Summary and Next Steps Linda Lord – Chief Pharmacist

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

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

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

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

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

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

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

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

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

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

Thank you