Schedule Update - effective 1 July 2005 (text extract)

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PHARMAC

Pharmaceutical Management Agency

New Zealand Pharmaceutical Schedule

UPDATE

Effective 1 July 2005

Cumulative for May, June and July 2005 Section H cumulative for December 2004, January, February, March, April, May, June and July 2005

Contents

Summary of PHARMAC decisions effective 1 July 2005 ................................. 3 Salbutamol 100 mcg aerosol inhaler - two brands listed............................... 6 Gabapentin - subsidy for neuropathic pain ................................................... 6 Antiretrovirals & Kaletra ................................................................................ 6 Methadone hydrochloride tab 5 mg ............................................................. 6 Ultraproct & Proctosedyl ............................................................................... 7 Blood Glucose Test Strips FAQ ....................................................................... 7 Signatories for Bulk Supply Orders ............................................................... 8 PCT’s – new rules for Section B ..................................................................... 8 Sofradex Ear/Eye Drops and Ointment .......................................................... 8 Recombinant factor VIII - New Listing of Section H ....................................... 9 Changes in Section H .................................................................................... 9 Tender News ................................................................................................ 10 Possible decisions for implementation 1 August 2005 ................................ 10 Sole Subsidised Supply products cumulative to July 2005 ........................... 12 New Listings ................................................................................................ 18 Changes to Restrictions ............................................................................... 24 Changes to Subsidy and Manufacturer’s Price............................................. 33 Changes to Brand Name ............................................................................. 38 Changes to Sole Subsidised Supply ............................................................. 38 Changes to General Rules ........................................................................... 39 Delisted Items ............................................................................................. 42 Items to be Delisted .................................................................................... 44 Section H changes to Part II ........................................................................ 47 Section H changes to Part IV ....................................................................... 60 Section H changes to Part V ........................................................................ 63 Index ........................................................................................................... 64

Summary of Pharmac decisions

effective 1 juLY 2005 New listings (pages 18 to 23) • Nystatin (Nilstat) oral liq 100,0000 u per ml • Compound electrolytes (Enerlyte) powder for soln for oral use 5 g – available on a PSO • Paracetamol (Panadol) tab 500 mg – available on a PSO • Methadone hydrochloride (HMG) tab 5 mg – only on a controlled drug form • Capecitabine (Xeloda) tab 150 mg and 500 mg – PCT only – specialist – Special Authority • Cyclophosphamide (Endoxan) inj 1g and 2g – PCT only – specialist • Cytarabine (Mayne) inj 100 mg per ml, 20 ml – PCT only – specialist • Fludarabine (Fludara) tab 10 mg – PCT only – specialist • Fludarabine phosphate (Fludara) inj 50 mg – PCT only – specialist • Fluorouracil sodium (Mayne) inj 25 mg per ml, 100 ml – PCT only – specialist • Ifosfamide (Holoxan) inj 1g and 2 g – PCT only – specialist • Irinotecan (Camptosar) inj 20 mg per ml, 2 ml and 5 ml – PCT only – specialist – Special Authority • Bleomycin sulphate (Blenoxane) inj 15 iu – PCT only – specialist • Doxorubicin (Mayne) inj 50 mg – PCT only – specialist • Epirubicin (Pharmorubicin) inj 2 mg per ml, 5 ml and 25 ml – PCT only – specialist • Mesna (Uromitexan) inj 100 mg per ml, 4 ml and 10 ml, tab 400 mg and 600 mg – PCT only – specialist • Mitozantrone (Onkotrone) inj 2 mg per ml, 10 ml – PCT only – specialist • Paclitaxel (Taxol) inj 30 mg and 100 mg – PCT only – specialist – Special Authority • Vinorelbine (Navelbine) inj 10 mg per ml, 1 ml and 5 ml – PCT only – specialist • Rituximab (Mabthera) inj 100 mg per 10 ml vial and 500 mg per 50 ml vial – PCT only – specialist – Special Authority • Trastuzumab (Herceptin) inj 150 mg vial and inj 440 mg vial – PCT only – specialist – Special Authority

Summary of Pharmac decisions

effective 1 juLY 2005 changes to restrictions (pages 24 to 32) • Antiretrovirals – new Special Authority criteria • Lopinavir with ritonavir (Kaletra) – new Special Authority criteria • Gabapentin (Neurontin) – new Special Authority criteria for neuropathic pain • Busulphan (Myleran) tab 2 mg – PCT • Calcium folinate (Mayne, Leucovorin) tab 15 mg, (Leucovorin Calcium) inj 3 mg per ml, 1 ml and inj 15 mg, and (Mayne) inj 50 mg – PCT • Chlorambucil (Leukeran FC) tab 2 mg – PCT • Cyclophosphamide (Cycloblastin) tab 50 mg and (Cytoxan) inj 1 g – PCT • Cytarabine (Mayne, Pharmacia) inj 100 mg and (Mayne) 500 mg – PCT • Fluorouracil sodium (Mayne) inj 250 mg per 10 ml, 500 mg per 10 ml, and 500 mg per 20 ml – PCT • Melphalan (Alkeran) tab 2 mg – PCT • Mercaptopurine (Purinethol) tab 50 mg - PCT • Thiotepa (Thiotepa) inj 15 mg – PCT • Etoposide (Vepesid) cap 50 mg and 100 mg, and (Mayne and Vepesid) inj 20 mg per ml, 5 ml – PCT • Hydroxyurea (Hydrea) cap 500 mg – PCT • Methotrexate (Methoblastin) tab 2.5 mg and 10 mg, (Mayne) inj 5 mg per 2 ml vial, 20 mg per 2 ml vial, 50 mg per 2 ml vial, 100 mg per 4 ml vial, 5 g per 50 ml vial, 500 mg per 20 ml vial, and 1 g per 10 ml vial – PCT • Thioguanine (Lanvis) tab 40 mg – PCT • Vinblastine sulphate (Mayne) inj 10 mg – PCT • Vincristine sulphate (Mayne) inj 1 mg per ml, 1ml and 2 ml – PCT • Dexamethasone with framycetin and gramicidin (Sofradex) ear/eye drops and ear/eye oint - reinstatement of restriction Decreased subsidy (page 33 to 37) • Diphenoxylate hydrochloride with atropine sulphate (Diastop) tab 2.5 mg with atropine sulphate 25 mcg • Ranitidine hydrochloride (Arrow-Ranitidine) tab 150 mg and 300 mg • Lansoprazole (Zoton) cap 30 mg • Pantoprazole (Somac) tab 20 mg and 40 mg • Glipizide (Minidiab) tab 5 mg

Summary of Pharmac decisions

effective 1 juLY 2005 Decreased subsidy (page 33 to 37) (continued) • Glucose oxidase (Ascensia Glucodisc, Glucocard, Precision Plus) blood diagnostic test strips with peroxidase • Docusate sodium (Coloxyl) oral drops 10% • Triamcinolone acetonide (Oracort) 0.1% in Dental Paste USP • Felodipine (Plendil ER) tab long-acting 2.5 mg • Verapamil hydrochloride (Verpamil SR) tab long-acting 120 mg • Chlorhexidine gluconate (Orion) soln 4% • Emulsifying (AFT) ointment BP • Alendronate (Fosamax) tab 10 mg and 70 mg • Prednisone (Apo-Prednisone) tab 1 mg, 5 mg and 20 mg • Ciprofloxacin (Cipflox) tab 250 mg, 500 mg and 750 mg • Co-trimoxazole (Trisul) tab trimethoprim 80 mg and sulphamethoxazole 400 mg, and oral liq sugar-free trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml • Ibuprofen (I-Profen) tab 200 mg • Paracetamol with codeine (Codalgin) tab paracetamol 500 mg with codeine phosphate 8 mg • Trimipramine maleate (Tripress) cap 25 mg and 50 mg • Clonazepam (Paxam) tab 500 mcg and 2 mg • Gabapentin (Neurontin) cap 100 mg, 300 mg and 400 mg • Ondansetron (Zofran) tab 4 mg and 8 mg • Bromocriptine mesylate (Alpha-Bromocriptine) tab 2.5 mg and 10 mg • Salbutamol (Ventolin) aerosol inhaler, 100 mcg per dose CFC-free • Sodium cromoglycate (Cromolux) eye drops 2% • Atropine sulphate (Atropt) eye drops 1% • Hypromellose (Poly-Tears) eye drops 0.3%

Salbutamol 100 mcg aerosol inhaler - two brands listed

The Salamol and Ventolin brands of salbutamol 100 mcg aerosol inhalers CFC-free will both be listed in the Pharmaceutical Schedule from 1 July 2005. Ventolin will be reference priced to Salamol at a subsidy of $4.00 per inhaler, which may result in a manufacturer’s surcharge.

Gabapentin - subsidy for neuropathic pain

From 1 July 2005, gabapentin will be subsidised under Special Authority criteria when used in the treatment of neuropathic pain. The Special Authority criteria has been expanded to include this indication when a patient has tried and failed, or has been unable to tolerate, an anticonvulsant agent and a tricyclic antidepressant. Specialists and vocationally registered general practitioners may apply for a Special Authority, as may other medical practitioners on the recommendation of a specialist or vocationally registered general practitioner. See page 26 of this Update for full details.

antiretrovirals & Kaletra

Effective 1 July 2005 the Special Authority criteria for access to antiretroviral therapy will be widened. The amended Special Authority would allow subsidies for a combination of up to three antiretroviral medications, but including a maximum of two protease inhibitors, for prevention of foetal transmission and for the treatment of the new-born for up to eight weeks. The CD4 count required for access to funding has been amended to be in line with international guidelines. The term “named general physician” has also been changed to “named specialist”, as the Ministry of Health currently approves the specialists who are able to prescribe antiretrovirals in New Zealand. Effective 1 July 2005 the Special Authority criteria for lopinavir with ritonavir (Kaletra) has been amended. Lopinavir with ritonavir will no longer be restricted for salvage treatment only and will be subsidised subject to the Special Authority criteria which apply to the prescribing and dispensing of other antiretrovirals currently listed.

methadone hydrochloride 5 mg tablets

Douglas Pharmaceuticals have informed PHARMAC that the Pallidone brand of methadone hydrochloride 5 mg tablets are likely to go out of stock in the June/July period. As a temporary measure, the HMG brand will be listed in the Pharmaceutical Schedule for a 6 month period to cover any stock shortages. Please note that both the Pallidone and HMG brands will be distributed by Douglas Pharmacueticals.

All decisions related to news items are effective from 1 July unless otherwise indicated

ultraproct & Proctosedyl

Effective 1 April 2005 PHARMAC awarded sole subsidised supply to Ultraproct ointment and suppositories. As Ultraproct and Proctosedyl have differing chemical compositions, Ultraproct is not automatically able to be substituted for scripts for Proctosedyl. It is therefore advisable for patients on Proctosedyl to have new prescriptions written for Ultraproct in order for easier claiming of subsidy.

Blood Glucose test Strips faQ

We have received a number of calls regarding the restriction on blood glucose test strips, which came into effect 1 June 2005. Below are answers to the most common questions we have received. Q. What type of endorsement is acceptable? a. The endorsement can be written as “certified condition” or “approved condition”, or state that the patient is being treated with insulin or a sulphonylurea, or state that the patient is pregnant. The endorsement must be either computer generated or hand written by the prescriber. Q. If test strips are not prescribed with a sulphonylurea or insulin and not endorsed, and prescribed for more than fifty (50) strips, are the first fifty (50) strips subsidised or is the whole lot NSS? a. Fifty (50) strips can be claimed. The balance, if dispensed, will be a charge to the patient. Q. Will repeats of prescriptions originally dispensed before 1 June 2005 be subsided without endorsement? a. Yes Q. Prescision Plus test strips come in a 100 OP pack. If a prescription is for fifty (50) strips, can a one hundred (100) OP be claimed? a. Yes Q. If test strips are prescribed at the same time as insulin or a sulphonylurea but are on different forms, is an endorsement still required? a. Not if the prescriptions were written on the same date and items are dispensed at the same time. It is recommended that the forms be stapled together.

All decisions related to news items are effective from 1 July unless otherwise indicated

Signatories for Bulk Supply Orders

Effective 1 July 2005 Bulk Supply Orders will need to be signed by a Hospital Care Operator. Previously Bulk Supply Orders had to be signed by Practitioners to be eligible for a subsidy. This amendment brings the signatory requirements into line with the legislative requirements. A Hospital Care Operator is defined by the Health and Disability Services (Safety) Act 2001, and means a person for the time being in charge of providing hospital care (i.e. the Manager or Licensee). See pages 39-40 of this Update for full details.

Pcts – new rules for Section B

PHARMAC is working with DHBs on a project to manage the budget for Pharmaceutical Cancer Treatments (PCTs) that are provided by DHB hospitals as part of their inpatient and outpatient services. The aim is to streamline the assessment and decision-making process for adding new treatments to the list of funded pharmaceuticals (currently defined in Part V of Section H), and improve national equity of access to pharmaceutical cancer treatments. The initial step is to list PCTs in Section B of the Pharmaceutical Schedule to allow hospitals to submit claims to HealthPAC. Initially claim submissions will be used only for data collection (and not payment). The Pharmaceutical Schedule rules have been amended from 1 July 2005 to allow listing of PCTs in Section B. There are two new definitions for PCTs: “PCT” that defines a pharmaceutical as a cancer treatment to which DHB hospitals must provide access, but may also be dispensed from other locations (e.g. hydroxyurea capsules through Retail Pharmacy); “PCT only” that defines a pharmaceutical as a cancer treatment to which DHB hospitals must provide access, but may only be dispensed from a DHB hospital pharmacy that is providing cancer treatment services (e.g. paclitaxel). Part V of Section H will be deleted on 1 January 2006 once the listing of PCTs in Section B is complete. Once sufficient usage data is collected to enable PHARMAC and the DHBs to agree a budget for PCTs, payment will be made for these pharmaceuticals through the HealthPAC system. We anticipate that this may be possible from 1 July 2007.

Sofradex ear/eye Drops and Ointment

During the production of the December 2004 Pharmaceutical Schedule the “Retail pharmacy - specialist when used in the treatment of eye conditions” restriction was left off the Sofradex ear drops and ointment. The restriction still applies and the error has been corrected in this Update.

All decisions related to news items are effective from 1 July unless otherwise indicated

recombinant factor viii - New Listing of Section h

From 1 July 2005, three brands of Recombinant Factor VIII will be listed in Section H of the Pharmaceutical Schedule. Under the agreed Preferred Supply Criteria, patients will be able to remain on their current brand of Recombinant Factor VIII; all new Recombinant Factor VIII patients would be required to receive Kogenate FS from Bayer unless their doctor deemed it clinically inappropriate for that patient to receive that brand. There will be no change to the current distribution arrangements for Recombinant Factor VIII and no requirement for a Special Authority or Exceptional Circumstances approval to receive any brand. All brands will remain listed on Section H until at least June 2008.

changes in Section h

There are a large number of changes to Section H this month, and to assist with the understanding of the changes we have categorised them. A brief description of the categories is as follows: Removal of Hospital Supply Status Hospital Supply Status (HSS) for some products is due to expire on 30 June 2005, and for these products you will no longer be obliged to purchase the HSS brand. For all these products the DV Limit and the DV Pharmaceuticals have been removed. Extension of HSS agreements As a result of an agreement with GSK, the HSS period for some products has been extended; the DV Limits and prices may have changed. Also a number of new tender agreements have been entered into by PHARMAC with the current HSS supplier. For the products with HSS resulting from a tender agreement the DV Limit may have changed. The new DV Limit will apply from 1 September 2005. PCT rule changes for Section H As part of the Pharmaceutical Cancer Treatment (PCT) project a number of rules changes will be effective in Section H from 1 July 2005. The changes alter the process for seeking approval to fund products not listed in Part V of Section H. The new process and application form can be found at www.pharmac.govt. nz/exceptional_circumstances.asp. Due to the size of the July Update, the rule changes have not been included, however they will be included in the July 2005 reprint of Section H, which should be available in late July 2005. In addition there are also changes to rules in Section B to permit DHB Hospitals to submit claims to HealthPAC for PCTs in order to form a national dataset. These changes are included on pages 39-41 of the Update.

All decisions related to news items are effective from 1 July unless otherwise indicated

tender News

Sole Subsidised Supply changes – effective 1 August 2005 There are no Sole Subsidised Supply changes effective 1 August 2005.

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes. It may assist pharmacists to manage stock levels and keep prescribers up-to-date with proposals to change the Pharmaceutical Schedule. Proposals under consideration The areas of health care funding set out below are currently under consideration. The PHARMAC Board will be reviewing these proposals, and the decisions taken will be published in future Updates. The dates represented below are the earliest date that these proposals may be implemented. Possible decisions for implementation 1 august 2005 • Aminophylline inj 25 mg per ml, 10 ml (Mayne) – subsidy increase • Heparin sodium inj 5,000 iu per ml, 1ml (Mayne) – subsidy increase • Heparinised saline inj 100 iu per ml, 5 ml (Mayne) – subsidy increase • Papaverine hydrochloride inj 12 mg per ml, 10 ml (Mayne) – subsidy increase • Hyoscine hydrobromide inj 400 mcg per ml, 1 ml (Mayne) – subsidy increase • Diazepam inj 5 mg per ml, 2 ml (Mayne) – subsidy increase • Methadone hydrochloride inj 10 mg per ml, 1 ml (Mayne) – subsidy increase • Adrenaline inj 1 in 1,000, 1 ml (Mayne) – subsidy increase • Adrenaline inj 1 in 10,000, 10 ml (Mayne) – subsidy increase • Sodium bicarbonate inj 8.4%, 10 ml (Mayne) – subsidy increase • Calcium folinate tab 15 mg (Mayne) – subsidy increase • Pethidine hydrochloride inj 50 mg per ml, 1 ml and 2 ml (Mayne) – subsidy increase • Promethazine hydrochloride inj 25 mg per ml, 2 ml (Mayne) – subsidy increase • Calcium gluconate inj 10%, 10 ml (Mayne) – subsidy increase • Cefoxitin sodium inj 1 g (Mayne) – subsidy increase • Tobramycin inj 40 mg per ml, 2 ml (Mayne) – subsidy increase • Erthromycin lactobionate inj 300 mg (Mayne) – subsidy increase • Gentamicin sulphate inj 10 mg per ml, 1 ml (Mayne) – subsidy increase • Bimatoprost (Lumigan) 0.03% eye drops – new listing with Special Authority criteria

All decisions related to news items are effective from 1 July unless otherwise indicated 10

Possible decisions for implementation 1 august 2005 (continued) • Brimonidine tartrate 0.2% with timolol maleate 0.5% (Combigan) eye drops – new listing with Prescribing Guidelines • Latanoprost (Xalatan) eye drops 50 mcg per ml, 2.5 ml – decreased subsidy • Travoprost (Travatan) eye drops 0.004%, 2.5 ml – decreased subsidy • Letrozole (Femara) tab 2.5 mg – change to Special Authority criteria • Anastrazole (Arimidex) tab 1 mg – change to Special Authority criteria • Pioglitazone (Actos) tab 15 mg, tab 30 mg and tab 45 mg – change to Special Authority criteria • Oxycodone (OxyNorm) cap 5 mg, 10 mg and 20 mg – new listings • Oxycodone (OxyContin) controlled-release tab 10 mg, 20 mg, 40 mg and 80 mg – new listing • Pyridoxine tab 25 mg – removal of co-payment

All decisions related to news items are effective from 1 July unless otherwise indicated 11

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Aciclovir Alfacalcidol Amantadine hydrochloride Amiloride with hydrochlorothiazide Amoxycillin

Presentation

Tab 00 mg, 00 mg & 00 mg Cap 0. mcg & 1 mcg Oral drops mcg per ml Cap 100 mg Tab mg with hydrochlorothiazide 0 mg Cap 0 mg & 00 mg Grans for oral liq 1 mg per ml Grans for oral liq 0 mg per ml Lozenges 10 mg Tab 0 mg & 100 mg Tab 10 mg Metered aqueous nasal spray, 0 mcg per dose & 100 mcg per dose Inj 1 mega u Tab 1 mg Scalp app 0.1% Eye drops 0.% Eye drops 0.% Tab mg Suppos 10 mg Metered aqueous nasal spray, 0 mcg per dose & 100 mcg per dose Inj 0.%, ml Inj 0.%, % glucose, ml Tab mg & 10 mg Oral liq 1 mcg per ml Tab 1. mg, mg & 0 mg Cap 0 mg Grans for oral liq 1 mg per ml Inj 0 mg Tab 00 mg Cap 0 mg & 00 mg Inj 00 mg & 1 g Tab 0 mg Crm 0.0% Tab 0 mg Tab mg Inj 1 mg per ml, 1 ml Vaginal crm 1% with applicators Vaginal crm % with applicators

Brand Name Expiry Date*

Acicvir One-Alpha One-Alpha Symmetrel Amizide Apo-Amoxi Ospamox Ospamox Fungilin Loten Pacifen Alanase Novartis Vergo 1 Beta Scalp Application Betoptic Betoptic S AFT Fleet Butacort Aqueous Marcain Isobaric Marcain Heavy Pacific Buspirone Rocaltrol Apo-Captopril Ranbaxy-Cefaclor Ranbaxy-Cefaclor Rocephin IV Celol Velosef Velosef Arrow-Citalopram Dermol Phenate Clopress Rivotril Clomazol Clotrimaderm % 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00

Amphotericin B Atenolol Baclofen Beclomethasone dipropionate Benzylpenicillin sodium Betahistine dihydrochloride Betamethasone Valerate Betaxolol hydrochloride Bisacodyl Budesonide Bupivacaine hydrochloride Buspirone hydrochloride Calcitriol Captopril Cefaclor monohydrate Ceftriaxone sodium Celiprolol Cephradine Citalopram hydrobromide Clobetasol propionate Clomiphene citrate Clomipramine hydrochloride Clonazepam Clotrimazole

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Codeine phosphate Cyproterone acetate Cyproterone acetate with ethinyloestradiol Danthron with poloxamer

Presentation

Tab 1 mg, 0 mg & 0 mg Tab 0 mg mg with ethinyloestradiol mcg tab with inert tablets Oral liq mg with poloxamer 00 mg per ml Oral liq mg with poloxamer 1 g per ml Inj 00 mg Rectal tubes mg & 10 mg Tab EC mg & 0 mg Tab long-acting mg & 100 mg Eye drops 1 mg per ml Suppos 1. mg, mg, 0 mg & 100 mg Tab 0 mg & 0 mg Eye drops 0.1% Tab 00 mg Tab 0 mg with total sennosides mg Tab mg & mg Tab 100 mg Tab mg, 10 mg & 0 mg Inj 1 g Tab 00 mg Tab 0 mg & 0 mg Tab long-acting mg Tab long-acting 10 mg Cap 0 mg & 00 mg Grans for oral liq 1 mg per ml Grans for oral liq 0 mg per ml Inj 0 mg, 00 mg & 1 g Tab 100 mcg Oint 0 mcg, with fluocortolone pivalate 0 mcg and cinchocaine hydrochloride mg per g Suppos 0 mcg, with fluocortolone pivalate 10 mcg, and cinchocaine hydrochloride 1 mg Eye drops 0.1% Cap 0 mg Tab disp 0 mg, scored

Brand Name Expiry Date*

HMG Pacific Cyproterone Estelle- ED Codalax Codalax Forte Mayne Stesolid Apo-Diclofenac Apo-Diclo SR Voltaren Ophtha Voltaren Dilzem Propine Antabuse Laxsol Dosan Doxine m-Enalapril Cafergot ERA Etidrate Famox Felo ER Felo 10 ER Staphlex AFT AFT Flucloxin Florinef Ultraproct Ultraproct Flucon Fluox Fluox 00 00 00 00 00 00 00 00 00

Desferrioxamine mesylate Diazepam Diclofenac sodium

Diltiazem hydrochloride Dipivefrin Hydrochloride Disulfiram Docusate sodium with sennosides Doxazosin mesylate Doxycycline Hydrochloride Enalapril Erythromycin lactobionate Etidronate Disodium Famotidine Felodopine Flucloxacillin sodium

00 00 00 00 00 00 00 00 00 00 00 00 00

Ergotamine tartrate with caffeine Tab 1 mg with caffeine 100 mg

Fludrocortisone Acetate Fluocortolone caproate with fluocortolone pivalate and cinchocaine

00 00

Fluoromethalone Fluoxetine hydrochloride

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Flupenthixol Decanoate

Presentation

Inj 0 mg per ml, 1 ml Inj 0 mg per ml, ml Inj 100 mg per ml, 1 ml Tab 0 mg Tab 0. mg & mg Inj 10 mg per ml, ml Tab 0 mg Tab 00 mg Tab 0 mg Eye drops 0.% Suppos . g TDDS mg and 10 mg Oral pump spray 00 mcg per dose Tab 00 mcg, 1. mg & mg Oral liq mg per ml Inj mg per ml, 1 ml Tab mg & 0 mg Oral liq 100 mg per ml Tab . mg Nebuliser soln 0 mcg per 1 ml, 1 ml Nebuliser soln 00 mcg per ml, ml Inj 0 mg per ml, ml Tab long-acting 0 mg Tab 0 mg Cap 10 mg Cap 0 mg Tab 00 mg Tab 0 mg, 100 mg, 00 mg & 00 mg Oral liq 10 g per 1 ml Inj . mg & 11. mg Eye drops 0.% & 0.% Cap 0 mg with benserazide 1. mg Tab dispersible 0 mg with benserazide 1. mg Cap 100 mg with benserazide mg Cap long-acting 100 mg with benserazide mg Cap 00 mg with benserazide 0 mg Inj 0.%, ml Inj 1%, ml Inj 1%, 0 ml

Brand Name Expiry Date*

Fluanxol 00

Flutamide Folic acid Frusemide

Flutamin Apo-Folic Acid Mayne Diurin 0 Diurin 00 Fucidin Genoptic HMG Nitroderm TTS Nitrolingual Pumpspray Serenace Serenace Serenace Douglas Micreme H Fenpaed Napamide Steri-Neb Steri-Neb Ferrosig Duride Ismo-0 Isotane 10 Isotane 0 Nizoral Hybloc Laevolac Lucrin Depot Betagan Madopar . Madopar Dispersible Madopar 1 Madopar HBS Madopar 0 Xylocaine 0.% Xylocaine 1.0% Xylocaine 1.0%

00 00 00 00 00 00 00 00 00

Fucidic acid Gentamicin Sulphate Glycerol Glyceryl trinitrate Haloperidol

Hydrocortisone Ibuprofen Indapamide Ipratropium bromide Iron polymaltose Isosorbide mononitrate Isotretinoin Ketoconazole Labetalol Lactulose Leuprorelin Levobunolol Levodopa with Benserazide

00 00 00 00 00 00 00 00 00 00 00 00 00 00 00

Hydrocortisone with miconazole Crm 1% with miconazole nitrate %

Lignocaine hydrochloride

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Lignocaine with prilocaine hydrochloride

Presentation

Brand Name Expiry Date*

Crm .% with prilocaine hydrochloride Emla .% g Crm .% with prilocaine hydrochloride Emla .% 0g Tab 10 mg Tab 1 mg & . mg Paste Liq 0.% Tab . mg, mg & 10 mg Enema 1 g per 100 ml Tab 00 mg & 0 mg Powder 1 g Tab mg Tab 10 mg Crm 0.1% Oint 0.1% Tab long-acting 00 mg Tab 00 mg & 00 mg Cap 0 mg Oral gel 0 mg per g Tab 10 mg & 00 mg Tab immediate release 10 mg & 0 mg Tab 0 mg & 0 mg Inj 00 mcg per ml, 1ml Inj . mg per ml, 1 ml Tab long-acting 0 mg Tab 00,000 u Oral liq mg per ml Tab mg Inj iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj iu with ergometrine maleate 00 mcg per ml, 1 ml Suppos 00 mg Eye oint with soft white paraffin Tab 100 mg Crm % Tab 0 mg & 100 mg Apo-Loratadine Ativan HMG AFT Provera Asacol Metomin AFT Pallidone Rubifen Advantan Advantan Metamide Slow Lopressor Trichozole Metopirone Daktarin Apo-Moclobemide Sevredol Apo-Nadolol Mayne AstraZeneca Nyefax Retard Nilstat Apo-Oxybutynin Apo-Oxybutynin Syntocinon Syntocinon Syntometrine Paracare Lacri-Lube Pexsig Lyderm HMG

Loratadine Lorazepam Magnesium hydroxide Malathion Medroxyprogesterone acetate Mesalazine Metformin hydrochloride Methadone Methadone hydrochloride Methylphenidate hydrochloride Methylprednisolone aceponate

00 00 00 00 00 00 00 00 00 00 00 2007 00 00 00 00 00 00 00 00 00 00 00 00 00

Metoclopramide hydrochloride Tab 10 mg Metoprolol tartrate Metronidazole Metyrapone Miconazole Moclobemide Morphine sulphate Nadolol Naloxone hydrochloride Neostigmine Nifedipine Nystatin Oxybutynin Oxytocin

Paracetamol Paraffin Liquid with Soft White Paraffin Perhexiline maleate Permethrin Pethidine hydrochloride

00 00 00 00 00

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Phenoxymethylpenicillin (Penicillin V) Phytomenadione

Presentation

Cap potassium salt 0 mg & 00 mg Oral liq benzathine 1 mg per ml Oral liq benzathine 0 mg per ml Inj mg per 0. ml Inj 10 mg per ml, 1 ml Tab 10 mg Tab mg, 10 mg & 1 mg Tab dispersible 10 mg & 0 mg Soln 0.% Eye drops 1.% Eye drops % Tab long-acting 00 mg Tab 1 mg, mg & mg Tab mg Tab 10 mg & 0 mg Cap long-acting 10 mg Tab 00 mg Tab 00 mg Cap 100 mg Tab 10 mg & 00 mg Tab mg Crm 1% with chlorhexidine digluconate 0.% Enema 0 mg with sodium lauryl sulphoacetate mg per ml, ml Grans effervescent g sachets Tab 0 mg & 10 mg Tab mg & 100 mg Tab 10 mg & 0 mg Inj 1 mg per ml, 1ml Inj 0 mcg Tab 10 mg, mg, 0 mg & 100 mg Tab 10 mg Eye Drops 0.% & 0.% Tab 00 mg Tab 00 mg Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate . mg and gramicidin 0 mcg per g

Brand Name Expiry Date*

Cilicaine VK AFT AFT Konakion MM Konakion MM Konakion Pindol Piram-D Condyline Liquifilm Tears Liquifilm Forte Tears Plus Span-K Hyprosin Redipred Antinaus Cardinol Cardinol LA Q 00 Q 00 Norvir Romicin Apo-Selegiline Silvazine Microlax Ural Pacific Spirotone Genox Synacthen Depot Synacthen Aldazine Apo-Timolol Apo-Timop Diatol Cyklokapron Kenacomb 00 00 00

Pindolol Piroxicam Podophyllotoxin Polyvinyl Alcohol

00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00

Polyvinyl Alcohol with Povidone Eye drops 1.% with povidone 0.% Potassium chloride Prazosin hydrochloride Prochlorperazine Propranolol Quinine sulphate Ritonavir Roxithromycin Selegiline Silver sulphadiazine Sodium citrate with sodium lauryl sulphoacetate Sodium citro-tartrate Sotalol Spironolactone Tamoxifen citrate Tetracosactrin Thioridazine hydrochloride Timolol Timolol maleate Tolbutamide Tranexamic acid Triamcinolone Acetonide with Gramicidin, Neomycin and Nystatin

Prednisolone sodium phosphate Oral liq mg per ml

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

Sole Subsidised Supply Products – cumulative to July 2005

Generic Name

Triamterene with hydrochlorothiazide Tropisetron Verapamil hydrochloride

Presentation

Tab 0 mg with hydrochlorothiazide mg Cap mg Tab 0 mg & 0 mg Tab long-acting 0 mg Inj . mg per ml, ml Purified for injection ml & 10 ml

Brand Name Expiry Date*

Triamizide Navoban Verpamil Verpamil SR Isoptin AstraZeneca 00 00 00

Water July changes are in bold type

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 1

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings

Effective 1 July 2005

111 11 NYSTATIN Oral liq 100,000 u per ml ........................................................... .0 COMPOUND ELECTROLYTES Powder for soln for oral use g - Available on a PSO ................. . PARACETAMOL ❋ Tab 00 mg - Available on a PSO ............................................ 1. ml OP 10 1,0 ✓ Nilstat

✓ Enerlyte

✓ Panadol

METHADONE HYDROCHLORIDE a) Only on a controlled drug form. b) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets). Tab mg ................................................................................... . 10 ✓ HMG CAPECITABINE – PCT only – specialist – Special Authority Tab 10 mg ........................................................................... 11.00 Tab 00 mg ........................................................................... 0.00 0 10

✓ Xeloda ✓ Xeloda

Special Authority for Subsidy - Form: SA0 Initial application only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: Any of the following: 1 The patient has advanced gastrointestinal malignancy; or The patient has metastatic breast cancer*; or Both: .1 The patient has poor venous access or needle phobia*; and . The patient requires a substitute for single agent fluoropyrimidine*. Renewal only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: The patient requires continued therapy; or The tumour has relapsed and requires re-treatment. Note indications marked with * are unapproved indications. 10 CYCLOPHOSPHAMIDE Inj 1 g – PCT only – specialist.................................................. 1.1 Inj g – PCT only – specialist.................................................. .00 CYTARABINE Inj 100 mg per ml, 0 ml - PCT only – specialist .................... 11.00 FLUDARABINE - PCT only – specialist Tab 10 mg ............................................................................. .0 FLUDARABINE PHOSPHATE - PCT only – specialist Inj 0 mg ........................................................................... 1,. FLUOROURACIL SODIUM Inj mg per ml, 100 ml - PCT only – specialist ...................... 1.1 1 1 1 1 1

✓ Endoxan ✓ Endoxan

10 10 10 10

✓ Mayne

✓ Fludara

✓ Mayne

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings - effective 1 July 2005 (continued)

10 IFOSFAMIDE – PCT only – specialist Inj 1 g ..................................................................................... . Inj g ................................................................................... 1.0 IRINOTECAN - PCT only – specialist – Special Authority Inj 0 mg per ml, ml ........................................................... 10.00 Inj 0 mg per ml, ml ........................................................... 00.00 1 1 1 1 ✓ Holoxan ✓ Holoxan

✓ Camptosar ✓ Camptosar

Special Authority for Subsidy - Form: SA0 Initial application only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: Both: 1 The patient has metastatic colorectal cancer; and Either: .1 To be used for first or second line use as part of a combination chemotherapy regimen; or . As single agent chemotherapy in fluropyrimidine-relapsed disease. Renewal only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: The patient requires continued therapy; or The tumour has relapsed and requires re-treatment. 11 11 11 BLEOMYCIN SULPHATE - PCT only – specialist Inj 1 iu................................................................................. 0.00 DOXORUBICIN - PCT only – specialist Inj 0 mg ................................................................................ . EPIRUBICIN - PCT only – specialist Inj mg per ml, ml ............................................................... .00 Inj mg per ml, ml ........................................................... 1.0 MESNA – PCT only – specialist Inj 100 mg per ml, ml ......................................................... 10. Inj 100 mg per ml, 10 ml ....................................................... 1. Tab 00 mg ........................................................................... 1.0 Tab 00 mg ........................................................................... 1. MITOZANTRONE – PCT only – specialist Inj mg per ml, 10 ml ........................................................... 0.00 PACLITAXEL - PCT only – specialist – Special Authority Inj 0 mg .............................................................................. 100.00 Inj 100 mg ............................................................................ .00 10 1 1 1 1 1 0 0 1 1 1

✓ Blenoxane

✓ Mayne

✓ Pharmorubicin ✓ Pharmorubicin

✓ Uromitexan ✓ Uromitexan ✓ Uromitexan ✓ Uromitexan

11 11

✓ Onkotrone

✓ Taxol ✓ Taxol

continued...

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once 1

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Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings - effective 1 July 2005 (continued)

1. Either: 1..1 Has not received prior chemotherapy; or 1.. Has received prior chemotherapy but have not previously been treated with taxanes; or The patient has metastatic breast cancer; or Both: .1 The patient has non small-cell lung cancer; and . Either: ..1 Has advanced disease (stage IIIa or above); or .. Is receiving combined chemotherapy and radiotherapy; or Both: .1 The patient has small-cell lung cancer*; and . Paclitaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: The patient has metastatic breast cancer, non small-cell lung cancer, or small-cell lung cancer* and .1 The patient requires continued therapy; or . The tumour has relapsed and requires re-treatment. Note indications marked with * are unapproved indications. 11 VINORELBINE - PCT only – specialist Inj 10 mg per ml, 1 ml ........................................................... 11.00 Inj 10 mg per ml, ml ........................................................... 0.00 RITUXIMAB - PCT only – specialist – Special Authority Inj 100 mg per 10 ml vial .................................................... 1,1.00 Inj 00 mg per 0 ml vial .................................................... ,.00 1 1 1 ✓ Navelbine ✓ Navelbine

✓ Mabthera ✓ Mabthera

Special Authority for Subsidy - Form: SA0 Initial application - (Post-transplant) only from a relevant specialist. Approvals valid for months for applications meeting the following criteria: 1 The patient has B-cell post-transplant lymphoproliferative disorder* Note for no more than cycles Initial application - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for months for applications meeting the following criteria: The patient has low grade NHL - relapsed disease following prior chemotherapy. Note for no more than treatment cycles. Initial application - (Large cell lymphomas) only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: Both: The patient has treatment naïve large B-cell NHL; and To be used with CHOP (or alternative anthracycline containing multi-agent chemotherapy regime given with curative intent). Note for no more than treatment cycles. Renewal - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for months for applications meeting the following criteria: Both: The patient has had a treatment-free interval of months or more; and Either: .1 Has B-cell post-transplant lymphoproliferative disorder*; or . Has low grade NHL - relapsed disease following prior chemotherapy. Note for no more than treatment cycles for low grade NHL. Indications marked with * are unapproved indications. Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supplier

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Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings - effective 1 July 2005 (continued)

1 TRASTUZUMAB - PCT only – specialist – Special Authority Inj 10 mg vial ................................................................... 1,0.00 Inj 0 mg vial ................................................................... ,.00 1 1 ✓ Herceptin ✓ Herceptin

Special Authority for Subsidy - Form: SA0 Initial application only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: The patient has metastatic breast cancer expressing HER- + or FISH+. Renewal only from a relevant specialist. Approvals valid for 1 months for applications meeting the following criteria: The cancer has not progressed.

Effective 1 June 2005

GLUCOSE OXIDASE - Not on a bulk supply order Urine diagnostic test with peroxidase ......................................... .1 (.0) FERROUS SULPHATE ❋‡Oral liq 10 mg per ml........................................................... . 0 strip OP Clinistix 0 ml ✓ Ferro-liquid

NICOTINIC ACID ❋ Tab 00 mg ............................................................................ 1.1 100 ✓ Niacin-Odan Niacin-Odan is an unapproved medication supplied under Section of the Medicines Act 11. Practitioners prescribing this medication should: (a) be aware of and comply with their obligations under Section of the Medicines Act 11 and otherwise under that Act and the Medicines Regulations 1; (b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and (c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an indication for which it is not approved. FUSIDIC ACID a) Only on a prescription, b) Not in combination, c) Maximum 1 g per prescription. Crm %..................................................................................... . Oint % ..................................................................................... . IMATINIB MESYLATE – Special Authority – access by application Tab 100 mg ........................................................................ ,00.00

1 g OP 1 g OP 0

✓ Foban ✓ Foban ✓ Glivec

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once 1

Check your Schedule for full details Schedule page ref

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Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings - effective 1 May 2005

COPPER - Not on a bulk supply order ❋ Tab, diagnostic .......................................................................... .0 (0.) GLUCOSE OXIDASE - Not on a bulk supply order Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid............................. . (.0) SODIUM NITROPRUSSIDE - Not on a bulk supply order ❋ Urine diagnostic strips, buffered................................................. .0 (.1) OP Clinitest

0 strip OP Keto-Diastix 0 strip OP Ketostix

INFLUENZA VACCINE (a) Subsidy is available between 1 March and 1 July 00 for patients who meet the following criteria, as set by the Ministry of Health: a) all people years of age and over; b) people under years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, ) congestive heart disease, ) rheumatic heart disease, ) congenital heart disease, or ) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or ) other chronic respiratory disease with impaired lung function; iii) diabetes; iv) chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi) the following other conditions: 1) autoimmune disease, ) immune suppression, ) HIV, ) transplant recipients, ) neuromuscular and CNS diseases, ) haemoglobinopathies, or ) children on long term aspirin. The following conditions are excluded from funding: i) asthma not requiring regular preventative therapy, ii) hypertension and/or dyslipidaemia without evidence of end-organ disease, iii) pregnancy in the absence of another risk factor. (b) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under (a) above for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. (c) Individual DHBs may fund patients over and above the criteria in (a) above. The claiming process for these additional patients should be determined between the DHB and Contractor. (d) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. Inj ........................................................................................... .0 10 ✓ Fluarix ✓ Fluvax ✓ Influvac ‡ safety cap reimbursed Sole Subsidised Supplier

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

New Listings - effective 1 May 2005 (continued)

1 TEMAZEPAM - Month restriction Tab 10 mg ................................................................................. 0. ✓ Normison

Normison is an unapproved medication supplied under Section of the Medicines Act 11. Practitioners prescribing this medication should: a) be aware of and comply with their obligations under Section of the Medicines Act 11 and otherwise under that Act and the Medicines Regulations 1; b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an indication for which it is not approved. 1 FAT SUPPLEMENT Emulsion (neutral) ................................................................... 1. Special Authority for Subsidy – Form: SA00 0 ml OP ✓ Calogen

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions

Effective 1 July 2005

10 ANTIRETROVIRALS Special Authority for Subsidy - Form: SA0SA0779 Initial application - (Confirmed HIV/AIDS) only from a named specialist general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS infection; and Any of the following: .1 Symptomatic patient; or . Both: ..1 Asymptomatic patient; and .. Patient aged 1 months and under; or . Both: ..1 Asymptomatic patient; and .. Patient has viral load counts > 10,000 copies per ml or equivalent value on the Chiron test; or . All of the following: ..1 Asymptomatic patient; and 2.3.1 .. Patient aged 1 to years; and 2.3.2 Either: 2.3.2.1 .. CD counts < 1,000 cells/mm; or . All of the following: ..1 Asymptomatic patient; and .. Patient aged 1 to years; and 2.3.2.2 .. CD counts < 0. x total lymphocyte white cell count; or 2.3.2.3 Patient has viral load counts > 100,000 copies per ml, or . All of the following: ..1 Asymptomatic patient; and 2.4 Both: .. 2.4.1 Patient aged years and over; and .. 2.4.2 CD counts < 00 350 cells/mm. Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application - (Percutaneous exposure) only from a named specialist general physician. Approvals valid for weeks for applications meeting the following criteria: Person with percutaneous exposure to blood known to be HIV positive. Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application - (Prevention of maternal transmission) only from a named specialist general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: Treatment with zidovudine; and 3 Either: 3.1 .1 Prevention of maternal foetal transmission; or 3.2 . Treatment of the newborn for up to six eight weeks. continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supplier

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 July 2005 (continued)

Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Some antiretrovirals are unapproved or contraindicated for this in indication. Practitioners prescribing these medications should exercise their own skill, judgement, expertise and discretion, and make their own prescribing decisions with respect to the use of a Pharmaceutical for an indication for which it is not approved or contraindicated. Renewal - (Confirmed HIV/AIDS) only from a named specialist general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: The treatment remains appropriate and the patient is benefiting from treatment. 10 LOPINAVIR WITH RITONAVIR - Special Authority - Hospital Pharmacy [HP1] Cap 1. mg with ritonavir . mg ..................................... .00 10 ✓ Kaletra Oral liq 0 mg with ritonavir 0 mg per ml.............................. .00 00 ml ✓ Kaletra Special Authority for Subsidy - Form: SA01 SA0779 Initial application only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient already has a Special Authority approval for anti-retroviral therapy (Details to be attached to application); and Kaletra is to be used as a salvage therapy in place of one protease inhibitor; and The patient must have trialed for at least six months and have failed on currently funded NNRTI based regimens or triple NRTI regimens; and The patient must have trialed for at least six months and have failed on currently funded PI based regimens. Note Failure is defined as: a) not achieving HIV RNA < 00 copies/ml after weeks of a regimen, or b) an increase of HIV RNA to > 00 copies/ml on two separate occasions not less than one month apart, after suppression to < 00 copies/ml in a patient taking the regimen. Initial application - (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV infection; and Any of the following: .1 Symptomatic patient; or . Patient aged 1 months and under; or . Both: ..1 Patient aged 1 to years; and .. Either: ...1 CD counts < 1,000 cells/mm; or ... CD counts < 0. x total lymphocyte count; or ... Patient has viral load counts > 100,000 copies per ml, or . Both: ..1 Patient aged years and over; and .. CD counts < 0 cells/mm. Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. continued...

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 July 2005 (continued)

Initial application - (Percutaneous exposure) only from a named specialist. Approvals valid for weeks for applications meeting the following criteria: Person with percutaneous exposure to blood known to be HIV positive. Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application - (Prevention of maternal transmission) only from a named specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: .1 Prevention of maternal foetal transmission; or . Treatment of the newborn for up to eight weeks. Note Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Some antiretrovirals are unapproved or contraindicated for this in indication. Practitioners prescribing these medications should exercise their own skill, judgement, expertise and discretion, and make their own prescribing decisions with respect to the use of a Pharmaceutical for an indication for which it is not approved or contraindicated. Renewal - (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: The treatment remains appropriate and the patient is benefiting from treatment. 11 NEW ANTIEPILEPSY DRUGS Special Authority for Subsidy – Form: SA0SA0780 Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 1 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 000; or Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note “Optimal older anti-epilepsy drug therapy” is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient’s age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Initial application - (Dual NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 1 months for applications meeting the following criteria: Either: Stabilised on two NAEDs on or before 1 July 000; or Both: .1 A second NAED has been added; and . An attempt to withdraw one NAED has been made and was unsuccessful. Initial application - (Neuropathic pain - gabapentin only) only from a relevant specialist, vocationally registered general practitioner or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 2 months where the patient has tried and failed, or has been unable to tolerate, treatment with a tricyclic antidepressant AND an anticonvulsant agent. continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supplier

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 July 2005 (continued)

Note Gabapentin is not interchangeable with other NAEDs when used for treating neuropathic pain. Vocationally registered general practitioners are a relevant specialist when recommending gabapentin for neuropathic pain. Renewal - (Single or Dual NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 1 months for applications meeting the following criteria: Either: Both: .1 Patient has been prescribed adequate doses of gabapentin, lamotrigine, topiramate or vigabatrin; and . Patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life; or Patient has had a previous approval but has not yet trialed monotherapy with all available NAEDs. Note As a guideline, clinical trials have referred to a notional 0% reduction in seizure frequency as an indicator of success with anti-convulsant therapy and have assessed quality of life from the patient’s perspective Renewal - (Triple NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for months for applications meeting the following criteria: Both: Patient is on dual therapy; and Patient switching from vigabatrin to another NAED. Renewal - (Neuropathic pain - gabapentin only) only from a relevant specialist, vocationally registered general practitioner or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 2 years where the patient has demonstrated a marked improvement in their control of pain (prescriber determined). Note Gabapentin is not interchangeable with other NAEDs when used for treating neuropathic pain. Vocationally registered general practitioners are a relevant specialist when recommending gabapentin for neuropathic pain. Note: Special Authority applications and reapplications for NAEDs (for use in epilepsy) must be made by a neurologist or paediatric neurologist. Applications from a general physician or paediatrician will be accepted if access to neurology or paediatric neurology services is limited in the locality in which they practice. 10 10 BUSULPHAN - Retail pharmacy-specialist - PCT Tab mg ................................................................................. . CALCIUM FOLINATE - Hospital pharmacy [HP1] or [HP]-specialist - PCT Tab 1 mg [HP] ..................................................................... .0 (.0) Inj mg per ml, 1 ml [HP1] ..................................................... 1.10 Inj 1 mg [HP1] ...................................................................... .0 Inj 0 mg [HP1] ...................................................................... . CHLORAMBUCIL - Retail pharmacy-specialist - PCT Tab mg ................................................................................. . CYCLOPHOSPHAMIDE Tab 0 mg - Retail pharmacy-specialist - PCT .......................... .1 Inj 1 g - Retail pharmacy-specialist - PCT .............................. 1.0 100 10 each 0 ✓ Myleran ✓ Mayne Leucovorin ✓ Leucovorin Calcium ✓ Leucovorin Calcium ✓ Mayne ✓ Leukeran FC ✓ Cycloblastin ✓ Cytoxan

10 10

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 July 2005 (continued)

10 10 CYTARABINE Inj 100 mg - Retail pharmacy-specialist - PCT ......................... 0.00 Inj 00 mg - Retail pharmacy-specialist - PCT ......................... .00 FLUOROURACIL SODIUM Inj 0 mg per 10 ml - Retail pharmacy-specialist - PCT .......... 1. Inj 00 mg per 10 ml - Retail pharmacy-specialist - PCT .......... . Inj 00 mg per 0 ml - Retail pharmacy-specialist - PCT .......... .0 MELPHALAN - Retail pharmacy-specialist - PCT Tab mg ................................................................................. 1.1 MERCAPTOPURINE - Retail pharmacy-specialist - PCT Tab 0 mg ............................................................................... .0 THIOTEPA - Retail pharmacy-specialist - PCT Inj 1 mg ................................................................................ 1. ETOPOSIDE - Hospital pharmacy [HP1] & [HP]-specialist - PCT Cap 0 mg [HP] .................................................................. 0. Cap 100 mg [HP] ................................................................ 0. Inj 0 mg per ml, ml [HP1] ................................................... 1. HYDROXYUREA - Retail pharmacy-specialist - PCT Cap 00 mg ............................................................................ 1. METHOTREXATE - Hospital pharmacy [HP1] & [HP]-specialist - PCT ❋ Tab . mg [HP] ...................................................................... .0 ❋ Tab 10 mg [HP] ..................................................................... 0. ❋ Inj mg per ml vial [HP1] ..................................................... . ❋ Inj 0 mg per ml vial [HP1] ................................................... . ❋ Inj 0 mg per ml vial [HP1] ................................................... .10 ❋ Inj 100 mg per ml vial [HP1] ................................................. .0 ❋ Inj g per 0 ml vial [HP1] .................................................... 00. ❋ Inj 00 mg, 0 ml vial [HP1].................................................... 0. ❋ Inj 1 g per 10 ml vial [HP1] ...................................................... .0 THIOGUANINE - Hospital pharmacy [HP]-specialist - PCT Tab 0 mg ............................................................................... .1 VINBLASTINE SULPHATE - Retail pharmacy-specialist - PCT Inj 10 mg .............................................................................. 1.0 VINCRISTINE SULPHATE - Retail pharmacy-specialist - PCT Inj 1 mg per ml, 1 ml ............................................................. 1.00 Inj 1 mg per ml, ml ............................................................. .0 each 10 each 0 10 each 100 0 0 each each each ✓ Mayne ✓ Pharmacia ✓ Mayne ✓ Mayne ✓ Mayne ✓ Mayne ✓ Alkeran ✓ Purinethol ✓ Thiotepa ✓ Vepesid ✓ Vepesid ✓ Mayne ✓ Vepesid ✓ Hydrea ✓ Methoblastin ✓ Methoblastin ✓ Mayne ✓ Mayne ✓ Mayne ✓ Mayne ✓ Mayne ✓ Mayne ✓ Mayne ✓ Lanvis ✓ Mayne ✓ Mayne ✓ Mayne

10 10 10 11

11 11

11 11 11

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 July 2005 (continued)

11 DEXAMETHASONE WITH FRAMYCETIN AND GRAMICIDIN Retail pharmacy – specialist when used in the treatment of eye conditions Ear/Eye drops 00 mcg with framycetin sulphate mg and gramicidin 0 mcg per ml ....................................................... .0 ml OP (.0) Ear/Eye oint 0. mg with framycetin sulphate mg and gramicidin 0 mcg per g......................................................... .0 g OP (.0)

Sofradex Sofradex

Changes to Restrictions - effective 1 June 2005

GLUCOSE DEHYDROGENASE The number of test strips available on a prescription is restricted to 50 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or b) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or c) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood/glucose test strips ......................................................... 11.00 test OP ✓ Medisense Optium .00 0 test OP ✓ Accu-Chek Advantage ✓ Medisense Optium GLUCOSE OXIDASE The number of test strips available on a prescription is restricted to 50 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or b) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or c) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood diagnostic test with peroxidase ...................................... . 0 test OP ✓ Ascensia Glucodisc Glucocard (.) Blood diagnostic test with peroxidase ...................................... .0 100 test OP (.0) Precision Plus IMIGLUCERASE - Special Authority - Hospital pharmacy [HP][HP1] Inj 0 iu per ml, 00 iu vial ................................................ 1,1. 1 ✓ Cerezyme

100

LAMIVUDINE - Special Authority - Retail pharmacy Tab 100 mg .......................................................................... 1.00 ✓ Zeffix Oral liq mg per ml ................................................................ 0.00 0 ml ✓ Zeffix Special Authority for Subsidy - Form: SA0 Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than months; and 1.1. HBeAg positive or HBV DNA positive defined as >0. pg/ml by quantitative PCR at reference laboratory; and 1.1. ALT greater than twice upper limit of normal or stage or fibrosis on liver histology clinical/ radiological evidence of cirrhosis; or continued...

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 June 2005 (continued)

1. HBV DNA positive cirrhosis prior to liver transplantation; or 1. HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; and or 1.4 Hepatitis B surface antigen positive (HbsAg) patient who is receiving chemotherapy for a malignancy, or who has received such treatment within the previous two months; and All of the following: .1 No continuing alcohol abuse or intravenous drug use; and . Not coinfected with HCV, HDV, or HIV; and . Neither ALT nor AST greater than 10 times upper limit of normal; and . No known or suspected hepatocellular carcinoma (AFP > 100 or liver mass on imaging) unless awaiting liver transplantation or other curative treatment; and . Not pregnant or breast feeding; and . No history of hypersensitivity to lamivudine; and . No previous lamivudine therapy with breakthrough (presumed YMDD mutant). Renewal only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for years for applications meeting the following criteria: All of the following: Have maintained continuous treatment with lamivudine; and Any of the following: .1 Most recent test result shows continuing biochemical response (normal ALT); or . HBeAg negative; or . HBV DNA negative defined as < 0. pg/ml by quantitative PCR at reference laboratory; and Either: .1 Have had less than three years of access to treatment with lamivudine; or . There is evidence of cirrhosis. 11 SELECTIVE SEROTONIN REUPTAKE INHIBITORS Higher subsidy by endorsement for: Citalopram tab 0 mg x (Celapram) up to $.00 Citalopram tab 0 mg x (Cipramil) up to $10.00 Paroxetine hydrochloride tab 0 mg x 0 (Aropax) up to $.0 is available for patients who: • were taking citalopram on 1 February 000; or paroxetine hydrochloride on February 001; or • have previously responded to treatment with citalopram or paroxetine hydrochloride; or • have had a trial of fluoxetine and have had to discontinue due to - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or • have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly. Note – this amendment results from citalopram hydrobromide (Celapram and Cipramil) tablets 0 mg being delisted 1 June 00. TIOTROPIUM BROMIDE – Special Authority – Retail pharmacy Powder for inhalation, monodose device, 1 mcg per dose .................................................................. 0.00 0 monodoses ✓ piriva S Special Authority for Subsidy – Form: SA0 Initial application only from a general practitioner or relevant specialist. Approvals valid for years for applications meeting the following criteria: All of the following: 1 To be used for the long-term maintenance treatment of bronchospasm and dyspnoea associated with COPD; and continued... ‡ safety cap reimbursed Sole Subsidised Supplier

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 June 2005 (continued)

In addition to standard treatment, the patient has trialled a dose of at least 0 mcg ipratropium q.i.d for one month; and The patient’s breathlessness >= grade according to the Medical Research Council (UK) dyspnoea scale (see note). Grade must be stated on the application; and FEV1 < 0% of predicted (copy of actual result and predicted value to be included in application, or values to be stated on form actual result and predicted value to be stated on form); and Either: .1 Patient is not a smoker; or . Patient is a smoker and been offered smoking cessation counselling; and The patient has been offered annual influenza immunisation. Renewal only from a general practitioner or relevant specialist. Approvals valid for years for applications meeting the following criteria: All of the following: Patient is compliant with the medication; and Patient has experienced improved COPD symptom control (prescriber determined); and Applicant must supply recent measurement of FEV1 (% of predicted). Details must be attached to the application (for reporting purposes only) Value to be stated on form. Note Grade = stops for breath after walking about 100 meters or after a few minutes on the level; Grade = too breathless to leave the house, or breathless when dressing or undressing

Effective 1 May 2005

CIMETIDINE a) Only on a prescription. b) Not as an effervescent or dispersible tab. ❋ Tab 00 mg ............................................................................... .00 ❋ Tab 00 mg ............................................................................. 10.00 PYRAZINAMIDE - Retail pharmacy-specialist Tab 00 mg ............................................................................. .00

100 100 100

✓ Apo-Cimetidine ✓ Apo-Cimetidine ✓ AFT-Pyrazinamide

AFT-Pyrazinamide is an unapproved medication supplied under Section of the Medicines Act 11. Practitioners prescribing this medication should: a) be aware of and comply with their obligations under Section of the Medicines Act 11 and otherwise under that Act and the Medicines Regulations 1; b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an indication for which it is not approved.

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once 1

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Restrictions - effective 1 May 2005 (continued)

10 INFLUENZA VACCINE (a) Subsidy is available between 1 March and 1 June 31 July 2005 of each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people years of age and over; b) people under years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, ) congestive heart disease, ) rheumatic heart disease, ) congenital heart disease, or ) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or ) other chronic respiratory disease with impaired lung function; iii) diabetes; iv) chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi) the following other conditions: 1) autoimmune disease, ) immune suppression, ) HIV, ) transplant recipients, ) neuromuscular and CNS diseases, ) haemoglobinopathies, or ) children on long term aspirin. The following conditions are excluded from funding: i) asthma not requiring regular preventative therapy, ii) hypertension and/or dyslipidaemia without evidence of end-organ disease, iii) pregnancy in the absence of another risk factor. (b) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under (a) above for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. (c) Individual DHBs may fund patients over and above the criteria in (a) above. The claiming process for these additional patients should be determined between the DHB and Contractor. (d) The manufacturer’s price as listed for Vaxigrip includes four deliveries to each address per calendar month on which freight will not be charged. (e) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. Inj ........................................................................................... .0 10 ✓ Fluarix ✓ Fluvax ✓ Influvac

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 July 2005

DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE (ê subsidy) ❋ Tab . mg with atropine sulphate mcg ................................. .0 100 RANITIDINE HYDROCHLORIDE - Only on a prescription. (ê subsidy) ❋ Tab 10 mg ............................................................................... . ❋ Tab 00 mg ............................................................................. 10. LANSOPRAZOLE (ê subsidy) ❋ Cap 0 mg ................................................................................ . (.0) PANTOPRAZOLE (ê subsidy) ❋ Tab 0 mg ................................................................................. . (.00) ❋ Tab 0 mg ................................................................................. . (.00) GLIPIZIDE (ê subsidy) ❋ Tab mg ................................................................................... .0 0 0 0 Zoton 0 Somac 0 Somac 100 ✓ Minidiab ✓ Diastop ✓ Arrow-Ranitidine ✓ Arrow-Ranitidine

GLUCOSE OXIDASE (ê subsidy) The number of test strips available on a prescription is restricted to 0 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or b) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or c) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood diagnostic test with peroxidase ...................................... .00 0 test OP Ascensia Glucodisc (.) (.) Glucocard Blood diagnostic test with peroxidase ...................................... .00 100 test OP (.0) Precision Plus DOCUSATE SODIUM (ê subsidy) ❋ Oral drops 10% ......................................................................... . TRIAMCINOLONE ACETONIDE (ê subsidy) 0.1% in Dental Paste USP .......................................................... .0 HEPARIN SODIUM (è price) Inj 1,000 iu per ml, ml .......................................................... . (1.10) FELODIPINE (ê subsidy) ❋ Tab long-acting . mg ............................................................ 11. No more than 1 tab per day VERAPAMIL HYDROCHLORIDE (ê subsidy) ❋ Tab long-acting 10 mg ........................................................... 1.0 0 ml OP g OP 1 Mayne 0 ✓ Plendil ER ✓ Coloxyl ✓ Oracort

✓ Verpamil SR

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 July 2005 (continued)

TRIAMCINOLONE ACETONIDE (ê price) Crm 0.0%................................................................................ . Oint 0.0% ................................................................................ . 100 g OP 100 g OP ✓ Aristocort ✓ Aristocort

CHLORHEXIDINE GLUCONATE (ê subsidy) a) Only if prescribed for a dialysis patient and the prescription is endorsed accordingly; and b) Maximum of 00 ml per month. ❋ Soln % .................................................................................... .0 00 ml ✓ Orion EMULSIFYING (ê subsidy) ❋ Ointment BP .............................................................................. . ALENDRONATE - Special Authority - Retail pharmacy (ê subsidy) Tab 10 mg ............................................................................... .00 Tab 0 mg ............................................................................... .00 PREDNISONE (ê subsidy) ❋ Tab 1 mg ................................................................................... . ❋ Tab mg - Available on a PSO ................................................. 11.0 ❋ Tab 0 mg ............................................................................... 0. CIPROFLOXACIN - Retail pharmacy-specialist (ê subsidy) Tab 0 mg ............................................................................... .10 Tab 00 mg ............................................................................... .1 Tab 0 mg ............................................................................. 1.0 CO-TRIMOXAZOLE (ê subsidy) ❋ Tab trimethoprim 0 mg and sulphamethoxazole 00 mg (Available on a PSO) ............................................................. 1.00 ❋ Oral liq sugar-free trimethoprim 0 mg and sulphamethoxazole 00 mg per ml (Available on a PSO) .................................... .0 00 g 0 00 00 00

✓ AFT

✓ Fosamax ✓ Fosamax

✓ Apo-Prednisone ✓ Apo-Prednisone ✓ Apo-Prednisone

✓ Cipflox ✓ Cipflox ✓ Cipflox

10 11 11

00 00 ml

✓ Trisul ✓ Trisul

IBUPROFEN - Special Authority available - Retail pharmacy, refer above (ê subsidy) ❋ Tab 00 mg ............................................................................... 1. 100 PARACETAMOL WITH CODEINE (ê subsidy) ❋ Tab paracetamol 00 mg with codeine phosphate mg ............. . TRIMIPRAMINE MALEATE (ê subsidy) Cap mg ................................................................................ .0 Cap 0 mg .............................................................................. 10.0 CLONAZEPAM (ê subsidy) Tab 00 mcg ............................................................................. . Tab mg ................................................................................... . GABAPENTIN - Special Authority - Retail pharmacy (ê subsidy) ▲ ap 100 mg ............................................................................ . C ▲ ap 00 mg ............................................................................ . C ▲ ap 00 mg .......................................................................... 11.1 C 100 100 100 100 100 100 100 100

✓ I-Profen

✓ Codalgin

✓ Tripress ✓ Tripress

✓ Paxam ✓ Paxam

✓ Neurontin ✓ Neurontin ✓ Neurontin

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 July 2005 (continued)

11 ONDANSETRON - Hospital pharmacy [HP]-specialist (ê subsidy) a) Maximum of tablets per dispensing; and b) Maximum of 1 tablets per prescription. Not more than one prescription per month. Tab mg ................................................................................. . Tab mg ................................................................................. . BROMOCRIPTINE MESYLATE (ê subsidy) ❋ Tab . mg .............................................................................. .0 ❋ Tab 10 mg ............................................................................. 10.

10 0 100 100

✓ Zofran ✓ Zofran

1 1

✓ Alpha-Bromocriptine ✓ Alpha-Bromocriptine

SALBUTAMOL - Available on a PSO (ê subsidy) Aerosol inhaler, 100 mcg per dose CFC-free .............................. .00 00 dose OP (.00) SODIUM CROMOGLYCATE (ê subsidy) Eye drops % ............................................................................ . ACETAZOLAMIDE (ê price) ❋ Tab 0 mg ............................................................................... . ATROPINE SULPHATE (ê subsidy) ❋ Eye drops 1% ............................................................................ .01 HYPROMELLOSE (ê subsidy) ❋ Eye drops 0.% ......................................................................... . 10 ml OP 100 1 ml OP 1 ml OP

Ventolin

1 1 1 1

✓ Cromolux

✓ Diamox

✓ Atropt

✓ Poly-Tears

Effective 1 June 2005

GLUCOSE OXIDASE - Not on a bulk supply order (è price) Urine diagnostic test with peroxidase ......................................... . 100 strip OP (11.1) MUCILAGINOUS LAXATIVES - Only on a prescription (è price) ❋ Dry ........................................................................................... . (1.1) VITAMIN A WITH VITAMINS D AND C (è price) Soln 1000 u with Vitamin D 00 u and ascorbic acid 0 mg per 10 drops ........................................................ . (.1) QUINAPRIL (ê subsidy) ❋ Tab mg ................................................................................... . ❋ Tab 10 mg ................................................................................. . ❋ Tab 0 mg ................................................................................. .0 QUINAPRIL WITH HYDROCHLOROTHIAZIDE (ê subsidy) ❋ Tab 10 mg with hydrochlorothiazide 1. mg ............................. . ❋ Tab 0 mg with hydrochlorothiazide 1. mg ............................. . 0 g OP Isogel

Clinistix

10 ml OP Vitadol C 0 0 0 0 0 ✓ Accupril ✓ Accupril ✓ Accupril ✓ Accuretic 10 ✓ Accuretic 20

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 June 2005 (continued)

CALAMINE - Not in combination (ê price) Lotn, BP .................................................................................. 1.0 (.) ETHAMBUTOL - Retail pharmacy-specialist (ê subsidy) ❋ Tab 00 mg ............................................................................. 1.0 DIHYDROCODEINE TARTRATE (ê subsidy) Tab long-acting 0 mg ............................................................. 0.0 ,000 ml HMG 100 0 ✓ Myambutol ✓ DHC Continus

11 11

DIAZEPAM (è price) Inj mg per ml, ml - Only on a PSO ...................................... 1. 10 (.) Diazemuls a) Injection subsidised only on a PSO and PSO is endorsed “not for anaesthetic procedures”. SALBUTAMOL (ê subsidy) ‡ Oral liq mg per ml ................................................................ . (.) 10 ml Ventolin

Effective 1 May 2005

SODIUM ALGINATE (è price) ❋ Oral liq 00 mg with sodium bicarbonate mg per 10 ml (aniseed) ................................................................ 1.0 (.) COPPER - Not on a bulk supply order (è price) ❋ Tab, diagnostic .......................................................................... . (.) GLUCOSE OXIDASE - Not on a bulk supply order (è price) Urine diagnostic test with peroxidase ......................................... .11 (.0)

00 ml

Gaviscon

Clinitest

0 strip OP

Diastix

GLUCOSE OXIDASE - Not on a bulk supply order (è price) Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid............................. .0 100 strip OP (1.0) SODIUM NITROPRUSSIDE - Not on a bulk supply order (è price) ❋ Urine diagnostic strips, buffered................................................. . 100 strip OP (10.) CHOLINE SALICYLATE WITH CETALKONIUM CHLORIDE (è price) ❋ Adhesive gel .% with cetalkonium chloride 0.01% .................. .0 (.0) ASPIRIN (è price) ❋ Tab, soluble 00 mg - Available on a PSO .................................. 1. (.) 1 g OP

Keto-Diastix

Ketostix

Bonjela

DisprinIMM

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 May 2005 (continued)

HEPARIN SODIUM (è price) Inj ,000 iu per ml, 0. ml - Hospital pharmacy [HP]-specialist ..................................................... .0 (.)

Mayne

10 11 1

IBUPROFEN - Special Authority available - Retail pharmacy, refer above (è price) ❋ Tab long-acting 00 mg ............................................................. .01 0 (1.) PARALDEHYDE (è price) ❋ Inj ml.................................................................................... .00 (.) INTERFERON BETA-1-ALPHA - Access by application (ê subsidy) Inj million iu per vial ......................................................... 1,1.0

Brufen Retard

Mayne ✓ Avonex

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to Brand Name

Effective 1 July 2005

BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u - Available on a PSO ............................................. . 10 ✓ Biochemie Novartis

Effective 1 June 2005

POVIDONE IODINE Antiseptic soln 10% ................................................................... . (.0) Alcohol skin preparation 10%..................................................... .1 (1.0) 00 ml Viodine Riodine 00 ml Viodine Riodine

Changes to Sole Subsidised Supply

Effective 1 July 2005

For the list of new Sole Subsidised Supply products effective 1 July 00 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 1-1.

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to General Rules

Effective 1 July 2005

1 EXCEPTIONAL CIRCUMSTANCES POLICIES The purposes of the Exceptional Circumstances policies are to provide: • funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule (“Community Exceptional Circumstances”); or • an assessment process for DHB Hospitals to determine whether they can fund medication, to be used in the community, in circumstances where the medication is neither a Community Pharmaceutical nor a Discretionary Community Supply Pharmaceutical and where the patient does not meet the criteria for Community Exceptional Circumstances (“Hospital Exceptional Circumstances”); or • an assessment process for DHB Hospitals to determine whether they can fund pharmaceuticals for the treatment of cancer in their DHB Hospital, or in association with Outpatient services provided in their DHB hospital, in circumstances where the pharmaceutical is not identified as a Pharmaceutical Cancer Treatment (“Cancer Exceptional Circumstances”) in Sections A-H of the Pharmaceutical Schedule. Upon receipt of an application for approval for Community Exceptional Circumstances or Hospital Exceptional Circumstances, the Exceptional Circumstances Panel first decides whether an application will be assessed initially under the Community Exceptional Circumstances criteria or the Hospital Exceptional Circumstances criteria. Cancer Exceptional Circumstances is a separate process. CANCER EXCEPTIONAL CIRCUMSTANCES Permission to fund a pharmaceutical for the treatment of cancer from the Hospital’s own budget under Cancer Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that the proposed use meets the criteria. If the patient being treated with a pharmaceutical under Cancer Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. Applications for Community Exceptional Circumstances, Hospital Exceptional Circumstances and Cancer Exceptional Circumstances should be made on the standard application form available from the PHARMAC website www.pharmac.govt.nz or the address below: The Coordinator, Exceptional Circumstances Panel Phone (0) 1 PHARMAC or fax (0) 0 PO Box 10 Email: ecpanel@pharmac.govt.nz Wellington “Cancer Exceptional Circumstances” means the policies and criteria administered by PHARMAC relating to the ability to fund, from a DHB hospital’s own budget, pharmaceuticals for the treatment of cancer that are not identified as Pharmaceutical Cancer Treatments in Sections A-H of the Pharmaceutical Schedule. “Hospital Care Operator” means a person for the time being in charge of providing hospital care, in accordance with the Health and Disability Services (Safety) Act 2001. “PCT” means Pharmaceutical Cancer Treatment in respect of which DHB hospital pharmacies and other Contractors can claim Subsidies. “PCT only” means Pharmaceutical Cancer Treatment in respect of which only DHB hospital pharmacies can claim Subsidies. “IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

1 1 1

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to General Rules - effective 1 July 2005 (continued)

1 “Pharmaceutical Cancer Treatments” means Pharmaceuticals listed in Part V of Section H of the Pharmaceutical Schedule, and their associated indications, that DHBs must fund, from their own budgets, for use in their hospitals, and/or in association with Outpatient services provided in their DHB Hospitals, in relation to the treatment of cancers, or a Pharmaceutical for the treatment of cancer, listed in Sections A to G of the Schedule and identified therein as a “PCT” or “PCT only” Pharmaceutical. “Subsidy” means the maximum amount that the government will pay Contractors for a Community Pharmaceutical dispensed to a person eligible for Pharmaceutical Benefits and is different from the cost to the Government of subsidising that Community Pharmaceutical. For the purposes of a DHB hospital pharmacy claiming for Pharmaceutical Cancer Treatments, Subsidy refers to any payment made to the DHB hospital pharmacy or service provider to which that pharmacy serves, and does not relate to a specific payment that might be made on submission of a claim. .1 Bulk Supply Orders .1. Community Pharmaceuticals listed in Part I of the First Schedule to the Medicines Regulations 1 will be subsidised only if supplied under a Bulk Supply Order placed by an institution certified to provide hospital care under the Health and Disability Services (Safety) Act 001 and: a) that institution employs a registered general nurse, registered with the Nursing Council and who holds a current annual practicing certificate under the HPCA Act 00; and b) the Bulk Supply Order is supported by a written requisition signed by a Hospital Care Operator Practitioner. 4.5 Pharmaceutical Cancer Treatments 4.5.1 DHBs must provide access to Pharmaceutical Cancer Treatments in Part V of Section H of the Pharmaceutical Schedule for use in the treatment of cancers in their DHB hospitals, and/or in association with Outpatient services provided in their DHB hospitals. 4.5.2 A DHB hospital pharmacy that holds a claiming agreement for Pharmaceutical Cancer Treatments with the Funder may claim a Subsidy for a Pharmaceutical Cancer Treatment marked as “PCT” or PCT only” in Sections A to G of this Schedule subject to that Pharmaceutical Cancer Treatment being dispensed in accordance with: (a) Part 1; (b) clauses 2.1 to 2.3; (b) clauses 3.1 and 3.4; and (c) clause 4.5, of Section A of the Schedule. 4.5.4 A Contractor (other than a DHB hospital pharmacy) may only claim a Subsidy for a Pharmaceutical Cancer Treatment marked as “PCT” in Sections A to G of the Schedule subject to that Pharmaceutical Cancer Treatment being dispensed in accordance with the rules applying to Sections A to G of the Schedule. 4.5.5 Some indications for Pharmaceutical Cancer Treatments listed in the Schedule have not been approved by Medsafe, but formed part of the October 2001 direction from the Minister of Health as to pharmaceuticals and indications for which DHBs must provide funding. As far as reasonably practicable, these indications are marked in the Schedule. However, PHARMAC makes no representation and gives no guarantee as to the accuracy of this information. Practitioners prescribing Pharmaceuticals Cancer Treatments for such unapproved indications should: (a) be aware of and comply with their obligations under section 29 of the Medicines Act 1981 and otherwise under the Medicines Act and the Medicines Regulations 1984; (b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Changes to General Rules - effective 1 July 2005 (continued)

(c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical Cancer Treatment or a Pharmaceutical Cancer Treatment for an indication for which it is not approved. . 6 Amendment of Schedule PHARMAC may amend the terms of the Schedule from time to time by notice in writing given in such manner as PHARMAC thinks fit, and in accordance with such protocols as agreed with the Pharmacy Guild of New Zealand (Inc) from time to time. . 7 Conflict in Provisions If any rules in Sections B–G of this Schedule conflict with the rules in Section A, the rules in Sections B–G apply.

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once 1

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Delisted Items

Effective 1 July 2005

METHYLDOPA WITH HYDROCHLOROTHIAZIDE ❋ Tab 0 mg with hydrochlorothiazide 1 mg ............................ .0 TOLNAFTATE - Not in combination Crm 1%..................................................................................... 1.00 (.0) Soln 1% .................................................................................... . (.) MOMETASONE FUROATE Lotn 0.1% ................................................................................. .00 100 0 g OP Tinaderm 10 ml OP Tinaderm 0 ml OP ✓ Elocon ✓ Hydromet

BETAMETHASONE DIPROPIONATE WITH CLOTRIMAZOLE - Only on a prescription Crm 0.0% with clotrimazole 1% ............................................... . 1 g OP (.1) BETAMETHASONE DIPROPIONATE WITH SALICYLIC ACID - Only on a prescription Oint 0.0% with salicylic acid %............................................... .10 0 g OP (11.) Lotn 0.0% with salicylic acid % .............................................. . 0 ml OP (1.1) BETAMETHASONE DIPROPIONATE Scalp lotn 0.0% ..................................................................... 1. (.1) GEMEPROST - Special Authority - Hospital pharmacy [HP1] Pessaries 1 mg ..................................................................... .1 (.) TESTOSTERONE ESTERS - Retail pharmacy-specialist Inj 0 mg per ml, 1 ml ........................................................... 1. METOCLOPRAMIDE HYDROCHLORIDE ❋ Tab 10 mg ................................................................................. . (.00) 100 ml OP

Lotricomb

Diprosalic Diprosalic

Diprosone Cervagem 1 ✓ Sustanon 0 Orgaject

100 Maxolon

TEMAZEPAM - Month restriction Cap 0 mg ................................................................................ .0 100 ✓ Euhypnos ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. AZATADINE MALEATE ❋‡Oral liq 00 mcg per ml ......................................................... . (10.) 100 ml Zadine

SALBUTAMOL - Available on a PSO Aerosol inhaler, 100 mcg per dose CFC-free ............................. . 00 dose OP (.00) AiromirIMM Aerosol inhaler, 100 mcg per dose ............................................ . 00 dose OP ✓ AsmolIMM ‡ safety cap reimbursed Sole Subsidised Supplier

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Delisted Items - effective 1 June 2005

ISOSORBIDE DINITRATE ❋ Tab 10 mg ................................................................................ .1 ETHINYLOESTRADIOL WITH LEVONORGESTREL - Available on a PSO ❋ Tab 0 mcg with levonorgestrel 0 mcg .................................. . (1.0) CITALOPRAM HYDROBROMIDE - Higher subsidy by endorsement available ❋ Tab 0 mg ................................................................................ 1. (.00) (1.) 100 ✓ Coronex

Nordiol 1 CelapramIMM CipramilIMM

SALBUTAMOL - Available on a PSO Aerosol inhaler, 100 mcg per dose, breath activated ................ 1. 00 dose OP (1.) SOYA INFANT FORMULA Powder ..................................................................................... .0 (1.11) 00 g OP

Respolin Autohaler

Karicare Infant Soya Formula

Effective 1 May 2005

OMEPRAZOLE, AMOXYCILLIN AND CLARITHROMYCIN Omeprazole cap 0 mg x 1, amoxycillin cap 00 mg x , clarithromycin tab 00 mg x 1.................................... .00 ASCORBIC ACID Only on a prescription not exceeding a strength of 100 mg per dose ❋ Tab 0 mg ................................................................................. .0 (.) THIAMINE HYDROCHLORIDE – only on a prescription ❋ Tab mg ................................................................................. . (.1) INFLUENZA VACCINE Inj ........................................................................................... .0 THIOTHIXENE Tab mg ................................................................................. 11. (1.) Tab 10 mg ............................................................................... .0 (.00) TRIFLUOPERAZINE HYDROCHLORIDE Cap long-acting 1 mg ............................................................ .0 (.0) TERBUTALINE SULPHATE Nebuliser soln, 10 mg per ml ................................................... 1.0

1 OP

✓ Klacid Hp

100 Apo-Ascorbic Acid 100 Apo-Thiamine 10 100 Thixit 100 Thixit 0 Stelazine Spansules 0 ml OP ✓ Bricanyl ✓ Vaxigrip

10 1

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Items to be Delisted

Effective 1 September 2005

MALDISON Crm shampoo 1% .................................................................... . (.) SALBUTAMOL ‡ Oral liq mg per ml ................................................................ . (.) 0 g OP Prioderm

10 ml Ventolin

Effective 1 October 2005

GLUCOSE OXIDASE The number of test strips available on a prescription is restricted to 0 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or b) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or c) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood diagnostic test with peroxidase ...................................... .00 0 test OP (.) Ascensia Glucodisc (.) Glucocard Blood diagnostic test with peroxidase ...................................... .00 100 test OP (.0) Precision Plus

Effective 1 November 2005

COPPER – Not on a bulk supply order ❋ Tab, diagnostic .......................................................................... . (.) OP Clinitest

GLUCOSE OXIDASE – Not on a bulk supply order Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid............................. .0 100 strip OP (1.0) SODIUM NITROPRUSSIDE – Not on a bulk supply order Urine diagnostic strips, buffered................................................. . 100 strip OP (10.) TRANDOLAPRIL ❋ Cap 1 mg .................................................................................. .0 (.) NAFARELIN ACETATE - Special Authority - Hospital pharmacy [HP] Nasal soln mg per ml.......................................................... 1.0 (11.)

Keto-Diastix

Ketostix

OdrikIMM ml OP Synarel

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Items to be Delisted - effective 1 November 2005 (continued)

CEFTRIAXONE SODIUM - Hospital pharmacy [HP]-specialist a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly. Inj 00 mg .............................................................................. .0 Inj 1 g ..................................................................................... .0 TERBUTALINE SULPHATE Aerosol inhaler, 0 mcg per dose ............................................. . EFORMOTEROL FUMARATE - Special Authority - Retail pharmacy Powder for inhalation, 1 mcg per dose, breath activated ......... .0

✓ Novartis ✓ Novartis

1 1

00 dose OP ✓ Bricanyl Aerosol 0 dose OP ✓ Oxis Turbuhaler

Effective 1 December 2005

GLUCOSE OXIDASE - Not on a bulk supply order Urine diagnostic test with peroxidase ......................................... . 100 strip OP (11.1) SODIUM CARBOXYMETHYLCELLULOSE With pectin and gelatin paste ................................................... 1.1 (.0) SODIUM BICARBONATE – Not in combination Inj .%, 10 ml ...................................................................... 100.0 TRANDOLAPRIL ❋ Cap mg .................................................................................. . (.) ADRENALINE Inj 1 in 10,000, 10 ml - Available on a PSO ............................ 1.00 POLYNOXYLIN a) Only on a prescription, b) Not in combination. Gel ............................................................................................ .0 (.) MEDROXYPROGESTERONE ACETATE - Retail pharmacy-specialist ❋ Tab 00 mg .......................................................................... 11.

Clinistix

0 g OP Orabase

✓ Mayne

OdrikIMM 0 ✓ Mayne

1 g OP Ponoxylan ✓ Farlutal

GENTAMICIN SULPHATE - Hospital pharmacy [HP] a) Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and; b) The prescription is endorsed accordingly. Inj 10 mg per ml, ml ............................................................. 1.00 ✓ Mayne PHYSOSTIGMINE SALICYLATE Inj 00 mcg per ml, ml ......................................................... .0 ✓ Mayne

▲

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

“IMM” Interchangeable Multi-source Medicines ❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✓ fully subsidised

Items to be Delisted - effective 1 December 2005 (continued)

11 DEXTROPROPOXYPHENE Cap napsylate 100 mg ............................................................... . (11.) TEMAZEPAM - Month restriction Cap 10 mg ................................................................................ . FLUOROURACIL SODIUM - Retail pharmacy-specialist Inj 0 mg per 10 ml ............................................................... 1. IMATINIB MESYLATE - Special Authority - access by application Cap 100 mg ....................................................................... ,00.00 BUDESONIDE Nebuliser soln, 00 mcg per ml, ml - Special Authority - Hospital Pharmacy [HP] .................... 1.00 NALOXONE HYDROCHLORIDE - Only on a PSO ❋ Inj 0 mcg per ml, ml ........................................................... . ENTERAL FEED 1KCAL/ML Liquid ........................................................................................ . 100 Doloxene 100 10

1 10 11 1

✓ Euhypnos ✓ Mayne ✓ Glivec

✓ Pulmicort ✓ Mayne

1 1

ml OP ✓ Osmolite

Effective 1 January 2006

INSULIN ANIMAL - Special Authority - Retail pharmacy ▲ Inj animal 100 u per ml, 10 ml ................................................. .

10 ml OP

✓ Velosulin

LIGNOCAINE HYDROCHLORIDE - Only on a PSO Inj twin pack 100 mg per ml ................................................... .0 (1.0) Xylocard a) Subsidised only on a PSO for patients with ventricular arrhythmia and PSO is endorsed accordingly. ECONAZOLE NITRATE Vaginal crm 1% with applicators ............................................... . (.) 0 g OP Gyno-Pevaryl

METHADONE HYDROCHLORIDE a) Only on a controlled drug form. b) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets). Tab mg ................................................................................... . 10 ✓ HMG THIORIDAZINE HYDROCHLORIDE Tab long-acting 00 mg ........................................................... .00 AMINOGLUTETHIMIDE - Retail pharmacy-specialist Tab 0 mg ........................................................................... .10 100 100 ✓ Melleril Retard ✓ Cytadren

1 1

Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

‡ safety cap reimbursed Sole Subsidised Supplier

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II

Effective 1 July 2005 New Listings

CEFEPIME HYDROCHLORIDE Inj 1 g, 1 ml ..................................Maxipime Inj g, ml ..................................Maxipime CLINDAMYCIN Inj phosphate 10 mg per ml, ml ....................Dalacin C CYCLOPHOSPHAMIDE Inj 1 g.............................................Endoxan Inj g.............................................Endoxan DESMOPRESSIN Tab 100 mcg ..................................Minirin FLUDARABINE Tab 10 mg ......................................Fludara GABAPENTIN Cap 100 mg ...................................Neurontin Cap 00 mg ...................................Neurontin Cap 00 mg ...................................Neurontin IFOSFAMIDE Inj 1 g.............................................Holoxan Inj g.............................................Holoxan MESNA Inj 100 mg per ml, ml ..................Uromitexan Inj 100 mg per ml, 10 ml ................Uromitexan Tab 00 mg ....................................Uromitexan Tab 00 mg ....................................Uromitexan METHYLPREDNISOLONE ACETATE Inj 0 mg per ml, 1 ml ....................Depo-Medrol METHYLPREDNISOLONE ACETATE WITH LIGNOCAINE Inj 0 mg per ml with lignocaine 1 ml .....................Depo-Medrol with Lidocaine MITOZANTRONE Inj mg per ml, 10 ml ....................Onkotrone NYSTATIN Oral liq 100,000 u per ml ................Nilstat .00 .00 1 1 1% 1% Sept-0 Sept-0 (B) (B)

1. 1.1 .00 .0 .0 . . 11.1 . 1.0 10. 1. 1.0 1. .0

1 1 1 0 1 100 100 100 1 1 1 1 0 0 1

Sept-0

(B)

1% 1%

Sept-0 Sept-0

(B) (B)

Sept-0

(B)

Sept-0

(B)

0.00 .0

1 ml 1% Sept-0 Mycostatin

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - New Listings effective 1 July 2005 (continued)

PROCAINE PENICILLIN Inj 1. mega u ................................Cilicaine RANITIDINE HYDROCHLORIDE Tab 10 mg ....................................Arrow Ranitidine .0 . 0 1% 1% Sept-0 Sept-0 (B) Apo-Ranitidine m-Ranitidine Zanidin Zantac Apo-Ranitidine m-Ranitidine Zanidin Zantac

Tab 00 mg ....................................Arrow Ranitidine 10.

Sept-0

RECOMBINANT FACTOR VIII Inj 0 IU .......................................Kogenate FS 00.00 1 ReFacto 1.00 1 Recombinate .00 1 Inj 00 IU .......................................Kogenate FS 00.00 1 ReFacto 0.00 1 Recombinate 0.00 1 Inj 1,000 IU ....................................Kogenate FS 00.00 1 ReFacto 0.00 1 Recombinate 0.00 1 (a) Subject to paragraphs (b) and (c) below: (i) patients receiving Kogenate FS prior to 1 July 00; (ii) patients commencing treatment with Recombinant Factor VIII after receiving plasma derived Factor VIII; (iii) new patients commencing treatment with Recombinant Factor VIII; (iv) patients undergoing tolerisation with Recombinant Factor VIII; or (v) patients requiring prophylaxis for surgical procedures or in emergency situations and being treated with Recombinant Factor VIII; are required to use Kogenate FS from 1 July 00. (b) Patients receiving, prior to 1 July 00, an alternate brand of Recombinant Factor VIII may continue to receive that brand if they continue to tolerate it. (c) Patients whose clinician, for clinical reasons, recommends that the patient receive an alternate brand of Recombinant Factor VIII listed in the Pharmaceutical Schedule may receive that brand.

Removal of Hospital Supply Status

AXOXYCILLIN SODIUM Inj 0 mg......................................Ibiamox Inj 00 mg......................................Ibiamox Inj 1 g.............................................Ibiamox BENZYLPENICILLIN SODIUM Inj 1 mega u ...................................Novartis BERACTANT Inj 00 mg per ml suspension......Survanta . . 11.00 . .00 10 1 0% 0% 0% 0% 0% Sept-0 Sept-0 Sept-0 Dec-0 May-0 (B) (B) (B) Benpen (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

CAPECITABINE Tab 10 mg ....................................Xeloda Tab 00 mg ....................................Xeloda CEFAZOLIN SODIUM Inj 00 mg......................................Biochemie 11.00 0.00 1. 0 10 1 0% 0% 0% Mar-0 Mar-0 Dec-0 (B) (B) AFT Eli Lilly Mayne Aventis Mayne Aventis Mayne Novartis Mayne Novartis AFT Mayne Novartis AFT Mayne Novartis AFT Mayne Novartis AFT Mayne Novartis (B) (B) (B) (B) (B) (B) (B)

CEFOTAXIME SODIUM Inj 00 mg vial................................AFT Inj 1 g vial ......................................AFT

. .

1 1

10% 10%

Apr-0 Apr-0

CEFTRIAXONE Inj IV 0 mg vial............................Rocephin Inj IV 00 mg vial............................Rocephin Inj IM 1 g vial..................................Rocephin Inj IV 1 g vial...................................Rocephin Inf g ............................................Rocephin

0.00 .00 .00 .00 0.00

% % % % %

Mar-0 Mar-0 Mar-0 Sept-0 Mar-0

CEPHRADINE Inj 00 mg......................................Velosef Inj 1 g.............................................Velosef CLONAZEPAM Inj 1 mg per ml, 1 ml ......................Rivotril CLOSTRIDUM BOTULINUM 100 iu ............................................Botox DACLIZUMAB Inj mg per ml vial ....................Zenapax DIAZEPAM Rectal tubes mg ..........................Stesolid Rectal tubes 10 mg ........................Stesolid

1. 1. . .0 .00 .0 .

1 1

0% 0% 0% 0% 0% 0% 0%

Sept-0 Sept-0 Sept-0 Sept-0 Mar-0 Sept-0 Sept-0

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

DICLOFENAC SODIUM Tab long-acting mg ....................Diclax Tab long-acting 100 mg ..................Diclax 1. .01 0 0 0% 0% Oct-0 Oct-0 Apo-Diclo SR Flameril Retard Voltaren SR Apo-Diclo SR Flameril Retard Voltaren SR (B) (B) Dipoquin Aredia (B) Aredia (B) Mayne

DICLOXACILLIN SODIUM Inj 00 mg......................................Diclocil Inj 1 g.............................................Diclocil DIPIVEFRIN HYDROCHLORIDE Eye drops 0.1% ..............................Propine DISODIUM PAMIDRONATE Inj 0 mg per 10 ml vial ..................Pamisol Inj 0 mg per 10 ml vial ..................Pamisol Inj 0 mg per 10 ml vial ..................Pamisol DISULFIRAM Tab 00 mg ....................................Antabuse ERYTHROMYCIN LACTOBIONATE Inj 1 g.............................................ERA FILGRASTIM Inj 00 mcg per 0. ml prefilled syringe...........Neupogen Inj 00 mcg per 1 ml vial ................Neupogen FLUCLOXACILLIN SODIUM Inj 0 mg......................................Flucloxin Inj 00 mg......................................Flucloxin Inj 1 g.............................................Flucloxin FLUMAZENIL Inj 0. mg per ml amp .................Anexate FLUPENTHIXOL DECANOATE Inj 0 mg per ml, 1 ml ....................Fluanxol Inj 0 mg per ml, ml ....................Fluanxol Inj 100 mg per ml, 1 ml ..................Fluanxol FUSIDIC ACID Eye drops 1% .................................Fucithalmic

. . .0 .00 1.00 .00 .0 .0

10 ml 1 1 1 100 1

0% 0% 0% 0% 0% 0% 0% 0%

Mar-0 Mar-0 Apr-0 May-0 May-0 May-0 Sept-0 Jan-0

1.00 0.00 . . .

0% 0% 0% 0% 0%

Mar-0 Mar-0 Sept-0 Sept-0 Sept-0

(B) (B) Floxapen Mayne Floxapen Mayne Floxapen Mayne (B) Psytixol Psytixol Psytixol (B)

10.10 1.1 0.0 0. .0

0% 0% 0% 0% 0%

Mar-0 Sept-0 Sept-0 Sept-0 Sept-0

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

GANCICLOVIR Cap 0 mg ...................................Cymevene Inj 00 mg vial................................Cymevene GELATIN PLASMA REPLACER Inf % per 00 ml bag ....................Gelofusine GENTAMICIN SULPHATE Inj 0 mg per ml, ml ....................Pharmacia Eye drops 0.% ..............................Genoptic GLYCERYL TRINITRATE Aerosol spray 00 mcg per dose 00 dose CFC-free ........Glytrin TDDS 10 mg ..................................Nitroderm TTS 10 TDDS mg ....................................Nitroderm TTS Inj 0 mg per 10 ml ........................Mayne GOSERELIN ACETATE Inj . mg syringe...........................Zoladex Inj 10. mg syringe.........................Zoladex HALOPERIDOL Tab 00 mcg ..................................Serenace Tab 1. mg .....................................Serenace Tab mg ........................................Serenace Oral liq mg per ml ........................Serenace Inj mg per ml, 1 ml ......................Serenace IMIPENEM WITH CILASTATIN Inj 00 mg with cilastatin 00 mg .....Primaxin ISOFLURANE Liq 0 ml bottle ............................Forane LEVOBUNOLOL Eye drops 0.% ............................Betagan Eye drops 0.% ..............................Betagan LIPOSOMAL AMPHOTERICIN Inj 0 mg vial..................................AmBisome LORAZEPAM Tab 1 mg ........................................Ativan Tab . mg .....................................Ativan Products with Hospital Supply Status (HSS) are in bold. 1.00 0.00 11.0 . 11.0 1 10 ml OP 0% 0% % 0% 0% Mar-0 Mar-0 May-0 Aug-0 Aug-0 (B) (B) Haemaccel Mayne (amp & vial) Minims (Smith and Nephew)

. . 1.0 0.00 .00 .0 . . . 1.0 1. 1.1 .00 .00 .00 .00 .0 .

1 0 0 1 1 100 100 100 100 ml 10 1 0 ml ml ml 1 0 100

% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Apr-0 Aug-0 Aug-0 Aug-0 Apr-0 Apr-0 Sept-0 Sept-0 Sept-0 Sept-0 Sept-0 Feb-0 May-0 Nov-0 Feb-0 May-0 Feb-0 Sept-0

Nitrolingual Pumpspray Minitran 10 Minitran (B) (B) (B) (B) (B) (B) (B) (B) (B) Aerrane (B) Alcon-Levobunolol (B) Lorapam Lorzem Lorapam

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

MAGNESIUM SULPHATE Inj .%, ml ...............................Mayne MEDROXYPROGESTERONE ACETATE Tab . mg .....................................Provera Tab mg ........................................Provera Tab 10 mg ......................................Provera MIDAZOLAM Inj 1 mg per ml ml amp................Hypnovel Inj mg per ml ml amp................Hypnovel MYCOPHENOLATE MOFETIL Inj 00 mg vial................................CellCept Tab 0 mg ....................................CellCept Tab 00 mg ....................................CellCept NALOXONE HYDROCHLORIDE Inj 00 mcg per ml, 1 ml ................Mayne NORADRENALINE ACID TARTRATE Inj 1:1000 per ml .........................Levophed ONDANSETRON HYDROCHLORIDE Wafer mg ....................................Zofran Wafer mg ....................................Zofran Tab mg ........................................Zofran Tab mg ........................................Zofran PARACETAMOL Oral liquid 10 mg per ml ............Junior Parapaed 1.00 .0 1. . 1. 1.00 0 0 100 0 10 1% 0% 0% 0% % % Sept-0 Aug-0 Aug-0 Aug-0 Mar-0 Mar-0 (B) (B) (B) (B) Mayne Pharmacia Mayne Pharmacia (B) (B) (B) CSL Narcan (B) (B) (B) (B) (B) Paracare Junior Suspension PSM Paracetamol Elixir Paediatric Douglas Pamol Paracare Double Strength Suspension Douglas Pamol (B) Health Support Ltd

1. 0. 0. .00

100 0

0% 0% 0% 0%

Mar-0 Mar-0 Mar-0 Sept-0

.00 .00 1.0 . . .0

10 10 10 0 00 ml

0% 0% 0% 0% 0% 0%

May-0 May-0 May-0 May-0 May-0 Nov-0

Oral liquid 0 mg per ml ............Six Plus Parapaed .0

00 ml

Nov-0

PERHEXILINE MALEATE Tab 100 mg ....................................Pexsig PHENYLEPHRINE HYDROCHLORIDE Inj 1%, 1 ml ....................................Neosynephrine HCL Products with Hospital Supply Status (HSS) are in bold.

. 11.0

100

0% 0%

Sept-0 Nov-0

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

PHYTOMENADIONE Inj mg per 0. ml .........................Konakion MM Inj 10 mg per ml, 1 ml ....................Konakion MM POLYVINYL ALCOHOL Eye drops 1.% ..............................Liquifilm Tears Eye drops % .................................Liquifilm Forte QUETIAPINE Tab mg ......................................Seroquel Tab 100 mg ....................................Seroquel Tab 10 mg ....................................Seroquel Tab 00 mg ....................................Seroquel RETEPLASE Inj 10 iu vial ....................................Rapilysin RITONAVIR Cap 100 mg ...................................Norvir RITUXIMAB Inj 100 mg per 10 ml vial ................Mabthera Inj 00 mg per 0 ml vial ................Mabthera SALBUTAMOL Inhaler 100 mcg dose, 00 doses .....Ventolin .00 .1 . . .00 110.00 1.00 1.00 1,0.00 . 1,1.00 ,.00 .00 1 ml 1 ml 0 0 0 0 1 1 1 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% % Sept-0 Sept-0 Sept-0 Sept-0 Apr-0 Apr-0 Apr-0 Apr-0 Mar-0 Sept-0 Mar-0 Mar-0 May-0 (B) (B) (B) (B) (B) (B) (B) (B) (B) (B) (B) (B) Airomir Asmol Buventol Easyhaler (B) Pacific (B) (B) (B) (B) Zytram Zytram Zytram (B) (B)

SEVOFLURANE Liq 0 ml bottle ............................Sevorane SODIUM HYALURONATE Ophthalmic soln 10 mg per ml ........Healon Clear

.00 .00

0 ml 0. ml 10 1 1 0 0 0 0

0% 0% 0% 0% 0% 10% 10% 10% 10% 0% 0%

May-0 Dec-0 Sept-0 Sept-0 Feb-0 Sept-0 Sept-0 Sept-0 Sept-0 Sept-0 Sept-0

TETRACOSACTRIN Inj 0 mcg ....................................Synacthen 1.1 Inj 1 mg per ml, 1ml .......................Synacthen Depot . TIROFIBAN HYDROCHLORIDE Inj 0. mg per ml, 0 ml ...............Aggrastat TRAMADOL HYDROCHLORIDE Cap 0 mg .....................................Tramal Tab sustained release 100 mg.........Tramal Retard Tab sustained release 10 mg.........Tramal Retard Tab sustained release 00 mg.........Tramal Retard Inj 0 mg per ml, 1 ml ....................Tramal 0 Inj 0 mg per ml, ml ....................Tramal 100 0.00 .0 .0 .0 11.0 .0 .0

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Removal of Hospital Supply Status effective 1 July 2005 (continued)

TRASTUZUMAB Inj 10 mg vial................................Herceptin Inj 0 mg vial................................Herceptin VANCOMYCIN HYDROCHLORIDE Inj 0 mg per ml, 10 ml ..................Mayne VERAPAMIL HYDROCHLORIDE Inj . mg per ml, ml ...................Isoptin 1,0.00 ,.00 .00 1 1 10 0% 0% 10% Mar-0 Mar-0 Sept-0 (B) (B) Abbott Vancocin (B)

Sept-0

Extensions to contracts – changes to price and/or DV Limits

AMOXYCILLIN WITH CLAVULANIC ACID (ê price & è DV Limit) Inj 00 mg, 00 mg with 100 mg clavulanic acid ........Augmentin 1.1 Inj 1. g, 1000 mg with 00 mg clavulanic acid ........Augmentin . AMOXYCILLIN WITH CLAVULANIC ACID (è DV Limit) Gran 1 mg with 1. mg clavulanic acid per ml ...............Augmentin Gran 0 mg with . mg clavulanic acid per ml ...............Augmentin Tab mg, 00 mg with 1 mg clavulanic acid ........Augmentin ATRACURIUM BESYLATE (ê price & è DV Limit) Inj mg per . ml amp ...............Tracrium Inj 0 mg per ml amp ..................Tracrium BERACTANT (ê price) Inj 00 mg per ml suspension......Survanta BLEOMYCIN SULPHATE (ê price & è DV Limit) Inj 1 iu ..........................................Blenoxane

10 10

1% 1%

May-0 May-0

(B) (B)

. . .0

100 ml 100 ml 0

1% 1% 1%

May-0 May-0 May-0

Alpha-Amoxyclav Synermox Alpha-Amoxyclav Synermox Alpha-Amoxyclav Synermox (B) (B)

.0 . .00 0.00

1 10

1% 1%

May-0 May-0

Sept-0

Mayne

BUPIVACAINE HYDROCHLORIDE WITH FENTANYL (ê price & amended DV Limit) Inj 0.1% with mcg fentanyl per ml, 1 ml pre-filled syringe ....Biomed . 1 Inj 0.1% with mcg fentanyl per ml, 0 ml pre-filled syringe ....Biomed . 1 Inf 0.1% with mcg fentanyl per ml, 100 ml bag ......................Bupafen 1.0 1 Inf 0.1% with mcg fentanyl per ml, 00 ml bag ......................Bupafen 1.0 1

1% 1% 1% 1%

Sept-0 Sept-0 Sept-0 Sept-0

(B) (B) Marcain Marcain

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Changes to price and/or DV Limits effective 1 July 2005 (continued)

CEFTAZIDIME SODIUM (ê price & è DV Limit) Inj 00 mg......................................Fortum Inj 1 g.............................................Fortum Inj g.............................................Fortum CEFUROXIME AXETIL (ê price & è DV Limit) Tab 0 mg ....................................Zinnat CEFUROXIME SODIUM (ê price & è DV Limit) Inj 0 mg......................................Zinacef Inj 1. g..........................................Zinacef CIPROFLOXACIN (ê price & è DV Limit) Tab 0 mg ....................................Cipflox Tab 00 mg ....................................Cipflox Tab 0 mg ....................................Cipflox FLUDARABINE PHOSPHATE (ê price & è DV Limit) Inj 0 mg........................................Fludara . 1.10 .1 .0 1.0 . 1 1 1 0 1 1% 1% 1% 1% 1% 1% May-0 May-0 May-0 May-0 May-0 May-0 Novartis Novartis Novartis (B) AFT Douglas Mayne AFT Mayne Ciproxin Ciproxin Ciproxin (B)

.10 .1 1.0 1,.

1% 1% 1% 1%

Sept-0 Sept-0 Sept-0 Sept-0

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Changes to price and/or DV Limits effective 1 July 2005 (continued)

HYDROCORTISONE (ê price & è DV Limit) Cream 1% ......................................AFT . 1. g 1% Sept-0 Cortaid 0 g Derm-Aid 0 g Derm-Aid Soft 0 g Egocort 1 g Egocort 0 g Lipobase Relief 0 g Mildison Lipocream 1 g Pharmacare 1 g Skincalm 1 g (B) (B) (B) (B) (B) Baxter Mayne Pharmacia Baxter Mayne Pharmacia (B) (B) Baxter Baxter Baxter Baxter (B) (B)

HYDROCORTISONE BUTYRATE (è DV Limit) Crm 0.1% .......................................Locoid Cream .00 Lipocream 0.1% .............................Locoid Lipocream .00 Oint 0.1% .......................................Locoid Ointment 1.00 Scalp lotn 0.1% ..............................Locoid Lotion 1.0 IRON POLYMALTOSE (ê price & è DV Limit) Inj 0 mg per ml, ml ....................Ferrosig .0

0 g 0 g 100 g 0 ml

1% 1% 1% 1% 1% 1% 1%

Sept-0 Sept-0 Sept-0 Sept-0 Sept-0 Sept-0 Sept-0

METHYLPREDNISOLONE SODUM SUCCINATE (ê price & è DV Limit) Inj 00 mg......................................Solu-Medrol 1. 1 Inj 1 g.............................................Solu-Medrol . 1

MIVACURIUM (ê price & è DV Limit) Inj 10 mg per ml ..........................Mivacron Inj 0 mg per 10 ml ........................Mivacron MORPHINE SULPHATE (amended price & è DV Limit) Inj 10 mg per 10 ml pre-filled syringe....Biomed Inj 0 mg per 0 ml pre-filled syringe....Biomed Inj 0 mg per 0 ml pre-filled syringe....Biomed Inj 0 mg per 0 ml pre-filled syringe....Biomed ONDANSETRON HYDROCHLORIDE (ê price) Inj mg per ml amp ....................Zofran Inj mg per ml amp ....................Zofran Tab mg ........................................Zofran Tab mg ........................................Zofran PACLITAXEL (ê price & è DV Limit) Inj 0 mg........................................Taxol Inj 100 mg......................................Taxol

1.1 1. . .0 . . . 0. . . 100.00 .00

1 1 1 1 10 0 1 1

1% 1% 1% 1% 1% 1% 0% 0%

May-0 May-0 Sept-0 Sept-0 Sept-0 Sept-0 May-0 May-0

1% 1%

Sept-0 Sept-0

Anzatax Anzatax

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - Changes to price and/or DV Limits effective 1 July 2005 (continued)

PENTASTARCH PLASMA EXPANDER (ê price & ê DV Limit) Inf 10% per 00 ml bag ..................Hemohes 1.0 REMIFENATNIL HYDROCHLORIDE (ê price & è DV Limit) Inj 1 mg vial ...................................Ultiva 1. Inj mg vial ...................................Ultiva 1. STREPTOKINASE (amended price & è DV Limit) Inj 0,000 IU ................................Streptase Inj 1,00,000 IU .............................Streptase 10.00 11.00 1 1% Sept-0 HAES-Steril Pentaspan (B) (B) (B) (B)

1 1

1% 1% 1% 1%

May-0 May-0 Sept-0 Sept-0

Changes to Brand Name Effective 1 July 2005

BENZYLPENICILLIN SODIUM Inj 1 mega u ...................................Biochemie Novartis . Note – change in brand name from Biochemie to Novartis only. 10 0% Dec-0 Benpen

Section H changes to Part II - effective 1 June 2005

CANDESARTAN Tab mg ........................................ Atacand . 0 Tab mg ........................................ Atacand .1 0 Tab 1 mg ...................................... Atacand . 0 Note – Atacand Tab mg, mg and 1 mg tab pack size to be delisted 1 December 00. FERROUS SULPHATE Oral liquid, 10 mg per ml ...........Ferro-liquid . 0 ml 1% Aug-0 Ferodan

IMATINIB MESYLATE Tab 100 mg .................................... Glivec ,00.00 0 Note – Glivec Cap 100 mg 10 cap pack size to be delisted 1 December 00. QUINAPRIL Tab mg ........................................Accupril Tab 10 mg ......................................Accupril Tab 0 mg ......................................Accupril . . .0 0 0 0 1% 1% 1% Aug-0 Aug-0 Aug-0 (B) (B) (B)

Effective 1 May 2005

CHLORAMPHENICOL Eye drops 0.% .............................. Chlorsig 1.0 10 ml 1% Jan-0 Isopto Fenicol Minims

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 March 2005

CARVEDILOL Tab . mg ...................................Dilatrend Tab 1. mg ...................................Dilatrend Tab mg ......................................Dilatrend CILAZAPRIL Tab 0. mg .....................................Inhibace Tab . mg .....................................Inhibace Tab mg ........................................Inhibace CILAZAPRIL WITH HYDROCHLOROTHIAZIDE Tab mg with 1. mg ...................Inhibace Plus 1.00 .00 . .0 . . .0 0 0 0 0 0 0

Effective 1 February 2005

NICOTINE Gum mg (mint flavour) ................Habitrol Gum mg (fruit flavour) .................Habitrol Gum mg (mint flavour) ................Habitrol Gum mg (fruit flavour) .................Habitrol Patch mg.....................................Habitrol Patch 1 mg ...................................Habitrol Patch 1 mg ...................................Habitrol ONDANSETRON HYDROCHLORIDE (ê price) Tab mg ........................................Zofran Tab mg ........................................Zofran TACROLIMUS (ê price) Cap 0. mg ....................................Prograf Cap 1 mg .......................................Prograf Cap mg .......................................Prograf TIOTROPIUM BROMIDE Powder for inhalation 1 mcg per dose .........................Spiriva 1. 1. 0.0 0.0 10. 11. 1. .0 1.0 1.00 .00 100.00 10 0 100 100 0 0% 0% May-0 May-0 (B) (B)

0.00

0 monodoses

ZOLENDRONIC ACID Powder for Inf, mg ....................... Zometa 0.00 1 Note: Zolendronic acid Soln for Inf mg, ml presentation was listed 1 August 00.

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 January 2005

AMILORIDE Oral liq 1 mg per ml ........................Biomed CHLOROTHIAZIDE Oral liq 0 mg per ml ......................Biomed DEXAMETHASONE Oral liq 1 mg per ml ........................Biomed FOLIC ACID Oral liq 0 mcg per ml ....................Biomed LETROZOLE Tab . mg ..................................... Femara .0 .0 .0 1.0 00.00 ml ml ml ml 0 00 ml 00 ml 00 ml ml

METHADONE HYDROCHLORIDE Oral liq mg per ml ........................Biodone . Oral liq mg per ml ........................Biodone Forte . Oral liq 10 mg per ml ......................Biodone Extra Forte .0 SPECIAL FOOD SUPPLEMENT Powder, sachet g ....................... Oral Impact SPIRONOLACTONE Oral liq mg per ml ........................Biomed 1.0 .0

Effective 1 December 2004

ALLOPURINOL Tab 100 mg ................................... Allohexal Tab 00 mg ................................... Allohexal . . 0 0 0% 0% Apr-0 Apr-0 Allorin Progout Zyloprim Allorin Progout Zyloprim

CALCIPOTRIOL Crm 0 mcg per g ..........................Daivonex Oint 0 mcg per g...........................Daivonex Crm 0 mcg per g ..........................Daivonex Oint 0 mcg per g...........................Daivonex Soln 0 mcg per ml ........................Daivonex Soln 0 mcg per ml ........................Daivonex

. . . . . .

0 g 0 g 100 g 100 g 0 ml 0 ml

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part IV

Effective 1 July 2005

CYCLOSPORIN Cap mg Cap 0 mg Cap 100 mg Oral liq 100 mg per ml For aplastic anaemia DALTEPARIN SODIUM Inj ,00 IU per 0. ml Fragmin Inj ,000 IU per 0. ml Fragmin Inj ,00 IU per 0. ml Fragmin Inj 10,000 IU per 0. ml Fragmin Inj 10,000 IU per 1 ml Fragmin Inj 1,00 IU per 0. ml Fragmin Inj 1,000 IU per 0. ml Fragmin Inj 1,000 IU per 0. ml Fragmin For the treatment of venous thromboembolism (VTE) for a maximum of 1 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to weeks post partum. For a maximum treatment period from diagnosis of pregnancy to weeks post partum for women normally maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 1 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 1 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism. DISODIUM PAMIDRONATE Inj 0 mg per 10 ml vial Pamisol Aredia Inj 0 mg per 10 ml vial Pamisol Inj 0 mg per 10 ml vial Pamisol For malignant hypercalcaemia, metastatic breast cancer – predominant lytic bone metastases, myeloma with lytic bone metastases, control of pain due to lytic bone metastases in addition to standard care (analgesics + radiotherapy), Gaucher disease with established bone disease. Gengraf Neoral Gengraf Neoral Gengraf Neoral Gengraf Neoral

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part IV - effective 1 July 2005 (continued)

ENOXAPARIN SODIUM Inj 0 mg per 0. ml Clexane Inj 0 mg per 0. ml Clexane Inj 0 mg per 0. ml Clexane Inj 0 mg per 0. ml Clexane Clexane Inj 100 mg per ml Inj 10 mg per 0. ml Clexane Inj 10 mg per ml Clexane For the treatment of venous thromboembolism (VTE) for a maximum of 1 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to weeks post partum. For a maximum treatment period from diagnosis of pregnancy to weeks post partum for women normally maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 1 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 1 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism. FILGRASTIM Inj 00 mcg per 0. ml prefilled syringe Neupogen Inj 00 mcg per 1 ml vial Neupogen Indefinite supply for any appropriate indication for the management of patients with cancer. GANCICLOVIR Cap 0 mg Cymevene Inj 00 mg Cymevene Maximum 1 weeks supply for cytomegalovirus (CMV) retinitis in immunocompromised patients and for prophylaxis of CMV following solid organ transplant For prophylaxis and treatment of CMV-associated disease in immunocompromised patients and following organ transplant. LENOGRASTIM Inj 1. million iu vial Granocyte Inj . million iu vial Granocyte Indefinite supply for any appropriate indication for the management of patients with cancer. MOLGRAMOSTIM Inj 00 mcg Leucomax Indefinite supply for any appropriate indication for the management of patients with cancer.

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part IV - effective 1 July 2005 (continued)

TINZAPARIN SODIUM Inj ,00 anti-Xa IU/0.ml Innohep Inj ,00 anti Xa IU/0.ml Innohep Innohep Inj 10,000 anti Xa IU/0.ml Inj 1,000 anti Xa IU/0.ml Innohep Inj 1,000 anti Xa IU/0.ml Innohep Inj 0,000 anti XaIU/ml, ml Innohep For the treatment of venous thromboembolism (VTE) for a maximum of 1 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to weeks post partum. For a maximum treatment period from diagnosis of pregnancy to weeks post partum for women normally maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 1 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 1 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism.

Effective 1 January 2005

SPECIAL FOOD SUPPLEMENT Powder, sachet g Oral Impact Three sachets per day for - days prior to major gastrointestinal or head or neck surgery.

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part V

Effective 1 July 2005

CYCLOSPORIN Cap mg Cap 0 mg Cap 100 mg Oral liq 100 mg per ml Gengraf Neoral Gengraf Neoral Gengraf Neoral Gengraf Neoral Sandimmun Mayne Aredia Mayne Mayne Aredia Mayne

DISODIUM PAMIDRONATE Inj mg per ml, ml vial Inj mg per ml, 10 ml vial Inj mg per ml, 10 ml vial Inj mg per ml, 10 ml vial

Restricted indication 1. Malignant hypercalcaemia . Metastatic breast cancer – predominant lytic bone metastases . Myeloma with lytic bone metastases . Pain – for control of pain due to lytic bone metastases in addition to standard care (analgesics ± radiotherapy) – subsidy available in hospice . Gaucher disease with established bone disease. FILGRASTIM Inj 00 mcg, 0. ml prefi lled syringe Inj 00 mcg, 1 ml LENOGRASTIM Inj 1. million iu vial Inj . million iu vial MOLGRAMOSTIM Inj (s) 00 mcg Neupogen Neupogen Granocyte 1 Granocyte Leucomax

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

index

Pharmaceuticals and brands A Accu-Chek Advantage ........................................ Accupril ....................................................... , Accuretic 10 ...................................................... Accuretic 0 ...................................................... Acetazolamide ................................................... Adrenaline.......................................................... AFT-Pyrazinamide .............................................. 1 Aggrastat ........................................................... Airomir............................................................... Alendronate........................................................ Alkeran .............................................................. Allohexal ............................................................ Allopurinol.......................................................... Alpha-Bromocriptine .......................................... AmBisome ......................................................... 1 Amiloride ........................................................... Aminoglutethimide ............................................. Amoxycillin sodium ............................................ Amoxycillin with clavulanic acid ......................... Anexate.............................................................. 0 Antabuse ........................................................... 0 Antiretrovirals ..................................................... Apo-Ascorbic Acid ............................................. Apo-Cimetidine .................................................. 1 Apo-Prednisone ................................................. Apo-Thiamine..................................................... Aredia .......................................................... 0, Aristocort .......................................................... Arrow-Ranitidine .......................................... , Ascensia Glucodisc................................ , , Ascorbic acid ..................................................... Asmol ................................................................ Aspirin ............................................................... Atacand ............................................................. Ativan ................................................................ 1 Atracurium besylate ........................................... Atropine sulphate ............................................... Atropt ................................................................ Augmentin ......................................................... Avonex............................................................... Azatadine maleate .............................................. B Benzylpenicillin sodium ................................ , Benzylpenicillin sodium (Penicillin G) .................. Beractant ..................................................... , Betagan ............................................................. 1 Betamethasone dipropionate .............................. Betamethasone dipropionate with clotrimazole .... Betamethasone dipropionate with salicylic acid... Biodone ............................................................. Biodone Extra Forte ............................................ Biodone Forte .................................................... Blenoxane .................................................... 1, Bleomycin sulphate ...................................... 1, Bonjela .............................................................. Botox ................................................................. Bricanyl ............................................................. Bricanyl Aerosol ................................................. Bromocriptine mesylate...................................... Brufen Retard..................................................... Budesonide ........................................................ Bupafen ............................................................. Bupivacaine hydrochloride with fentanyl ............. Busulphan.......................................................... C Calamine............................................................ Calcipotriol......................................................... Calcium folinate ................................................. Calogen ............................................................. Camptosar ......................................................... 1 Candesartan ...................................................... Capecitabine ................................................ 1, Carvedilol........................................................... Cefazolin sodium ............................................... Cefepime hydrochloride...................................... Cefotaxime sodium ............................................ Ceftazidime sodium............................................ Ceftriaxone ........................................................ Ceftriaxone sodium ............................................ Cefuroxime axetil................................................ Cefuroxime sodium ............................................ Celapram ........................................................... CellCept ............................................................. Cephradine ........................................................ Cerezyme........................................................... Cervagem .......................................................... Chlorambucil...................................................... Chloramphenicol ................................................ Chlorhexidine gluconate ..................................... Chlorothiazide .................................................... Chlorsig ............................................................. Choline salicylate with cetalkonium chloride........ Cilazapril ............................................................ Cilazapril with hydrochlorothiazide ...................... Cilicaine ............................................................. Cimetidine.......................................................... 1 Cipflox ......................................................... , Cipramil ............................................................. Ciprofloxacin ................................................ , Citalopram hydrobromide ................................... Clexane .............................................................. 1

index

Pharmaceuticals and brands Clindamycin ....................................................... Clinistix .................................................. 1, , Clinitest.................................................. , , Clonazepam ................................................. , Clostridum botulinum ......................................... Co-trimoxazole ................................................... Codalgin ............................................................ Coloxyl .............................................................. Compound electrolytes....................................... 1 Copper................................................... , , Coronex ............................................................. Cromolux ........................................................... Cycloblastin ....................................................... Cyclophosphamide ................................ 1, , Cyclosporin.................................................. 0, Cymevene.................................................... 1, 1 Cytadren ............................................................ Cytarabine ................................................... 1, Cytoxan ............................................................. D Daclizumab ........................................................ Daivonex ............................................................ Dalacin C ........................................................... Dalteparin sodium .............................................. 0 Depo-Medrol ...................................................... Depo-Medrol with Lidocaine ............................... Desmopressin .................................................... Dexamethasone ................................................. Dexamethasone with framycetin and gramicidin.. Dextropropoxyphene .......................................... DHC Continus .................................................... Diamox .............................................................. Diastix ............................................................... Diastop .............................................................. Diazemuls .......................................................... Diazepam..................................................... , Diclax ................................................................ 0 Diclocil .............................................................. 0 Diclofenac sodium ............................................. 0 Dicloxacillin sodium ........................................... 0 Dihydrocodeine tartrate ...................................... Dilatrend ............................................................ Diphenoxylate hydrochloride with atropine sulphate .. Dipivefrin hydrochloride...................................... 0 Diprosalic .......................................................... Diprosone .......................................................... Disodium pamidronate ........................... 0, 0, Disprin ............................................................... Disulfiram .......................................................... 0 Docusate sodium ............................................... Doloxene............................................................ Doxorubicin ....................................................... 1 E Econazole nitrate ................................................ Eformoterol fumarate ......................................... Elocon ............................................................... Emulsifying ........................................................ Endoxan....................................................... 1, Enerlyte ............................................................. 1 Enoxaparin sodium............................................. 1 Epirubicin .......................................................... 1 ERA ................................................................... 0 Erythromycin lactobionate .................................. 0 Ethambutol ........................................................ Ethinyloestradiol with levonorgestrel ................... Etoposide........................................................... Euhypnos..................................................... , F Farlutal ............................................................... Fat supplement................................................... Felodipine .......................................................... Femara .............................................................. Ferro-liquid .................................................. 1, Ferrosig ............................................................. Ferrous sulphate .......................................... 1, Filgrastim ............................................... 0, 1, Fluanxol ............................................................. 0 Fluarix .......................................................... , Flucloxacillin sodium .......................................... 0 Flucloxin ............................................................ 0 Fludara................................................... 1, , Fludarabine .................................................. 1, Fludarabine phosphate ................................. 1, Flumazenil.......................................................... 0 Fluorouracil sodium................................ 1, , Flupenthixol decanoate ....................................... 0 Fluvax .......................................................... , Foban ................................................................ 1 Folic acid ........................................................... Forane ............................................................... 1 Fortum ............................................................... Fosamax ............................................................ Fragmin ............................................................. 0 Fucithalmic ........................................................ 0 Fusidic acid.................................................. 1, 0 G Gabapentin .................................................. , Ganciclovir................................................... 1, 1 Gaviscon ........................................................... Gelatin plasma replacer ...................................... 1 Gelofusine.......................................................... 1

index

Pharmaceuticals and brands Gemeprost ......................................................... Gengraf........................................................ 0, Genoptic ............................................................ 1 Gentamicin sulphate ..................................... , 1 Glipizide ............................................................. Glivec .................................................... 1, , Glucocard .............................................. , , Glucose dehydrogenase ..................................... Glucose oxidase....... 1, , , , , , , Glyceryl trinitrate ................................................ 1 Glytrin ................................................................ 1 Goserelin acetate ............................................... 1 Granocyte .......................................................... 1 Granocyte 1 ..................................................... Granocyte ..................................................... Gyno-Pevaryl ..................................................... H Habitrol .............................................................. Haloperidol ........................................................ 1 Healon Clear ...................................................... Hemohes ........................................................... Heparin sodium............................................ , Herceptin ..................................................... 1, Holoxan ....................................................... 1, Hydrea ............................................................... Hydrocortisone .................................................. Hydrocortisone butyrate ..................................... Hydromet ........................................................... Hydroxyurea ...................................................... Hypnovel ........................................................... Hypromellose..................................................... I I-Profen.............................................................. Ibiamox.............................................................. Ibuprofen ..................................................... , Ifosfamide.................................................... 1, Imatinib mesylate ................................... 1, , Imiglucerase ...................................................... Imipenem with cilastatin ..................................... 1 Influenza vaccine.................................... , , Influvac ........................................................ , Inhibace ............................................................. Inhibace Plus ..................................................... Innohep ............................................................. Insulin animal..................................................... Interferon beta-1-alpha ....................................... Irinotecan........................................................... 1 Iron polymaltose ................................................ Isoflurane ........................................................... 1 Isogel................................................................. Isoptin ............................................................... Isosorbide dinitrate............................................. J Junior Parapaed ................................................. K Kaletra ............................................................... Karicare Infant Soya Formula .............................. Keto-Diastix ........................................... , , Ketostix.................................................. , , Klacid Hp ......................................................... Kogenate FS....................................................... Konakion MM..................................................... L Lamivudine ........................................................ Lansoprazole ..................................................... Lanvis ................................................................ Lenograstim ................................................. 1, Letrozole ............................................................ Leucomax .................................................... 1, Leucovorin ......................................................... Leucovorin Calcium ........................................... Leukeran FC ....................................................... Levobunolol ....................................................... 1 Levophed ........................................................... Lignocaine hydrochloride ................................... Liposomal amphotericin ..................................... 1 Liquifilm Forte .................................................... Liquifilm Tears.................................................... Locoid Cream .................................................... Locoid Lipocream .............................................. Locoid Lotion ..................................................... Locoid Ointment................................................. Lopinavir with ritonavir ....................................... Lorazepam ......................................................... 1 Lotricomb .......................................................... M Mabthera ..................................................... 0, Magnesium sulphate .......................................... Maldison ............................................................ Maxipime ........................................................... Maxolon ............................................................. Medisense Optium ............................................. Medroxyprogesterone acetate....................... , Melleril Retard .................................................... Melphalan .......................................................... Mercaptopurine .................................................. Mesna ......................................................... 1, Methadone hydrochloride ....................... 1, , Methoblastin ...................................................... Methotrexate ...................................................... Methyldopa with hydrochlorothiazide .................. Methylprednisolone acetate ................................

index

Pharmaceuticals and brands Methylprednisolone acetate with lignocaine ........ Methylprednisolone sodum succinate ................. Metoclopramide hydrochloride ........................... Midazolam ......................................................... Minidiab ............................................................. Minirin ............................................................... Mitozantrone ................................................ 1, Mivacron ........................................................... Mivacurium ........................................................ Molgramostim.............................................. 1, Mometasone furoate .......................................... Morphine sulphate.............................................. Mucilaginous laxatives ....................................... Myambutol......................................................... Mycophenolate mofetil ....................................... Myleran ............................................................. N Nafarelin acetate ................................................ Naloxone hydrochloride ................................ , Navelbine ........................................................... 0 Neoral .......................................................... 0, Neosynephrine HCL ........................................... Neupogen .............................................. 0, 1, Neurontin ..................................................... , New antiepilepsy drugs ...................................... Niacin-Odan ....................................................... 1 Nicotine ............................................................. Nicotinic acid ..................................................... 1 Nilstat .......................................................... 1, Nitroderm TTS 10 .............................................. 1 Nitroderm TTS ................................................ 1 Noradrenaline acid tartrate ................................. Nordiol 1 .......................................................... Normison ........................................................... Norvir ................................................................ Nystatin ....................................................... 1, O Odrik............................................................ , Omeprazole, amoxycillin and clarithromycin ....... Ondansetron ...................................................... Ondansetron hydrochloride..................... , , Onkotrone .................................................... 1, Orabase ............................................................. Oracort .............................................................. Oral Impact .................................................. , Osmolite ............................................................ Oxis Turbuhaler .................................................. P Paclitaxel ..................................................... 1, Pamisol........................................................ 0, 0 Panadol ............................................................. 1 Pantoprazole ...................................................... Paracetamol ................................................. 1, Paracetamol with codeine................................... Paraldehyde ....................................................... Paxam ............................................................... Pentastarch plasma expander ............................. Perhexiline maleate ............................................ Pexsig ................................................................ Pharmorubicin ................................................... 1 Phenylephrine hydrochloride .............................. Physostigmine salicylate .................................... Phytomenadione ................................................ Plendil ER .......................................................... Poly-Tears .......................................................... Polynoxylin ........................................................ Polyvinyl alcohol ................................................ Ponoxylan .......................................................... Povidone iodine.................................................. Precision Plus ........................................ , , Prednisone......................................................... Primaxin ............................................................ 1 Prioderm ............................................................ Procaine penicillin .............................................. Prograf............................................................... Propine .............................................................. 0 Provera .............................................................. Pulmicort ........................................................... Purinethol .......................................................... Pyrazinamide ..................................................... 1 Q Quetiapine.......................................................... Quinapril ...................................................... , Quinapril with hydrochlorothiazide ...................... R Ranitidine hydrochloride ............................... , Rapilysin ............................................................ Recombinant factor VIII ...................................... Recombinate...................................................... ReFacto ............................................................. Remifenatnil hydrochloride ................................. Respolin Autohaler ............................................. Reteplase ........................................................... Riodine .............................................................. Ritonavir ............................................................ Rituximab .................................................... 0, Rivotril ............................................................... Rocephin ........................................................... S Salbutamol........................... , , , , , Sandimmun ....................................................... Selective serotonin reuptake inhibitors ................ 0

index

Pharmaceuticals and brands Serenace ........................................................... 1 Seroquel ............................................................ Sevoflurane ........................................................ Sevorane ........................................................... Six Plus Parapaed .............................................. Sodium alginate ................................................. Sodium bicarbonate ........................................... Sodium carboxymethylcellulose ......................... Sodium cromoglycate ........................................ Sodium hyaluronate ........................................... Sodium nitroprusside ............................. , , Sofradex ............................................................ Solu-Medrol ....................................................... Somac ............................................................... Special food supplement .............................. , Spiriva ......................................................... 0, Spironolactone ................................................... Stelazine Spansules ........................................... Stesolid ............................................................. Streptase ........................................................... Streptokinase ..................................................... Survanta ...................................................... , Sustanon 0 Orgaject ....................................... Synacthen.......................................................... Synacthen Depot ................................................ Synarel .............................................................. T Tacrolimus ......................................................... Taxol ............................................................ 1, Temazepam ........................................... , , Terbutaline sulphate...................................... , Testosterone esters ............................................ Tetracosactrin .................................................... Thiamine hydrochloride ...................................... Thioguanine ....................................................... Thioridazine hydrochloride.................................. Thiotepa............................................................. Thiothixene ........................................................ Thixit.................................................................. Tinaderm ........................................................... Tinzaparin sodium .............................................. Tiotropium bromide ...................................... 0, Tirofiban hydrochloride....................................... Tolnaftate ........................................................... Tracrium ............................................................ Tramadol hydrochloride ...................................... Tramal ............................................................... Tramal 100 ........................................................ Tramal 0 .......................................................... Tramal Retard..................................................... Trandolapril .................................................. , Trastuzumab ................................................ 1, Triamcinolone acetonide ............................... , Trifluoperazine hydrochloride .............................. Trimipramine maleate ......................................... Tripress.............................................................. Trisul.................................................................. U Ultiva ................................................................. Uromitexan .................................................. 1, V Vancomycin hydrochloride ................................. Vaxigrip.............................................................. Velosef............................................................... Velosulin ............................................................ Ventolin............................................ , , , Vepesid .............................................................. Verapamil hydrochloride ............................... , Verpamil SR ....................................................... Vinblastine sulphate ........................................... Vincristine sulphate ............................................ Vinorelbine ......................................................... 0 Viodine .............................................................. Vitadol C ............................................................ Vitamin A with vitamins D and C ......................... X Xeloda ......................................................... 1, Xylocard ............................................................ Z Zadine................................................................ Zeffix.................................................................. Zenapax ............................................................. Zinacef ............................................................... Zinnat ................................................................ Zofran .............................................. , , , Zoladex .............................................................. 1 Zolendronic acid................................................. Zometa .............................................................. Zoton .................................................................

While care has been taken in compiling this Update, Pharmaceutical Management Agency takes no responsibility for any errors or omissions and shall not be liable to any person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Update. Pharmaceutical Management Agency Level 14 Cigna House 40 Mercer Street PO Box 10 254 Wellington New Zealand Telephone 64 4 460 4990 Facsimile 64 4 460 4995 freephone information line (9 am – 4 pm weekdays) 0800 66 00 50 http://www.pharmac.govt.nz

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Schedule Update - effective 1 July 2005

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