Items Identified as Low Value for Prescribing in Wales

The following guidance document has been prepared by the All Wales Prescribing Advisory Group (AWPAG) with support from the All Wales Therapeutics and Toxicology Centre (AWTTC), and has been endorsed by the All Wales Medicines Strategy Group (AWMSG) at their February 2020 meeting:

Items Identified as Low Value for Prescribing in NHS Wales – Paper 3

This is the third paper in the ongoing initiative, previously entitled “Medicines Identified as Low Priority for Funding in NHS Wales”.

This Low Value for Prescribing document has been developed to provide healthcare professionals with information to minimise the prescribing of medicines that offer a limited clinical benefit to patients and where more cost effective treatments may be available.  Nine items/item groups have been identified for the purposes of this document.  These are:

·       Items of low clinical effectiveness:

• chloral hydrate (cloral betaine)
• minocycline
• probiotics
• rubefacients
• silk garments
• vitamins and minerals.
• Items where more cost-effective alternatives are available:
• alimemazine
• aliskiren
• blood glucose testing strips.

As well as providing recommendations, this document also details both general and specific exceptions. Prescribers are expected to have due regard for this advice when deciding whether or not to prescribe these items. However, the guidance contained herein does not remove the clinical discretion of the prescriber in accordance with their professional duties.