Immune system | |||||
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Immune system / Immune system disorders and transplantation | |||||
antithymocyte immunoglobulin (rabbit) | Off Formulary |
NICE TA481 |
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avacopan | Restricted |
NICE TA825 |
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Avacopan
Treatment in accordance with NICE guidelines and criteria.This is commissioned by NHSE for active granulomatosis and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. |
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azathioprine | Restricted | ||||
AZATHIOPRINE
For oncological treatment, or for immunological therapy by those experienced. For use in Gastroenterology, azathioprine is SC in the Black Country formulary, i.e. for prescribing in primary care under a shared care agreement. |
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basiliximab | Off Formulary |
NICE TA481 |
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belimumab | Off Formulary |
NICE TA752 |
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Belimumab
This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. Any other use is non-formulary and the non-formulary request process should be followed. Active autoantibody-positive systemic lupus erythematous |
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canakinumab | Off Formulary | ||||
Canakinumab
This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. Any other use is non-formulary and the non-formulary request process should be followed. Periodic fevers and autoinflammatory diseases |
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chloroquine | Off Formulary | ||||
Chloroquine
For malaria this is Black in the Black Country IMOC formulary for prophylaxis, but can be supplied on a private prescription. For all other uses it is Green. |
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ciclosporin | Restricted |
NICE TA369 |
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Solution for infusion | |||||
Sandimmun (Novartis Pharmaceuticals UK Ltd) | Off Formulary | ||||
hydroxychloroquine sulfate | On Formulary | ||||
mycophenolate mofetil | Restricted |
NICE TA481 NICE TA481 |
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Gastro-resistant tablet | |||||
Mycophenolate mofetil (Non-proprietary) | Off Formulary | ||||
rituximab | Restricted |
NICE TA308 NICE TA195 NICE TA243 NICE TA137 NICE TA193 NICE TA226 NICE TA174 NICE TA359 NICE TA561 |
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RITUXIMAB
This is commissioned by NHSE 1. for the treatment of ANCA-associated vasculitis in adults, or 2. for refractory Systemic Lupus Erythematosus (SLE) in Adults and children, or 3. for adult and post-pubescent patients for the prevention of Delayed Haemolytic Transfusion Reactions and Hyperhaemolysis in patients with haemoglobinopathies, or 4. for the treatment of immunobullous disease in adults and children with pemphigoid (as 4th line treatment), or 5. for the treatment of immunobullous disease in adults and children with pemphigus (as 3rd line treatment), or 6. in combination with venetoclax for the treatment of previously treated chronic lymphatic leukaemia and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. All other indications are ICB commissioned and a Blueteq form is required before prescribing, if available.
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sirolimus | Off Formulary |
NICE TA481 |
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tacrolimus | Restricted |
NICE TA82 NICE TA481 NICE TA481 |
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voclosporin | Restricted |
NICE TA882 |
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Voclosporin
This is commissioned by NHSE and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. |
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Immune system / Multiple sclerosis | |||||
dimethyl fumarate | Nice-approved drug | ||||
DIMETHYL FUMARATE
This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. Any other use is non-formulary and the non-formulary request process should be followed. Multiple Sclerosis relapsing–remitting in adults and children |
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Skilarence® NICE TA475 Tecfidera® NICE TA320 |
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fingolimod | Nice-approved drug |
NICE TA254 |
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FINGOLIMOD
This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required. Treatment of highly active relapsing remitting multiple sclerosis after 1st line treatment in children Treatment of rapidly evolving severe (RES) relapsing-remitting multiple sclerosis after natalizumab treatment in children Treatment of rapidly evolving severe (RES) relapsing-remitting multiple sclerosis after natalizumab treatmen |
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glatiramer acetate | Off Formulary |
NICE TA527 |
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natalizumab | Nice-approved drug |
NICE TA127 |
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Immune system / Autoimmune hepatitis | |||||
budesonide | Restricted |
NICE TA708 |
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Modified-release tablet | |||||
Cortiment (Ferring Pharmaceuticals Ltd) | Off Formulary | ||||
Gastro-resistant capsule | |||||
Budenofalk (Dr. Falk Pharma UK Ltd) | Off Formulary | ||||
Gastro-resistant granules | |||||
Budenofalk (Dr. Falk Pharma UK Ltd) | Off Formulary | ||||
penicillamine | Restricted |