication included in the legacy classification chapter 8.1 and 8.2 of the BNF 68.
This Tag was created at the request of a Trust keen to ensure cost-effective prescribing, and other users may find it useful for the same purpose.
ITEMS THAT SHOULD NOT BE PRESCRIBED IN PRIMARY CARE
A new Tag has been created called ‘NHSE – CCG non-prescribable drugs’ which includes the majority of the drugs in the consultation document ‘Items which should not be routinely prescribed in primary care’. This was discussed on the BBC website.
This Tag does NOT include homeopathic products: the majority of these are not included on dm+d, so cannot be added to a Tag. However, Define captures this by the Flag ‘homeopathic’ and total spend is a tiny percentage of total costs (£12,000 in 6.5 years).
Many of the preparations on the list are not widely used in secondary care and so the impact of the proposed changes will be small. However, there are two items on the list that are prescribed in secondary care and patients would expect to be continued on the medication on discharge.
These items are liothyronine, which is quite widely prescribed in secondary care, and tadalafil which, although on this list, is also included on the NHSE list of high-cost drugs for 2017-19 for its use in pulmonary hypertension, and so is also on the list of Pass-through drugs.