Glucosamine and chondrotin (osteoarthritis) - Do not offer glucosamine or chondroitin products for the management of osteoarthritis £7,000 Lack of evidence to support benefit of lutein and other antioxidant vitamins. £4,000 NICE states do not use; For secondary prevention of MI To manage sleep problems in children with autism Preventing hypertension in pregnancy Familial hypercholesterolemia Primary prevention of cardiovascular disease in people with type 2 diabetes Review in association with psychiatrist in schizophrenia indication. People with hypertriglyceridaemia receiving advice from a healthcare professional with special expertise in blood lipid management. A of highly concentrated licensed omega 3 fish oils can be considered for refractory hypertriglyceridaemia if lifestyle measures and fibrate therapy have failed. £31,000 Probiotics Limited evidence and preparations and food supplements available OTC. ABSC criteria must be confirmed. VSL#3 ACBS: for use under supervision of physician for maintenance of remission of ileoanal pouchitis in adults as induced by antibiotics. Other probiotics are classed as food supplements £5,000 Complementary therapies, herbal supplements and homeopathy is limited clinical evidence and a lack of robust randomised controlled trials directly comparing them with standard treatments. Some are associated with severe adverse effects, they may significantly interact with other medicines and can delay accurate diagnosis of underlying pathology. None reviewed by NICE recommend their use. £6,000 hyaluronic injections (osteoarthritis) states ‘Do not offer intra-articular hyaluronan injections for the management of osteoarthritis.’ No evidence of recent prescribing Cannabis sativa IFR approval only £7,000
Painkillers for pain in adults: paracetamol, aspirin 300mg, ibuprofen 200-400mg and 8/500mg Short courses of analgesics for acute common ailments can be purchased by the patient under self care with community pharmacist support. Prescribing short courses of pain relief for acute conditions costs the NHS more than the equivalent products purchased If long-term treatment is required. Note – ordinary tablets are recommended as more cost effective. Soluble preparations have a high sodium content compared with standard formulations and are up to 3 times more expensive. £1,727,000 Vitamin supplements and tonics Vitamins should be obtained through dietary means where possible, if a supplement is required patients should be encouraged to purchase these over the counter. Healthy Start vitamins are available free to eligible pregnant and breast feeding women from all children’s centres in Sheffield, or at low cost from childrens centres and some pharmacies. Other low cost supplements suitable for conception and pregnancy are also available from pharmacies, supermarkets and health food shops. Renal dialysis. ACBS criteria met. Where appropriate in malnutrition. Premature baby (Note: clinical leads at Jessops confirm that premature babies (born before 36 weeks gestation) should remain on Abidec® until their 1st birthday at which point, unless there is another clinical need, a switch to Healthy Start would be suitable) £79,000 Hay fever preparations (OTC antihistamines) Products can be purchased as self-care. Chronic rhinitis and urticaria, and for children £182,000 References NICE savings and productivity – ‘do not do’ - BNF – Medicines less suitable for prescribing - =+ PrescQipp DROP-List bulletin and supporting documents - Note the formulary for the local minor ailments scheme can be found here -