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Pharmaceutical Services Negotiating Committee

General News

The use of antivirals in seasonal flu - NICE guidance triggered

A letter has been sent today from the CMO/CPHO informing GPs and community pharmacies that antiviral medicines may now be prescribed for the prophylaxis and treatment of influenza at NHS expense, in accordance with NICE guidance and Schedule 2 to the National Health Service (General Medical Services  Contracts) (Prescription of drugs etc) Regulations 2004), commonly known as the Grey List or Selected List Scheme (SLS). The incidence of flu has risen rapidly over the last week and there has been a marked increase in school outbreaks and hospitalised cases which has triggered the letter. The group mainly affected so far is children in the 5-14 age range.

Wholesalers are aware of the announcement and there is adequate stock of antivirals in the supply chain. Pharmacies are urged not to overorder stock.

Pharmacy teams should note that:

  • the suspension is unlicensed for seasonal flu and should only be used for under 1s using prescribers’ clinical judgement; older children and adults who cannot swallow capsules should open them and use as previously advised to avoid a stock shortage of suspension
  • The current suspension is a new formulation and 6mg/ml – all of the old formulation of 12mg/ml has gone out of date so is no longer available.
  • Regulations have been changed so that prescribers can prescribe antivirals for anyone, not just at risk groups, using clinical judgement.
  • Prescriptions must be endorsed ‘SLS’ by the prescriber.

When the news of increasing levels of flu becomes public, it often triggers an increase in the requests for vaccination through the NHS. The DH Immunisation Team provide a regular update on all vaccines at  and the December issue is dedicated exclusively to flu vaccination. Currently the seasonal flu vaccine uptake among those in 'at risk' groups under 65 remains low at 45%, and 69% of the over 65s have been vaccinated.

The full details of the letter are available by clicking here.

Posted 17 December 2012

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