This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is commissioned by NHSE 

1. in the treatment of relapsed/refractory Hodgkin lymphoma in children, or 

2. in the treatment of relapsed/refractory Hodgkin lymphoma in adults, or      

3. for the treatment of brentuximab-naïve relapsed/refractory Hodgkin lymphoma following autologous stem cell transplant in adults, or       

4. for the treatment of brentuximab-naïve relapsed/refractory Hodgkin lymphoma following autologous stem cell transplant in children. or 

5. for the treatment of relapsed or refractory systemic anaplastic large cell lymphoma in children, or 

6. for brentuximab-naïve relapsed/refractory Hodgkin lymphoma following at least 2 prior therapies when autologous stem cell transplant or multi-agent chemotherapy is not a treatment option in ADULT patients, or      

7. for brentuximab-naïve relapsed/refractory Hodgkin lymphoma following at least 2 prior therapies when autologous stem cell transplant or multi-agent chemotherapy is not a treatment option in CHILD patients, or  

8. for the treatment of CD30+ cutaneous T cell lymphoma following at least 1 prior systemic theray, or

9. for the treatment of CD30+ cutaneous T cell lymphoma following at least 1 prior systemic therapy in CHILD patients, or

10. for the treatment of relapsed or refractory systemic anaplastic large cell lymphoma in adults, or

11. in combination with cyclophosphamide, doxorubicin and prednisone for previously untreated systemic anaplastic large cell lymphoma (sALCL) in an ADULT patient, or     

12. in combination with chemotherapy for previously untreated systemic anaplastic large cell lymphoma (sALCL) in CHILD patients

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is commissioned by NHSE 

1. in combination with bortezomib, thalidomide and dexamethasone for induction and consolidation therapy of transplant-eligible multiple myeloma, or

2. for treating relapsed and refractory multiple myeloma

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

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.

Untreated chronic lymphocytic leukaemia

Untreated advanced follicular lymphoma

Treating follicular lymphoma refractory to rituximab-containing induction chemotherapy or rituximab maintenance therapy

This is commissioned by NHSE

1. for relapsed/refractory classical Hodgkin lymphoma in patients aged 3 years and older who have been treated with stem cell transplantation but never previously received brentuximab vedotin, or

2. for relapsed/refractory classical Hodgkin lymphoma in patients aged 3 years and older who have NOT been previously treated with stem cell transplantation or brentuximab vedotin

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is commissioned by NHSE 

1. in combination with bendamustine and rituximab for previously treated patients with relapsed or refractory diffuse large B-cell lymphoma and who are not candidates for haematopoietic stem cell transplantation, or 

2.  in combination with rituximab, cyclophosphamide, doxorubicin and prednisolone for people with previously untreated diffuse large B-cell lymphoma

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

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.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Treatment in accordance with NICE guidelines and criteria.

This is commissioned by NHSE

1. or treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality, or

2. in combination with dexamethasone as 1st line treatment in transplant ineligible patients with multiple myeloma in whom thalidomide is contraindicated or who cannot tolerate thalidomide, or

3. in combination with rituximab for previously treated follicular lymphoma, or

4. as maintenance treatment in newly diagnosed patients with multiple myeloma who have undergone autologous stem cell transplantation, or

5. in combination with dexamethasone as 2nd line treatment in transplant ineligible patients with multiple myeloma previously treated with a 1st line bortezomib-containing regimen, or 

6. in combination with dexamethasone as 3rd or later line of treatment in transplant ineligible patients with multiple myeloma previously treated with at least 2 prior regimens, or 

7. with ixazomib and dexamethasone for treating relapsed or refractory multiple myeloma in patients who have had either 2 or 3 prior lines of therapy

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Treatment in accordance with NICE guidelines and criteria.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

This is Red in the Black Country formulary, i.e. for hospital prescribing only. A biosimilar product, Afqlir, will be rolled out i nthe Trust from February 2026.

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.

Refractory focal onset seizures associated with tuberous sclerosis complex 

This is Red in the Black Country formulary, i.e. for hospital prescribing only

This is commissioned by NHSE for

1. monotherapy for the treatment of patients with chronic lymphatic leukaemia which has a 17p deletion or TP53 mutation, or

2. monotherapy for the treatment of patients with 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.

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.

treating relapsed or refractory multiple myeloma in patients who have had either 2 or 3 prior lines of therapy

This is commissioned by NHSE 

1. for the treatment of previously untreated chronic phase chronic myeloid leukaemia, or 

2. for treating imatinib-resistant or imatinib-intolerant Philadelphia chromosome positive chronic phase chronic myeloid leukaemia in children

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is an oral anti-cancer drug and so F1 doctors must not prescribe it, nor may they transcribe prescriptions for it.
For further details see the NPSA alert at this link

This is commissioned by NHSE for treating disease-related splenomegaly or symptoms in adults with intermediate-2 or high-risk myelofibrosis and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is commissioned by NHSE

1. in combination with obinutuzumab for the treatment of patients with previously untreated chronic lymphatic leukaemia which has a 17p deletion or TP53 mutation, or

2. in combination with obinutuzumab for the treatment of patients with previously untreated chronic lymphatic leukaemia in whom chemotherapy with the combinations of either FCR or BR would otherwise have been UNSUITABLE, or

3. in combination with rituximab for the treatment of previously treated chronic lymphatic leukaemia, or 

4.  in combination with azacitidine for untreated adult acute myeloid leukaemia in patients unsuitable for intensive chemotherapy, or

5. in treatment of chronic lymphatic leukaemia in the ABSENCE of 17p deletion (and absence of TP53 mutation if tested), or 

6. in treatment of chronic lymphatic leukaemia in the PRESENCE of 17p deletion or TP53 mutation, or 

7. in combination with low dose cytarabine for previously untreated adult acute myeloid leukaemia in patients unsuitable for intensive chemotherapy and who have a bone marrow blast count >30%

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

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.

Chronic lymphatic leukaemia in the ABSENCE of 17p deletion (and absence of TP53 mutation if tested)

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. 

Acute promyelocytic leukaemia

Treatment by consultant haematologists in accordance with the NICE guidelines and criteria.

This is commissioned by NHSE for maintenance therapy in newly diagnosed AML patients in remission following at least induction chemotherapy and who are not candidates for, or who choose not to proceed to, haemopoietic stem cell transplantation and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

This is commissioned by NHSE 

1. for Low Grade Non-Hodgkin’s Lymphoma (1st line treatment), or 

2. for Mantle Cell Non-Hodgkin’s Lymphoma (1st Line Treatment), or 

3. for Low Grade Non-Hodgkin’s Lymphoma (Relapsed Disease)

and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

For oncological treatment by those experienced.

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 highly active, relapsing-remitting in adults and children

This is commissioned by NHSE for Acute Lymphoblastic Leukaemia and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

For oncological treatment by those experienced.

This is an oral anti-cancer drug and so F1 doctors must not prescribe it, nor may they transcribe prescriptions for it.
For further details see the NPSA alert at this link

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For oncological treatment by those experienced.

This is an oral anti-cancer drug and so F1 doctors must not prescribe it, nor may they transcribe prescriptions for it.
For further details see the NPSA alert at this link.

For use in gastroenterology mercaptopurine is SC in the Black Country formulary, i.e. for prescribing in primary care under a shared care agreement.

For oncological treatment, or for immunological therapy by those experienced - for oral treatment only the 2.5mg tablets are stocked. The solution for injection should be prescribed by brand and the patient should be maintained on that brand due to device familiarity.

This is an oral anti-cancer drug and so F1 doctors must not prescribe it, nor may they transcribe prescriptions for it.
For further details see the NPSA alert at this link
The dose is usually weekly
NPSA improving compliance with oral methotrexate guidelines

For use in gastroenterology, methotrexate is SC in the Black Country formulary, i.e. for prescribing in primary care on completion of the RMOC ESCA. The patient's brand must be specified.

For oncological treatment by those experienced or ophthalmology consultants

This is Red in the Black Country formulary

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.

T-cell non-Hodgin's lymphoma

Consultant use only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

N.B. National Patient Safety Alert: Harm from delayed administration of rasburicase for tumour lysis syndrome (September 2025)

This is AR in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist recommendation.

The government has introduced regulations to restrict the prescribing and supply of puberty-suppressing hormones, known as ‘puberty blockers’, to children and young people under 18 in England, Wales and Scotland.

The emergency ban will last from 3 June to 3 September 2024. It will apply to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

During this period no new patients under 18 will be prescribed these medicines for the purposes of puberty suppression in those experiencing gender dysphoria or incongruence under the care of these prescribers. Additional measures may be put in place following the General Election.

3.6 mg - for breast cancer
10.8 mg - for use at prostate clinic only (second-line use). Leuprorelin is the first-line product.

This is AI in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist initaition.

The government has introduced regulations to restrict the prescribing and supply of puberty-suppressing hormones, known as ‘puberty blockers’, to children and young people under 18 in England, Wales and Scotland.

The emergency ban will last from 3 June to 3 September 2024. It will apply to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

During this period no new patients under 18 will be prescribed these medicines for the purposes of puberty suppression in those experiencing gender dysphoria or incongruence under the care of these prescribers. Additional measures may be put in place following the General Election.

The government has introduced regulations to restrict the prescribing and supply of puberty-suppressing hormones, known as ‘puberty blockers’, to children and young people under 18 in England, Wales and Scotland.

The emergency ban will last from 3 June to 3 September 2024. It will apply to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

During this period no new patients under 18 will be prescribed these medicines for the purposes of puberty suppression in those experiencing gender dysphoria or incongruence under the care of these prescribers. Additional measures may be put in place following the General Election.

For oncological treatment of those experienced, and for first-line use in Gynaecology/Urology. The 11.25g product is formulary for the licensed indication only.

This is AI in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist initaition.

For oncological treatment by those experienced and also Gynaecology

Oncological treatment only by those experienced in its use.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

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 Cushing's disease

The government has introduced regulations to restrict the prescribing and supply of puberty-suppressing hormones, known as ‘puberty blockers’, to children and young people under 18 in England, Wales and Scotland.

The emergency ban will last from 3 June to 3 September 2024. It will apply to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

During this period no new patients under 18 will be prescribed these medicines for the purposes of puberty suppression in those experiencing gender dysphoria or incongruence under the care of these prescribers. Additional measures may be put in place following the General Election.

For oncological treatment, or for immunological therapy by those experienced.

This is AR in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist recommendation.

This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

This is Red for bone metabolism disorders in the Black Country IMOC formulary, i.e. for hospital prescribing only.