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Other - Cost: £652,109,405.62 Empagliflozin (Jardiance) - Cost: £7,788,101.39 Edoxaban (Lixiana) - Cost: £8,056,980.75 Influenza vaccine (Fluad) - Cost: £13,930,057.90 Beclometasone / Formoterol MDI (Fostair) - Cost: £17,160,087.08 Rivaroxaban (Xarelto) - Cost: £20,491,468.20 Apixaban (Eliquis) - Cost: £33,811,997.20
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Notes for: Skin
Last edited [16/11/2021 14:55:40]


NHS Kernow emollient prescribing guideline September 2021

NHS Kernow moisture associated skin damage pathway September 2021

Fire risk with paraffin-containing products


Management of skin conditions

    With skin disease it is extremely important to consider patient acceptability of a product to maximise patient compliance. There is a wide range of products available and patient acceptance of individual products is very variable.
    Where a consultant or GP with specialist interest asks a GP to prescribe a non-formulary agent they should check that formulary agents have been tried and not tolerated by the patient

    Greasy preparations (ointments) are often preferable to creams in most circumstances because:

    • They contain fewer skin sensitisers
    • They are more hydrating (ie water retaining)
    • There is better penetration of active ingredients

    However, patient preference or activity may necessitate a combination of ointments and creams, for example, patients may prefer to apply creams during the day and use ointments at night, or different preparations on different parts of the body.

    Application technique: It is important to educate patients with the correct application technique. Ointments and creams should be applied down the direction of hair growth. They should also be smeared on and not rubbed in.

    Pot Hygiene: When supplying patients with pots of emollient, it is important to educate them about the hygiene required. Patients should be advised to decant from the pot onto plate/bowl etc. using a spoon or a spatula. Hands should not be put into the pot as this will lead to the introduction of foreign particles.

    In many cases generic prescribing will be difficult because products contain a combination of active ingredients. In this chapter brand names are used for products which should not be prescribed generically.

    Extemporaneous preparations: A product should only be extemporaneously prepared when there is no product with a marketing authorisation available. Depending on the formulation this may be done in a pharmacy, or by a specials manufacturer, usually depending on the formulation. Where a specials manufacturer prepares the product, additional charges will be incurred. The cost can, and usually does, exceed £100 for a cream. The cost is usually the same whether 500 g or 50 g of a product is ordered. Specials all have a very short shelf life with an expiry date of a maximum of 28 days from manufacture.

    A range (but not all) of specials preferred by the British Association of Dermatologists has been approved for use within Cornwall & IoS mainly for prescribing by secondary care. The website also lists various clinical guidelines.



     

    Cornwall Joint Formulary Recommended Choices     (...Top)
    Displaying 10 Drugs

    Key:
    First Line Drugs First Line Drugs
    Second Line Drugs Second Line Drugs
    Specialist Initiated Drugs Specialist Initiated Drugs
    Hospital Only Drugs Hospital Only Drugs
    Discouraged Discouraged
    No comment available No comment available
    Antibiotics Antibiotics

    NameTariffBNF Sub Paragraph
    Salicylic Acid Gel (Cuplex Gel)
    11 % with lactic acid 4% (5g unit) Pack of 1
    £2.88PCT FORMULARY STATUS: First Line Drugs Preparations For Warts And CallusesView BNF Article on 'Salicylic Acid Gel'View SPC on 'Salicylic Acid Gel'View PIL on 'Salicylic Acid Gel'
    Salicylic Acid Gel (Salatac Gel)
    12 % gel (8g tube+emery board) Pack of 8
    £2.98PCT FORMULARY STATUS: First Line Drugs Preparations For Warts And CallusesView BNF Article on 'Salicylic Acid Gel'View SPC on 'Salicylic Acid Gel'View PIL on 'Salicylic Acid Gel'
    Glutaraldehyde Solution (Glutarol)
    10 % solution Pack of 10
    £2.07PCT FORMULARY STATUS: Second Line Drugs Preparations For Warts And CallusesView BNF Article on 'Glutaraldehyde Solution'View SPC on 'Glutaraldehyde Solution'View PIL on 'Glutaraldehyde Solution'
    Formaldehyde Gel (veracur)
    0.75 % Gel Pack of 15
    £2.41PCT FORMULARY STATUS: Second Line Drugs Preparations For Warts And CallusesView BNF Article on 'Formaldehyde Gel'View SPC on 'Formaldehyde Gel'View PIL on 'Formaldehyde Gel'
    salicylic acid 26% w/w (Occlusal )
    10 ml cutaneous solution Pack of 10
    £3.56PCT FORMULARY STATUS: Specialist Initiated Drugs Preparations For Warts And CallusesView BNF Article on 'salicylic acid 26% w/w'View SPC on 'salicylic acid 26% w/w'View PIL on 'salicylic acid 26% w/w'
    Podophyllotoxin Solution (Condyline)
    0.5 % Alcohol Solution (3.5ml Unit) Pack of 1
    £14.49PCT FORMULARY STATUS: Specialist Initiated Drugs Preparations For Warts And CallusesView BNF Article on 'Podophyllotoxin Solution'View SPC on 'Podophyllotoxin Solution'View PIL on 'Podophyllotoxin Solution'
    Podophyllotoxin Solution (Warticon / Warticon Fem)
    0.5 % Alcohol Solution (3ml Unit) Pack of 1
    £14.86PCT FORMULARY STATUS: Specialist Initiated Drugs Preparations For Warts And CallusesView BNF Article on 'Podophyllotoxin Solution'View SPC on 'Podophyllotoxin Solution'View PIL on 'Podophyllotoxin Solution'
    Podophyllotoxin Cream (Warticon)
    0.15 % Cream (5g Unit) with mirror Pack of 1
    £17.83PCT FORMULARY STATUS: Specialist Initiated Drugs Preparations For Warts And CallusesView BNF Article on 'Podophyllotoxin Cream'View SPC on 'Podophyllotoxin Cream'View PIL on 'Podophyllotoxin Cream'
    Camellia (Catephen)
    10 % ointment gm Pack of 15
    £39.00PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] Catephen (green tea leaf extract 10% ointment) is accepted onto the formulary as a specialist initiated drug for use in patients not suitable for podophyllotoxin or who have not responded to treatment with podophyllotoxin Preparations For Warts And CallusesView BNF Article on 'Camellia'View SPC on 'Camellia'View PIL on 'Camellia'
    Catephen (green tea leaf extract 10% ointment) is accepted onto the formulary as a specialist initiated drug for use in patients not suitable for podophyllotoxin or who have not responded to treatment with podophyllotoxin
    Imiquimod Cream (Aldara Cream)
    5 % in sachets Pack of 12
    £48.60PCT FORMULARY STATUS: Specialist Initiated Drugs Preparations For Warts And CallusesView BNF Article on 'Imiquimod Cream'View SPC on 'Imiquimod Cream'View PIL on 'Imiquimod Cream'

     
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