Date June 2016
To: Practice Prescribing Leads
Practice Managers / Unit 1
St James Business Park
Grimbald Crag Court
Knaresborough
HG5 8QB
Re: Ropinirole MR
Dear Colleague,
For the June “Hints and Tips on Prescribing”, the Medicines Management Team is asking practices to review their prescribing of ropinirole MR (branded or generic) and consider switching patients where appropriate to Eppinix XL or an alternative branded generic with a low NHS cost price.
Background
Generic prescribing is recognised as a sign of good practice as well as generally being more cost effective. However, for generic ropinirole MR, the drug tariff price is based on the brand Requip XL and considerable savings can be made by prescribing as a low cost brand such as Eppinix XL.
In HaRD CCG the annual spend on ropinirole MR and Requip XL (based on April 15 – March 16 data) was £25.5k. The estimated potential savings if all patients are switched to a low cost brand is over £11k per annum. Local specialists are supportive of this change.
Cost per 28 tablets / 2mg / 3mg / 4mg / 6mg / 8mgRopinirole MR generic / £12.54 / - / £25.09 / - / £42.11
Requip XL / £12.54 / - / £25.09 / - / £42.11
Eppinix XL / £5.64 / £8.46 / £11.29 / £15.32 / £18.95
- preparation not available in that strength
Action Points
· Please share this information with all prescribers in your practice.
· Please review the prescribing of ropinirole MR (branded or generic) and consider switching patients where appropriate to Eppinix XL or an alternative branded generic with a low NHS cost price.
· When completing this work, please ensure that patients are on the least number of tablets possible to achieve the required dose, i.e. 1 x 8mg rather than 2 x 4mg.
· Prescribers are reminded of the need to check the manufacturer’s SPC for licensed indications, contraindications and other product specific details for any product they are changing a patient to. The content of SPCs change over time.
Additional information
The MMT reviewed available data of different ropinirole MR products and recommended Eppinix XL. Selected data is available below:
Ø The manufacturer of Eppinix XL (DB Ashbourne) states that Eppinix XL (ropinirole prolonged release) tablets are bioequivalent to Requip XL.
Ø Eppinix XL is also available in 3mg and 6 mg tablets, which may provide additional options during dose titration.
Weighted prescribing of Ropinirole MR in HaRD CCG (April 2015 – March 2016)
The prescribing support team is available to help to practices with this work if required.
Local community pharmacies have been e-mailed to inform them that practices will be undertaking this switch. As the timings of the switch will vary among practices it is advisable to notify local pharmacies in advance of the switch to enable effective management of stock.
HaRD versions of OptimiseRx and SystmOne and EMIS formularies will be amended to incorporate these recommendations.
Should you have any queries, recommendations or ideas about these or future initiatives then we would be pleased to hear from you.
Yours sincerely,
The Medicines Management Team, HaRD CCG.
References
BNF vol 70 September 2015
Department of Health Drug Tariff. June 2016.
Ropinerole MR
Monthly briefing/letter – June 16 Page 1 of 2 HaRD Medicines Management Team