Sheffield CCG Medicines Management Team:

Cost Effective Medication Switches(Based on Drug Tariff October 2017and Chemist and Druggist October 2017)

Changes this month: Addition/ of fluoxetine orodispersible sf tablets. Venlafaxine tablets removed. Reduced cost saving on Azathromycin capsules, Butec 15mcg added Carbociestine Sachets added, Rizatriptan 10mg oral lyophilisate s/f tabs pack size 3 removed.Dicycloverine alternative recommendation added.

Prescribed / Current Cost / Cost effective alternative / Current Cost / Saving Per Pack / Consider / better
Azithromycin 250mg capsules / £6.16
/6 / Azithromycin 250mg Tablets / £1.25
/4
£1.57
/6 / £4.29
/6
Butrans 5mcg/h patch and generic equivalent
Butrans 10mcg/h patch and generic equivalent
Butrans 20mcg/h patch and generic equivalent
Butrans 15mcg/h patch and generic
equivalnat / £17.60
/4
£31.55
/4
£57.46
/4
£49.15
/4 / Butec 5mcg/h patch
Butec 10mcg/h
Patch
Butec 20mcg/h patch
Butec 15mcg/h patch / £7.92
/4
£14.20
/4
£25.86
/4
£22.12
/4 / £9.68
£17.35
£31.60
£27.03
Carbocosteine 250mg/5ml Oral Solution / £8.39
/300ml / Carbociesteine 750mg/10ml S/F Sachets / £3.85
/15 / SF sachets £0.25/dose
Solution
£0.41/ 750mg dose
Co-Codamol 15/500mg Capsules / £7.85
/100 / Co-Codamol 15/500mg Tablets / £4.93
/100 / £2.92 / Is codeine still required?
Be mindful of gelatine content of capsules
Prescribed / Current Cost / Cost effective alternative / Current Cost / Saving Per Pack / Consider / better
Dicycloverine 10mg tablets
Dicycloverine 10mg/5ml Oral Solution
Dicycloverine 20mg tablets / £184.25
/100
£179.73
/120ml
£196.69 / Alternatives to consider
Alverine Citrate 120mg
Alverline Citrate 60mg
Mebeverine 135mg tablets
Peppermint Oil Mintec
Peppermint Oil Colpermin / £23.28
/60
£5.12
/100
£4.47
/100
£7.04
/100
£13.09
/100 / Current alternative treatments
/ CCG Pathway

Durogesic/Fentanyl 12mcg/h patch
Durogesic/Fentanyl 25mcg/h patch x5
Durogesic/Fentanyl 50mcg/h patch x5
Durogesic/Fentanyl 75mcg/h patch x5
Durogesic/Fentanyl 100mcg/h patch x5 / £12.59
/5
£17.99
/5
£33.66
/5
£46.99
/5
£57.86
/5 / Matrifen 12mcg/h patch
Matrifen 25mcg patch
Matrifen 50mcg/h patch
Matrifen 75mcg/h patch
Matrifen 100mcg/h patch / £7.52
/4
£10.76
/4
£20.12
/4
£28.06
/4
£34.57
/4 / £5.07
£7.23
£15.34
£18.93
£23.29 / Action sheet now available on MMTIS
Fluoxetine 20mg/5ml Solution Sugar Free 70ml, 14 day supply / £12.95 70ml x2
£25.90 / Fluoxetine 20mg Dispersible S/F tabs
Fluoxetine 20mg/5ml
Solution ( if sugar free not required) / £3.44
28
£2.58
70ml x2
£5.16 / £22.46
£20.74 / Consider for 10mg caps dose as are scored. Cost 10mg £62.34 saving £59.90
Prescribed
X Pack size / Current Cost / Pack Size / Cost effective alternative / Current Cost/ Pack Size / Saving Per Pack / Consider / better
Galantamine MR 24mg capsules
Galantamine MR 16mg capsules
Galantamine MR 8mg capsules / £79.80
/28
£64.90
/28
£51.88
/28 / Luventa XL 24mg capsules
x28
Luventa XL 16mg capsules
x28
Luventa XL 8mg capsules / £39.10
/28
£31.80
/28
£25.42
/28 / £40.70
£33.10
£26.46
Metronidazole Gel 0.75%
Zyomet gel
Metrosa gel
Metrosa gel
Metrogel gel / £12.00
£12.00
/30g
£19.90
/40
£22.63
/40g / Rozex Cream or Gel(30g)
Rosex Cream or Gel(40g) / £6.60
/30
£9.88
/40 / £5.40
£10.02
/30
£12.75
/40
Proctosedyl /Generic Cinchocaine HCl/HydrocortisoneOintment
Proctosedyl/Generic Cinchocaine HCl/Hydrocortisone Suppositories / £10.34
/30
£5.08
/12 / Scheriproct (cinchocaine/prednisolone)
Ointment
Scheriproct
(cinchocaine/prednisolone)
Suppositories / £3.23
/30
£1.52
/12 / £7.11
£3.56
Rivastigmine 4.6mg patches
Rivastigmine 9.5mg patches / £77.97
/30
£30.02
/30 / Alzest 4.6mg patches
Alzest 9.5mg patches / £35.10
/30
£19.97
/30 / 42.87
£10.05 / SPC states
after a minimum of four weeks of treatment, if well tolerated according to the treating physician, the dose of 4.6 mg/24 h should be increased to 9.5 mg/24 h. Note this change would normally be iniaitiated by the specialist
Rizatriptan 10mg oral lyophilisate s/f tabs
x6 / £26.74 / Rizatriptan 10mg orodispersible s/f tabs / £23.90
/2 x3 / £2.48
Prescribed
X Pack size / Current Cost / Pack Size / Cost effective alternative / Current Cost/ Pack Size / Saving Per Pack / Consider / better
Tolterodine MR 4mg capsules / £25.78
/28 / Neditol XL 4mg capsules / £12.89
/28 / £12.89 / Tolterodine plain release 2mg x56 £1.68 saving £24.10
Topiramate 25mg capsules
Topiramate 50mg capsules
(Exclude epilepsy) / £13.67
/60
£56.23
/60 / Topiramate 25mg tablets
Topiramate 50mg tablets / £1.44
/60
£1.52
/60 / £12.33
£54.71

Agreed by Sheffield CCG Medicines Management Team Operations Group

18th October 2017

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