Common use of Restricted Use Clause in Contracts

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol NHSE Xxxxxxx Pick disease Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ (Translarna® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol Gevokizumab () NHSE Xxxxxxx Pick disease Uveitis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary Hospital Gilteritinib Xospata® NHSE relapsed or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic refractory acute myeloid leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance TA642 – August 2020 Hospital Asciminib Scemblix® Givosiran Givlaari NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Hepatic porphyria Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 HST16 - Nov 2021 BLACK Glasdegib () NHSE with chemotherapy for untreated acute myeloid leukaemia (terminated appraisal) Not commissioned. No NHS prescribing in primary or secondary care TA646 – August 2022 September 2020 Hospital Asfotase alfa Strensiq® Glatiramer (Copaxone®) NHSE paediatric-onset hypophosphatasia Multiple Sclerosis - as per NICE TA 527 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 TA527 - Jun 18 Hospital Glecaprevir-pibrentasvir ▼ (Maviret® ▼) NHSE Chronic hepatitis C Restricted use – March 2023 Double Red Aspirin Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA499 - Jan 18 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance DM Glibenclamide (Various eg Daonil®, Euglucon®) ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin Type 2 diabetes mellitus Discontinued Medicines NICE has not issued any guidance. BLACK Gliclazide modified release (Diamicron® MR) ICB Primary prevention of CVD Type 2 diabetes mellitus Not commissioned. No NHS prescribing in T1 primary or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use secondary care NICE has not issued any guidance. Hospital Atacicept Glofitamab Columvi® NHSE relapsed or refractory diffuse large B- cell lymphoma after 2 or more systemic treatments Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA927 – October 2023 Hospital Glucarpidase (Voraxase) NHSE Systemic Lupus Erythematosus Urgent treatment of methotrexate- induced renal dysfunction in patients receiving high-dose MTX chemotherapy - as per NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. BLACK Glucocorticoids (SLEinc hydrocortisone, prednisolone) (Generics are available) ICB Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) - as per NICE CG 53 - Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG53 - Aug 07 BLACK Glucosamine (Various) ICB Osteoarthritis - as per NICE CG 177 - Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG177 - Feb 14 BLACK Glucosamine, Glucosamine & Chondroitin (Alateris and various) ICB Osteoarthritis Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. BLACK Gluten-free foods (Various) ICB Gluten sensitive enteropathies in all patients across N+W Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. Hospital Glycerol phenylbutyrate (Ravicti® 1.1 g/ml oral liquid) NHSE Urea cycle disorders (specialist use only) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ GlycoPEGylated Factor IX (Translarna® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir (ReyatazRebinyn®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Haemophilia B Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18.

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA29 - Sep 01 BLACK Fludarabine (Fludara®) NHSE B-cell Chronic Lymphocytic Leukaemia - 1st line treatment - as per NICE TA 119 Not commissioned. No NHS prescribing in primary or secondary care TA119 - Feb 07 ADVICE Fludroxycortide tape (previously Haelan) ICB Adjunctive therapy for chronic, localised, recalcitrant dermatoses that may respond to topical corticosteroids and particularly dry, scaling lesions Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation NICE has not issued any guidanceguidance BLACK Fludroxycortide tape (previously Haelan) ICB All unlicensed uses including hypertrophic scars and keloids Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Arimoclomol NHSE Xxxxxxx Pick disease Fluocinolone acetonide intravitreal implant (Iluvien®) ICB Treatment of chronic diabetic macular oedema after inadequate response to prior therapy - pseudophakic eye only - as per NICE TA 301 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA301 - Nov 13 Hospital Fluocinolone acetonide intravitreal implant (Iluvien®) ICB Recurrent non-infectious uveitis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA590 - Jul 19 BLACK Fluocinolone acetonide intravitreal implant (Iluvien®) ICB Chronic diabetic macular oedema insufficiently responsive to available therapies in an eye with a natural lens (phakic eye) Not commissioned. No NHS prescribing in primary or secondary care TA613 - Nov 2019 Hospital Fluoride supplements - Toothpaste; dental products (Duraphat 0.619% DPF; 1.1% DPF Toothpaste) ICB Prevention of dental caries in at-risk patients (where the specialist is a dentist) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole BLACK Folic acid (Abilify®Generics are available) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder Secondary prevention of MI / reduce cardiovsacular risk post MI - as per NICE CG 82 and TA 213 Formulary 172 - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products Do Not Do (Armour Thyroid) ICB Any indication Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance CG172 - June 2019 ADVICE Aromatase inhibitors Nov 13 BLACK Folic Acid (Various) (VariousGenerics are available) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women For preventing hypertensive disorders during pregnancy - as per local protocol Formulary NICE CG 107 - Specialist advice required from Do Not Do (Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 CG107 - Nov 06 Aug 10 Hospital Arsenic trioxide Fomepizole (TrisenoxAntizol®) NHSE Acute promyelocytic leukaemia ICB Methanol and ethylene glycol poisoning (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No Poison Centre prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLEonly) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Fondaparinux sodium (Translarna® ▼Arixtra®) NHSE Duchenne muscular dystrophy with a nonsense mutation Treatment of unstable angina or non- ST segment elevation myocardial infarction (UA/NSTEMI) in the dystrophin gene in people aged ≥5 years who can walk adults for whom urgent (< 120 mins) invasive management i.e. percutaneous coronary intervention (PCI) is not indicated - as per NHS England regional network policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 CG94 - Feb 2023 Hospital Atazanavir (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18Mar 10

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA29 - Sep 01 BLACK Fludarabine (Fludara®) NHSE B-cell Chronic Lymphocytic Leukaemia - 1st line treatment - as per NICE TA 119 Not commissioned. No NHS prescribing in primary or secondary care TA119 - Feb 07 ADVICE Fludroxycortide tape (previously Haelan) ICB Adjunctive therapy for chronic, localised, recalcitrant dermatoses that may respond to topical corticosteroids and particularly dry, scaling lesions Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation NICE has not issued any guidanceguidance BLACK Fludroxycortide tape (previously Haelan) ICB All unlicensed uses including hypertrophic scars and keloids Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Arimoclomol NHSE Xxxxxxx Pick disease Fluocinolone acetonide intravitreal implant (Iluvien®) ICB Recurrent non-infectious uveitis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA590 - Jul 19 Hospital Fluocinolone acetonide intravitreal implant (Iluvien®) ICB chronic diabetic macular oedema Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA953 – March 2024 Hospital Fluoride supplements - Toothpaste; dental products (Duraphat 0.619% DPF; 1.1% DPF Toothpaste) ICB Prevention of dental caries in at-risk patients (where the specialist is a dentist) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole BLACK Folic acid (Abilify®Generics are available) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder Secondary prevention of MI / reduce cardiovsacular risk post MI - as per NICE CG 82 and TA 213 Formulary 172 - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products Do Not Do (Armour Thyroid) ICB Any indication Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance CG172 - June 2019 ADVICE Aromatase inhibitors Nov 13 BLACK Folic Acid (Various) (VariousGenerics are available) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women For preventing hypertensive disorders during pregnancy - as per local protocol Formulary NICE CG 107 - Specialist advice required from Do Not Do (Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 CG107 - Nov 06 Aug 10 Hospital Arsenic trioxide Fomepizole (TrisenoxAntizol®) NHSE Acute promyelocytic leukaemia ICB Methanol and ethylene glycol poisoning (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No Poison Centre prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLEonly) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Fondaparinux sodium (Translarna® ▼Arixtra®) NHSE Duchenne muscular dystrophy with a nonsense mutation Treatment of unstable angina or non- ST segment elevation myocardial infarction (UA/NSTEMI) in the dystrophin gene in people aged ≥5 years who can walk adults for whom urgent (< 120 mins) invasive management i.e. percutaneous coronary intervention (PCI) is not indicated - as per NHS England regional network policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 CG94 - Feb 2023 Hospital Atazanavir Mar 10 BLACK Fondaparinux sodium (ReyatazArixtra®) NHSE HIV infection Prophylaxis of venous thromboembolism in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with those undergoing major orthopaedic surgery of the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy legs - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist serviceDoNotDo recommendation Not commissioned. No NHS prescribing in primary or secondary care TA520 NG89 - May Mar 18

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol Factor X (Coagadex) NHSE Xxxxxxx Pick disease Hereditary factor X deficiency Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® Factor XIII NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE) Specialist indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ FactorR VIII Inhibitor Bypassing Factor (Translarna® ▼FEIBA) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Specialist indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir NICE has not issued any guidance. BLACK Fampridine (ReyatazFampyra®) NHSE HIV infection Improvement of walking in combination adults with other antiretroviral drugs Multiple Sclerosis with walking disability (EDSS 4-7) - as per BHIVA Guidelines NHS England policy Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. BLACK Farco-fill Protect ICB Indwelling urinary catheterisation Not commissioned. No NHS prescribing in primary or secondary care MIB 121 – September 2017 Hospital Faricimab Vabysmo® ICB diabetic macular oedema Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA799 – June 2022 Hospital Faricimab Vabysmo® ICB wet age-related macular degeneration Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA800 – June 2022 GREEN Febuxostat (Adenuric®) ICB Management of chronic hyperuricaemia in patients with gout who are intolerant of allopurinol - as per NICE TA 164 Formulary - Drugs that can be initiated by Prescriber in Primary Care TA164 - Dec 08 Hospital Fedratinib Inrebic® NHSE disease-related splenomegaly or symptoms in myelofibrosis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA756 – December 2021 Hospital Fenfluramine Fintepla® NHSE seizures associated with Dravet syndrome Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA808 – July 2022 Double Red Fenofibrate (Lipantil®; Supralip®; Cholib®) ICB Prevention of CVD - as per NICE CG 181 "Do Not Do" (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Double Red Fentanyl I-R - buccal tabs, loz, nasal sprays (Effentora®, Actiq®, Instanyl®, PecFent®) ICB (Acute) breakthrough pain in cancer Not recommended for routine use CG140 - July 12 Hospital Fentanyl I-R sublingual tabs (Abstral®) (Abstral®) ICB 3rd line option for (Acute) breakthrough pain in cancer as part of an agreed pathway of care Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Ferric maltol (Feraccru®) (Feraccru®) ICB Treatment of iron-deficiency anaemia in adults (see separate Red entry regarding use in IBD) Not recommended for routine use NICE has not issued any guidance. Hospital Ferric maltol (Feraccru®) (Feraccru®) ICB Treatment of iron-deficiency anaemia in adults with Inflammatory Bowel Disease that are intolerant of at least 2 other oral iron products Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. GREEN Fesoterodine M-R (Toviaz®) ICB Increased urinary frequency and/or urgency and/or urgency incontinence) in Overactive Bladder Syndrome Formulary - Drugs that can be initiated by Prescriber in Primary Care CG171 - Oct 06 Hospital Fibrin sealants (Fibrin sealants) NHSE Haemostatic / tissue glue Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat Fibrinogen, dried (Evotaz®Human) () NHSE HIV infection Treatment of haemorrhage in combination with other antiretroviral drugs congenital hypofibrinogenaemia or afibrinogenaemia - as per BHIVA BCSH guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab Fibroblast growth factor 1 (Tecentriq®FGF1) gene therapy () NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 All indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 NICE has not issued any guidance. ADVICE Fidaxomicin (Dificlir®) ICB Treatment of mild to moderate C. difficile infection (CDI) in patients who have had two previous episodes in the last 3 months under consultant microbiologist recommendation - May 18as per local policy Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Filgotinib Jyseleca®) ICB Moderate to severe rheumatoid arthritis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA676 – February 2021 Hospital Filgotinib () NHSE Paediatric indications (where adult TA available) - specialist centres only Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Filgotinib Jyseleca® ICB moderately to severely active ulcerative colitis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA792 – June 2022 Hospital Filgrastim () NHSE Xxxxx Syndrome - specialist centres only Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Filgrastim (Various ▼) NHSE Reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Filibuvir () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. BLUE Finerenone Kerendia® ICB chronic kidney disease in type 2 diabetes NWICB are committed to fund positive NICE TA treatments. Awaiting clarification of place in pathway and commissioning arrangements. Further guidance will be issued when available. For all other treatments, formulary application and discussion will be required TA877- March 2023 Hospital Fingolimod ▼ (Gilenya® ▼) NHSE Highly active relapsing remitting multiple sclerosis as per NICE TA 254 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA254 - Apr 12

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance GREEN Heparin - Low Molecular Weight (LMWH) (Various) ICB DVT (if suspected out of hours - first dose only) Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Hospital Arimoclomol NHSE Xxxxxxx Pick disease Heparin - Low Molecular Weight (LMWH) (Various) ICB Unstable angina/coronary artery disease/NSTEMI Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole AMB 2 Heparin - Low Molecular Weight (Abilify®LMWH) (currently under review) (Various) ICB Moderate to severe manic episodes For patients requiring long term anticoagulation in adolescents with bipolar I disorder whom warfarin is contraindicated or inappropriate Shared Care Agreement Level 2 - Prescribe the drug and perform a more intense level of monitoring, e.g. quarterly NICE has not issued any guidance. Double Red Heparinised saline (Saline (heparinised)) ICB Central venous catheter lock in adults - as per RMOC guidance (Feb 2019) Not recommended for routine use NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) has not issued any guidance. BLACK Heparinoid Cream / Gel Hirudoid 0.3%, Bruiseze 0.8%, Lasonil ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Improving circulation in bruising, superficial thrombophlebitis, chilblains, varicose veins Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors NICE has not issued any guidance. OTC Herbal medicines / supplements incl St John's Wort (Various) (Various, including St John's Wort) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women All uses (Not a licensed indication). Available to buy over the counter CG90 - Oct 09 BLACK HGH - Saizen®, Zomacton®, Nordiflex®, Nutropin® Aq (Saizen®, Zomacton®, Nordiflex®, Nutropin Aq) ICB Growth hormone deficiency (GHD) - as per local protocol Formulary - Specialist advice required from East of England PAC policy Not commissioned. No NHS prescribing in primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 NICE has not issued any guidance. Hospital Arsenic trioxide HIV vaccine (Trisenox®HIV vaccine) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 HIV infection prophylaxis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva NICE has not issued any guidance. Hospital HIV/AIDS treatments (Various) NHSE HIV infection / post exposure prophylaxis (PEP) Restricted use – Prescribing to remain with the hospital or salivary stimulants specialist service. No prescribing in primary care NICE has not issued any guidance. OTC Homeopathy (Xerotin Oral spray or other cost- effective productVarious) ICB Xerostomia from Various (Not a licensed indication). Available to buy over the counter NICE has not issued any cause where simple measures alone have been ineffective Formulary guidance. BLACK Hormone Replacement Therapy (HRT) - Drugs that can be initiated by Prescriber systemic (Various) ICB Treatment of urinary incontinence - as per NICE CG 171 - NICE Do Not Do (Not a licensed indication). Not commissioned. No NHS prescribing in Primary Care primary or secondary care CG171 - Nov 15 NF HRT implants (Various) ICB Hormone replacement therapy Non-formulary NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® Human alpha-1 proteinase inhibitor NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Emphysema Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. BLACK Human alpha1- proteinase inhibitor N/A emphysema Not commissioned. No NHS prescribing in primary or secondary care TA965 – March 2024 Hospital Atacicept Human heterologous liver cells (HHLivC) (Heparesc®) NHSE Systemic Lupus Erythematosus (SLE) Urea cycle disorders Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Human Normal Immunoglobulin (Translarna® ▼Aragam®) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir (ReyatazAragam®) NHSE HIV infection in combination with other antiretroviral drugs As per National Demand Management Plan - as per BHIVA Guidelines NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat Human Normal Immunoglobulin (EvotazFlebogamma®) (Flebogamma®) NHSE HIV infection in combination with other antiretroviral drugs - as As per BHIVA guidelines National Demand Management Plan Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab Human normal immunoglobulin (TecentriqGammagard®) (Gammagard®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy As per National Demand Management Plan - as per NICE TA 520 NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 NICE has not issued any guidance. Hospital Human normal immunoglobulin (Gammanorm®) (Gammanorm®) NHSE As per National Demand Management Plan - May 18NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Human normal immunoglobulin (Gammaplex®) (Gammaplex®) NHSE As per National Demand Management Plan - NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Human normal immunoglobulin (Gamunex®) (Gamunex®) NHSE As per National Demand Management Plan - NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Human Normal Immunoglobulin (Hizentra) (Hizentra®) NHSE As per National Demand Management Plan - NHSE policy Plan - NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance.

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. TA47 - Sep 02 Hospital Arimoclomol NHSE Xxxxxxx Pick disease Eptinezumab VYEPTI® ICB preventing migraine Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole TA871 – March 2023 Hospital Eptotermin alfa (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Complex spinal surgery Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance GREEN Erectile dysfunction drugs (Various) ICB Erectile dysfunction - limited categories of patients under SLS for certain drugs Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Erectile dysfunction drugs (Various) ICB Severe distress from erectile dysfunction seeking treatment on the NHS Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 NICE has not issued any guidance. BLUE Erenumab Aimovig® ICB Preventing migraine NWICB are committed to fund positive NICE TA treatments. Awaiting clarification of place in pathway and commissioning arrangements. Further guidance will be issued when available. For all other treatments, formulary application and discussion will be required TA682 – August 2022 March 2021 Hospital Asfotase alfa Strensiq® Eribulin (Halaven®) NHSE paediatric-onset hypophosphatasia Locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens only when it has progressed after at least 2 chemotherapy regimens (which may include an anthracycline or a taxane, and capecitabine) - as per NICE TA 423 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin TA423 - Dec 16 Hospital Eribulin (Halaven®) ICB Primary prevention NHSE Treatment of CVD in T1 locally advanced or T2 Diabetes metastatic breast cancer - as per NG17 NICE TA 423 and NG 28 Do Not Do's Not recommended for routine NHS England policy Restricted use NG17 – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA423 - May 17 Double Red Aspirin Dec 16 BLACK Eribulin (Halaven®) ICB Primary prevention of CVD in T1 NHSE Locally advanced or T2 Diabetes metastatic breast cancer after 1 chemotherapy regimen - as per NG17 NICE TA 515 Not commissioned. No NHS prescribing in primary or secondary care TA515 - Mar 18 BLACK Erlotinib (Tarceva®) NHSE Monotherapy for maintenance treatment of non-small-cell lung cancer - as per NICE TA 227 and NG 28 Do NHS England policy Not Do's commissioned. No NHS prescribing in primary or secondary care TA227 - Jun 11 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Erlotinib (Tarceva®) NHSE First-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer - as per NICE TA 258 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA258 - Jun 12 BLACK Erlotinib (Tarceva®) NHSE Treatment of non-small-cell lung cancer (NSCLC) as per NICE TA 374 - as per NHS England policy Not recommended commissioned. No NHS prescribing in primary or secondary care TA374 - Dec 15 BLACK Erlotinib (Tarceva®) NHSE Treating locally advanced or metastatic NSCLC that doesn’t test positive for routine use NG28 - May 17 Double Red Asunaprevir the EGFR TK mutation (with Daclatasviras per NICE TA 374) (Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care TA374 - Dec 15 ADVICE Ertugliflozin (Steglatro®) NHSE Viral Hepatitis ICB As monotherapy or with metformin for treating type 2 diabetes - as per NICE TA 572 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA572 - Mar 19 GREEN Ertugliflozin (B&CSteglatro®) ICB With metformin and Respiratory Syncytial Virus Not recommended a depeptidyl peptidase-4 inhibitor for routine Type 2 diabetes Formulary - Drugs that can be initiated by Prescriber in Primary Care TA583 - Jun 19 Hospital Erythropoietin (epoetin / darbepoetin) (Various) ICB Treatment of anaemia in people with cancer having chemotherapy - as per NICE TA 323 and NHS England policy Restricted use NICE has not issued any guidance– Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA323 - Nov 14 Hospital Atacicept Erythropoietin / Epoetin (Eprex) NHSE Systemic Lupus Erythematosus (SLE) ICB Treatment of transfusion-dependent anaemia in myelodysplasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Erythropoietin / Epoetin (TranslarnaEprex®, NeoRecormon® ▼and others) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Dialysis-induced anaemia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 CG114 - Feb 2023 Hospital Atazanavir Nov 11 Double Red Erythropoietin / Epoetin (ReyatazEprex®, NeoRecormon® and others) NHSE HIV infection ICB Anaemia in combination with other antiretroviral drugs renal failure pre-dialysis. Not recommended for routine use NG8 - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist serviceJun 15 BLACK Esketamine Spravato® ICB nasal spray for treatment-resistant depression Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use TA854 – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18December 2022

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidanceTA47 - Sep 02 Hospital Eptinezumab VYEPTI® ICB preventing migraine Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA871 – March 2023 Hospital Arimoclomol Eptotermin alfa () NHSE Xxxxxxx Pick disease Complex spinal surgery Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole Traffic Light Classification Drug Name Brand Name Commissione r Indication (Abilifyassume licenced unless stated) Instructions for Prescriber NICE Guidance GREEN Erectile dysfunction drugs (Various) ICB Erectile dysfunction - limited categories of patients under SLS for certain drugs Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Hospital Erectile dysfunction drugs (Various) ICB Severe distress from erectile dysfunction seeking treatment on the NHS Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. BLUE Erenumab Aimovig® ICB Preventing migraine NWICB are committed to fund positive NICE TA treatments. Awaiting clarification of place in pathway and commissioning arrangements. Further guidance will be issued when available. For all other treatments, formulary application and discussion will be required TA682 – March 2021 Hospital Eribulin (Halaven®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder NHSE Locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens only when it has progressed after at least 2 chemotherapy regimens (which may include an anthracycline or a taxane, and capecitabine) - as per NICE TA 292 423 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA423 - Dec 16 Hospital Eribulin (Halaven®) NHSE Treatment of locally advanced or metastatic breast cancer - as per NICE TA 423 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA423 - Dec 16 BLACK Eribulin (Halaven®) NHSE Locally advanced or metastatic breast cancer after 1 chemotherapy regimen - as per NICE TA 515 Not commissioned. No NHS prescribing in primary or secondary care TA515 - Mar 18 BLACK Erlotinib (Tarceva®) NHSE Monotherapy for maintenance treatment of non-small-cell lung cancer - as per NICE TA 227 and NHS England policy Not commissioned. No NHS prescribing in primary or secondary care TA227 - Jun 11 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Erlotinib (Tarceva®) NHSE First-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer - as per NICE TA 258 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA258 - Jun 12 BLACK Erlotinib (Tarceva®) NHSE Treatment of non-small-cell lung cancer (NSCLC) as per NICE TA 374 - as per NHS England policy Not commissioned. No NHS prescribing in primary or secondary care TA374 - Dec 15 BLACK Erlotinib (Tarceva®) NHSE Treating locally advanced or metastatic NSCLC that doesn’t test positive for the EGFR TK mutation (as per NICE TA 374) (Not a licensed indication). Not commissioned. No NHS prescribing in primary or secondary care TA374 - Dec 15 ADVICE Ertugliflozin (Steglatro®) ICB As monotherapy or with metformin for treating type 2 diabetes - as per NICE TA 572 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 TA572 - Jul 13 ADVICE Aripiprazole Mar 19 GREEN Ertugliflozin (AbilifySteglatro®) ICB Schizophrenia With metformin and bipolar mood disorder - as per NICE CG 82 and TA 213 a depeptidyl peptidase-4 inhibitor for Type 2 diabetes Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 Drugs that can be initiated by Prescriber in Primary Care TA583 - Mar 09 BLACK Armour Thyroid Jun 19 Hospital Erythropoietin (epoetin / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Variousdarbepoetin) (Various) ICB Adjuvant hormonal treatment Treatment of early oestrogen-receptor-positive breast anaemia in people with cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults having chemotherapy - as per NICE TA 526 323 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 TA323 - Jun 18 GREEN Artificial saliva or salivary stimulants Nov 14 Hospital Erythropoietin / Epoetin (Xerotin Oral spray or other cost- effective productEprex) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber Treatment of transfusion-dependent anaemia in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE) myelodysplasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Erythropoietin / Epoetin (TranslarnaEprex®, NeoRecormon® ▼and others) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Dialysis-induced anaemia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 CG114 - Feb 2023 Hospital Atazanavir Nov 11 Double Red Erythropoietin / Epoetin (ReyatazEprex®, NeoRecormon® and others) NHSE HIV infection ICB Anaemia in combination with other antiretroviral drugs renal failure pre-dialysis. Not recommended for routine use NG8 - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist serviceJun 15 BLACK Esketamine Spravato® ICB nasal spray for treatment-resistant depression Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use TA854 – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18December 2022

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol Eculizumab (Soliris®) NHSE Xxxxxxx Pick disease Atypical haemolytic uremic syndrome (aHUS) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST1 - Jan 2015 Hospital Edasalonexent NHSE Duchenne muscular dystrophy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole Edoxaban ▼ (Abilify®Lixiana® ▼) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - Treatment and secondary prevention of pulmonary embolism as per NICE TA 292 354 (where warfarin is not appropriate - see Full Guidance) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 TA354 - Jul 13 Aug 15 ADVICE Aripiprazole Edoxaban ▼ (Abilify®Lixiana® ▼) ICB Schizophrenia Treatment and bipolar mood disorder - as per NICE CG 82 and TA 213 prevention of proximal deep vein thrombosis in specified patient groups (see Full Guidance) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 Consultant/Specialist should prescribe for an initial period of 3 weeks. TA354 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products Aug 15 Hospital Edoxaban ▼ (Armour ThyroidLixiana® ▼) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors Treatment of calf vein deep vein thrombosis (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE354) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren TA354 - Aug 15 GREEN Edoxaban ▼ (TranslarnaLixiana® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene ICB For preventing stroke and systemic embolism in people aged ≥5 years with non valvular atrial fibrillation who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital have one or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir more risk factors (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing 355) Formulary - Drugs that can be initiated by Prescriber in primary care TA520 Primary Care TA355 - May 18Sep 15

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol NHSE Xxxxxxx Pick disease Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ (Translarna® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol NHSE Xxxxxxx Pick disease Bevacizumab (Avastin®) ICB Radiation retinopathy macular oedema Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole Hospital Bexarotene (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (TrisenoxTargretin®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 All indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication Double Red Bezafibrate (assume licensed unless statedBezalip; Fibrazate) Instructions ICB Prevention of CVD - as per NICE CG 181 "Do Not Do" Not recommended for Prescriber NICE Guidance routine use CG181 - Jul 14 BLACK Bezlotoxumab (Zinplava®) ICB Prevention of recurrent clostridium difficile infection (terminated appraisal) Not commissioned. No NHS prescribing in primary or secondary care TA601 - Sep 19 Hospital Asciminib Scemblix® Bictecravir (in combination with emtricitabine and tenofivir alafenamide) Biktarvy ®) NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors HIV Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 NICE has not issued any guidance. Hospital Asfotase alfa Strensiq® Bimagrumab ((BYM338)) NHSE paediatric-onset hypophosphatasia Inclusion body myositis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept Bimekizumab Bimzelx® ICB active psoriatic arthritis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA916 – October 2023 Hospital Bimekizumab Bimzelx® ICB axial spondyloarthritis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA918 – October 2023 Hospital Bimekizumab Bimzelx® ICB moderate to severe plaque psoriasis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA723 – September 2021 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Binimetinib (Mektovi®) NHSE (with encorafenib (Braftovi®)) for treating unresectable or metastatic BRAF V600 mutation-positive melanoma in adults - as per NICE TA 562 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA562 - Feb 19 BLACK Bioidentical HRT (Bioidentical hormone replacement therapy) ICB Menopausal symptoms Not commissioned. No NHS prescribing in primary or secondary care NG23 - Nov 13 Hospital Biotin (vitamin H) (Qizenday®, Cerenday®, MD1003) NHSE various Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Birch bark extract n/a NHSE epidermolysis bullosa Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST28 – September 2023 Hospital Bivalirudin (Angiox®) ICB Treatment of ST-segment-elevation myocardial infarction - as per NICE TA 230 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA230 - Jul 11 Hospital Blinatumomab (Blincyto®) NHSE Acute lymphoblastic leukaemia in remission with minimal residual disease activity Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA589 - Jul 19 BLACK Blinatumomab N/A NHSE previously treated Philadelphia- chromosome-positive acute lymphoblastic leukaemia (terminated appraisal) Not commissioned. No NHS prescribing in primary or secondary care TA686 – March 2021 Hospital Blinatumomab ▼ (Blincyto® ▼) NHSE Philadelphia-chromosome-negative relapsed or refractory precursor B-cell acute lymphoblastic leukaemia in adults - as per NICE TA 450 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA450 - Jun 17 Hospital Blisibimod () NHSE Systemic Lupus Erythematosus lupus erythematosus (SLE) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ (Translarna® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 - May 18.

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Clomethiazole (Heminevrin®) PHE Community-based assisted alcohol withdrawal - as per NICE CG 115 - Do Not Do Not recommended for routine use CG115 - Feb 11 GREEN Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Prevention of atherosclerotic events Formulary - Drugs that can be initiated by Prescriber in Primary Care TA210 - Dec 10 Hospital Arimoclomol NHSE Xxxxxxx Pick disease Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Prophylaxis pre-elective PCI Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir ADVICE Clopidogrel (with Daclatasvirlow dose aspirin) (Plavix®, generics approved for use - Sept 2009) NHSE Viral Hepatitis ICB Acute Coronary Syndrome without ST- segment elevation (B&CNSTEMI) and Respiratory Syncytial Virus (with aspirin) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant responsible for the first script. TA80 - Jul 04 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance ADVICE Clopidogrel (with low dose aspirin) (Plavix®, generics approved for use - Sept 2009) ICB Post elective percutaneous coronary intervention (PCI) - bare metal stent (Not recommended a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant should prescribe for routine an initial period of in-patient stay. NICE has not issued any guidance. ADVICE Clopidogrel (with low dose aspirin) (Plavix®, generics approved for use - Sept 2009) ICB ST-elevation myocardial infarction (STEMI) (Not a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant should prescribe for an initial period of in patient stay; max one month. NICE has not issued any guidance. Hospital Atacicept Clozapine (Clozaril®, Denzapine®, Zaponex®) ICB Schizophrenia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care CG82 - Mar 09 Hospital Cobicistat ▼ (Tybost® ▼) NHSE Systemic Lupus Erythematosus Use as a booster in treatment of HIV positive adults and adolescents - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. BLACK Cobimetinib ▼ (SLEin combination with vemurafenib) (Cotellic® ▼) NHSE Unresectable or metastatic BRAF V600 mutation-positive melanoma - as per NICE TA 414 Not commissioned. No NHS prescribing in primary or secondary care TA414 - Oct 16 Hospital Co-careldopa intestinal gel (Duodopa® ▼) NHSE Severe Xxxxxxxxx'x disease inadequately controlled by other preparations - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Cochlear implants (Translarna® ▼Various) NHSE Duchenne muscular dystrophy For children and adults with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk severe to profound deafness - specialist commissioned use only as per NHS England NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 TA566 - Feb 2023 Hospital Atazanavir Mar 19 Double Red Codeine linctus generic ICB Cough suppressant Not recommended for routine use NICE has not issued any guidance Traffic Light Classification Drug Name Brand Name Commissione r Indication (Reyataz®assume licensed unless stated) NHSE HIV infection in combination with other antiretroviral drugs Instructions for Prescriber NICE Guidance BLACK Co-enzyme Q10 (Healthcrafts, Nature's Best, Lamb, Natrahealth etc) ICB All indications - as per BHIVA Guidelines NICE NG 71 & CG181 Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG181 - Jul 17 BLACK Co-enzyme Q11 (Healthcrafts, Nature's Best, Lamb, Natrahealth etc) ICB All indications - as per NICE NG 71 & CG181 Do Not Do Not commissioned. No NHS prescribing in primary or secondary care NG71 -Sep 17 GREEN Colecalciferol (Vitamin D) (Licensed Vitamin D products) ICB Treatment of vitamin D deficiency in adults and children - as per local policies Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. BLACK Colecalciferol (Vitamin D) (Various) ICB To increase adherence to statin treatment - as per NICE CG 181 - Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG181 - Jul 14 ADVICE Colesevelam HCl (Cholestagel®) ICB Third-line option for (unlicensed) use in bile salt malabsorption causing diarrhoea (for patients under the NNUH only) (Not a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant/Specialist should prescribe for an initial period of 8 weeks (for new patients). NICE has not issued any guidance. Double Red Colesevelam HCl ▼ (Cholestagel® ▼) ICB Hypercholesterolaemia - as per NICE CG 181 Do Not Do Not recommended for routine use CG181 - Jul 14 Double Red Colesevelam hydrochloride (Cholestagel®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do Not recommended for routine use CG181 - Jul 14 Hospital Colestilan () NHSE Management of hyperphosphataemia in adults on renal dialysis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Colestipol hydrochloride (Colestid®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Double Red Colestyramine (Questran®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Atazanavir and Cobicistat Colistimethate sodium (Evotaznebulised) (Colomycin®, Promixin®) NHSE HIV Pseudomonas lung infection in combination with other antiretroviral drugs Cystic Fibrosis (new patients from 1st April 2013) - as per BHIVA guidelines NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA276 - Mar 13 AMB Colistimethate sodium (Nebulised) (Colomycin®, Promixin®) ICB Ps. aeurginosa infection in non-Cystic Fibrosis bronchiectasis Prescribe the drug and perform a basic level of monitoring, e.g. a standard annual review NICE has not issued any guidance. Hospital Atezolizumab Colistimethate sodium Dry Powder Inhaler (Tecentriq®Colobreathe® Dry Powder Inhaler) NHSE Locally advanced or metastatic non- small-cell Pseudomonas lung cancer after chemotherapy infection in cystic fibrosis - as per NICE TA 520 276 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 TA276 - May 18Mar 13 DM Collagenase clostridium histolyticum (Xiapex®) ICB Dupuytren's contracture with a palpable cord in adults - as per NICE TA 459 Discontinued Medicines TA459 - Jul 17 DM Collagenase Clostridium Histolyticum (Xiapex®) ICB Peyronie’s Disease Discontinued Medicines NICE has not issued any guidance. BLACK Combination analgesics with caffeine () ICB Pain relief Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance.

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol Eculizumab (Soliris®) NHSE Xxxxxxx Pick disease Atypical haemolytic uremic syndrome (aHUS) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST1 - Jan 2015 Hospital Edasalonexent NHSE Duchenne muscular dystrophy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole Edoxaban ▼ (Abilify®Lixiana® ▼) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - Treatment and secondary prevention of pulmonary embolism as per NICE TA 292 354 (where warfarin is not appropriate - see Full Guidance) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 TA354 - Jul 13 Aug 15 ADVICE Aripiprazole Edoxaban ▼ (Abilify®Lixiana® ▼) ICB Schizophrenia Treatment and bipolar mood disorder - as per NICE CG 82 and TA 213 prevention of proximal deep vein thrombosis in specified patient groups (see Full Guidance) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 Consultant/Specialist should prescribe for an initial period of 3 weeks. TA354 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products Aug 15 Hospital Edoxaban ▼ (Armour ThyroidLixiana® ▼) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors Treatment of calf vein deep vein thrombosis (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE354) Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren TA354 - Aug 15 GREEN Edoxaban ▼ (TranslarnaLixiana® ▼) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene ICB For preventing stroke and systemic embolism in people aged ≥5 years with non valvular atrial fibrillation who can walk - have one or more risk factors (as per NHS England policy Restricted NICE TA 355) Formulary - Drugs that can be initiated by Prescriber in Primary Care TA355 - Sep 15 Double Red Edoxaban ▼ (Lixiana® ▼) ICB Combined use – Prescribing to remain with the hospital or specialist service. No prescribing with dual antiplatelet therapy in primary care HST22 - Feb 2023 Hospital Atazanavir (Reyataz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA Guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat (Evotaz®) NHSE HIV infection in combination with other antiretroviral drugs - as per BHIVA guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab (Tecentriq®) NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy people who otherwise need anticoagulation, who have had an MI - as per NICE TA 520 Restricted CG 172 - Do Not Do (Not a licensed indication). Not recommended for routine use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 CG172 - May 18Nov 13

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Arimoclomol Factor X (Coagadex) NHSE Xxxxxxx Pick disease Hereditary factor X deficiency Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® Factor XIII NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin () ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir (with Daclatasvir) () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. Hospital Atacicept () NHSE Systemic Lupus Erythematosus (SLE) Specialist indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ FactorR VIII Inhibitor Bypassing Factor (Translarna® ▼FEIBA) NHSE Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk - as per NHS England policy Specialist indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 - Feb 2023 Hospital Atazanavir NICE has not issued any guidance. BLACK Fampridine (ReyatazFampyra®) NHSE HIV infection Improvement of walking in combination adults with other antiretroviral drugs Multiple Sclerosis with walking disability (EDSS 4-7) - as per BHIVA Guidelines NHS England policy Not commissioned. No NHS prescribing in primary or secondary care NICE has not issued any guidance. BLACK Farco-fill Protect ICB Indwelling urinary catheterisation Not commissioned. No NHS prescribing in primary or secondary care MIB 121 – September 2017 Hospital Faricimab Vabysmo® ICB diabetic macular oedema Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA799 – June 2022 Hospital Faricimab Vabysmo® ICB wet age-related macular degeneration Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA800 – June 2022 GREEN Febuxostat (Adenuric®) ICB Management of chronic hyperuricaemia in patients with gout who are intolerant of allopurinol - as per NICE TA 164 Formulary - Drugs that can be initiated by Prescriber in Primary Care TA164 - Dec 08 Hospital Fedratinib Inrebic® NHSE disease-related splenomegaly or symptoms in myelofibrosis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA756 – December 2021 Hospital Fenfluramine Fintepla® NHSE seizures associated with Dravet syndrome Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA808 – July 2022 Double Red Fenofibrate (Lipantil®; Supralip®; Cholib®) ICB Prevention of CVD - as per NICE CG 181 "Do Not Do" (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Double Red Fentanyl I-R - buccal tabs, loz, nasal sprays (Effentora®, Actiq®, Instanyl®, PecFent®) ICB (Acute) breakthrough pain in cancer Not recommended for routine use CG140 - July 12 Hospital Fentanyl I-R sublingual tabs (Abstral®) (Abstral®) ICB 3rd line option for (Acute) breakthrough pain in cancer as part of an agreed pathway of care Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Ferric maltol (Feraccru®) (Feraccru®) ICB Treatment of iron-deficiency anaemia in adults (see separate Red entry regarding use in IBD) Not recommended for routine use NICE has not issued any guidance. Hospital Ferric maltol (Feraccru®) (Feraccru®) ICB Treatment of iron-deficiency anaemia in adults with Inflammatory Bowel Disease that are intolerant of at least 2 other oral iron products Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. GREEN Fesoterodine M-R (Toviaz®) ICB Increased urinary frequency and/or urgency and/or urgency incontinence) in Overactive Bladder Syndrome Formulary - Drugs that can be initiated by Prescriber in Primary Care CG171 - Oct 06 Hospital Fibrin sealants (Fibrin sealants) NHSE Haemostatic / tissue glue Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atazanavir and Cobicistat Fibrinogen, dried (Evotaz®Human) () NHSE HIV infection Treatment of haemorrhage in combination with other antiretroviral drugs congenital hypofibrinogenaemia or afibrinogenaemia - as per BHIVA BCSH guidelines Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Atezolizumab Fibroblast growth factor 1 (Tecentriq®FGF1) gene therapy () NHSE Locally advanced or metastatic non- small-cell lung cancer after chemotherapy - as per NICE TA 520 All indications Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 NICE has not issued any guidance. ADVICE Fidaxomicin (Dificlir®) ICB Treatment of mild to moderate C. difficile infection (CDI) in patients who have had two previous episodes in the last 3 months under consultant microbiologist recommendation - May 18as per local policy Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Filgotinib Jyseleca®) ICB Moderate to severe rheumatoid arthritis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA676 – February 2021 Hospital Filgotinib () NHSE Paediatric indications (where adult TA available) - specialist centres only Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Filgotinib Jyseleca® ICB moderately to severely active ulcerative colitis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA792 – June 2022 Hospital Filgrastim () NHSE Xxxxx Syndrome - specialist centres only Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Filgrastim (Various ▼) NHSE Reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Filibuvir () NHSE Viral Hepatitis (B&C) and Respiratory Syncytial Virus Not recommended for routine use NICE has not issued any guidance. BLUE Finerenone Kerendia® ICB chronic kidney disease in type 2 diabetes NWICB are committed to fund positive NICE TA treatments. Awaiting clarification of place in pathway and commissioning arrangements. Further guidance will be issued when available. For all other treatments, formulary application and discussion will be required TA877- March 2023 Hospital Fingolimod ▼ (Gilenya® ▼) NHSE Highly active relapsing remitting multiple sclerosis as per NICE TA 254 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA254 - Apr 12

Restricted Use. Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Double Red Clomethiazole (Heminevrin®) PHE Community-based assisted alcohol withdrawal - as per NICE CG 115 - Do Not Do Not recommended for routine use CG115 - Feb 11 GREEN Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Prevention of atherosclerotic events Formulary - Drugs that can be initiated by Prescriber in Primary Care TA210 - Dec 10 Hospital Arimoclomol NHSE Xxxxxxx Pick disease Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Prophylaxis pre-elective PCI Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. ADVICE Aripiprazole (Abilify®) ICB Moderate to severe manic episodes in adolescents with bipolar I disorder - as per NICE TA 292 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation TA292 - Jul 13 ADVICE Aripiprazole (Abilify®) ICB Schizophrenia and bipolar mood disorder - as per NICE CG 82 and TA 213 Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG82 - Mar 09 BLACK Armour Thyroid / any unlicensed thyroid products (Armour Thyroid) ICB Any indication Not commissioned. No NHS prescribing in primary or secondary care RMOC guidance - June 2019 ADVICE Aromatase inhibitors (Various) (Various) ICB Adjuvant hormonal treatment of early oestrogen-receptor-positive breast cancer in post menopausal women - as per local protocol Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation CG81 - Nov 06 Hospital Arsenic trioxide (Trisenox®) NHSE Acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR- alpha gene) in adults - as per NICE TA 526 Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA526 - Jun 18 GREEN Artificial saliva or salivary stimulants (Xerotin Oral spray or other cost- effective product) ICB Xerostomia from any cause where simple measures alone have been ineffective Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licensed unless stated) Instructions for Prescriber NICE Guidance Hospital Asciminib Scemblix® NHSE chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA813 – August 2022 Hospital Asfotase alfa Strensiq® NHSE paediatric-onset hypophosphatasia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST23 – March 2023 Double Red Aspirin Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG17 - May 17 Double Red Aspirin Clopidogrel (Plavix®, generics approved for use - Sept 2009) ICB Primary prevention of CVD in T1 or T2 Diabetes - as per NG17 and NG 28 Do Not Do's Not recommended for routine use NG28 - May 17 Double Red Asunaprevir ADVICE Clopidogrel (with Daclatasvirlow dose aspirin) (Plavix®, generics approved for use - Sept 2009) NHSE Viral Hepatitis ICB Acute Coronary Syndrome without ST- segment elevation (B&CNSTEMI) and Respiratory Syncytial Virus (with aspirin) Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant responsible for the first script. TA80 - Jul 04 ADVICE Clopidogrel (with low dose aspirin) (Plavix®, generics approved for use - Sept 2009) ICB Post elective percutaneous coronary intervention (PCI) - bare metal stent (Not recommended a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant should prescribe for routine use an initial period of in-patient stay. NICE has not issued any guidance. ADVICE Clopidogrel (with low dose aspirin) (Plavix®, generics approved for use - Sept 2009) ICB ST-elevation myocardial infarction (STEMI) (Not a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant should prescribe for an initial period of in patient stay; max one month. NICE has not issued any guidance. Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance Hospital Atacicept Clozapine (Clozaril®, Denzapine®, Zaponex®) ICB Schizophrenia Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care CG82 - Mar 09 Hospital Cobicistat ▼ (Tybost® ▼) NHSE Systemic Lupus Erythematosus Use as a booster in treatment of HIV positive adults and adolescents - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. BLACK Cobimetinib ▼ (SLEin combination with vemurafenib) (Cotellic® ▼) NHSE Unresectable or metastatic BRAF V600 mutation-positive melanoma - as per NICE TA 414 Not commissioned. No NHS prescribing in primary or secondary care TA414 - Oct 16 Hospital Co-careldopa intestinal gel (Duodopa® ▼) NHSE Severe Xxxxxxxxx'x disease inadequately controlled by other preparations - as per NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Hospital Ataluren ▼ Cochlear implants (Translarna® ▼Various) NHSE Duchenne muscular dystrophy For children and adults with a nonsense mutation in the dystrophin gene in people aged ≥5 years who can walk severe to profound deafness - specialist commissioned use only as per NHS England NHSE policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care HST22 TA566 - Feb 2023 Hospital Atazanavir Mar 19 Double Red Codeine linctus generic ICB Cough suppressant Not recommended for routine use NICE has not issued any guidance BLACK Co-enzyme Q10 (Reyataz®Healthcrafts, Nature's Best, Lamb, Natrahealth etc) NHSE HIV infection in combination with other antiretroviral drugs ICB All indications - as per BHIVA Guidelines NICE NG 71 & CG181 Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG181 - Jul 17 BLACK Co-enzyme Q11 (Healthcrafts, Nature's Best, Lamb, Natrahealth etc) ICB All indications - as per NICE NG 71 & CG181 Do Not Do Not commissioned. No NHS prescribing in primary or secondary care NG71 -Sep 17 GREEN Colecalciferol (Vitamin D) (Licensed Vitamin D products) ICB Treatment of vitamin D deficiency in adults and children - as per local policies Formulary - Drugs that can be initiated by Prescriber in Primary Care NICE has not issued any guidance. BLACK Colecalciferol (Vitamin D) (Various) ICB To increase adherence to statin treatment - as per NICE CG 181 - Do Not Do Not commissioned. No NHS prescribing in primary or secondary care CG181 - Jul 14 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance ADVICE Colesevelam HCl (Cholestagel®) ICB Third-line option for (unlicensed) use in bile salt malabsorption causing diarrhoea (for patients under the NNUH only) (Not a licensed indication). Formulary - Specialist advice required from primary or secondary care clinician with relevant expertise prior to primary care initiation Consultant/Specialist should prescribe for an initial period of 8 weeks (for new patients). NICE has not issued any guidance. Double Red Colesevelam HCl ▼ (Cholestagel® ▼) ICB Hypercholesterolaemia - as per NICE CG 181 Do Not Do Not recommended for routine use CG181 - Jul 14 Double Red Colesevelam hydrochloride (Cholestagel®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do Not recommended for routine use CG181 - Jul 14 Hospital Colestilan () NHSE Management of hyperphosphataemia in adults on renal dialysis Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care NICE has not issued any guidance. Double Red Colestipol hydrochloride (Colestid®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Double Red Colestyramine (Questran®) ICB Prevention of CVD, alone or added to a statin - as per NICE CG 181 - Do Not Do (Not a licensed indication). Not recommended for routine use CG181 - Jul 14 Hospital Atazanavir and Cobicistat Colistimethate sodium (Evotaznebulised) (Colomycin®, Promixin®) NHSE HIV Pseudomonas lung infection in combination with other antiretroviral drugs Cystic Fibrosis (new patients from 1st April 2013) - as per BHIVA guidelines NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA276 - Mar 13 AMB Colistimethate sodium (Nebulised) (Colomycin®, Promixin®) ICB Ps. aeurginosa infection in non-Cystic Fibrosis bronchiectasis Prescribe the drug and perform a basic level of monitoring, e.g. a standard annual review NICE has not issued any guidance. Hospital Atezolizumab Colistimethate sodium Dry Powder Inhaler (Tecentriq®Colobreathe® Dry Powder Inhaler) NHSE Locally advanced or metastatic non- small-cell Pseudomonas lung cancer after chemotherapy infection in cystic fibrosis - as per NICE TA 520 276 and NHS England policy Restricted use – Prescribing to remain with the hospital or specialist service. No prescribing in primary care TA520 TA276 - May 18Mar 13 DM Collagenase clostridium histolyticum (Xiapex®) ICB Dupuytren's contracture with a palpable cord in adults - as per NICE TA 459 Discontinued Medicines TA459 - Jul 17 Traffic Light Classification Drug Name Brand Name Commissione r Indication (assume licenced unless stated) Instructions for Prescriber NICE Guidance