Pre-Reg Study Day

15
th
March 2014

GPhC Topic Learning Outcomes (Prescribing guidelines, data and formularies)

You must be able to demonstrate an understanding of
The purpose of prescribing guidelines and of data from pricing authorities including the
right to access confidential data
The purpose and use of local and national formularies
The sources of evidence used in the development of prescribing guidelines, data and
formularies
NHS limited list
Borderline substance list

TASK
You have 30 minutes to answer the following questions.
You may use your BNF.


Question 1 - Give THREE reasons why a pharmacist may need to use PACT data?
1.

2.

3.



Question 2 Use the data table below extracted from the 2012 PACT data for England to
answer the following questions regarding primary care prescriptions for penicillins?



Which penicillin (Primary Care prescribing)
Accounted for most NHS prescriptions?


Cost the NHS the most money?


Was the most expensive per prescription?


Had the highest percentage of items
prescribed as a proprietary (Class 2)
product?



Question 3 concerns prescribing guidelines and formularies
What is the definition of a
guideline?



Give 3 examples of prescribing
guidelines used nationally?
1


2


3


What is a formulary?



Give 3 reasons why a formulary
could improve patient care?
1


2


3


Give 3 reasons why a formulary
could worsen patient care?
1


2


3




Question 4 You have been asked to
be part of a team preparing a local
guideline for the treatment of
cellulitis in iv drug users.

Give 3 sources of information that
you would use when preparing your
guideline.
1


2


3



Question 5 concerns specific national prescribing guidelines
When is rivaroxaban recommended for use in NHS patients?








When is imatinib recommended for use in NHS patients?








On 24
th
February 2014, NICE issued TA306 which stated that Pixantrone monotherapy is
recommended as a possible treatment for multiply relapsed or refractory aggressive non-
Hodgkins B-cell lymphoma if: they have previously been treated with rituximab and they are
having third- or fourth-line treatment and the manufacturer provides pixantrone with the
discount agreed in the patient access scheme.

Mrs Cs oncologist determines that she meets the criteria for pixantrone and prescribes it on
15
th
March 2014. However, the Hospital Trust refuses the prescription. Is the Trust acting
lawfully?





In February 2014, NICE issued an updated draft for consultation of CG67 (Lipid modification)
which stated
1.3.15 Offer high-intensity statin treatment for the primary prevention of CVD to people
who have a 10% or greater 10-year risk of developing CVD. Estimate the level of risk using
the QRISK2 assessment tool
1.3.16 Offer atorvastatin 20mg for the primary prevention of CVD

Mr BP presents at your pharmacy NHS Health Check Clinic and you calculate his 10 year
cardiovascular risk to be 21% using an on-line JBS calculator and 8.7% using QRISK 2. His BP
is 135/85 and hes not diabetic. What treatment should Mr BP be offered?







Question 5 Explain the following terms Give 2 examples of products affected and
explain why?
NHS Blacklist 1


2


SLS 1


2


ACBS 1


2




Further Reading / References

Health and Social Care Information Centre Prescribing Data
http://www.hscic.gov.uk/prescribing

NICE
http://www.nice.org.uk/

Drug Tariff
http://www.ppa.org.uk/edt/March_2014/mindex.htm