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 Formulary Chapter 6: Endocrine system - Full Chapter
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06.01.06  Expand sub section  Diagnostic and monitoring agents for diabetes mellitus
06.01.06  Expand sub section  Blood glucose monitoring
GlucoRx Nexus®
(blood glucose meter)
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First Choice
Green

1st Choice in primary care for all Type 2 diabetics for existing patients

 
GlucoRx Nexus®
(blood glucose test strips)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green

1st Choice in primary care for all Type 2 diabetics for existing patients

 
GlucoRx Q (blood glucose test strips)
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First Choice
Green

1st choice in primary care for new patients

 
GlucoRx Q® (blood glucose meter)
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First Choice
Green

1st choice in primary care for new patients

 
Accu-Chek® Performa Nano
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Formulary
Amber Initiation

Alternative glucose meter for  type 2 diabetes patients who require a small meter with a pre and post meal tagging facility. Used for blood glucose monitoring in gestational diabetes patients. For existing patients prior to switching to Wavesense Jazz(R) if an app is required.

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
Accu-Chek®Mobile
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Formulary
Green

Alternative glucose meter for  type 2 diabetes patients who have a specific need e.g. dexterity problems, occupational drivers/travelers/where visual prompts required. 

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
Acensia Microfil®
(test strips (blood and ketone) )
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Restricted Drug Restricted
Red
Restricted - only for Type 1 diabetics and patients on insulin with a history of diabetic ketoacidosis. 
   
Continuous glucose monitoring
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Restricted Drug Restricted
Red
High Cost Medicine
BlueTeq

FOR ALL PRESCRIBING - a completed and approved High Cost Drugs form, via BLUETEQ, is required.


Use in accordance with TVPC64 Continuous glucose monitoring for adults with type 1 Diabetes (Dec 2018) or TVPC89 Continuous glucose monitoring for paediatric patients with Type 1 diabetes (June 2019).

 
Link  TVPC64 Continuous glucose monitoring for adults with type 1 Diabetes (Dec 2018)
Link  TVPC89 Continuous glucose monitoring for paediatric patients with Type 1 diabetes (June 2019).
   
FreeStyle Libre®
(meter, sensor)
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Formulary

Amber Initiation by Diabetes, Paediatric  or Obstetric consultant  following confirmation via MDT that criteria in TVPC73: Flash Glucose Monitoring System (FreeStyle Libre®)  are met.  FreeStyle Libre® reader and 1 sensor are supplied by the hospital, with ongoing prescribing and supply from primary care thereafter. Patients are reviewed by the Specialist at six months and annually, to confirm via MDT that continuation criteria are met (via audited records).


Amber Recommentation EXISTING PATIENTS SELF-FUNDING: Diabetes, Paediatric or Obstetric consultant  to assess via MDT whether TVPC73: criteria were met prior to starting treatment. If met, primary care clinician may continue prescribing. Specialist review at six months and annually (via audited records).


Note  NOTE: For existing NHS funded patients on Freestyle Libre®,  GPs can switch prescribing to Freestyle Libre® 2 sensors after patients have been informed via a standard letter from the Diabetes team. An updated reader or update to the app is required (see Freestyle Libre® 2 entry). 


 

 
Link  TVPC 73: Flash Glucose Monitoring System (Freestyle Libre®)
   
FreeStyle Libre® 2
(meter, sensor)
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Formulary

 Amber NEW PATIENTS: Freestyle Libre® 2 to be initiated for all new patients by the Diabetes, Paediatric or Obstetrics consultant following confirmation via MDT that criteria in TVPC73: Flash Glucose Monitoring System (FreeStyle Libre®)  are met.  FreeStyle Libre® reader and 1 sensor are supplied by the hospital, with ongoing prescribing and supply from primary care thereafter. Patients are reviewed by the Specialist at six months and annually, to confirm via MDT that continuation criteria are met (via audited records) 


Amber Recommentation EXISTING PATIENTS SELF-FUNDING: Diabetes, Paediatric or Obstetric consultant  to assess via MDT whether TVPC73: criteria were met prior to starting treatment. If met, primary care clinician may continue prescribing. Specialist review at six months and annually (via audited records).


Green EXISTING PATIENTS on Freestyle Libre®: Patients may be switched to Freestyle Libre® 2 at  follow-up clinics with specialists. In addition, GPs may prescribe Freestyle Libre® 2 sensors in line with formulary restrictions after patients have received a letter from the Diabetes team.  Patients need to obtain a FreeStyle Libre® 2 reader via www.freestylelibre.co.uk/replacement or update to the latest version of the FreeStyle LibreLink app (v.2.5) and access educational information via www.FreeStyleDiabetes.co.uk/progress 

 
Link  TVPC 73: Flash Glucose Monitoring System (Freestyle Libre®)
   
FreeStyle Optium®
(test strip (blood glucose))
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Restricted Drug Restricted
Green
Restricted - only for use by patients using FreeStyle Optium beta-ketone test strips 
   
FreeStyle Optium®
(beta-ketone test strip (blood ketone))
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Restricted Drug Restricted
Green
Restricted - only for Type 1 diabetics and patients on insulin with a history of diabetic ketoacidosis 
   
GlucoRx HCT and Ketone
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Formulary
Green

For practice use only

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
GlucoRx Nexus Blue
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Formulary
Green

1st choice  for type 2 diabetes patients in primary care who require a meter with specific software features 

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
GlucoRx Nexus Mini Ultra
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Formulary
Green

1st choice  for type 2 diabetes patients in primary care who require a smaller meter. 


 

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
GlucoRx Nexus Voice
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Formulary
Green

1st choice for type 2 diabetes patients in primary care who require a voice response 

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
Medisense Control®
(solution)
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Restricted Drug Restricted
Red
Only for use within secondary care for blood glucose and ketone testing 
   
Precision Xceed Pro®
(blood glucose test strips )
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
Only for use within secondary care for blood glucose testing 
   
Precision Xceed Pro®
(ketone test strips )
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red
Only for use within secondary care for blood ketone testing 
   
SuperCheck2®
(blood glucose test strips)
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Formulary
Green

For primary care for all Type 2 diabetics

 
   
SuperCheck2®
(blood glucose meter)
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Formulary
Green

In primary care for Type 2 diabetics

 
   
Wavesense Jazz®
(Wireless blood glucose meter, app and test strips)
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Restricted Drug Restricted
Amber Initiation

For initiation by Obstetrics and Diabetes teams, continuation by GPs for blood glucose monitoring of new and existing gestational diabetic patients (type 1 or type 2) via the app. The meter is to be supplied by the hospital together with the first supply of Wavesense glucose test strips. GP to continue prescribing of the test strips for patients with gestational diabetes.

 
Link  Preferred Blood Glucose meters for patients with Type 2 Diabetes – Primary/Secondary Care Guideline (BHTCG 212FM)
   
Apollo Twist®
(lancets)
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Formulary
Green

For primary care for all Type 2 diabetics

 
   
06.01.06  Expand sub section  Blood glucose strips recommended for type 2 diabetes (excluding pregnancy)
06.01.06  Expand sub section  Blood glucose testing strips for gestational diabetes
06.01.06  Expand sub section  Blood glucose testing strips for type 1 diabetes - for meters that can also measure ketones to top
06.01.06  Expand sub section  Blood test strips which measure ketones alone
06.01.06  Expand sub section  Lancets
06.01.06  Expand sub section  Syringes and needles (used for vials of insulin)
06.01.06  Expand sub section  Needles (used for insulin pens)
06.01.06  Expand sub section  Autoinjection needles to top
06.01.06  Expand sub section  Urinalysis
06.01.06  Expand sub section  Oral glucose tolerance test
 ....
 Non Formulary Items
Meters  (One Touch®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Black

Not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.
Drugs which have been evaluated and rejected by the Medicines Value Group (MVG)
Drugs defined as ‘Low Priority’ by the South Central Priorities Committee
New drugs which have not as yet been evaluated by the MVG
Any drug not listed in the Buckinghamshire Formulary  

Red

Drugs which should only be prescribed in secondary care by a specialist.
Require specialist knowledge and/or equipment for patient selection and initiation
Require long term on-going monitoring and dose adjustment to ensure efficacy and minimise toxicity by a specialist
Designated as “hospital only“ by product licence, NICE, DoH or BNF
May need further evaluation by a specialist
Are hospital initiated clinical trial materials  

Red Specialist Centre

As for ‘red’ (above) with the addition of the following:
Designated by NHS England to require initiation by or in prior agreement with a Specialist Centre. Continuation where appropriate by BHT (or other secondary care provider)
Detailed requirements for Specialist Centre initiation to be described in the wording of the formulary restriction  

Amber Protocol

Drugs which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a drug specific Shared Care Protocol(SCP). Prescribing may be continued in primary care following the SCP
Require specialist knowledge and/or equipment for patient selection and initiation
Require short or medium term (eg. 3 to 6 months) specialist monitoring of efficacy or toxicity. The need for stabilisation will vary with different drugs and patients, but is usually a minimum of 2 months (see principles for shared care)
Require significant long term monitoring
Require ongoing communication between the GP and the specialist
Have clearly defined consultant, GP and patient responsibilities documented in a shared care protocol (see responsibilities for amber protocol drugs)  

Amber Initiation

Drugs suitable for primary care prescribing following specialist initiation
Require specialist knowledge and/or equipment for patient selection
Monitoring does not require specialist knowledge or equipment
If the drug is one with which the primary care prescriber is unfamiliar the specialist is expected to provide sufficient information on the drug indication, dose, duration , monitoring and any further necessary dose adjustments
Require the first prescription to be written by the specialist  

Amber Recommended

Drugs suitable for primary care prescribing following specialist recommendation
As for amber initiation except that:- The first prescription may be written by the GP after specialist recommendation.  

Green

Drugs for which primary care prescribers would normally take full responsibility for prescribing and monitoring
Drugs not included in the Traffic Light list but included on joint formulary.
New drugs classified as red or amber but as greater experience regarding their safety and efficacy is established may move to Green after re-consideration by the MVG and APC.  

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