Girish Mehta
Raj Patel
Rachel Solanki
Gary Michaels
Helen Musson – Chief Operating Officer, Local
Pharmaceutical Committee
Pharmacy and Medicines Optimisation Team
NHS Herts Valleys CCG
The Avenue Clinic
11, The Avenue
Watford
Herts
WD17 3NU
01923 234282 ext.: 324
Paul.Larkin@hertsvalleysccg.nhs.uk
25th September 2015
Dear Colleagues,
I enclose a list of the latest drug switches that will take place in GP practices in HVCCG:
Cost-Effective Prescribing – Commencing October 2015
1. Branded Generics:
Preferred choice:
 Venlafaxine M/R tablets and capsules (generic
 Vensir® (first choice) or Venlablue®
and brands)
(second choice) M/R capsules

Stalevo® (generic and branded) – 50mg, 75mg,
100mg, 125mg, 150mg, 175mg, and 200mg.
2. Alternative cost-effective brands:
 Seretide® (generic and brand) - 125/25 and
250/25 MDI.
3. All topical NSAIDs prescribed as a generic or
brand

Sastravi® (1st choice) or Stanek® (2nd
choice) tablets
Preferred choice:
 Sirdupla® 125/25 and 250/25 MDI
Only for patients >18 years.
Preferred choice:
 Fenbid® 5% gel
We have no option but to do this as the GP prescribing budget is forecast to overspend by over £1m.
To make this decision, we have scoped out work undertaken by many CCGs. We are aware of the
national impact of this work. Unfortunately, national changes in Category M and other drugs
negatively impacts HVCCG anyway.
The CCG pharmacy team will be supporting practices to implement these changes, starting in the
second week of October. Our experience with Fencino and Oxycodone shows that it takes 2 months
for before the change in prescription is dispensed.
These changes have gone through the process of reviewing for supply, price guarantee, availability,
strengths, formulations, etc. and have been discussed with the LPC.
Document1
We look forward to your support and from your colleagues to successfully implement these in the
most safe and effective manner.
Yours sincerely,
Paul Larkin
Lead Pharmacist (Localities)
Cc
Dr Clair Moring
Dr Chas Thenuwara
Dr Panni Sissou
Dr Catherine Page
Dr Kunal Patel
Dr David Buckle
Rasila Shah
Document1
– Board lead for Medicine Optimisation
- Clinical Lead for medicines optimisation, St Albans and Harpenden
Locality
- Clinical Lead for Medicines Optimisation, Dacorum Locality
- Clinical Lead for Medicines Optimisation, Hertsmere Locality
- Clinical Lead for Medicines Optimisation, Watford Commissioning
Locality
- Medical Director, HVCCG
- Head of Pharmacy and Medicines Optimisation, HVCCG