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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 13 - Skin 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

13.05.03 Drugs affecting the immune response

Abrocitinib (Cibinqo®)
(50mg, 100mg and 200mg f/c tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

Adalimumab (Amgevita®)
(Dermatology)

RED
Restricted Drug Restricted

Choice:

Amgevita (biosimilar brand) preferred brand for new patients.

Imraldi & Idacio for existing patients only

Humira for existing patients only (originator brand)

 

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with the below NICE TAs (note: must be initiated by a NHSE designated specialist centre for TA392):

Apremilast (Otezla®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Specialist consultant prescribing according to NICE TA419.

10mg, 20mg, 30mg tablets.

Azathioprine tablets
(Dermatology indications)

Formulary

25mg, 50mg tablets

10mg/mL suspension. Restricted to paediatric patients or patients with swallowing difficulties.

Avoid concomitant use of azathioprine with allopurinol, unless supervised by an appropriate specialist.

NB: 75mg and 100mg tablets were rejected for use Feb 2024 due to safety concerns relating to dosing errors and disproportionate cost. Do not prescribe these strengths. 

Entry reviewed: August 2024

Bimekizumab (Bimzelx®)
(160 mg solution for injection in pre-filled pen or pre-filled syringe)

RED
Restricted Drug Restricted

RESTRICTED FOR ALL PRESCRIBING - Blueteq or high cost drug form required - see link from Formulary homepage,

 

To be used in accordance with the following NICE TA(s) only:-

Brodalumab 210mg (Kyntheum®)
(Injection)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Restricted - for consultant dermatologist prescribing in line with NICE TA511.

Certolizumab pegol 200 mg Injection (Cimzia® Pre-filled Pen or Pre-filled Syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High Cost Drug Form required - see link from Formulary Homepage

RESTRICTED for Consultant Dermatologist prescribing in line with the following NICE TA(s):

Ciclosporin
(For dermatology use)

Formulary

See section 8.2.1

Entry reviewed May 2025

Deucravacitinib (Sotkytu®)
(6mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or high cost drug form required - see link from formulary homepage.

To be used in accordance with the following NICE TA(s):

 

Entry update: July 2023

Dimethyl fumarate 30mg, 120mg (Skilarence®)
(Tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
Prescribing by specialist in accordance with NICE TA475.

Must not be prescribed on FP10 prescriptions

Dupilumab (Dupixent®)
(For severe atopic eczema)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with NICE TA534 for the treatment of moderate to severe atopic eczema.

Etanercept (Benepali®)

RED
Restricted Drug Restricted

Preferred brand: Benepali

Enbrel (originator brand) for existing patients only

ALL prescribing of etanercept must be by brand name. 

 

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
  
 
Restricted - must be initiated by a Dermatology consultant only and must be prescribed by generic and brand name

Approved for use in accordance with the following NICE TA(s):

Guselkumab (Tremfya®)
(Injection)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
Prescribing by Dermatologist in accordance with NICE TA521.

Ixekizumab 80mg (Taltz® )
(Pre-filled pen or syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
To be prescribed by specialists in accordance with NICE TA442 and TA537.

Lebrikizumab (Ebglyss®)
(250 mg solution for injection in pre-filled pen/syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

Methotrexate
(For dermatology)

Amber SPIS
Formulary

See section 10.1.3

 

Important: Metoject new pen device (available from March 2024): Manufacturer is updating the pen device to a button free autoinjector. Please ensure patients are aware and counselled appropriately on how to use the new device. Further details can be found here.

Nemolizumab (Nemluvio®)
(30 mg pre-filled pen)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

Pimecrolimus 1% (Elidel®)
(Cream)

Formulary

Approved in accordance with NICE TA82 for the treatment of mild atopic eczema. For more information click the link below.

Approved for facial psoriasis where other topical agents have failed in line with BLMK ICB Management of plaque psoriasis in primary care pathway

 

Entry reviewed: May 2023

Risankizumab (Skyrizi®)
(150mg solution for injection in pre-filled syringe or pen)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High Cost Drug Form required - see link from Formulary Homepage.

Restricted to Specialist Prescribing in accordance with the following NICE TAs:

Ritlecitinib (Litfulo®)
(50mg Hard Capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

Secukinumab 150mg (Cosentyx®)
(Pre-filled pen or syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved for prescribing by Specialists in accordance with the following NICE TAs (note: must be initiated by a NHSE designated specialist centre for TA935):

Spesolimab (Spevigo®)
(450 mg concentrate for solution for infusion)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

 

Entry reviewed: June 2025

Tacrolimus (Protopic®)

Formulary

0.03% & 0.1% Ointment

Approved in accordance with NICE TA82 for the treatment of mild atopic eczema.

Approved for facial psoriasis where other topical agents have failed in line with BLMK ICB Management of plaque psoriasis in primary care pathway

 

Entry reviewed: May 2023

Tildrakizumab (Ilumetri 100mg®)
(Injection)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High Cost Drug Form Required - see link from Formulary Home Page. 

Approved in accordance NICE TA (s) below:-

Tralokinumab (Adtralza®)
(150 mg solution for injection in pre-filled syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be used in accordance with the following NICE TA(s) only:

Upadacitinib (Rinvoq®)
(15mg, 30mg and 45mg p/r tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High Cost Drug Form required - see link from Formulary Homepage.

To be used in accordance with the following NICE TA(s) only:

Ustekinumab 45mg, 90mg (Pyzchiva® Wezenla®)
(Pre-filled syringe or injection)

RED
Restricted Drug Restricted

Pyzchiva® or Wezenla® (biosimilar brands) preferred for new patients.

Stelara® for existing patients only (originator brand)

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with NICE TA180, TA455 and TA456.

Entry reviewed: October 2024

Infliximab (Remsima®)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Remicade (originator brand) for existing patients only


 
Approved in accordance with the below NICE TA(s):

Non formulary items

Efalizumab (Raptiva®)

 
Non Formulary

Ruxolitinib (Opzelura®) (15mg/g cream (for vitiligo))

DNP
Non Formulary

NOT RECOMMENDED FOR PRESCRIBING in accordance with NICE TA1088.

Entry reviewed: August 2025

Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.