Enzalutamide Medication Supply

Service specification

Enzalutamide (brand name Xtandi®) is a specialist cancer medicine used for men with metastatic castration-resistant prostate cancer (mCRPC). The supply process in NHS Highland is tightly controlled:

  • Prescribing:
    • Done in secondary care (urology oncology clinic) by a consultant oncologist or trained prescriber.
    • Prescriptions are written on a Hospital-Based Prescription (HBP) form.
  • Initial Supply:
    • Hospital pharmacy provides the first 5-week supply to start treatment.
  • Community Pharmacy Role:
    • Each patient is linked to one nominated community pharmacy for ongoing dispensing.
    • The Community Pharmacy Development Team (CPDT) contacts the nominated pharmacy with patient details and checks for drug interactions.
  • Procurement:
    • Enzalutamide is supplied exclusively via Astellas Pharma.
    • Pharmacies must register with Astellas to order the drug.

Resources

There are several official NHS Highland resources you can access for Enzalutamide prescribing and supply:

1. NHS Highland Formulary

  • The Highland Formulary lists Enzalutamide under the Malignant Disease and Immunosuppression section.
  • It provides formulary status, approved indications, and links to Scottish Medicines Consortium (SMC) guidance.

2. NHS Board Service Outline & Governance Checklist

  • This PDF is specific to NHS Scotland Boards, including Highland.
  • Covers:
    • Indications (mCRPC pre- and post-docetaxel)
    • Prescribing arrangements (secondary care only)
    • Supply process (hospital pharmacy initial 5-week supply, then nominated community pharmacy)
    • Cost & Patient Access Scheme
    • Contact details for Astellas Pharma
  • Download: Governance Checklist – Enzalutamide

 3. NHS Highland Oncology Guidelines

  • Available via the Right Decisions platform.
  • Includes cancer treatment protocols, medicines management, and monitoring guidance.
  • Access: NHS Highland Oncology Guidelines

4. Treatments and Medicines (TAM) Portal

  • Central hub for NHS Highland therapeutic guidelines, formulary updates, and patient resources.
  • Access: TAM – NHS Highland

5. Specialist Pharmacy Service (SPS)