23. Medical Devices


First line drugs Specialist drugs Secondary Care drugs
Recommended in both primary and secondary care Where a specialist input is needed (see introduction for definition) Prescribing principally within secondary care only

BCAP considered the following

Device PAC commissioning recommendations BCAP Decision re formulary  and traffic light status Cost Implications
Oscillating positive expiratory pressure (OPEP) device, e.g. Flutter® and Acapella®  Cornet® PARI O-PEP* Recommended for cystic fibrosis patients where PEP alone has proved ineffective. Formulary cystic fibrosis patients Red TLS £27.28 to £40.50* most cost effective** least cost effective
Oscillating positive expiratory pressure (OPEP) device, e.g. Flutter® and Acapella®  Cornet® PARI O-PEP* BTS guidelines recommend OPEP should be considered for use with postural drainage and forced expiration when helping patients develop effective mucus clearance techniques Formulary Red TLS Bronchiectasis patients as per BTS. Physios to supply first device and show patients how to use. Replacement devices via FP10 via Physiotherapy ONLY £27.28 to £40.50* most cost effective** least cost effective  
 Resperate® - Adjunctive treatment of hypertension Not recommended as the British Hypertension Society consider that the small effect over short durations do not provide sufficient evidence for this equipment to be recommended. Non Formulary  None
Needle free insulin devices,e.g. Insujet® and Injex®. Not routinely recommended unless there is aconfirmed diagnosis of needle phobia which would result in the patient not injecting insulin. Non Formulary (Individual Funding Request if required) None
Vacuum pumps for erectile dysfunction (ED) Recommended - arrangements for supply and appropriate training should be agreed locally. In process Jan 2018 to make hospital only In process Jan 2018 to make hospital only
Normal saline nasal sprays, e.g. Sterimar®, Aqua Maris® Not recommended. Non Formulary None
Vaginal dilators or trainers, e.g.Femmax®*, Ameille Care® and Ameille Comfort® Recommended for women following vaginal reconstruction surgery or following pelvic radiotherapy when recommended by an appropriate Secondary Care Specialist. Formulary Amber TLS £16.48 to £35.55 per kit* most cost effective option.
Potassium hydroxide solution, e.g. MolluDab® 5%, Molutrex® 5% Not recommended as this is a limited clinical value treatment. Patients may purchase from a pharmacy or on-line directly from the manufacturers if wanted. Non Formulary Self Purchase None
Jaw rehabilitation device, e.g. Therabite® Recommended for patients following head and neck radiotherapy or head and neck surgery when recommended by an appropriate Secondary Care Specialist. Formulary Amber TLS Only when recommended by maxillofacial surgeon with clear follow up plan by specialist Device, initial Bite Pads and Accessories £225.03Bite Pad s £10.51 (4) 
Pelvic toning devices, e.g. PelvicToner® Not recommended as there is no evidence ofadditional benefit compared to undertaking pelvic floor exercises alone. Patients may purchase from a pharmacy or on-line if wanted. Non Formulary Self Purchase None

Last updated by: Joy Craine on 24-05-2018 14:52