8. Immune System and Malignant Disease

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

Traffic light status (TLS) explained:

Green: Routine prescribing within licensed indication
Amber 1: specialist recommendation followed by GP initiation and continuation
Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
Amber 3: specialist initiation and stabilisation followed by GP continuation
Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
Red: Hospital or specialist prescribing only
Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.