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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.01  Cytotoxic drugs
Durvalumab (Imfinzi®)
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Formulary
Red
Cancer Drugs Fund
NHS England

For treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation in line with NICE TA578.

Funded by specialised commissioning.

APCO July 2019.

 
Link  NICE TA578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation
   
Pegaspargase (Oncaspar®)
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Formulary
Red

For treating acute lymphoblastic leukaemia as per NICE TA408. Funded by specialised commissioning.

APCO November 2016.

 
Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
   
08.01  Side-effects of cytotoxic drugs
08.01  Drugs for cytotoxic-induced side-effects
Calcium Folinate
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
Link  NICE TA212: Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer
   
Calcium Levofolinate (Isovorin®)
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Dexrazoxane (Savene®)
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Formulary
Red
High Cost Medicine

Secondary care use only for anthracycline extravasation. 

APCO July 2018. 

 
   
Mesna
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
08.01.01  Alkylating drugs
Bendamustine (Levact®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light 

  • For the first-line treatment of chronic lymphocytic leukaemia as per NICE TA216 (APCO May 2011).
  • In combination with obinutuzumab for treating follicular lymphoma refractory to rituximab, as per NICE TA472 (APCO November 2017). Funded by specialised commissioning. 

Black Traffic Light 

  • For the treatment of indolent (low grade) non-Hodgkin's lymphoma that is refractory to rituximab as per NICE TA206 (APCO September 2010).
  • In combination with ibrutinib and rituximab for treating relapsed or refractory chronic lymphocytic leukaemia after systemic therapy (NICE TA437 - terminated appraisal). APCO May 2017.
 
Link  NICE TA216: Bendamustine for CLL
Link  NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab
Link  NICE TA206: Bendamustine for the treatment of indolent (low grade) non-Hodgkin’s lymphoma that is refractory to rituximab
Link  Letter: Bendamustine (Levact) - Increased mortality observed when used in non-approved combination treatments or outside approved indications
   
Cytotoxic Drug Busulfan
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Carmustine (Gliadel®)
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Formulary

Red Traffic Light  For the treatment of newly diagnosed high-grade glioma as per NICE TA121.

Black Traffic Light  For the treatment of recurrent glioblastoma multiforme as per NICE TA149 (terminated appraisal).

APCO September 2010.

 
Link  NICE TA121: Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide
   
Cytotoxic Drug Chlorambucil (Leukeran®)
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Chlormethine Hydrochloride
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Cyclophosphamide
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Estramustine Phosphate (Estracyt®)
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Formulary
Red

Secondary care use only.

APCO July 2008.

 
   
Cytotoxic Drug Ifosfamide
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Lomustine
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Melphalan
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Formulary
Red

Secondary care use only.

APCO July 2008.

 
   
Thiotepa (Tepadina®)
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Formulary
Red

Secondary care use only. 

 
   
Treosulfan
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Formulary
Red

Secondary care use only.

APCO July 2008.

 
   
Mitobronitol
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Unlicensed Drug Unlicensed
Red

Secondary care use only for the treatment of chronic myeloid leukaemia; it is available on a named-patient basis from specialist importing companies.

APCO July 2008.

 
   
08.01.02  Anthracyclines and other cytotoxic antibiotics to top
Cytotoxic Drug Bleomycin
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Formulary
Red

For treatment of vascular malformations in patients unable to receive sodium tetradecyl sulfate (STS).

APCO July 2008.

 
   
Cytotoxic Drug Dactinomycin (Actinomycin D)
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Daunorubicin
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Doxorubicin (Caelyx®)
(Pegylated Liposomal)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of:

  • Recurrent ovarian cancer as per NICE TA389 (APCO May 2016).
  • Advanced soft tissue sarcoma in combination with doxorubicin as per NICE TA465 (APCO September 2017).

 
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
Cytotoxic Drug Epirubicin
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Idarubicin (Zavedos®)
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Liposomal cytarabine–daunorubicin (Vyxeos® )
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Formulary
Red
NHS England

For untreated acute myeloid leukaemia as per NICE TA552.

Funded by specialised commissioning.

APCO March 2019.

 
Link  NICE TA552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia
   
Cytotoxic Drug Mitomycin (Mitomycin C Kyowa®)
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Mitoxantrone  (Onkotrone®)
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Pixantrone
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Formulary
Red
High Cost Medicine

For the treatment of lymphoma (non-Hodgkin’s, relapsed, refractory) as per NICE TA306.

Funded by specialised commissioning.

APCO March 2013.

 
Link  NICE TA306: Pixantrone monotherapy
   
08.01.03  Antimetabolites
Cytotoxic Drug Azacitidine (Vidaza®)
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Formulary
High Cost Medicine

Red Traffic Light  For the treatment of myelodysplastic syndromes, chronic myelomonocytic leukaemia and acute myeloid leukaemia as per NICE TA218.

APCO May 2011.

Black Traffic Light  For acute myeloid leukaemia with more than 30% bone marrow blasts as per NICE TA399.

APCO September 2016.

Funded by specialised commissioning.

 
Link  NICE TA218: azacitidine for myelodysplastic syndromes
Link  NICE TA399: Azacitidine for treating acute myeloid leukaemia with more than 30% bone marrow blasts
   
Cytotoxic Drug Capecitabine (Xeloda®)
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Formulary
Red

For the treatment of:

  • Colorectal cancer as per NICE TA61 and TA100 
  • Gastric cancer as per NICE TA191
  • Breast cancer as per NICE CG81

APCO July 2008.

 
Link  NICE CG81: Advanced breast cancer: diagnosis and treatment
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
Link  NICE TA191: Gastric cancer (advanced) - capecitabine
Link  NICE TA61: Colorectal cancer - capecitabine and tegafur uracil with uracil for metastatic colorectal cancer
Link  MHRA: Risk of severe skin reactions—discontinue treatment
   
Cytotoxic Drug Cladribine (Mavenclad®)
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Formulary
Red

For treating relapsing–remitting multiple sclerosis as per NICE TA616.

Funded by specialised commissioning.

APCO March 2020.

 

 
Link  NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis
   
Cytotoxic Drug Clofarabine (Evoltra®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of relapsed/refractory acute lymphoblastic leukaemia.

 
   
Cytotoxic Drug Cytarabine
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Fludarabine Phosphate (Fludara®)
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Formulary
Red

For the treatment of B-cell chronic lymphocytic leukaemia as per NICE TA29.

APCO July 2008.

 
Link  NICE TA119: Leukaemia (lymphocytic) - fludarabine
Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
   
Cytotoxic Drug Fluorouracil
(Chemotherapy)
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Gemcitabine (Gemzar®)
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Formulary

Red Traffic Light  For the treatment of:

  • Pancreatic cancer and metastatic breast cancer as per NICE TA25 and NICE TA116 (APCO March 2008).
  • Untreated metastatic pancreatic cancer in combination with paclitaxel as albumin-bound nanoparticles as per NICE TA476 (APCO November 2017).

Funded by specialised commissioning.

Black Traffic Light  Not recommended for the following:

  • Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer as per NICE TA389 (APCO May 2016).
  • Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer as per NICE TA285 (APCO July 2013).
  • Nab-paclitaxel (Abraxane) with gemcitabine in previously untreated metastatic pancreatic cancer as per NICE TA360 (APCO November 2015).
 
Link  NICE TA116: Breast cancer - gemcitabine
Link  NICE TA25: Pancreatic cancer - gemcitabine
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
   
Cytotoxic Drug Mercaptopurine
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Formulary
Red

For the treatment of acute leukaemias, chronic myeloid leukaemia, cancer.

 
   
Cytotoxic Drug Methotrexate 10mg tablets
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Formulary
Red

Secondary care use only. 

APCO March 2004.

 
Link  UKMI Q&A: alcohol and methotrexate guidance
Link  UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins?
   
Nelarabine (Atriance®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of refractory T-cell acute lymphoblastic leukaemia or refractory T-cell lymphoblastic non-Hodgkin's lymphoma.

Funded by specialised commissioning.

 
   
Cytotoxic Drug Pemetrexed (Alimta®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of:

  • Non-squamous non-small-cell lung cancer after pemetrexed and cisplatin as per NICE TA402 (APCO September 2016).
  • Non-small-cell lung cancer as per NICE TA190 (APCO July 2010).

Funded by specialised commissioning.

 
Link  NICE TA135: Mesothelioma - pemetrexed disodium
Link  NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
Link  NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
Link  NICE TA402: Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
   
Cytotoxic Drug Raltitrexed (Tomudex®)
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Tioguanine (Lanvis®)
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Trifluridine–tipiracil (Lonsurf®)
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Formulary
Red

For previously treated metastatic colorectal cancer as per NICE TA405.

APCO September 2016.

 
Link  NICE TA405: Trifluridine–tipiracil for previously treated metastatic colorectal cancer
   
08.01.04  Vinca alkaloids and etoposide
Cytotoxic Drug Etoposide
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Vinblastine Sulphate
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Vincristine Sulphate
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
Cytotoxic Drug Vinorelbine
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Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
08.01.05  Other antineoplastic drugs
Alectinib (Alecensa®)
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Formulary
NHS England

Red Traffic Light For untreated ALK-positive advanced non-small-cell lung cancer as per NICE TA536. 

Funded by specialised commissioning.

APCO September 2018.

Black Traffic Light For previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer (NICE TA438 - terminated appraisal). 

APCO May 2017.

 
Link  NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer
   
Avelumab (Bavencio®)
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Formulary
Red
High Cost Medicine
NHS England

For treating metastatic Merkel cell carcinoma, as per NICE TA517. 

Funded by specialised commissioning. 

APCO May 2018. 

 
Link  NICE TA517: Avelumab for treating metastatic Merkel cell carcinoma
   
Axitinib (Inlyta®)
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Formulary
Red
High Cost Medicine

For treating advanced renal cell carcinoma after failure of prior systemic treatment as per NICE TA333.

Funded by specialised commissioning.

APCO March 2015.

 
Link  NICE TA333: Axitinib for advanced renal cell carcinoma
   
Bevacizumab (Avastin®)
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Restricted Drug Restricted
Cancer Drugs Fund

Red Traffic Light  For ovarian cancer (as per Bevacizumab Extended Access Program) and neurofibromatosis type 2 (off-label use).

Black Traffic Light

    • First-line for the treatment of advanced and/or metastatic renal cell carcinoma as per NICE TA178.
    • Diabetic macular oedema (APCO January 2012).
    • Macular oedema caused by retinal vein occlusion (APCO January 2012).
    • Metastatic colorectal cancer after first line chemotherapy as per NICE TA242.
    • First-line treatment of metastatic breast cancer as per NICE TA214.
    • In combination with capecitabine. First line treatment of metastatic breast cancer as per NICE TA263.
    • In combination with gemcitabine and carboplatin for first recurrence of platinum-sensitive advanced ovarian cancer as per NICE TA285.
    • In combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for treatment of metastatic colorectal cancer as per NICE TA212.
    • In combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer as per NICE TA284.
    • Bevacizumab for treating relapsed, platinum‑resistant epithelial ovarian, fallopian tube or primary peritoneal cancer (NICE TA353 - terminated appraisal).
    • Bevacizumab for treating EGFR mutation-positive non-small-cell lung cancer (NICE TA436 - terminated appraisal). APCO May 2017. 

 

 
Link  NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma
Link  NICE TA212: Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer
Link  NICE TA214: Bevacizumab in combination with a taxane for the first-line treatment of metastatic breast cancer
Link  NICE TA242: Cetuximab, bevacizumab and panitumumab for the treatment of metastatic colorectal cancer after first-line chemotherapy: Cetuximab (monotherapy or combination chemotherapy), bevacizumab (in combination with non-oxaliplatin chemotherapy) and pan
Link  NICE TA263: Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer
Link  NICE TA284: Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer
Link  NICE TA285: Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer
   
Bosutinib (Bosulif®)
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Formulary
Red
Cancer Drugs Fund

For previously treated chronic myeloid leukaemia as per NICE TA401.

APCO September 2016.

Black Traffic Light Not recommended for untreated chronic myeloid leukaemia as per NICE TA576 (terminated appraisal).

APCO May 2019.

 
Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
Link  NICE TA576: Bosutinib for untreated chronic myeloid leukaemia (terminated appraisal)
   
Carfilzomib (Kyprolis®)
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Formulary
Red

For previously treated multiple myeloma as per NICE TA457.

Funded by specialised commissioning.

APCO September 2017.

 
Link  NICE TA457: Carfilzomib for previously treated multiple myeloma
   
Ceritinib (Zykadia®)
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Formulary
Red
Cancer Drugs Fund
NHS England

For:

  • Previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer as per NICE TA395 (APCO July 2016).
  • Untreated anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer in adults as per NICE TA500 (APCO March 2018).
 
Link  NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer
Link  NICE TA500: Ceritinib for untreated ALK-positive non-small-cell lung cancer
   
Dabrafenib (Tafinlar®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red 

  • In combination with trametinib for treating unresectable or metastatic melanoma as per NICE TA396 (APCO July 2016).
  • In combination with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma as per NICE TA544 (APCO November 2018).

Funded by specialised commissioning.

 Black Traffic Light Not recommended for treating advanced metastatic BRAF V600E mutation-positive non-small-cell lung cancer in combination with trametinib as per NICE TA564 (terminated appraisal).

APCO March 2019.

 
Link  NICE TA321:Dabrafenib for BRAF V600 +ve melanoma
Link  NICE TA396:Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
Link  NICE TA544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma
Link  NICE TA564: Dabrafenib with trametinib for treating advanced metastatic BRAF V600E mutation-positive non-small-cell lung cancer (terminated appraisal)
   
Cytotoxic Drug Daratumumab (Darzalex®)
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Formulary
High Cost Medicine
NHS England

Red Traffic Light  

  • Monotherapy for treating relapsed and refractory multiple myeloma as per NICE TA510 (APCO May 2018). 
  • With bortezomib and dexamethasone for previously treated multiple myeloma as per NICE TA573 (APCO May 2019).

Funded by specialised commissioning.

Black Traffic Light Not recommended for treating relapsed or refractory multiple myeloma with lenalidomide and dexamethasone.

APCO September 2017.

 
Link  NICE TA510: Daratumumab monotherapy for treating relapsed and refractory multiple myeloma
Link  NICE TA573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma
   
Cytotoxic Drug Eribulin (Halaven®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens as per NICE TA423.

APCO January 2017.

Black Traffic Light  Not recommended for treating locally advanced or metastatic breast cancer after 1 year chemotherapy regimen as per NICE TA515. 

APCO May 2018. 

 
Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
Link  NICE TA515: Eribulin for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen
Link  SMC advice (March 2016)
   
Ibrutinib (Imbruvica®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light  For treating;

  • Previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation as per NICE TA429 (APCO March 2017).
  • Waldenstrom's macroglobulinaemia as per NICE TA491 (APCO January 2018).
  • Relapsed or refractory mantle cell lymphoma in adults as per NICE TA502 (APCO March 2018).

Black Traffic Light  For:

    • Relapsed or refractory chronic lymphocytic leukaemia after systemic therapy (with bendamustine and rituximab) NICE TA437 - terminated appraisal (APCO May 2017).
    • Untreated chronic lymphocytic leukaemia without a 17p deletion or TP53 mutation as per NICE TA465 - terminated appraisal (APCO September 2017).
    • With rituximab for treating Waldenstrom’s macroglobulinaemia as per NICE TA608 - terminated appraisal (APCO January 2020).
 
Link  NICE TA429: Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation
Link  NICE TA491: Ibrutinib for treating Waldenstrom’s macroglobulinaemia
Link  NICE TA608: Ibrutinib with rituximab for treating Waldenstrom’s macroglobulinaemia (terminated appraisal)
Link  MHRA: Reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and of opportunistic infections
   
Idelalisib (Zydelig®)
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Formulary

Red Traffic Light  For treating chronic lymphocytic leukaemia as per NICE TA359.

APCO November 2015.

Black Traffic Light  Not recommended for

  • For treating chronic lymphocytic leukaemia with ofatumumab as per NICE TA469 - terminated appraisal (APCO September 2017).
  • For treating refractory follicular lymphoma as per NICE TA604 (APCO November 2019).
 
Link  NICE TA359: Chronic lymphocytic leukaemia - Idelalisib
Link  NICE TA604: Idelalisib for treating refractory follicular lymphoma
Link  MHRA: Interim advice in light of new findings related to infection
   
Inotuzumab ozogamicin (Besponsa®)
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Formulary
Red
NHS England

For treating relapsed or refractory B-cell acute lymphoblastic leukaemia as per NICE TA541.

Funded by specialised commissioning.

APCO November 2018.

 
Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
   
Ixazomib (Ninlaro®)
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Formulary
Red
NHS England

With lenalidomide and dexamethasone for relapsed or refractory multiple myeloma in adults as per NICE TA505.

 
Link  NICE TA505: Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma
   
Lenvatinib (Lenvima®)
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Formulary
Red
NHS England
  • For treating differentiated thyroid cancer after radioactive iodine as per NICE TA535 (APCO September 2018).
  • for untreated advanced hepatocellular carcinoma as per NICE TA551 (APCO March 2019).

Funded by specialised commissioning. 

 

 
Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
Link  NICE TA551:Lenvatinib for untreated advanced hepatocellular carcinoma
   
Niraparib (Zejula®)
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Formulary
Red
NHS England
  • For treating ovarian/fallopian tube/peritoneal cancer (APCO September 2017).
  • For maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer, as per NICE TA528. Funded by specialised commissioning. (APCO September 2018).
 
Link  NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
   
Cytotoxic Drug Olaratumab (Lartruvo®)
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Formulary
Red
Cancer Drugs Fund

In combination with doxorubicin for treating advanced soft tissue sarcoma as per NICE TA465

APCO September 2017.

 
   
Cytotoxic Drug Panitumumab (Vectibix®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For the treatment of previously untreated metastatic colorectal cancer in combination with cetuximab as per NICE TA439 (APCO May 2017).

Funded by specialised commissioning.

Black Traffic Light  For the treatment of:

  • Metastatic colorectal cancer after first-line chemotherapy as per NICE TA242 (APCO March 2012).
  • Metastatic colorectal cancer in combination with chemotherapy (NICE TA240 -terminated appraisal). APCO May 2017.


 
Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
   
Pembrolizumab (Keytruda®)
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Formulary
High Cost Medicine
NHS England

Red Traffic Light For the treatment of:

    • Advanced melanoma after disease progression with ipilimumabas per NICE TA357 (APCO November 2015).
    • Advanced melanoma not previously treated with ipilimumab as per NICE TA366 (APCO January 2016).
    • PD-L1-positive non-small-cell lung cancer after chemotherapy as per NICE TA428 (APCO March 2017).
    • Locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy as per NICE TA519 (APCO May 2018).
    • Untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable as per NICE TA522 (APCO September 2018). 
    • Untreated PD-L1-positive metastatic non-small-cell lung cancer as per NICE TA531 (APCO September 2018).
    • Relapsed or refractory classical Hodgkin lymphoma (for patients who cannot have an autologous stem cell transplant) as per NICE TA 540 (APCO November 2018).
    • Adjuvant treatment of resected melanoma with high risk of recurrence as per NICE TA553 (APCO March 2019).
    • Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer as per NICE TA557 (APCO March 2019). 
    • Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer as per NICE TA600 (APCO November 2019).

Funded by specialised commissioning.

Black Traffic Light Not recommended:

  • For treating relapsed or refractory classical Hodgkin lymphoma for patients who have had autologous stem cell transplant as per NICE TA540 (APCO November 2018).
  • For treating recurrent or metastatic squamous cell carcinoma of the head and neck after platinum-based chemotherapy as per NICE TA570 (terminated appraisal)  (APCO May 2019). 

 

 
Link  NICE TA357: Pembrolizumab for melanoma after ipilimumab
Link  NICE TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab
Link  NICE TA428: Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy
Link  NICE TA519: Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
Link  NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Link  NICE TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
Link  NICE TA540: Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma
Link  NICE TA553: Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence
Link  NICE TA557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer
Link  NICE TA570: Pembrolizumab for treating recurrent or metastatic squamous cell carcinoma of the head and neck after platinum-based chemotherapy (terminated appraisal)
Link  NICE TA600: Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer
   
Ponatinib (Iclusig®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For treating chronic myeloid leukaemia and acute lymphoblastic leukaemia in adults as per NICE TA451.

Funded by specialised commissioning.

APCO November 2017.

 
Link  MHRA: Risk of vascular occlusive events with ponatinib
Link  NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
   
Ruxolitinib (Jakavi®)
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Formulary
Red
High Cost Medicine

For the treatment of disease-related splenomegaly or symptoms in adults with myelofifibrosis (also known as chronic idiopathic myelofibrosis), post polycythaemia vera myelofibrosis or post essential thrombocythaemia myelofibrosis as per NICE TA386.

Funded by specialised commissioning.

APCO May 2016.

 
Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
   
Cytotoxic Drug Talimogene laherparepvec (Imlygic®)
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Formulary
Red

For treating unresectable metastatic melanoma as per NICE TA410.

APCO November 2016.

 
Link  NICE TA410: Talimogene laherparepvec for treating unresectable metastatic melanoma
   
Trametinib (Mekinist®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

In combination with dabrafenib for treating unresectable or metastatic melanoma as per NICE TA396.

APCO July 2016.

 
Link  NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
Link  MHRA: Risk of gastrointestinal perforation and colitis
   
Venetoclax (Venclyxto®)
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Formulary
Red
Cancer Drugs Fund
  • For treating chronic lymphocytic leukaemia as per NICE TA487 (APCO January 2018).
  • For previously treated chronic lymphocytic leukaemia in combination with Rituximab as per NICE TA561 (APCO March 2019).

Funded by specialised commissioning.

 
Link  NICE TA487: Venetoclax for treating chronic lymphocytic leukaemia
Link  NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia
   
08.01.05  Amsacrine
08.01.05  Arsenic trioxide to top
Cytotoxic Drug Arsenic Trioxide (Trisenox®)
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Formulary
Red
NHS England

For treating acute promyelocytic leukaemia as per NICE TA526.

APCO July 2018.

 
Link  NICE TA526: Arsenic trioxide for treating acute promyelocytic leukaemia
   
08.01.05  Bexarotene
08.01.05  Bortezomib
Cytotoxic Drug Bortezomib (Velcade®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For the treatment of:

  • Multiple Myeloma as per NICE TA129, TA228 and TA311 (APCO September 2011).
  • Mantel cell lymphoma as per NICE TA370 (APCO January 2016).

Black Traffic Light  For treating multiple myeloma after second or subsequent relapse NICE TA453 (terminated appraisal).

APCO September 2017.

 
Link  NICE TA129: Multiple myeloma - bortezomib
Link  NICE TA228: 1st line treatment of multiple myeloma
Link  NICE TA311: Bortezomib for induction therapy in multiple myeloma
Link  NICE TA370: Bortezomib for previously untreated mantle cell lymphoma
Link  MHRA: Risk of cracked or broken vials
   
08.01.05  Brentuximab vedotin
Brentuximab vedotin (Adcetris®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light For the treatment of:

  • Relapsed or refractory systemic anaplastic large cell lymphoma as per NICE TA478 (APCO November 2017).
  • CD30-positive Hodgkin lymphoma as per NICE TA524 (APCO July 2018). 
  • CD30-positive cutaneous T-cell lymphoma in line with NICE TA577 (APCO July 2019).

Funded by specialised commissioning.

Black Traffic Light Not recommended for untreated advanced Hodgkin lymphoma in line with NICE TA594 (terminated appraisal).

APCO September 2019.

 
Link  Brentuximab vedotin for treating CD30-positive cutaneous T-cell lymphoma
Link  NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma
Link  NICE TA524: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
Link  NICE TA594: Brentuximab vedotin for untreated advanced Hodgkin lymphoma (terminated appraisal)
   
08.01.05  Cetuximab
Cetuximab (Erbitux®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For the treatment of:

  • Locally advanced squamous cell cancer of the head and neck as per NICE TA145.
  • Previously untreated metastatic colorectal cancer in combination with panitumumab as per NICE TA439 (APCO May 2017). 
  • Recurrent or metastatic squamous cell cancer of the head and neck as per NICE TA473 (APCO November 2017).

Funded by specialised commissioning. 

Black Traffic Light  For the treatment of:

  • Recurrent or metastatic squamous cell cancer of the head and neck as per NICE TA172 (APCO July 2009).
  • Metastatic colorectal cancer after first-line chemotherapy as per NICE TA242 (APCO March 2012).
 
Link  NICE TA145: Head and neck cancer - cetuximab
Link  NICE TA172: Recurrent and/or metastatic squamous cell cancer of the head and neck
Link  NICE TA242: Metastatic colorectal cancer after first-line chemotherapy
Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
Link  NICE TA473: Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck
Link  MHRA: importance of establishing wild type RAS (KRAS and NRAS) status before treatment of metastatic colorectal cancer
   
08.01.05  Crisantaspase to top
Crisantaspase (Erwinase®)
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Formulary
Red

For patients being treated on the UKALL 2011 (Paediatric Haemato-oncology).

 

 
   
08.01.05  Dacarbazine and Temozolomide
Cytotoxic Drug Dacarbazine
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Formulary
Red

Secondary care use only. 

 
   
Cytotoxic Drug Temozolomide (Temodal®)
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Formulary
Red
High Cost Medicine

For the treatment of;

  • Recurrent malignant glioma (brain cancer) as per NICE TA23.
  • Newly diagnosed high-grade glioma as per NICE TA121.


APCO May 2011.

 
Link  NICE TA121: Glioma (newly diagnosed and high grade)
Link  NICE TA23: Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer)
Link  MHRA: Risk of hepatic injury, including fatal hepatic failure
   
08.01.05  Erlotinib
Erlotinib (Tarceva® )
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Formulary
High Cost Medicine

Red Traffic Light  For the treatment of:

  • Non-small-cell lung cancer that has progressed after prior chemotherapy if EGFR-TK POSITIVE (or likely to be) as per NICE TA374 (APCO January 2016).
  • First-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer as per NICE TA258 (APCO September 2012).


Black Traffic Light  For the treatment of:

  • Non-small-cell lung cancer that has progressed after prior chemotherapy if EGFR-TK NEGATIVE (or likely to be) as per NICE TA374 (APCO January 2016).
  • Monotherapy for maintenance treatment of non-small-cell lung cancer as per NICE TA227 (APCO September 2011).

 
Link  NICE TA227: Lung cancer (non-small-cell) maintenance - erlotinib
Link  NICE TA258: Lung cancer (non-small-cell) 1st line- erlotinib
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
   
08.01.05  Hydroxycarbamide
Hydroxycarbamide (500mg/5ml oral liquid)
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Formulary
Red

Secondary care use only. Liquid formulation is not included in the shared care protocols. 

APCO November 2019.

 
   
Cytotoxic Drug Hydroxycarbamide (Hydroxyurea) (Hydrea®)
(Tablets/ capsules)
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Formulary
Amber Shared Care Protocol

 

 

 
   
08.01.05  Imatinab
08.01.05  Ipilimumab to top
Ipilimumab (Yervoy®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For previously untreated advanced (unresectable or metastatic) melanoma  as per NICE TA319.

 
Link  NICE TA268: Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma
Link  NICE TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
   
08.01.05  Mitotane
Mitotane (Lysodren®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
08.01.05  Panitumumab
08.01.05  Pentostatin
Cytotoxic Drug Pentostatin (Nipent®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
08.01.05  Platinum compounds
Cytotoxic Drug Oxaliplatin
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Formulary
Red

In combination with capecitabine in the adjuvant treatment of stage III (Dukes' C) colon cancer as per NICE TA100.

 
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
   
08.01.05  Porfimer sodium and temoporfin to top
08.01.05  Procarbazine
Cytotoxic Drug Procarbazine
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

APCO July 2008.

 
   
08.01.05  Protein kinase inhibitors
Abemaciclib (Verzenios®)
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Red
  • For previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer in combination with an aromatase inhibitor, as per NICE TA563 (APCO March 2019).
  • With fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy as per NICE TA579 (APCO July 2019). Funded by specialised commissioning. 
 
Link  NICE TA563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
   
Afatinib (Giotrif®)
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NHS England

Red Traffic Light  For treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer as per NICE TA310.

Funded by specialised commissioning.

APCO May 2014.

Black Traffic Light  For treating advanced squamous non-small-cell lung cancer after platinum-based chemotherapy (Terminated appraisal NICE TA444).

APCO July 2017. 

 
Link  NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer
Link  NICE TA444: Afatinib for treating advanced squamous non-small-cell lung cancer after platinum-based chemotherapy (terminated appraisal)
   
Brigatinib (Alunbrig®)
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Formulary
Red
NHS England

For treating ALK-positive advanced non-small-cell lung cancer after crizotinib as per NICE TA571.

Funded by specialised commissioning.

APCO May 2019.

 
Link  NICE TA571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib
   
Cabozantinib (Cabometyx®)
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Formulary
Red
High Cost Medicine
NHS England

For treating

  • Previously treated advanced renal cell carcinoma as per NICE TA463 (APCO September 2017).
  • Untreated advanced renal cell carcinoma as per NICE TA542 (APCO November 2018).

Funded by specialised commissioning.

 

 
Link  NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma
Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
   
Cabozantinib (Cometriq®)
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Formulary
Cancer Drugs Fund
NHS England

Red Traffic Light For treating medullary thyroid cancer, as per NICE TA516.

Funded by specialised commissioning.

APCO May 2018. 

Black Traffic Light Not recommended for previously treated advanced hepatocellular carcinoma as per NICE TA582 (terminated appraisal). 

APCO July 2019.

 
Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
Link  NICE TA582: Cabozantinib for previously treated advanced hepatocellular carcinoma (terminated appraisal)
   
Crizotinib (Xalkori®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For:

  • Untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer as per NICE TA406 (APCO November 2016).
  • Previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer as per NICE TA422 (APCO January 2017).
  • For treating ROS1-positive advanced non-small-cell lung cancer as per NICE TA529 (APCO September 2018). 

Funded by specialised commissioning.

 
Link  NICE TA406: Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
Link  NICE TA422: Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
Link  NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer
Link  MHRA: Risk of cardiac failure with crizotinib
   
Dacomitinib  (Vizimpro®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For untreated EGFR mutation-positive non-small-cell lung cancer as per NICE TA595.

Funded by specialised commissioning. 

APCO September 2019.

 
Link  NICE TA595: Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer
   
Dasatinib (Sprycel®)
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For the treatment of:

  • Imatinib-resistant or intolerant chronic myeloid leukaemia as per NICE TA425.
  • Untreated chronic myeloid leukaemia as per NICE TA426.

Funded by specialised commissioning.

APCO January 2017.

Black Traffic Light  Not recommended for patients with CML resistant to standard dose imatinib or unable to tolerate imatinib as per NICE TA241.

APCO March 2012.

 
Link  NICE TA241: CML where treatment with imatinib has failed
Link  NICE TA425: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
   
Encorafenib (Braftovi®)
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Formulary
Red

For treating unresectable or metastatic BRAF V600 mutation-positive melanoma in combination with binimetinib as per NICE TA562.

Funded by specialised commissioning.

APCO March 2019.

 

 
Link  NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
   
Cytotoxic Drug Everolimus
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Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For:

  • Treating advanced breast cancer in combination with exemestane after endocrine therapy as per NICE TA421 (APCO January 2017).
  • Treating advanced renal cell carcinoma after previous treatment as per NICE TA432 (APCO March 2017).
  • Use with sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease as per NICE TA449 (APCO July 2017). 
  • SEGA-TS, agreed at MMTC in October 2018 (APCO November 2018).

Funded by specialised commissioning.

Black Traffic Light  Not recommended for renal transplant patients as per NICE TA481 and TA482.

APCO November 2017.

 
Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
Link  NICE TA432: Everolimus for advanced renal cell carcinoma after previous treatment
Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
   
Gefitinib (Iressa®)
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Formulary
High Cost Medicine

Red Traffic Light  For the first-line treatment of locally advanced or metastatic non-small-cell lung cancer as per NICE TA192.

Funded by specialised commissioning.

APCO September 2010.

Black Traffic Light  Not recommended for treating non-small-cell lung cancer that has progressed after prior chemotherapy as per NICE TA374.

APCO January 2016.

 
Link  NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
   
Cytotoxic Drug Imatinib (Gilvec®)
(100mg and 400mg )
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of:

  • Gastrointestinal stromal tumours as per NICE TA86 and NICE TA326 (APCO January 2015).
  • Untreated chronic myeloid leukaemia as per NICE TA70 and NICE TA426 (APCO January 2017).
  • Chronic graft versus host disease as per NHS England: 16069/P (APCO September 2017).

Funded by specialised commissioning.

 
Link  NICE TA70: Guidance on the use of imatinib for chronic myeloid leukaemia
Link  NICE TA86: Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours
Link  NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
Link  NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
   
Lenvatinib (Kisplyx®)
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Formulary
Red
NHS England

With everolimus for previously treated advanced renal cell carcinoma in adults as per NICE TA498.

APCO March 2018.

 
Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
   
Midostaurin (Rydapt®)
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Formulary
Red
NHS England

Red Traffic Light  For untreated acute myeloid leukaemia as per NICE TA523.

Funded by specialised commissioning.

APCO July 2018.

 
Link  NICE TA523: Midostaurin for untreated acute myeloid leukaemia
   
Nilotinib (Tasigna®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For the treatment of:

  • Imatinib-resistant or intolerant chronic myeloid leukaemia as per NICE TA425.
  • Untreated chronic myeloid leukaemia as per NICE TA426.

Funded by specialised commissioning.

APCO January 2017.

 
Link  NICE TA241: Dasatinib, nilotinib and high dose imatinib for CML
Link  NICE TA251: Dasatinib, nilotinib and imatinib for first line treatment of CML
   
Nintedanib  (Vargatef®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer as per NICE TA347.

Funded by specialised commissioning.

APCO September 2015.

 
   
Palbociclib (Ibrance®)
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Formulary
Red
  • With an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer as per NICE TA495 (APCO January 2018).
  • With fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer as per NICE TA619 (APCO March 2020).

Funded by specialised commissioning.

 

 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA619: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
   
Pazopanib (Votrient®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England

For first-line treatment of advanced renal cell carcinoma as per NICE TA215.

Funded by specialised commissioning.

APCO May 2011.

 
Link  NICE TA215: Pazopanib in renal cell cancer
   
Regorafenib (Stivarga® )
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light 

  • For previously treated unresectable or metastatic gastrointestinal stromal tumours as per NICE TA488 (APCO January 2018).
  • For previously treated advanced hepatocellular carcinoma as per NICE TA555 (APCO March 2019).

Funded by specialised commissioning.

Black Traffic Light Not recommended for previously treated advanced hepatocellular carcinoma as per NICE TA514. 

APCO May 2018.

 
Link  NICE TA488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
Link  NICE TA514: Regorafenib for previously treated advanced hepatocellular carcinoma
Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
   
Ribociclib (Kisqali®)
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Formulary
Red

With an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer as per NICE TA496.

Funded by specialised commissioning.

APCO January 2018.

 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Sorafenib (Nexavar®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light For the treatment of:

  • Advanced hepatocellular carcinoma as per NICE TA474 (APCO November 2017).
  • Differentiated thyroid cancer after radioactive iodine as per NICE TA535 (APCO September 2018).

Funded by specialised commissioning.

Black Traffic Light   Not recommended for:

  • Treatment of advanced hepatocellular carcinoma as per NICE TA189 (APCO July 2010).
  • Treatment of advanced or metastatic renal cell carcinoma (first- and second-line) as per NICE TA178 (APCO September 2009).
 
Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
   
Sunitinib (Sutent®)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of:

  • Advanced and/or metastatic renal cell carcinoma as per NICE TA169 (APCO July 2009).
  • Gastrointestinal stromal tumours as per NICE TA179 (APCO November 2009).
  • With everolimus for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease ss per NICE TA449 (APCO July 2017). Funded by specialised commissioning. 

 
Link  NICE TA169: Renal cell carcinoma - sunitinib
Link  NICE TA179: Gastrointestinal stromal tumours - sunitinib
Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
Link  MHRA: Risk of osteonecrosis of the jaw
   
Tivozanib (Fotivda®)
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Formulary
Red
High Cost Medicine
NHS England

For treating advanced renal cell carcinoma, in line with NICE TA512. 

Funded by specialised commissioning. 

APCO May 2018. 

 
Link  NICE TA512: Tivozanib for treating advanced renal cell carcinoma
   
Vemurafenib (Zelboraf®)
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Formulary
Red
High Cost Medicine
NHS England

For unresectable or metastatic melanoma with the BRAF V600 mutation as per NICE TA269.

Funded by specialised commissioning.

APCO January 2013.

 
Link  NICE TA269: Vemurafenib for treating malignant melanoma
Link  MHRA: Risk of potentiation of radiation toxicity with vemurafenib
   
08.01.05  Taxanes
Cytotoxic Drug Cabazitaxel (Jevtana®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For hormone-refractory metastatic prostate cancer previously treated with a docetaxel as per NICE TA391.

APCO July 2016.

 
Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
   
Cytotoxic Drug Paclitaxel
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Formulary

Red Traffic Light  For the treatment of ovarian cancer as per NICE TA55 and NICE TA389 (APCO May 2016).

Black Traffic Light  For the treatment of:

  • Adjuvant treatment of early node-positive breast cancer as per NICE TA108 (APCO November 2006).
  • First-line treatment of advanced ovarian cancer in combination with Bevacizumab and carboplatin as per NICE TA284 (APCO July 2013).
  • Other indications outside NICE.

 
Link  NICE TA108: Breast cancer (early) - paclitaxel
Link  NICE TA284:Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
Link  NICE TA55: Guidance on the use of paclitaxel in the treatment of ovarian cancer
   
Cytotoxic Drug Paclitaxel - Albumin Bound Formulation (Abraxane®)
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High Cost Medicine

Red Traffic Light  In combination with gemcitabine for untreated metastatic pancreatic cancer as per NICE TA476 (APCO November 2017). Funded by specialised commissioning. 

Black Traffic Light  In combination with carboplatin for untreated non-small-cell lung cancer (NICE TA362 - terminated appraisal).

 
Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
   
08.01.05  Topoisomerase I inhibitors
Cytotoxic Drug Topotecan
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Red Traffic Light  For the treatment of:

  • Relapsed small-cell lung cancer as per NICE TA184 (APCO January 2010).
  • Recurrent and stage IVB cervical canceras per NICE TA183 (APCO November 2009).


Black Traffic Light  For the treatment of recurrent ovarian cancer as per NICE TA389.

APCO May 2016.

 
Link  NICE TA183: Cervical cancer (recurrent) - topotecan
Link  NICE TA184: Lung cancer (small-cell) - topotecan
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
08.01.05  Trabectedin to top
Cytotoxic Drug Trabectedin (Yondelis®)
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Red Traffic Light  For the treatment of advanced soft tissue sarcoma as per NICE TA185.

APCO March 2010.

Black Traffic Light  In combination with PLDH is not recommended for treating recurrent ovarian cancer as per NICE TA389.

APCO May 2016.

 
Link  NICE TA185: Soft tissue sarcoma - trabectedin
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
08.01.05  Trastuzumab
Cytotoxic Drug Pertuzumab (Perjeta®)
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Red
High Cost Medicine
Cancer Drugs Fund
NHS England

For:

  • Neoadjuvant treatment of HER2-positive breast cancer as per NICE TA424 (APCO January 2017).
  • With trastuzumab and docetaxel for treating HER2-positive breast cancer as per NICE TA509 (APCO March 2018).
  • For adjuvant treatment of HER2-positive early stage breast cancer as per NICE TA569 (APCO May 2019). Funded by specialised commissioning. 
 
Link  NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer
Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
Link  NICE TA569: Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer
Link  SMC advice (March 2016)
   
Cytotoxic Drug Trastuzumab (Herceptin®)
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High Cost Medicine
Cancer Drugs Fund

Red Traffic Light  For the treatment of:

  • Advanced breast cancer as per NICE TA34
  • Early-stage HER2-positive breast cancer as per NICE TA107
  • HER2-positive metastatic gastric cancer as per NICE TA208 (APCO January 2011).
  • HER2-positive advanced breast cancer after trastuzumab and a taxane as per NICE TA458. (APCO September 2017).

Black Traffic Light  Not recommended for first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2 as per NICE TA257.

APCO July 2012.

 
Link  NICE TA208: Gastric cancer (HER2-positive metastatic) - trastuzumab
Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
Link  NICE TA34: Breast cancer - trastuzumab
Link  NICE TA458: Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
   
08.01.05  Tretinoin
Tretinoin (Vesanoid®)
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Red

Secondary care use only. 

APCO July 2008.

 
   
08.01.05  Vismodegib
08.02  Drugs affecting the immune response
Blinatumomab (Blincyto®)
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Red
NHS England
  • For previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia as per NICE TA450 (APCO July 2017).
  • For treating acute lymphoblastic leukaemia in remission with minimal residual disease activity as per NICE TA589 (APCO September 2019).

Funded by specialised commissioning.

 

 
Link  NICE TA450: Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia
Link  NICE TA589: Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity
   
08.02  Immunosuppressant therapy to top
08.02.01  Antiproliferative immunosuppressants
Cytotoxic Drug Azathioprine
(Immunosuppression / Post-transplant)
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Amber Shared Care Protocol

In line with Shared Care Protocol.

APCO March 2016.

 
Link  UKMI Q&A: Can mothers breastfeed while taking azathioprine?
   
Mycophenolate Mofetil
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Amber Traffic Light  For adults and paediatrics in line with Shared Care Protocol for:

  • Dermatology
  • Gastroenterology
  • Hepatology
  • Respiratory
  • Neurology
  • Renal (Not transplant)

Rheumatology

For rheumatology please use Shared Care Protocol here.

APCO September 2019

Opthalmology

  • For opthalmology (ocular inflammation in adults and pediatrics) please see Shared Care Protocol here. 

APCO May 2019.

Red Traffic Light  For renal transplant patients as per NICE TA481 and TA482.

Funded by specialised commissioning.

APCO November 2017.

 
Link  NICE Evidence Summary: Mycophenolate for scleroderma
Link  NICE Evidence Summary: Mycophenolate for SLE
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
Link  EMA advice to avoid mycophenolate use in pregnancy
Link  MHRA: Risk of hypogammaglobulinaemia & bronchiectasis with mycophenolate
   
08.02.02  Corticosteroids and other immunosuppressants
Basiliximab (Simulect®)
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Red
High Cost Medicine

For renal transplant patients as per NICE TA481 and TA482.

Funded by specialised commissioning.

 APCO November 2017.

 
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
   
Belatacept (Nulojix®)
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Red
High Cost Medicine

Red Traffic Light  To prevent rejection in bowel transplant patients who have demonstrable tacrolimus nephrotoxicity.

Funded by specialised commissioning.

Black Traffic Light  Not recommended for renal transplant patients as per NICE TA481 and TA482.

APCO November 2017.

 
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
   
Ciclosporin
(Renal)
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Red
High Cost Medicine

*Ciclosporin must be prescribed by BRAND NAME.*

For all renal patients, supply will be provided in secondary care.

APCO May 2015.

 
Link  UKMI Q&A: Brand name prescribing in primary care
   
Ciclosporin
(Neurology)
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Amber Shared Care Protocol

*Ciclosporin must be prescribed by BRAND NAME.*

Used as a second-line therapy (unlicensed) for a range of neurological disorders in line with Shared Care Protocol including:

    • Myasthenia gravis
    • Inflammatory myopathies and neuropathies
    • Vasculitis and other immune-mediated central and peripheral nervous system diseases



APCO May 2015.

 
Link  UKMI Q&A: Brand name prescribing in primary care
   
Prednisolone
(Post-transplant)
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Red

Immunosuppressants for use post-transplant should be prescribed by the Transplant Centre that carried out the transplant.

 
Link  UKMI: Prednisolone - Use plain, Not EC Tablets
Link  UKMI: Prednisolone - Use plain, Not Soluble Tablets
   
Tacrolimus
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*Tacrolimus must be prescribed by BRAND NAME.*

Amber Traffic Light  For use in:

  • Adult liver transplant patients and autoimmune liver disease in line with Shared Care Protocol (APCO July 2011).
  • Opthalmology (ocular inflammation) in line with Shared Care Protocol AdoPORT® brand only (APCO May 2019).

Red Traffic Light  Immediate release formulations. For renal transplant patients as per NICE TA481 and TA482 (APCO November 2017).

Funded by specialised commisisoning. 

Black Traffic Light  Prolonged release formulations. Not recommended for use in renal transplant patients, as per NICE TA481 and TA482 (APCO November 2017). 

 
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
Link  CAS letter: Oral tacrolimus products should be prescribed and dispensed by brand name to avoid the risk of medication errors
Link  UKMI Q&A: Brand name prescribing in primary care
   
08.02.03  Anti-lymphocyte monoclonal antibodies
Alemtuzumab (Lemtrada®)
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Red
High Cost Medicine
NHS England

For the treatment of relapsing-remitting multiple sclerosis as per NICE TA312. 

Funded by specialised commissioning.

APCO July 2014.

 
Link  NICE TA312: Alemtuzumab for relapsing‑remitting multiple sclerosis
   
Atezolizumab (Tecentriq®)
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Cancer Drugs Fund
NHS England

Red Traffic Light For the treatment of:

  • Untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable as per NICE TA492 (APCO January 2018).
  • Locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy, as per NICE TA525 (APCO July 2018).
  • Untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable, as per NICE TA492 (APCO September 2018).
  • Metastatic non-squamous non-small-cell lung cancer in combination with bevacizumab (Avastin), carboplatin and paclitaxel, as per NICE TA584 (APCO July 2019).

Funded by specialised commissioning.

 Black Traffic Light With carboplatin and nab-paclitaxel for untreated advanced non-squamous non-small-cell lung cancer as per NICE TA618 (terminated appraisal). 

APCO March 2020. 

 
Link  NICE TA492: Atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Link  NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
Link  NICE TA584: Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer
Link  NICE TA618: Atezolizumab with carboplatin and nab-paclitaxel for untreated advanced non-squamous non-small-cell lung cancer (terminated appraisal)
   
Cemiplimab (Libtayo®)
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Red
NHS England

For treating metastatic or locally advanced cutaneous squamous cell carcinoma as per NICE TA592.

Funded by specialised commissioning. 

APCO September 2019.

 
Link  NICE TA592: Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma
   
Gemtuzumab oxogamicin  (Mylotarg®)
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Red
NHS England

For untreated acute myeloid leukaemia as per NICE TA545. Funded by specialised commissioning.

APCO January 2019.

 

 
Link  NICE TA545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia
   
Obinutuzumab (Gazyvaro®)
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Red
High Cost Medicine
NHS England
  • In combination with chlorambucil for untreated chronic lymphocytic leukaemia as per NICE TA343 (APCO July 2015).
  • In combination with bendamustine for treating follicular lymphoma refractory to rituximab, as per NICE TA472 (APCO November 2017).
  • For untreated advanced follicular lymphoma, as per NICE TA513 (APCO May 2018). 
  • Funded by specialised commissioning. 
 
Link  NICE TA343: Obinutuzumab with chlorambucil for CLL
Link  NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab
Link  NICE TA513: Obinutuzumab for untreated advanced follicular lymphoma
   
Ocrelizumab (Ocrevus®)
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Red

For treating

  • Relapsing–remitting multiple sclerosis as per NICE TA533 (APCO May 2019).
  • Treating primary progressive multiple sclerosis as per NICE TA585 (APCO July 2019).

Funded by specialised commissioning.

 
Link  NICE TA533: Ocrelizumab for treating relapsing–remitting multiple sclerosis
Link  NICE TA585: Ocrelizumab for treating primary progressive multiple sclerosis
   
Ofatumumab (Arzerra®)
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High Cost Medicine
NHS England

Red Traffic Light  In combination with chlorambucil or bendamustine for untreated chronic lymphocytic leukaemia as per NICE TA344.

APCO July 2015.

Black Traffic Light  For the treatment of:

  • Chronic lymphocytic leukaemia refractory to fludarabine and alemtuzumab as per NICE TA202 (APCO November 2015). 
  • Chronic lymphocytic leukaemia with chemotherapy. NICE TA 470 -terminated appraisal (APCO September 2017). 

Funded by specialised commissioning.

 
Link  NICE TA344: Ofatumumab with chlorambucil or bendamustine for CLL
Link  MHRA: Ofatumumab - screen for hepatitis B virus before treatment
Link  MHRA: Risk of serious and fatal infusion reactions—always give premedication and monitor carefully
   
Rituximab (MabThera®)
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Red
High Cost Medicine
NHS England

Red Traffic Light  For the treatment of:

  • Anti-neutrophil cytoplasmic - Antibody-associated vasculitis as per TA308. (APCO May 2014).
  • Chronic lymphocytic leukaemia as for NICE TA174 and TA193. (APCO May 2014).
  • Follicular lymphoma (first-line treatment of stage III-IV) as per TA243. (APCO May 2014).
  • Non-Hodgkin's lymphoma as per TA137 and TA226 (APCO May 2014).
  • Immunoglobulin G4 related disease (APCO May 2017).
  • Myasthenia Gravis (APCO January 2019).

Funded by specialised commissioning.

Black Traffic Light  In combination with ibrutinib and bendamustine for treating relapsed or refractory chronic lymphocytic leukaemia after systemic therapy (NICE TA437 - terminated appraisal). APCO May 2017.

 
Link  NICE Evidence Summary: Rituximab for ITP
Link  Commissioning Policy - Rituximab for immunoglobulin G4- related disease (IgG4-RD)
Link  Commissioning Policy: For relapsing steroid-sensitive nephrotic syndrome
Link  Commissioning Policy: For steroid resistant nephrotic syndrome in paediatric patients
Link  Commissioning Policy: For the eradication of inhibitors in acquired haemophilia
   
08.02.04  Other immunomodulating drugs
Axicabtagene ciloleucel  (Yescarta®)
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Red
NHS England

For treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies as per NICE TA559.

Funded by specialised commissioning.

APCO March 2019.

 
Link  NICE TA559: Axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies
   
Daclizumab (Zinbryta®)
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Red
NHS England

For treating relapsing-remitting multiple sclerosis as per NICE TA441. Funded by specialised commissioning. 

APCO July 2017. 

 
Link  NICE TA441: Daclizumab for treating relapsing–remitting multiple sclerosis
   
Dimethyl fumarate (Tecfidera®)
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Red
High Cost Medicine
NHS England

For the treatment of relapsing-remitting multiple sclerosis, as per NICE TA320 and in line with Monitoring Protocol 

APCO July 2016.

Funded by specialised commissioning. 

 
Link  NICE TA320: Dimethyl fumarate for multiple sclerosis
Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
Link  EMA advice re minimising risk of PML
Link  MHRA: Fatal PML with dimethyl fumarate
Link  MHRA: Updated advice on risk of PML with dimethyl fumarate
   
Dinutuximab Beta (Qarziba®)
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Formulary
Red
NHS England

For treating neuroblastoma as per NICE TA538.

Funded by specialised commissioning.

APCO November 2018.

 
Link  Dinutuximab beta for treating neuroblastoma
   
Fingolimod
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Formulary
Red
High Cost Medicine
NHS England

For the treatment of highly active relapsing-remitting multiple sclerosis as per NICE TA254.

Funded by specialised commissioning.

APCO May 2012.

 
Link  NICE TA254: Fingolimod for highly active relapsing remitting multiple sclerosis
Link  MHRA: Risks of PML, basal-cell carcinoma, and opportunistic infections
Link  MHRA: Update on bradycardia and heart block
   
Lenalidomide (Revlimid®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light

  • For treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality as per NICE TA322 (APCO November 2014).
  • Plus dexamethasone for multiple myeloma after 1 treatment with bortezomib as per NICE TA586 (APCO September 2019). 
  • Plus dexamethasone for previously untreated multiple myeloma in line with NICE TA587 (APCO September 2019). 

Funded by specialised commissioning. 

Black Traffic Light Not recommended for with bortezomib and dexamethasone for untreated multiple myeloma (NICE TA603 - terminated appraisal).

APCO November 2019.

 
Link  MHRA investigation of second primary malignancies update
Link  MHRA: Risk of thrombosis and thromboembolism
Link  NICE TA322: Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality
Link  NICE TA586: Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib
Link  NICE TA587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma
Link  NICE TA603: Lenalidomide with bortezomib and dexamethasone for untreated multiple myeloma (terminated appraisal)
   
Nivolumab (Opdivo®)
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High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light For the treatment of:

  • Advanced (unresectable or metastatic) melanoma in adults as per NICE TA384 (APCO March 2013).
  • Advanced melanoma in combination with ipilimumab as per NICE TA400 (APCO September 2016)
  • Previously treated advanced renal cell carcinoma as per NICE TA417 (APCO January 2017).
  • Relapsed or refractory classical Hodgkin lymphoma as per NICE TA462 (APCO September 2017).
  • Previously treated squamous non-small-cell lung cancer as per NICE TA483 (APCO January 2018).
  • Previously treated non-squamous non-small-cell lung cancer as per NICE TA484 (APCO January 2018).
  • Treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy as per NICE TA490 (APCO January 2018).
  • For adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease as per NICE TA558 (APCO March 2019).
  • With ipilimumab for untreated advanced renal cell carcinoma as per NICE TA581 (APCO July 2019).

Funded by specialised commissioning.

Black Traffic Light Not recommended for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy as per NICE TA530.

APCO September 2018.

 
Link  NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
Link  NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma
Link  NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer
Link  NICE TA490: Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy
Link  NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy
Link  NICE TA558: Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease
Link  NICE TA581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma
Link  NICT TA483: Nivolumab for previously treated squamous non-small-cell lung cancer
Link  SMC advice (March 2016)
   
Olaparib (Lynparza®)
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High Cost Medicine
NHS England

Red Traffic Light For maintenance treatment of:

  • BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy, in line with NICE TA598 (APCO November 2019).
  • Relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer as per NICE TA620 (APCO March 2020).  

Funded by specialised commissioning. 

Black Traffic Light Not recommended for maintenance treatment of relapsed, platinum-sensitive, BRCA mutation-positive ovarian, fallopian tube and peritoneal cancer after response to second-line or subsequent platinum-based chemotherapy, in line with NICE TA381.

 

 
Link  NICE TA381: Olaparib for maintenance treatment of relapsed, platinum-sensitive, BRCA mutation-positive ovarian, fallopian tube and peritoneal cancer after response to second-line or subsequent platinum-based chemotherapy
Link  NICE TA598: Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy
Link  NICE TA620: Olaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer
   
Osimertinib (Tagrisso®)
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Red Traffic Light For treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer as per NICE TA416.

APCO November 2016.

Black Traffic Light Not recommended for untreated EGFR mutation-positive non-small-cell lung cancer as per NICE TA621.

APCO March 2020.

 
Link  NICE TA416: Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer
Link  NICE TA621: Osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer
   
Pomalidomide (Imnovid®)
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Formulary
High Cost Medicine
Cancer Drugs Fund
NHS England

Red Traffic Light For the treatment of multiple myeloma previously treated with lenalidomide and bortezomib as per NICE TA427.

Funded by specialised commissioning.

APCO March 2017.

Black Traffic Light Not recommended with bortezomib and dexamethasone for treating relapsed or refractory multiple myeloma (NICE TA602 - terminated appraisal).

APCO November 2019.

 
Link  NICE TA427: Pomalidomide for myeloma
Link  NICE TA602: Pomalidomide with bortezomib and dexamethasone for treating relapsed or refractory multiple myeloma (terminated appraisal)
Link  MHRA: Risk of cardiac failure, ILD & hepatoxicity with pomalidomide
Link  MHRA: Risk of Hepatitis B Reactivation
   
Rucaparib (Rubraca®)
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Formulary
Red
NHS England

For maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer in line with NICE TA611. 

Funded by specialised commissioning.

APCO January 2020.

 
Link  NICE TA611: Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer
   
Teriflunomide (Aubagio®)
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Formulary
Red
High Cost Medicine

For treating relapsing-remitting multiple sclerosis as per NICE TA303.

APCO March 2014.

 
Link  NICE TA303: Teriflunomide for relapsing remitting MS
Link  NICE TA405:Trifluridine–tipiracil for previously treated metastatic colorectal cancer
   
Thalidomide (Celgene®)
(Haematology)
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Formulary
Red
High Cost Medicine

For the first‑line treatment of multiple myeloma as per NICE TA228.

APCO September 2011.

 
Link  MHRA: Risk of arterial and venous thromboembolism
Link  MHRA: Risk of second primary malignancies
   
Tisagenlecleucel (Kymriah®)
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Red
  • For treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years as per NICE TA554 (APCO March 2019).
  • for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies as per NICE TA567 (APCO May 2019).

Funded by specialised commissioning.

 

 
Link  NICE TA554: Tisagenlecleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years
Link  NICE TA567: Tisagenlecleucel for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies
   
08.02.04  Interferon Alfa to top
Peginterferon Alfa (Pegasys®)
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Formulary
Red
High Cost Medicine

For the treatment of:

  • Hepatitis B as per NICE TA96
  • Hepatitis C as per TA75, TA106, TA200 and TA300.

Funded by specialised commissioning.

APCO July 2005.

 
Link  NICE TA106: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA200: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA300: Hepatitis C - peginterferon alfa
Link  NICE TA75: Hepatitis C - pegylated interferons, ribavirin & alfa interferon
Link  NICE TA96: Hepatitis B - peginterferon alfa
   
Peginterferon Alfa (ViraferonPeg®)
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Red
High Cost Medicine

For the treatment of:

  • Hepatitis B as per NICE TA96
  • Hepatitis C as per TA75, TA106, TA200 and TA300.

Funded by specialised commissioning.

APCO November 2010.

 
   
08.02.04  Interferon beta
Interferon Beta-1a (Avonex® )
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Formulary
Red
NHS England

For treating multiple sclerosis as per NICE TA527. 

Funded by specialised commissioning.

APCO July 2018.

 
Link  Commissioning Policy - Multiple Sclerosis
Link  MHRA: Interferon-beta: risk of thrombotic microangiopathy and risk of nephrotic syndrome
Link  NICE TA527:Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Interferon Beta-1a (Rebif®)
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Formulary
Red
NHS England

For treating multiple sclerosis as per NICE TA527.

Funded by specialised commissioning. 

APCO July 2018.

 
Link  Commissioning Policy - Multiple Sclerosis
Link  MHRA: Interferon-beta: risk of thrombotic microangiopathy and risk of nephrotic syndrome
Link  NICE TA527:Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Interferon Beta-1b (Extavia®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
NHS England

For treating multiple sclerosis as per NICE TA527.

Funded by specialised commissioning.

APCO July 2018.

 
Link  Commissioning Policy - Multiple Sclerosis
Link  MHRA: Interferon-beta: risk of thrombotic microangiopathy and risk of nephrotic syndrome
Link  NICE TA527:Beta interferons and glatiramer acetate for treating multiple sclerosis
   
Peginterferon Beta-1a (Plegridy®)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine
NHS England

Red  For treating relapsing–remitting multiple sclerosis as per NICE TA624. Funded by specialised commissioning.

APCO March 2020. 

 
Link  NICE TA624: Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis
   
08.02.04  Interferon gamma
08.02.04  Aldesleukin
Aldesleukin (Proleukin®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Secondary care use only. 

 
   
BCG bladder instillation (ImmuCyst®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
BCG bladder instillation (OncoTICE®)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Secondary care use only. 

 
   
08.02.04  BCG bladder instillation
08.02.04  Canakinumab to top
08.02.04  Dimethyl fumarate
08.02.04  Fingolimod
08.02.04  Glatiramer acetate
Glatiramer Acetate (Copaxone®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
NHS England

Red Traffic Light  For treating multiple sclerosis as per NICE TA527.

Funded by specialised commissioning.

APCO July 2018.

 
Link  NICE TA527:Beta interferons and glatiramer acetate for treating multiple sclerosis
Link  Commissioning Policy: Multiple Sclerosis
   
08.02.04  Histamine
08.02.04  Lenalidomide, pomalidomide, and thalidomide to top
08.02.04  Mifamurtide
08.02.04  Natalizumab
Natalizumab (Tysabri®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

For the treatment of adults with highly active relapsing–remitting multiple sclerosis as per NICE TA127.

Funded by specialised commissioning.

APCO September 2012.

 
Link  NICE TA127: Multiple sclerosis - natalizumab
Link  Commissioning Policy - Multiple Sclerosis
Link  MHRA: Early detection of progressive multifocal leukoencephalopathy
   
08.02.04  Teriflunomide
08.03  Sex hormones and hormone antagonists in malignant disease
08.03.01  Oestrogens to top
Diethylstilbestrol
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Ethinylestradol
(Cancer)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
08.03.02  Progestogens
Medroxyprogesterone Acetate (Provera®)
(Malignancy)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Megestrol Acetate (Megace®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
Norethisterone
(Malignancy)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following specialist initiation.

 
   
08.03.03  Androgens
08.03.04  Hormone antagonists
08.03.04.01  Breast cancer
Anastrozole
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for prescribing in primary care following

  • Oncology Consultant recommendation for adjuvant hormonal therapy of breast cancer as per NICE TA112In line with Endocrine Therapy in Breast Cancer Guidelines (APCO May 2007).
  • Genetics service recommendation for prevention of breast cancer in women at high and moderate risk of breast cancer as per NICE CG164 (APCO May 2018). 
 
Link  NICE CG164: Familial Breast Cancer
   
Exemestane
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  Suitable for prescribing in primary care following Oncology Consultant recommendation for adjuvant hormonal therapy of breast cancer as per NICE TA112. In line with Endocrine Therapy in Breast Cancer Guidelines.

APCO May 2007.

Red Traffic Light  In combination with everolimus for treating advanced breast cancer after endocrine therapy as per NICE TA421. In line with Endocrine Therapy in Breast Cancer Guidelines.

APCO January 2017.

 
Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
   
Letrozole
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light Suitable for prescribing in primary care following Oncology Consultant recommendation for adjuvant hormonal therapy of breast cancer as per NICE TA112.

APCO May 2007.

Red Traffic Light Second line ovulation induction treatment for patients that have unsuccessful clomiphene citrate ovulation induction or are intolerable to the side effects of clomiphene citrate.

APCO September 2018.


 
   
Neratinib (Nerlynx®)
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Formulary
Red
NHS England

For extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab, in line with NICE TA612.

Funded by specialised commissioning.

APCO January 2020.

 
Link  NICE TA612: Neratinib for extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab
   
Raloxifene (Evirex®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for prescribing in primary care following recommendation from genetics service for prevention of breast cancer in women at high and moderate risk of breast cancer as per NICE CG164.

APCO May 2018. 

 

 
Link  NICE CG164: Familial breast cancer
   
Tamoxifen
View adult BNF View SPC online View childrens BNF
Formulary

Amber Traffic Light  Suitable for prescribing in primary care following

  • Oncology Consultant recommendation for breast cancerIn line with Endocrine Therapy in Breast Cancer Guidelines (APCO July 2016).
  • Genetics service recommendation for the prevention of breast cancer in women at high and moderate risk of breast cancer as per NICE CG164 (APCO May 2018). 

Red Traffic Light  Tamoxifen 20mg is for secondary care use only for treating hereditary Haemorrhagic Telangectasia (HHT) (APCO July 2018).

 
Link  MHRA Drug Safety Update: Drug interactions, genetic variants and variability in clinical response
Link  NICE CG164: Familial Breast Cancer
Link  UKMI Q&A: Does Tamoxifen interact with SSRI or SNRI antidepressants?
   
08.03.04.02  Prostate cancer and gonadorelin analogues to top
Radium-223 dichloride
(Xofigo®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For treating hormone-relapsed prostate cancer with bone metastases as per NICE TA412.

APCO November 2016.

 
Link  NICE TA376: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
Link  NICE TA412: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
   
08.03.04.02  Gonadorelin analogues
Degarelix (Firmagon®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For treating newly diagnosed advanced hormone-dependent prostate cancer with spine metastases as per NICE TA404.

APCO July 2017.

 
Link  NICE TA404: Degarelix for treating advanced hormone-dependent prostate cancer
   
08.03.04.02  Anti-androgens
Triptorelin SR 22.5mg (Decapeptyl® SR)
View adult BNF View SPC online View childrens BNF
First Choice
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotrophin-releasing hormone analogue (GnRH) for the treatment of prostate cancer. See GnRH analogues in prostate cancer guidelines. NB. This is a 6-monthly preparation.

APCO January 2014.

 
Goserelin 10.8mg (Zoladex LA®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 12-weekly preparation.

APCO January 2014.

 
   
Goserelin 3.6mg (Zoladex®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 4-weekly preparation.

APCO January 2014.

For treatment of breast cancer, in line with Endocrine Therapy in Breast Cancer Guidelines. 

 
   
Leuprorelin Acetate 11.25mg (Prostap 3 DCS®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation
  • For Central Precocious Puberty (CPP) see section 06.07.02.
  • Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).
  • First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 3-monthly preparation. (APCO January 2014)
  • During COVID-19 only: For treatment of breast cancer, only for patients who cannot attend or will not attend for monthly injections during COVID-19. (APCO May 2020)

 

 
   
Leuprorelin Acetate 3.75mg (Prostap SR DCS®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a monthly preparation.

APCO January 2014.

 
   
Triptorelin 3.75mg (Gonapeptyl Depot®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 4-weekly preparation.

APCO January 2014.

 
   
Triptorelin SR 11.25mg (Decapeptyl® SR)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 3-monthly preparation.

APCO January 2014.

 
   
Triptorelin SR 3mg (Decapeptyl® SR)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

For Central Precocious Puberty (CPP) see section 06.07.02.

Suitable for prescribing in primary care following specialist recommendation (for indications other than CPP).

First-line gonadotropin-releasing hormone (GnRH) analogue for the treatment of prostate cancer is triptorelin SR 22.5mg. See GnRH analogues in prostate cancer guidelines. NB. This is a 4-weekly preparation.

APCO January 2014.

 
   
Abiraterone (Zytiga®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For the treatment of:

  • Castration-resistant metastatic prostate cancer previously treated with a docetaxel-containing regimen as per NICE TA259 (APCO July 2012).
  • Metastatic hormone-relapsed prostate cancer before chemotherapy is indicated as per NICE TA387 (APCO May 2016).


Funded by specialised commissioning.

 
Link  NICE TA259: Abiraterone for castration resistant prostate cancer
Link  NICE TA387:Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
   
Bicalutamide
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following initiation in secondary care by urology or oncology.

 
   
Cyproterone
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following initiation in secondary care by urology or oncology.

 
   
Enzalutamide (Xtandi®)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine
Cancer Drugs Fund

Red Traffic Light For the treatment of:

  • Metastatic hormone-relapsed prostate cancer previously treated with a docetaxel containing regimen as per NICE TA316.
  • Metastatic hormone-relapsed prostate cancer before chemotherapy is indicated as per NICE TA377.

APCO March 2016.

Black Traffic Light Not recommended for hormone-relapsed non-metastatic prostate cancer as per NICE TA580.

APCO July 2019. 

 
Link  NICE TA316: Enzalutamide for prostate cancer
Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
Link  NICE TA580: Enzalutamide for hormone-relapsed non-metastatic prostate cancer
Link  SMC advice (March 2016)
   
Flutamide
View adult BNF View SPC online View childrens BNF
Formulary
Amber Continuation

Suitable for continuation in primary care following initiation in secondary care by urology or oncology.

 
   
08.03.04.03  Somatostatin analogues
Lanreotide  (Somatuline Autogel®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Shared Care Protocol
High Cost Medicine
NHS England

For the treatment of:

    • Acromegaly in line with Shared Care Protocol (APCO November 2011).
    • Neuroendocrine tumours in line with Shared Care Protocol. The OCDEM team will be responsible for prescribing the medication and delivery via the homecare team (APCO September 2016).

 

 
   
Lutetium (177Lu) oxodotreotide (Lutathera®)
View adult BNF View SPC online View childrens BNF
Formulary
Red
NHS England

For treating unresectable or metastatic neuroendocrine tumours as per NICE TA539.

Funded by specialised commissioning.

APCO November 2018.

 
Link  Lutetium (177Lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours
   
Octreotide (Sandostatin LAR®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Shared Care Protocol
High Cost Medicine
NHS England

For the treatment of:

    • Acromegaly in line with Shared Care Protocol (APCO November 2011).
    • Neuroendocrine tumours in line with Shared Care Protocol. The OCDEM team will be responsible for prescribing the medication and delivery via the homecare team (APCO September 2016).
 
   
Octreotide (Sandostatin®)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine

Red Traffic Light  Secondary care use only for chemotherapy (capecitabine only) induced diarrhoea.

APCO September 2017.

Amber Traffic Light  For continuation in primary care for gastric secretions, nausea and vomiting due to bowel obstruction in oncology and palliative care.

 
   
 ....
 Non Formulary Items
Cytotoxic Drug  Aflibercept  (Zaltrap®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine
Cancer Drugs Fund

Not recommended in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that is resistant to or has progressed after an oxaliplatin-containing regimen.

Not routinely commissioned by NHSE as per NICE TA307, CDIFR approval required.

APCO May 2014.

Link  NICE TA307: Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy
Link  MHRA: Minimising the risk of osteonecrosis of the jaw
 
Amifostine  (Ethyol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Amsacrine  (Amsidine®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Anamorelin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Antithymocyte immunoglobulin (Rabbit)  (Thymoglobuline®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

For renal transplant patients as per NICE TA481 and TA482.

APCO November 2017.

Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
 
Begelomab  (Begedina®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Bexarotene  (Targretin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended for cutaneous T-cell lymphoma.

APCO November 2010.

 
Buserelin
(Prostate)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Canakinumab  (Ilaris®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

For treating gouty arthritis attacks and reducing the frequency of subsequent attacks as per NICE TA281 (terminated appraisal).

APCO May 2013.

Link  NICE TA281: Canakinumab for treating gouty arthritis attacks and reducing the frequency of subsequent attacks (terminated appraisal)
 
Cytotoxic Drug  Carboplatin

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended:

  • In combination with bevacizumab, paclitaxel, as first-line treatment for advanced ovarian cancer (including fallopian tube and primary peritoneal cancer) as per NICE TA284.
  • In combination with bevacizumab and gemcitabine for treating the first recurrence of platinum-sensitive advanced ovarian cancer as per NICE TA285.


APCO July 2013.

Link  NICE TA284: Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer
Link  NICE TA285: Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer
 
Cediranib  (Recentin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Cisplatin

View adult BNF View SPC online View childrens BNF
Non Formulary
Cancer Drugs Fund
 
Cobimetinib  (Cotellic®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended for treating unresectable or metastatic melanoma in adults with a BRAF V600 mutation as per NICE TA414.

APCO November 2016.

Link  NICE TA414: Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma
 
Daclizumab  (Zenapax®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Discontinued.

 
Daunorubicin  (DaunoXome®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Lipid formulation.

 
Cytotoxic Drug  Decitabine  (Dacogen®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not recommended for untreated acute myeloid leukaemia as per NICE TA548.

APCO January 2019.

Link  NICE TA270: Leukaemia (acute myeloid ) - decitabine (terminated appraisal)
Link  NICE TA548: Decitabine for untreated acute myeloid leukaemia (terminated appraisal)
 
Disodium Folinate  (Sodiofolin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Disodium Levofolinate
(Levofolinic acid )

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Docetaxel  (Taxotere®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA101: Prostate cancer (hormone-refractory) - docetaxel
Link  NICE TA109: Breast cancer (early) - docetaxel
 
Cytotoxic Drug  Doxorubicin  (Myocet®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Elotuzumab  (Empliciti®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

For previously treated multiple myeloma (NICE TA434 - terminated appraisal).

APCO May 2017. 

 
Fampridine

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Fulvestrant  (Faslodex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

For:

  • The treatment of locally advanced or metastatic breast cancer as per NICE TA239 (APCO January 2012).
  • For treating locally advanced or metastatic oestrogen-receptor positive breast cancer as per NICE TA503 (APCO March 2018).
Link  NICE TA239: Fulvestrant for the treatment of locally advanced or metastatic breast cancer
Link  NICE TA503: Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer
 
Histrelin  (Vantas®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Imatinib  (Gilvec®)
(600mg and 800mg)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not recommended for treating imatinib-resistant or intolerant chronic myeloid leukaemia as per NICE TA425.

APCO January 2017.

Link  NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
 
Interferon Alfa
(IntronA)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
Link  NICE TA75: Interferon Alfa - Chronic Hepatitis C
 
Interferon Alfa  (Roferon-A®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Interferon Alfa  (Viraferon®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Interferon Beta-1b  (Betaferon®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
NHS England

 For treating multiple sclerosis as per NICE TA527.

APCO July 2018. 

Link  Commissioning Policy - Multiple Sclerosis
Link  MHRA: Interferon-beta: risk of thrombotic microangiopathy and risk of nephrotic syndrome
Link  NICE TA527:Beta interferons and glatiramer acetate for treating multiple sclerosis
 
Cytotoxic Drug  Irinotecan Hydrochloride  (Onivyde®)
(Pegylated liposomal)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

For treating:

  • Metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy as per NICE TA307 (APCO May 2014).
  • Pancreatic cancer after gemcitabine as per NICE TA440 (APCO July 2017). 

Link  NICE TA307: Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy
Link  NICE TA440: Pegylated liposomal irinotecan for treating pancreatic cancer after gemcitabine
 
Lanreotide  (Somatuline® LA)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lapatinib  (Tyverb®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not recommended for in combination with an aromatase inhibitor for the first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2 as per NICE TA257.

APCO July 2012.

Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
 
Mifamurtide  (Mepact®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA235: Osteosarcoma - mifamurtide: guidance
 
Mycophenolate Sodium  (Myfortic®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended for use in renal transplant patients as per NICE TA481 and TA482. 

APCO November 2017.

Link  NICE Evidence Summary: Mycophenolate for scleroderma
Link  NICE Evidence Summary: Mycophenolate for SLE
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
 
Necitumumab  (Portrazza®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not recommended for untreated advanced or metastatic squamous non-small-cell lung cancer as per NICE TA411.

APCO November 2016.

Link  NICE TA411: Necitumumab for untreated advanced or metastatic squamous non-small-cell lung cancer
 
Pablociclib  (Ibrance®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Padeliporfin  (Tookad®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not recommended for untreated localised prostate cancer as per NICE TA546.

APCO January 2019.

Link  NICE TA546: Padeliporfin for untreated localised prostate cancer
 
Palifermin  (Kepivance®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Panobinostat  (Farydak®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
 
Pemrolizumab  (Keytruda®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Porfimer Sodium  (Photofrin ®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ramucirumab  (Cyramza®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
High Cost Medicine

Not recommended for:

    • Advanced gastric cancer or gastro–oesophageal junction adenocarcinoma previously treated with chemotherapy as per NICE TA378 (APCO March 2016).
    • Previously treated locally advanced or metastatic non-small-cell lung cancer as per NICE TA403 (APCO September 2016).
    • Unresectable hepatocellular carcinoma after sorafenib (terminated appraisal) as per NICE TA609 (APCO January 2020).

 

Link  NICE TA378: Ramucirumab for treating advanced gastric cancer or gastro–oesophageal junction adenocarcinoma previously treated with chemotherapy
Link  NICE TA403: Ramucirumab for previously treated locally advanced or metastatic non-small-cell lung cancer
Link  NICE TA609: Ramucirumab for treating unresectable hepatocellular carcinoma after sorafenib (terminated appraisal)
 
Razoxane  (Razoxin®)

View adult BNF View SPC online View childrens BNF
Non Formulary

Discontinued.

 
Rociletinib

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cytotoxic Drug  Sirolimus  (Rapamune®)

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Non Formulary
Black
High Cost Medicine

Not recommended for use in renal transplant patients as per NICE TA481 and TA482.

APCO November 2017.

Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
 
Sonidegib  (Odomzo®)

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Non Formulary
 
Cytotoxic Drug  Tegafur with Uracil  (Uftoral®)

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Non Formulary

Now discontinued.

Link  NICE TA61: Capcitabine and tegafur - Colorectal cancer
 
Temoporfin  (Foscan®)

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Non Formulary
 
Cytotoxic Drug  Temsirolimus  (Torisel®)

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Non Formulary
Black
High Cost Medicine
Cancer Drugs Fund

Not recommended for:

  • Treatment of advanced and/or metastatic renal cell carcinomas per NICE TA178 (APCO September 2009).
  • Treatment of relapsed or refractory mantle cell lymphoma (NICE TA 207 - terminated appraisal). APCO November 2010.

Link  NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma
 
Toremifene  (Fareston®)

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Non Formulary
 
Cytotoxic Drug  Trastuzumab emtansine  (Kadcyla®)

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Non Formulary
Black
High Cost Medicine

For the treatment of HER2-positive, unresectable locally advanced or metastatic breast cancer after treatment with trastuzumab and a taxane as per NICE TA371.

APCO January 2016.

 
Cytotoxic Drug  Vandetanib  (Caprelsa®)

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Non Formulary
Black
High Cost Medicine
Cancer Drugs Fund

Not recommended for treating medullary thyroid cancer as per NICE TA550.

APCO January 2019.

Link  NICE TA550: Vandetanib for treating medullary thyroid cancer
 
Cytotoxic Drug  Vindesine Sulphate  (Eldisine®)

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Non Formulary
 
Cytotoxic Drug  Vinflunine  (Javlor®)

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Non Formulary
Link  NICE TA272: Urothelial tract carcinoma (transitional cell, advanced, metastatic) - vinflunine
 
Cytotoxic Drug  Vismodegib  (Erivedge®)

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Non Formulary
Black
High Cost Medicine

Not recommended within its marketing authorisation for treating symptomatic metastatic basal cell carcinoma, or locally advanced basal cell carcinoma that is inappropriate for surgery or radiotherapy as per NICE TA489.

APCO January 2018.

Link  NICE TA489: Vismodegib for treating basal cell carcinoma
 
Vosaroxin  (Qinprezo)

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Non Formulary
High Cost Medicine
 
  
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

Red

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

Amber Shared Care Protocol

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO).   

Green

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

netFormulary