This is the text extract for Schedule Update - effective 1 December 2008, browse documents here.
Pharmaceutical Management Agency
Update
New Zealand Pharmaceutical Schedule
Effective 1 December 2008 Cumulative for September, October, November and December 2008 Section H cumulative for December 2008
Contents
2
Summary of PHARMAC decisions
EFFECTIVE 1 DECEMBER 2008 New listings (page 17)
Changes to restrictions (pages 25 to 26)
Decreased subsidy (page 37)
Increased subsidy (page 37)
3
4 Pharmaceutical Schedule - Update News
Fluorouracil sodium 5% cream (Efudix) – Fully subsidised and restriction change
Efudix, a topical treatment for superficial pre-malignant and malignant skin lesions, will be fully subsidised in Section B of the Pharmaceutical Schedule from 1 December 2008 as a result of a subsidy increase and price decrease. The “Retail pharmacySpecialist” restriction has also been removed meaning that from 1 December 2008 prescriptions written by non-specialist
practitioners will no longer require a specialist endorsement for subsidy.
Aromatase inhibitors
A new brand of anastrozole will be listed in the Pharmaceutical Schedule from 1 December 2008. DP-Anastrozole will be available fully subsidised under endorsement criteria for the treatment of advanced breast cancer. The Special Authority restrictions for the Arimidex brand of anastrozole, and for letrozole, have been amended to remove the criterion relating to advanced breast cancer. Patients with existing Special Authority approvals for either Arimidex or letrozole (Femara) will be unaffected by this change.
Pharmaceutical Schedule - Update News
5
Paracetamol 500 mg tablet brand change
As a result of a new tender agreement, Pharmacare Paracetamol 500 mg tablets will become the sole subsidised brand of prescription paracetamol 500 mg tablets from 1 May 2009. Pharmacare Paracetamol 500 mg tablets will be available and subsidised from 1 December 2008. The current tender holder, GSK Consumer Healthcare, notified PHARMAC of a significant increase in the price of Panadol – from $1.38 to $14.67 per 150 tablets (ex-manufacturer, excluding GST) – to take effect on 1 January 2009. The price increase on Panadol means that between 1 January 2009 and 30 April 2009 a manufacturer’s surcharge will apply to the Panadol brand of paracetamol 500 mg tablets, as PHARMAC will not be increasing the subsidy to match the new price. From 1 May 2009 the Panadol brand will be delisted from the Pharmaceutical Schedule. Pharmacare Paracetamol tablets are not film coated (unlike Panadol) and may be less palatable for some patients. However, Pharmacare Paracetamol tablets are capsuleshaped which should aid in swallowing. Patients who are currently taking the Panadol brand will need to change to Pharmacare Paracetamol in order to continue to receive fully subsidised paracetamol 500 mg tablets. The tender agreement for Pharmacare Paracetamol will prevent a cost of $19.6 million (in the next financial year) to the Pharmaceutical Budget that would result from continuing to fully subsidise Panadol at the increased price. This would have significantly restricted our ability fund new pharmaceuticals. Patient information leaflets have been sent to medical practitioners and pharmacies to help assist with explaining this change to patients. To order more patient leaflets please contact PHARMAC on 0800-66-00-50 or Marketing Impact by fax 0800 455 442.
Change to the available presentations of diltiazem hydrochloride
As a result of concerns about diltiazem hydrochloride prescribing and dispensing errors, (not the quality of the pharmaceuticals), some preparations will be delisted from the Pharmaceutical Schedule. The preparations that will be delisted are Dilzem SR sustained release capsules 90 mg and 120 mg (twice daily) and Dilzem LA long-acting tablets 180 mg and 240 mg (from 1 June 2009). The preparations that will remain subsidised will be Dilzem immediate release tablets 30 mg and 60 mg and Cardizem CD long-acting tablets 120 mg, 180 mg and 240 mg. Price changes will also occur from 1 December 08. To assist in the implementation of the patient switch, all the current preparations will remain listed on the Pharmaceutical Schedule fully subsidised until 1 June 2009. PHARMAC will shortly send a letter to all clinicians and pharmacists providing more detailed advice regarding switching patients.
6 Pharmaceutical Schedule - Update News
Amisulpride – new listing
The antipsychotic agent amisulpride (Solian) will be listed fully subsidised from 1 December 2008. Amisulpride will be listed without the requirement for Special Authority or endorsement for subsidy.
Adrenaline injection – new brand listed
The Aspen Adrenaline brand of adrenaline injection 1:1000, 1 ml will be listed fully subsidised on the Pharmaceutical Schedule from 1 December 2008. Adrenaline injections are an essential pharmaceutical for the emergency management of anaphylaxis and cardiac arrest
Mebendazole
Multichem’s brand of mebendazole 100 mg tablets in a pack size of 24 tablets will be listed in Section B and fully subsidised from 1 March 2009, not 1 October 2008 as included in the August tender notification. Reference pricing of Vermox will apply from 1 May 2009.
Erythropoietin beta – price reduction
The price and subsidy of all strengths of 20% and 48% depending upon the strength). erythropoietin beta (Recormon/NeoRecormon) Recormon/NeoRecormon will remain fully will decrease from 1 December 2008 (between subsidised until at least 30 June 2011.
Habitrol – Nicotine Replacement Therapy
The Habitrol lozenge has been listed on the Pharmaceutical Schedule since 1 September 2008. We are aware of some uncertainty regarding the number of packs that are to be issued per quit card. We are therefore taking this opportunity to clarify the maximum number of packs of NRT that can be dispensed per quit card as follows:
Tender News
Chemical Name Acetazolamide Atropine sulphate Benzylpenicillin sodium (Penicillin G) Bezafibrate Calcitonin Clonazepam Clonazepam Erythromycin ethyl succinate Erythromycin ethyl succinate Finasteride Ketoconazole Mebeverine hydrochloride Methyldopa Methyldopa Methyldopa Nortriptyline hydrochloride Nortriptyline hydrochloride Nystatin Poloxamer Prednisone Prednisone Prednisone Prednisone Procaine penicillin Tar with triethanolamine lauryl sulphate and fluorescein sodium Temazepam Triamcinolone acetonide Triamcinolone acetonide Triamcinolone acetonide Trimethoprim Presentation; Pack size Tab 250 mg; 100 tab Eye drops 1%; 15 ml OP Inj 1 mega u; 10 inj Tab 200 mg; 90 tab Inj 100 iu per ml, 1 ml; 5 inj Tab 500 μg; 100 tab Tab 2 mg; 100 tab Grans for oral liq 200 mg per 5 ml; 100 ml Grans for oral liq 400 mg per 5 ml; 100 ml Tab 5 mg; 30 tab Shampoo 2%; 100 ml OP Tab 135 mg; 90 tab Tab 125 mg; 100 tab Tab 250 mg; 100 tab Tab 500 mg; 100 tab Tab 10 mg; 100 tab Tab 25 mg; 250 tab Oral liq 100,000 u per ml, 24 ml OP Oral drops 10%, 30 ml OP Tab 1 mg; 500 tab Tab 2.5 mg; 500 tab Tab 5 mg; 500 tab Tab 20 mg; 500 tab Inj 1.5 mega u; 5 inj Soln 2.3%; 500 ml and 1,000 ml Tab 10 mg; 25 tab Crm 0.02%; 100 g OP Oint 0.02%; 100 g OP Inj 40 mg per ml, 1 ml; 5 inj Tab 300 mg; 50 tab Sole Subsidised Supply brand (and supplier) Diamox (Sigma) Atropt (Sigma) Sandoz (Novartis) Fibalip (Pacific) Miacalcic (Novartis) Paxam (Pacific) Paxam (Pacific) E-Mycin (Pacific) E-Mycin (Pacific) Fintral (Douglas) Sebizole (Douglas) Colofac (Solvay) Prodopa (Pacific) Prodopa (Pacific) Prodopa (Pacific) Norpress (Pacific) Norpress (Pacific) Nilstat (Sigma) Coloxyl (Sigma) Apo-Prednisone (Apotex) Apo-Prednisone (Apotex) Apo-Prednisone (Apotex) Apo-Prednisone (Apotex) Cilicaine (Sigma) Pinetarsol (Douglas) Normison (Sigma) Aristocort (Sigma) Aristocort (Sigma) Kenacort-A40 (Bristol-Myers Squibb) TMP (Pacific)
7
Vancomycin hydrochloride Zinc sulphate Zopiclone
Inj 50 mg per ml, 10 ml; 1 inj Cap 220 mg; 100 cap Tab 7.5 mg; 500 tab
Pacific (Pacific) Zincaps (Aspen) Apo-Zopiclone (Apotex)
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. Possible decisions for implementation 1 January 2009
8
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Aciclovir Alprazolam
Presentation
Tab dispersible 200 mg Tab dispersible 400 mg Tab 250 μg Tab 500 μg Tab 1 mg Inj 10 mg per ml, 1 ml Cap 100 mg Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 100 mg Tab dispersible 300 mg Tab 100 mg Tab 50 mg & 100 mg Inj 600 μg, 1 ml Inj 1200 μg, 1 ml Tab 500 mg Metered aqueous nasal spray 50 μg Metered aqueous nasal spray 100 μg Scalp app 0.1% Tab 5 mg Eye drops 0.2% Inj 0.5%, 4 ml Inj 0.5%, 8% glucose, 4 ml Lotion BP Crm, aqueous, BP Cap 0.25 μg & 0.5 μg Tab eff 1 g; 30 tab Inj 50 mg Tab 12.5 mg, 25 mg & 50 mg Cap 250 mg Grans for oral liq 125 mg per 5 ml Inj 750 mg & 1.5 g Crm BP Eye drops 0.5% Eye oint 1% Soln 4% Handrub 1% with ethanol 70% Mouthwash 0.2% Tab 25 mg
Brand Name Expiry Date*
Lovir Lovir Arrow-Alprazolam Arrow-Alprazolam Arrow-Alprazolam Mayne Symmetrel Apo-Amoxi Ranbaxy Amoxicillin Ranbaxy Amoxicillin Apo-Ascorbic Acid Ethics Aspirin Ethics Aspirin EC Loten AstraZeneca AstraZeneca Arrow-Azithromycin Alanase Alanase Beta Scalp Lax-Tab AFT Marcain Isobaric Marcain Heavy ABM ABM Calcitriol-AFT Calsource Calcium Folinate Ebewe Apo-Captopril Ranbaxy Cefaclor Ranbaxy Cefaclor Zinacef PSM Chlorsig Chlorsig Orion Orion Orion Hygroton 2009 2010
Apomorphine hydrochloride Amantadine hydrochloride Amoxycillin
2009 2011 2010 2009 2009 2010 2009 2009 2009 2009 2009 2010 2011 2010 2009 2009 2011 2011 2010 2010 2011 2010 2009 2011 2009 2009
Ascorbic acid Aspirin Atenolol Atropine sulphate Azithromycin Beclomethasone dipropionate Betamethasone valerate Bisacodyl Brimonidine tartrate Bupivicaine hydrochloride Calamine Calcitriol Calcium Calcium folinate Captopril Cefaclor monohydrate Cefuroxime sodium Cetomacrogol Chloramphenicol Chlorhexidine gluconate
Chlorthalidone
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 9
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Clarithromycin Clobetasol propionate Clotrimazole Codeine phosphate Colchicine Colestipol hydrochloride Colistin sulphomethate Compound electrolytes Cyclizine hydrochloride Cyclophosphamide Cyproterone acetate Dantrolene sodium Desferrioxamine mesylate Desmopressin Dexamethasone sodium phosphate Dexamphetamine sulphate Dextrose Dextrose with electrolytes
Presentation
Tab 250 mg Grans for oral liq 125 mg per 5 ml Crm 0.05% Crm 1% Vaginal crm 1% with applicator(s) Tab 15 mg, 30 mg & 60 mg Tab 500 μg Sach 5 g Inj 150 mg Powder for soln for oral use Tab 50 mg Tab 50 mg Tab 50 mg Cap 25 mg & 50 mg Inj 500 mg Nasal spray 10 mcg per dose Inj 4 mg per ml, 1 ml Inj 4 mg per ml, 2 ml Tab 5 mg Inj 50%, 10 ml Oral soln with electrolytes
Brand Name Expiry Date*
Klamycin Klacid Dermol Clomazol Clomazol PSM Colgout Colestid Colistin-Link Enerlyte Nausicalm Cycloblastin Siterone Dantrium Mayne Desmopressin-PH&T Mayne PSM Biomed Pedialyte – Plain Pedialyte – Bubblegum Pedialyte – Fruit Voltaren Ophtha Voltaren Voltaren Voltaren Voltaren Voltaren Apo-Diclo Apo-Diclo SR Videx EC Pytazen SR Apo-Doxazosin AFT m-Enalapril Mayne Cafergot 2010 2009 2011 2010 2010 2010 2010 2010 2010 2009 2010 2009 2009 2010 2011 2009 2010 2011 2010
Dicloflenac sodium
Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg Suppos 25 mg Suppos 50 mg Suppos 100 mg Tab EC 25 mg & 50 mg Tab long-acting 75 mg & 100 mg Cap 125 mg, 200 mg, 250 mg & 400 mg Tab long-acting 150 mg Tab 2 mg & 4 mg Oint BP Tab 5 mg, 10 mg & 20 mg Inj 500 μg per ml, 1 ml Tab 1 mg with caffeine 100 mg
2011
2009 2009 2011 2010 2011 2009 2009 2009
Didanosine (DDI) Dipyridamole Doxazosin mesylate Emulsifying ointment Enalapril Ergometrine maleate Ergotamine tartrate with caffeine
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 10
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Ethinyloestradiol Ethinyloestradiol with norethisterone
Presentation
Tab 10 μg Tab 35 μg with norethisterone 500 μg Tab 35 μg with norethisterone 1 mg Tab 35 μg with norethisterone 1 mg and 7 inert tab Cap 50 mg & 100 mg Oral liq 150 mg per 5 ml Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap 50 mg Cap 150 mg Cap 200 mg Inj 50 mg Tab 10 mg Oint 950 μg, with fluocortolone pivalate 920 μg, and cinchocaine hydrochloride 5 mg per g Suppos 630 μg, with fluocortolone pivalate 610 μg, and cinchocaine hydrochloride 1 mg Eye drops 0.1% Cap 20 mg Tab disp 20 mg, scored Tab 0.8 mg & 5 mg Crm 2% & Oint 2% Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg Oral pump spray 400 μg per dose TDDS 5 mg TDDS 10 mg Oral liq 2 mg per ml Tab 500 μg, 1.5 mg & 5 mg Inj 5 mg per ml, 1 ml Inj 10 iu per ml, 5 ml Crm 1% Tab 5 mg & 20 mg Rectal foam 10%, CFC-Free Scalp lotn 0.1%
Brand Name Expiry Date*
New Zealand Medical and Scientific Brevinor 21 Brevinor 1/21 Brevinor 1/28 Vepesid Ferodan Staphlex AFT AFT Pacific Pacific Pacific Fludara Fludara Ultraproct Ultraproct 2009 2010 2009 2009 2010
Etoposide Ferrous sulphate Flucloxacillin sodium
Fluconazole
2011
Fludarabine phosphate Fluocortolone caproate with fluocortolone pivalate and cinchocaine
2011 2010
Fluorometholone Fluoxetine hydrochloride Folic Acid Fusidic acid Gentamicin sulphate Gliclazide Glipizide Glyceryl trinitrate
Flucon Fluox Fluox Apo-Folic Acid Foban Pfizer Apo-Gliclazide Minidiab Nitrolingual pumpspray Nitroderm TTS 5 Nitroderm TTS 10 Serenace Serenace Serenace AstraZeneca PSM Douglas Colifoam Locoid
2009 2010 2009 2010 2009 2011 2011 2011
Haloperidol
2010 2009 2009 2011 2009 2009 2010
Heparinised saline Hydrocortisone Hydrocortisone acetate Hydrcortisone butyrate
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 11
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Hydrocortisone with wool fat and mineral oil Ibuprofen Imipramine hydrochloride Indapamide Ipratropium bromide
Presentation
Lotn 1% with wool fat hydrous 3% and mineral oil Oral liq 100 mg per 5 ml, 200 ml Tab 10 mg & 25 mg Tab 2.5 mg Aqueous nasal spray, 0.03% Nebuliser soln, 250 μg per ml, 1 ml Nebuliser soln, 250 μg per ml, 2 ml Inj 50 mg per ml, 2 ml Tab long-acting 60 mg Cap 10 mg Cap 20 mg Cap 100 mg Oral liq 10 g per 15 ml Eye drops 0.25% & 0.5% Cap 50 mg with benserazide 12.5 mg Tab dispersible 50 mg with benserazide 12.5 mg Cap 100 mg with benserazide 25 mg Cap long-acting 100 mg with benserazide 25 mg Cap 200 mg with benserazide 50 mg Inj 0.5%, 5 ml Inj 1%, 5 ml Inj 1%, 20 ml Crm 2.5% with prilocaine 2.5%; 30 g OP Crm 2.5% with prilocaine 2.5%; 5 g Tab 5 mg, 10 mg & 20 mg Tab 2 mg Tab 10 mg Oral liq 1 mg per ml
Brand Name Expiry Date*
DP Lotn HC Fenpaed Tofranil Napamide Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Ferrum H Duride Isotane 10 Isotane 20 Sporanox Duphalac Betagan Madopar 62.5 Madopar Dispersible Madopar 125 Madopar HBS Madopar 250 Xylocaine Xylocaine Xylocaine EMLA EMLA Arrow-Lisinopril Nodia Loraclear Hayfever Relief Lorapaed Ativan Mayne Derbac M A-Lices Ludiomil Provera Pentasa 2009 2010 2010 2010 2011 2010 2009 2009 2010
Iron polymaltose Isosorbide mononitrate Isotretinoin Itraconazole Lactulose Levobunolol Levodopa with benserazide
2011 2009 2009 2010 2010 2010 2009
Lignocaine hydrochloride
Lignocaine with prilocaine
2010
Lisinopril Loperamide hydrochloride Loratadine
Lorazepam Magnesium sulphate Malathion Maldison Maprotiline hydrochloride Medroxyprogesterone acetate Mesalazine
Tab 1 mg & 2.5 mg Inj 49.3% Liq 0.5% Shampoo 1% Tab 25 mg & 75 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Enema 1 g per 100 ml
2009 2009 2010 2010 2009 2010 2009
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 12
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Metformin hydrochloride Methadone hydrochloride Methotrexate
Presentation
Tab 500 mg & 850 mg Tab 5 mg Powder 1 g Inj 100 mg per ml, 10 ml Inj 100 mg per ml, 50 ml Tab 2.5 mg & 10 mg Tab long-acting 20 mg Tab 5 mg & 20 mg Tab 10 mg Tab 4 mg & 100 mg Crm 0.1% and oint 0.1% Inj 40 mg per ml, 1 ml Inj 40 mg per ml with lignocaine 1 ml Inj 40 mg per ml, 1 ml Inj 62.5 mg per ml, 1 ml Inj 500 mg & 1 g Inj 5 mg per ml, 2 ml Tab long-acting 200 mg Cap 250 mg Crm 2% Tab 2.5 mg & 5 mg Tab 200 μg Tab 150 mg & 300 mg Oral liq 1 mg per ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Inj 5 mg per ml, 1 ml Inj 15 mg per ml, 1 ml Cap long-acting 10 mg, 30 mg, 60 mg, 100 mg & 200 mg Tab immediate release 10 mg & 20 mg Inj 80 mg per ml, 1.5 ml & 5 ml Tab 40 mg & 80 mg Tab 50 mg Tab 250 mg Tab 500 mg
Brand Name Expiry Date*
Arrow-Metformin Methatabs AFT Methotrexate Ebewe Methotrexate Ebewe Methoblastin Rubifen SR Rubifen Rubifen Medrol Advantan Depo-Medrol Depo-Medrol with Lidocaine Solu-Medrol Solu-Medrol Solu-Medrol Pfizer Slow-Lopresor Metopirone Multichem Gutron Cytotec Apo-Moclobemide RA-Morph RA-Morph RA-Morph RA-Morph Mayne Mayne Mayne Mayne m-Eslon Sevredol Mayne Apo-Nadolol ReVia Noflam 250 Noflam 500 2009 2010 2010 2009 2009 2010 2009 2011 2009 2009
Methylphenidate hydrochloride
Methylprednisolone Methylprednisolone aceponate Methylprednisolone acetate Methylprednisolone acetate with lignocaine Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol tartrate Metyrapone Miconazole nitrate Midodrine Misoprostol Moclobemide Morphine hydrochloride
2009 2009 2011 2011 2009
2011 2009 2009 2011 2009 2009 2009 2009
Morphine sulphate
2011 2009
Morphine tartrate Nadolol Naltrexone hydrochloride Naproxen
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 13
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Naproxen sodium Neostigmine Nevirapine Nicotinic acid Nifedipine Norethisterone Nystatin
Presentation
Tab 275 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Tab 50 mg & 500 mg Tab long-acting 20 mg Tab 5 mg Tab 350 μg Cap 500,000 u Tab 500,000 u Vaginal crm 100,000 u per 5 g with applicators Tab 4 mg & 8 mg Tab disp 4 mg & 8 mg Tab 5 mg Oral liq 5 mg per 5 ml Inj 10 mg per ml, 1 ml and 2 ml Oral liq 5 mg per 5 ml Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 μg per ml, 1 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml Tab 20 mg Tab 40 mg
Brand Name Expiry Date*
Sonaflam AstraZeneca Viramune Suspension Apo-Nicotinic Acid Nyefax Retard Primolut N Noriday 28 Nilstat Nilstat Nilstat Zofran Zofran Zydis Apo-Oxybutynin Apo-Oxybutynin OxyNorm OxyNorm Syntocinon Syntocinon Syntometrine Pamisol Pamisol Pamisol Dr Reddy’s Pantoprazole Dr Reddy’s Pantoprazole Paracare Junior Paracare Double Strength Lacri-Lube Loxamine Permax Permax Pexsig AFT AFT Cilicaine VK Cilicaine VK Prefrin Span-K 2010 2010 2009 2009 2009 2011 2009 2010 2009 2010 2010 2010 2009
Ondansetron Oxybutynin Oxycodone hydrochloride Oxytocin
Pamidronate disodium
2011
Pantoprazole
2010
Paracetamol
Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml Eye oint with soft white paraffin Tab 20 mg Tab 0.25 mg Tab 1 mg Tab 100 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap potassium salt 250 mg Cap potassium salt 500 mg Eye drops 0.12% Tab long-acting 600 mg
2011
Paraffin liquid with soft white paraffin Paroxetine hydrochloride Pergolide Perhexiline maleate Phenoxymethylpenicillin (Penicillin V)
2010 2010 2011 2009 2010
Phenylephrine hydrochloride Potassium chloride
2010 2009
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 14
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Prazosin hydrochloride Pregnancy tests - HCG urine Pyridoxine hydrochloride Quinapril Quinapril with hydroclorothiazide
Presentation
Tab 1 mg, 2 mg & 5 mg Cassette Tab 50 mg Tab 5 mg; 10 mg & 20 mg Tab 10 mg with hydroclorothiazide 12.5 mg Tab 20 mg with hydroclorothiazide 12.5 mg Tab 200 mg Tab 300 mg Oral liq 150 mg per 10 ml Cap 150 mg Tab 150 mg & 300 mg Nebuliser soln 1 mg per ml, 2.5 ml Nebuliser soln 2 mg per ml, 2.5 ml Oral liq 2 mg per 5 ml Nebuliser soln, 2.5 mg with ipratropium bromide 0.5 mg Tab 5 mg Inj 0.9%, 5 ml & 10 ml Grans eff 4 g sachets Nasal spray 4% Tab 500 mg Tab EC 500 mg Liq Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Inj 250 mcg Inj 1 mg per ml, 1 ml Eye drops 0.25% Eye drops 0.5% Tab 10 mg Tab 50 mg 0.1% in Dental Paste USP Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 mcg per g Cap 300 mg
Brand Name Expiry Date*
Apo-Prazo MDS Quick Card Apo-Pyridoxine Accupril Accuretic 10 Accuretic 20 Q 200 Q 300 Peptisoothe Mycobutin Arrow-Roxithromycin Asthalin Asthalin Salapin Duolin Apo-Selegiline AstraZeneca Ural Rex Salazopyrin Salazopyrin EN Midwest Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timop Apo-Timop Apo-Timol Apo-Thiamine Oracort Kenacomb 2009 2010 2010 2009 2009 2010 2009 2009 2009 2010 2009 2009 2010 2011 2011 2011 2011 2009 2009 2011 2009 2010 2009 2009 2011 2011
Quinine sulphate Ranitidine hydrochloride Rifabutin Roxithromycin Salbutamol
Salbutamol with ipratropium bromide Selegiline hydrochloride Sodium chloride Sodium citro-tartrate Sodium cromoglycate Sulphasalazine Syrup (pharmaceutical grade) Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate
Thiamine hydrochloride Triamcinolone acetonide Triamcinolone acetonide with gramicidin, neomycin and nystatin Ursodeoxycholic acid
Actigall
2011
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 15
Sole Subsidised Supply Products – cumulative to December 2008
Generic Name
Vincristine sulphate Vitamins Vitamin B complex Water Zinc and castor oil December changes in bold type.
Presentation
Inj 1 mg per ml, 1 ml Inj 1 mg per ml, 2 ml Tab (BPC cap strength) Tab, strong, BPC Purified for injection 20 ml Ointment BP
Brand Name Expiry Date*
Mayne Mayne Healtheries Apo-B-Complex Multichem PSM 2009 2009 2009 2009 2011
*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 16
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
53 56 58
DOXAZOSIN MESYLATE Tab 4 mg ............................................................................... 30.26 ATENOLOL Tab 50 mg ................................................................................ 0.39 AMLODIPINE Tab 5 mg .................................................................................. 7.33 Tab 10 mg .............................................................................. 11.79 ADRENALINE Inj 1 in 1,000, 1ml – Up to 5 inj available on a PSO .................... 4.98 EFAVIRENZ –Special Authority see SA0779 – Hospital Pharmacy [HP1} Tab 50 mg ............................................................................ 158.33 Tab 200 mg ......................................................................... 474.99 PARACETAMOL Tab 500 mg .............................................................................. 9.60 CARBAMAZEPINE Tab 200 mg ........................................................................... 14.53 AMISULPRIDE Tab 100 mg ........................................................................... 22.52 Tab 200 mg ............................................................................ 97.03 Tab 400 mg .......................................................................... 185.44 Oral liquid 100 mg per ml ........................................................ 55.44
500 30 100 100 5 30 90 1000 100 30 60 60 60 ml
✔ Apo-Doxazosin ✔ Noten S29 ✔ Apo-Amlodipine ✔ Apo-Amlodipine ✔ Aspen Adrenaline ✔ Stocrin ✔ Stocrin ✔ Pharmacare ✔ Tegretol ✔ Solian ✔ Solian ✔ Solian ✔ Solian
60 97
107 112 119
133 139
ANAGRELIDE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA0879 ✔ Teva S29 Cap 0.5 mg .......................................................................... CBS 100 ANASTROZOLE-DP Tab 1 mg – Subsidy by endorsement ....................................... 29.50 30 ✔ DP-Anastrozole Subsidised only for patients with hormone receptor positive advanced breast cancer and the prescription is endorsed accordingly CETIRIZINE HYDROCHLORIDE Tab 10 mg ................................................................................ 2.21 ‡ Oral liquid 1 mg per ml ............................................................ 3.50 100 200 ml ✔ Zetop ✔ Cetirizine-AFT
147
29
INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE Inj lispro 25% with insulin lispro protamine 75%, 100 u per ml, 3 ml .............................................................. 52.15 Inj lispro 50% with insulin lispro protamine 50%, 100 u per ml, 3 ml .............................................................. 52.15 DOXAZOSIN MESYLATE Tab 2 mg ............................................................................... 22.85 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
5 5 500
✔ Humalog Mix 25 ✔ Humalog Mix 50 ✔ Apo-Doxazosin
53
Three months or six months, as applicable, dispensed all-at-once
17
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
66 76 82 84
AQUEOUS CREAM Crm........................................................................................... 2.28 CLOTRIMAZOLE Vaginal crm 2% with applicators ............................................... 2.75 OESTRADIOL VALERATE – See prescribing guideline Tab 2 mg ................................................................................. 8.24 THYROXINE Tab 50 μg ................................................................................. 1.71 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 100 μg ............................................................................... 1.78 ‡ Safety cap for extemporaneously compounded oral liquid preparations. AMOXYCILLIN Drops 100 mg per 1 ml ............................................................ 4.00 Inj 250 mg ............................................................................. 12.42 Inj 500 mg ............................................................................. 14.24 Inj 1 g – Up to 5 inj available on a PSO..................................... 21.62 CIPROFLOXACIN Tab 250 mg – Up to 5 tab available on a PSO ............................ 3.35 Tab 500 mg – Up to 5 tab available on a PSO ............................ 4.90 Tab 750 mg – Retail pharmacy-Specialist ................................. 7.54 CITALOPRAM HYDROBROMIDE Tab 20 mg ............................................................................... 3.78 CARBOPLATIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.13 CARMUSTINE – PCT only – Specialist Inj 100 mg for ECP ............................................................... 204.13 CYCLOPHOSPHAMIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.02 CISPLATIN – PCT only – Specialist Inj 1 mg for ECP ........................................................................ 0.46 IFOSFAMIDE – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.09 OXALIPLATIN – PCT only – Specialist – Special Authority see SA0900 Inj 1 mg for ECP ....................................................................... 8.74 CALCIUM FOLINATE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 CLADRIBINE – PCT only – Specialist Inj 10 mg for ECP ................................................................. 749.96
500 g 20 g OP 56 28 28
✔ AFT ✔ Clomazol ✔ Progynova ✔ Goldshield ✔ Goldshield
91
30 ml OP 10 10 10 30 30 30 84 1 mg
✔ Ospamox ✔ Ibiamox ✔ Ibiamox ✔ Ibiamox ✔ Rex Medical ✔ Rex Medical ✔ Rex Medical ✔ Arrow-Citalopram ✔ Biomed
92
110 130 130 130 130 130 130 131 132
100 mg OP ✔ Biomed 1 mg 1 mg 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed
10 mg OP ✔ Biomed
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
18
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
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Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
132
CYTARABINE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.03 Inj 100 mg intrathecal syringe for ECP – PCT only – Specialist ....................................................... 16.00 FLUDARABINE PHOSPHATE – PCT only – Specialist Inj 50 mg for ECP ................................................................. 299.25 FLUOROURACIL SODIUM Inj 1 mg for ECP – PCT only – Specialist ................................... 0.01
1 mg
✔ Biomed
100 mg OP ✔ Biomed 50 mg OP ✔ Biomed 1 mg ✔ Biomed
132 132 132 132 133
GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA0877 Inj 1 mg for ECP ........................................................................ 0.38 1 mg ✔ Biomed IRINOTECAN – PCT only – Specialist – Special Authority see SA0878 Inj 1 mg for ECP ........................................................................ 3.19 METHOTREXATE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 Inj 5 mg intrathecal syringe for ECP – PCT only – Specialist .................................................................... 4.73 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 1,000 iu for ECP .................................................................. 5.26 1 mg 1 mg 5 mg OP 1,000 iu ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed
134 134 134 134 134 134 135 135 135 135
COLASPASE (L-ASPARAGINASE) – PCT only – Specialist Inj 10,000 iu for ECP ............................................................ 102.32 10,000 iu OP ✔ Biomed DACARBAZINE – PCT only – Specialist Inj 200 mg for ECP ................................................................. 43.86 DACTINOMYCIN (ACTINOMYCIN D) – PCT only – Specialist Inj 0.5 mg for ECP .................................................................. 13.52 DAUNORUBICIN – PCT only – Specialist Inj 20 mg for ECP ................................................................... 99.00 DOCETAXEL – PCT only – Specialist – Special Authority see SA0880 Inj 1 mg for ECP ..................................................................... 23.81 DOXORUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.87 EPIRUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 2.74 ETOPOSIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.30 ETOPOSIDE PHOSPHATE – PCT only – Specialist Inj 1 mg (of etoposide base) for ECP ........................................ 0.47 200 mg OP ✔ Biomed 0.5 mg OP ✔ Biomed 20 mg OP ✔ Biomed 1 mg 1 mg 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
19
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
135 136 136 136 136 136 137 137 137 139
IDARUBICIN HYDROCHLORIDE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 37.74 MESNA – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.02 MITOMYCIN C – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 11.85 MITOZANTRONE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 12.43 PACLITAXEL – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 1.32 TENIPOSIDE – PCT only – Specialist Inj 50 mg for ECP ................................................................... 84.51 VINBLASTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................... 3.05 VINCRISTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................. 21.46 VINORELBINE – PCT only – Specialist – Special Authority see SA0901 Inj 1 mg for ECP ....................................................................... 4.75 BICALUTAMIDE – Special Authority see SA0941 below Tab 50 mg .............................................................................. 27.10
1 mg 1 mg 1 mg 1 mg 1 mg
✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed
50 mg OP ✔ Biomed 1 mg 1 mg 1 mg 30 ✔ Biomed ✔ Biomed ✔ Biomed ✔ Bicalox
➽ SA0941 Special Authority for Subsidy Initial application from any medical practitioner. Approvals valid without further renewal unless notified where the patient has advanced prostate cancer. 139 OCTREOTIDE (SOMATOSTATIN ANALOGUE) – Special Authority see SA0563 – Hospital pharmacy [HP3] Inj 50 μg per ml, 1 ml ............................................................. 25.65 5 ✔ Hospira Inj 100 μg per ml, 1 ml ........................................................... 48.50 5 ✔ Hospira Inj 500 μg per ml, 1 ml ......................................................... 175.00 5 ✔ Hospira RITUXIMAB – PCT only – Specialist – Special Authority see SA0884 See prescribing guideline Inj 1 mg for ECP ....................................................................... 6.27 TRASTUZUMAB – PCT only – Specialist – Special Authority see SA0885 See prescribing guideline Inj 1 mg for ECP ....................................................................... 9.36
144
1 mg
✔ Biomed
144
1 mg
✔ Biomed
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
20
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
153
SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices also available to paediatricians employed by a DHB on a wholesale supply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via a hospital pharmacy. 2) Only available for children aged six years and under. 3) For Space Chamber and Foremount Child’s Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. 4) Distributed by Airflow Products. Forward orders to: Airflow Products Telephone: 04 499 1240 or 0800 AIR FLOW PO Box 1485, Wellington Facsimile: 04 499 1245 or 0800 323 270 230 ml (single patient) .............................................................. 8.38 1 ✔ Space Chamber
50 77
SIMVASTATIN - see prescribing guidelines on the preceding page Tab 80 mg ................................................................................ 3.18
30
✔ SimvaRex
FINASTERIDE Special Authority see SA0928 – Retail Pharmacy Tab 5 mg ................................................................................ 19.20 30 ✔ Fintral ➽ SA0928 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has symptomatic benign prostatic hyperplasia; and 2 Either: 2.1 The patient is intolerant of non-selective alpha blockers or these are contraindicated; or 2.2 Symptoms are not adequately controlled with non-selective alpha blockers Note: patients with enlarged prostates are the appropriate candidates for therapy with finasteride. CEFAZOLIN SODIUM – Hospital Pharmacy [HP3] – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patients and the prescription is endorsed accordingly. Inj 500 mg ................................................................................ 5.00 5 ✔ Hospira Inj 1 g ....................................................................................... 8.00 5 ✔ Hospira FLUCLOXACILLIN SODIUM Inj 250 mg ................................................................................ 9.00 Inj 500 mg .............................................................................. 10.40 Inj 1 g – Up to 5 inj available on a PSO..................................... 14.00 CLOZAPINE – Hospital pharmacy [HP4] – Specialist prescription Tab 25 mg .............................................................................. 35.20 Tab 50 mg .............................................................................. 45.60 Tab 100 mg ............................................................................ 91.20 Tab 200 mg .......................................................................... 145.92 RISPERIDONE Tab 0.5 mg ............................................................................. 15.60 10 10 10 100 100 100 100 60 ✔ Flucloxin ✔ Flucloxin ✔ Flucloxin ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Ridal
89
92
119
120
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
21
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
173
PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA0896 – Hospital Pharmacy [HP3] Liquid (strawberry) .................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (chocolate) ..................................................................... 1.07 200 ml OP ✔ Pediasure ADULT PRODUCTS STANDARD ENTERAL FEED 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.24 250 ml OP ✔ Isosource HN – Unflavoured 5.29 1000 ml OP ✔ Isosource HN – Unflavoured ENTERAL FEED WITH FIBRE 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.24 250 ml OP ✔ Fibersource HN – Unflavoured 5.29 1,000 ml OP ✔ Fibersource HN – Unflavoured PHENYL FREE PASTA – Special Authority see SA0733 – Hospital Pharmacy [HP3] Animal shapes......................................................................... 10.65 500 g OP (11.91) Lasagne .................................................................................... 5.32 250 g OP (5.99) Penne...................................................................................... 10.65 500g OP (11.91) Macaroni ................................................................................... 5.32 250 g OP (5.95)
176
177
182
Loprofin Loprofin Loprofin Loprofin
182
AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital Pharmacy [HP3] Liquid (berry) .......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (berry) .......................................................................... 31.20 125 ml OP ✔ Lophlex LQ Liquid (citrus) .......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (citrus) .......................................................................... 31.20 125 ml OP ✔ Lophlex LQ Liquid (orange) ........................................................................ 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (orange) ........................................................................ 31.20 125 ml OP ✔ Lophlex LQ
29 43
INSULIN GLARGINE – Special Authority see SA0834 – Retail pharmacy Inj 100 iu per ml, 3 ml disposable pen ..................................... 94.50
5
✔ Lantus SoloStar ✔ Eprex ✔ Eprex ✔ Apo-Clopidogrel ✔ Cozaar
ERYTHROPOIETIN ALPHA – Special Authority SA0922 – Hospital pharmacy [HP3] Inj human recombinant 5,000 iu, pre-filled syringe ................. 243.26 6 Inj human recombinant 6,000 iu, pre-filled syringe ................. 291.92 6 CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy Tab 75 mg .............................................................................. 35.00 LOSARTAN – Special Authority see SA0911 – Retail pharmacy Tab 25 mg .............................................................................. 21.76 28 30
45 55
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
22
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
56
ATENOLOL Tab 50 mg ................................................................................ 6.50 Tab 100 mg ............................................................................ 11.30 NICOTINE – Only on a Quitcard Lozenge 1 mg ......................................................................... 11.08 Lozenge 2 mg ......................................................................... 11.08
500 500 36 36
✔ Pacific Atenolol ✔ Pacific Atenolol ✔ Habitrol ✔ Habitrol
61
70
IMIQUIMOD – Special Authority see SA0923 – Retail pharmacy Crm 5 % ................................................................................ 110.40 12 sachets ✔ Aldara ➽ SA0923 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 4 months for Applications meeting the following criteria: Either: 1 The patient has external anogenital warts and podophyllotoxin has been tried and failed (or is contraindicated); or 2 The patient has external anogenital warts and podophyllotoxin is unable to be applied accurately to the site; or 3 The patient has confirmed superficial basal cell carcinoma where other standard treatments, including surgical excision, are contraindicated or inappropriate. Note Superficial basal cell carcinoma Surgical excision remains remains first-line treatment for superficial basal cell carcinoma as it has a higher cure rate than imiquimod and allows histological assessment of tumour clearance. Imiquimod has not been evaluated for the treatment of superficial basal cell carcinoma within 1 cm of the hairline, eyes, nose, mouth or ears. Imiquimod is not indicated for recurrent, invasive, infiltrating, or nodular basal cell carcinoma. External anogenital warts Imiquimod is only indicated for external genital and perianal warts (condyloma acuminata). Renewal from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: Any of the following: 1 Inadequate response to initial treatment for anogenital warts; or 2 New confirmed superficial basal cell carcinoma where other standard treatments, including surgical excision, are contraindicated or inappropriate; or 3 Inadequate response to initial treatment for superficial basal cell carcinoma. Note Confirmation that the lesion is a superficial basal cell carcinoma should be obtained using a biopsy.
109
AMITRIPTYLINE Tab 10 mg ................................................................................ 2.77
50
✔ Amirol
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
23
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
128
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE – Special Authority SA0924 – Retail Pharmacy Only on a controlled drug form Tab extended-release 18 mg .................................................... 58.96 30 ✔ Concerta Tab extended-release 27 mg .................................................... 65.44 30 ✔ Concerta Tab extended-release 36 mg .................................................... 71.93 30 ✔ Concerta Tab extended-release 54 mg .................................................... 86.24 30 ✔ Concerta ➽ SA0924 Special Authority for Subsidy Initial application only from a paediatrician, psychiatrist or any other medical practitioner on the recommendation of a relevant specialist. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficit and Hyperactivity Disorder); and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Either: 3.1 Applicant is a paediatrician or psychiatrist; or 3.2 Both 3.2.1 Applicant is a medical practitioner and confirms that a relevant specialist has been consulted within the last 2 years and has recommended treatment for the patient; and 3.2.2 Provide name of the recommending specialist; and 4 Either: 4.1 Patient is taking a currently subsidised formulation of methylphenidate hydrochloride (immediaterelease or sustained-release) which has not been effective due to significant administration and/or compliance difficulties; or 4.2 There is significant concern regarding the risk of diversion or abuse of immediate-release methylphenidate hydrochloride. Renewal only from a paediatrician, psychiatrist or any other medical practitioner on the recommendation of a relevant specialist. Approvals valid for 24 months for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 Applicant is a paediatrician or psychiatrist; or 2.2 Both: 2.2.1 Applicant is a medical practitioner and confirms that a relevant specialist has been consulted within the last 2 years and has recommended treatment for the patient; and 2.2.2 Provide name of the recommending specialist
75
MEDROXYPROGESTERONE ACETATE Inj 150 mg per ml, 1ml – Up to 5 inj available on a PSO ............. 8.05
1
✔ Depo-Provera
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
24
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
25 70 92
DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE Tab 2.5 mg with atropine sulphate 25 μg ................................... 3.90 FLUOROURACIL SODIUM – Retail pharmacy-Specialist Crm 5% ................................................................................... 26.49 CLINDAMYCIN Cap hydrochloride 150 mg – Maximum of 34 cap per prescription;can be waived by endorsement – Retail pharmacy-specialist ................................................................ 11.39
100 20 g OP
✔ Diastop S29 ✔ Efudix
16
✔ Dalacin C
139
ANASTROZOLE Tab 1 mg – Higher subsidy of $240.00 per 30 with Special Authority see SA0942 0810 below......................................... 146.46 30 (240.00) Arimidex ➽ SA0942 0810 Special Authority for Alternate Subsidy Initial application - New Patients - only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal womean; and 2 Patient has hormone receptor positive early breast cancer; and 3 Either: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.12 The patient has a very clear history of intolerance to tamoxifen; or 3.23 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Initial application – Patient has had a Special Authority approval for anastrozole prior to 1 December 2008 – only from a relevant specialist. Approval valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Note: If the patient had an approval for anastrozole prior to 1 December 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone Ministry of Health Sector Services on 0800 243 666 for clarification if needed.
139
LETROZOLE Tab 2.5 mg – Higher subsidy of $200.00 per 30 with Special Authority see SA0943 0811 below......................................... 146.46 30 (200.00) Femara ➽ SA0943 0811 Special Authority for Alternate Subsidy Initial application - New Patients - only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal womean; and 2 Patient has hormone receptor positive early breast cancer; and 3 Either: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.12 The patient has a very clear history of intolerance to tamoxifen; or 3.23 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. continued...
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
25
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued... Initial application – Patient has had a Special Authority approval for letrozole prior to 1 December 2008 – only from a relevant specialist. Approval valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Renewal – only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Note: If the patient had an approval for letrozole prior to 1 December 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone Ministry of Health Sector Services on 0800 243 666 for clarification if needed.
44
FOLIC ACID Oral liq 50 μg per ml – Retail pharmacy-Specialist .................. 21.05 Specialist must be a paediatrician or paediatric cardiologist.
25 ml OP
✔ Biomed
46
DIPYRIDAMOLE Tab 25 mg – Additional subsidy by Special Authority see SA0930 0648 below – Retail pharmacy ................................ 0.16 84 (8.36) Persantin Tab long-acting 150 mg – Special Authority see SA0929 0649 below – Retail pharmacy ..................................................... 11.52 60 ✔ Pytazen SR ➽ SA0930 0648 Special Authority for Manufacturers Price Initial application — (Conditions other than transient ischaemic episodes) from any relevant practitioner only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves – as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft – as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Initial application — (Transient ischaemic episodes) from any relevant practitioner only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where the patient continues to have transient ischaemic episodes despite aspirin therapy or has transient ischaemic episodes and is aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Renewal — (Existing 2 year approvals) from any relevant practitioner only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. ➽ SA0929 0649 Special Authority for Subsidy Initial application — (Conditions other than transient ischaemic episodes) from any relevant practitioner only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves – as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft – as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. continued...
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
26
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued... Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Initial application — (Transient ischaemic episodes) from any relevant practitioner only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where the patient continues to have transient ischaemic episodes despite aspirin therapy or has transient ischaemic episodes and is aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Renewal — (Existing 2 year approvals) from any relevant practitioner only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. 47 HEPARIN SODIUM Inj 25,000 iu per ml, 0.2 ml – Hospital pharmacy [HP3]Specialist .............................................................................. 9.50 CALCIUM POLYSTYRENE SULPHONATE – Retail pharmacy-Specialist Powder ................................................................................. 169.85 POTASSIUM BICARBONATE – Retail pharmacy-Specialist Tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg - for phosphate supplementation ................................................................ 75.00 ACIPIMOX – Retail pharmacy-Specialist Cap 250 mg ........................................................................... 18.75 SODIUM POLYSTYRENE SULPHONATE – Retail pharmacy-Specialist Powder ................................................................................... 89.10
5 300 g OP
✔ Mayne ✔ Calcium Resonium
48 48
100 30 450 g OP
✔ Phosphate-Sandoz ✔ Olbetam ✔ Resonium-A
49 49 50
PRAVASTATIN – Special Authority see SA0932 0849 below – Retail pharmacy See prescribing guideline Tab 10 mg ............................................................................. 27.46 30 ✔ Pravachol Tab 20 mg ............................................................................. 42.58 30 ✔ Pravachol Tab 40 mg ............................................................................. 65.31 30 ✔ Pravachol ➽ SA0932 0849 Special Authority for Subsidy Initial application — (Confirmed HIV/AIDS) from any relevant practitioner only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater; and 2 Confirmed HIV infection; and 3 Patient is being treated with an HIV protease inhibitor. CANDESARTAN – Special Authority see SA0933 0862 below – Retail pharmacy Tab 4 mg – No more than 1.5 tab per day ............................... 16.22 30 ✔ Atacand Tab 8 mg – No more than 1.5 tab per day ............................... 19.30 30 ✔ Atacand Tab 16 mg – No more than 1 tab per day ................................ 23.54 30 ✔ Atacand Tab 32 mg – No more than 1 tab per day ................................ 38.50 30 ✔ Atacand ➽ SA0933 0862 Special Authority for Subsidy Initial application from any relevant practitioner only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: continued... Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. Three months or six months, as applicable, dispensed all-at-once
54
27
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued... Either: 1 Both: 1.1 Patient with congestive heart failure; and 1.2 Either: 1.2.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 1.2.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years; or 2 All of the following: 2.1 Patient with raised blood pressure; and 2.2 Use of fully funded beta blockers or diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 2.3 Either: 2.3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 2.3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. 56 MIDODRINE – Special Authority see SA0934 0361 below – Hospital pharmacy [HP3] Tab 2.5 mg ............................................................................ 53.00 100 ✔ Gutron Tab 5 mg ............................................................................... 79.00 100 ✔ Gutron ➽ SA0934 0361 Special Authority for Subsidy Initial application from any relevant practitioner only from a geriatrician, neurologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Disabling orthostatic hypotension not due to drugs; and 2 Patient has tried fludrocortisone (unless contra-indicated) with unsatisfactory results; and 3 Patient has tried non pharmacological treatments such as support hose, increased salt intake, exercise, and elevation of head and trunk at night. Notes: Treatment should be started with small doses and titrated upwards as necessary. Hypertension should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg. Renewal from any relevant practitioner only from a geriatrician, neurologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. AMILORIDE ‡ Oral liq 1 mg per ml – Retail pharmacy-Specialist ................... 26.20 Specialist must be a paediatrician or paediatric cardiologist. FRUSEMIDE Tab 500 mg – Retail pharmacy-Specialist ............................... 12.00 Infusion 10 mg per ml, 25 ml – Retail pharmacy-Specialist ..... 48.14 CHLOROTHIAZIDE ‡ Oral liq 50 mg per ml – Retail pharmacy-Specialist ................. 22.60 Specialist must be a paediatrician or paediatric cardiologist. SPIRONOLACTONE ‡ Oral liq 5 mg per ml – Retail pharmacy-Specialist ................... 26.80 Specialist must be a paediatrician or paediatric cardiologist. 25 ml OP ✔ Biomed
59
59
100 5 25 ml OP
✔ Diurin 500 ✔ Lasix ✔ Biomed
60
60
25 ml OP
✔ Biomed
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
28
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
102
LEFLUNOMIDE – Special Authority see SA0635 – Retail pharmacy Tab 10 mg ............................................................................. 55.00 30 ✔ AFT-Leflunomide 79.27 ✔ Arava Tab 20 mg ............................................................................. 76.00 30 ✔ AFT-Leflunomide 108.60 ✔ Arava Tab 100 mg ........................................................................... 54.44 3 ✔ Arava ➽ SA0635 Special Authority for Subsidy Initial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Rheumatoid arthritis; and 2 Patient is not a pregnant woman, or a woman of child-bearing age without adequate contraception; and 3 Patient has been unable to tolerate or has a contraindication to or has had an inadequate response to sulphasalazine and methotrexate (individually or in combination) . Renewal only from a rheumatologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Compliance (prescriber determined) with medication; and 2 Improved rheumatoid arthritis symptom control. Note: Patient should have full blood count and liver function tests regularly monitored. FENTANYL – Special Authority see SA0935 0743 – Retail pharmacy a) Only on a controlled drug form b) No patient co-payment payable Transdermal patch, matrix 25 μg per hour .............................. 55.23 5 ✔ Durogesic Transdermal patch, matrix 50 μg per hour ............................ 100.52 5 ✔ Durogesic Transdermal patch, matrix 75 μg per hour ............................ 139.18 5 ✔ Durogesic Transdermal patch, matrix 100 μg per hour .......................... 171.22 5 ✔ Durogesic ➽ SA0935 0743 Special Authority for Subsidy Initial application only from a relevant specialist from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is terminally ill and is opioid-responsive; and 2 Either: 2.1 is unable to take oral medication; or 2.2 is intolerant to morphine, or morphine is contraindicated. Renewal only from a relevant specialist or general practitioner from any relevant practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. GABAPENTIN – Special Authority see SA0936 0873 – Retail pharmacy Tab 600 mg ........................................................................... 79.79 100 ✔ Neurontin Cap 100 mg ........................................................................... 13.26 100 ✔ Nupentin 15.67 ✔ Neurontin Cap 300 mg ........................................................................... 39.76 100 ✔ Nupentin 47.00 ✔ Neurontin Cap 400 mg ........................................................................... 53.01 100 ✔ Nupentin 62.66 ✔ Neurontin ➽ SA0936 0873 Special Authority for Subsidy Initial application - (Epilepsy - new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Either: continued...
107
112
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
29
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued... 1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents. Note: "Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given 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 - (Epilepsy - patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life from gabapentin, topiramate, vigabatrin and/or lamotrigine. Note: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Initial application - (Neuropathic pain - new patients) from any relevant practitioner. Approvals valid for 3 months where the patient has tried and failed, or has been unable to tolerate, treatment with a tricyclic antidepressant AND an anticonvulsant agent. Initial application - (Neuropathic pain - patient has had an approval for gabapentin for neuropathic pain prior to 1 August 2007) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Renewal - (Epilepsy) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Renewal - (Neuropathic pain) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Note: If the patient had an approval for gabapentin for neuropathic pain prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. 114 VIGABATRIN – Special Authority see SA0937 0875 – Retail pharmacy Tab 500 mg ......................................................................... 119.30 100 ✔ Sabril ➽ SA0937 0875 Special Authority for Subsidy Initial application - (new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Both: 1 Either: 1.1 The patient has infantile spasms; or 1.2 Both 11.2.1 The patient has epilepsy; and 21.2.2 Either: 2.11.2.2.1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
S29
30
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued...
2.21.2.2.2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents; and
32 Either: 3.12.1 Patient is, or will be, receiving regular automated visual field testing (ideally before starting therapy and on a 6-monthly basis thereafter); or 3.22.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: "Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. Initial application - (patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life from gabapentin, topiramate, vigabatrin and /or lamotrigine; and 2 Either: 2.1 Patient is receiving regular automated visual field testing (ideally every 6 months) on an ongoing basis for the duration of treatment with vigabatrin; or 2.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. Renewal from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life; and 2 Either: 2.1 Patient is receiving regular automated visual field testing (ideally every 6 months) on an ongoing basis for the duration of treatment with vigabatrin; or 2.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. 116 116 BETAHISTINE DIHYDROCHLORIDE – Retail pharmacy-Specialist Tab 16 mg ............................................................................... 7.56 84 ✔ Vergo 16
DOMPERIDONE – Additional subsidy by Special Authority see SA0938 0435 – Retail pharmacy Tab 10 mg ............................................................................... 3.90 100 (7.99) Motilium ➽ SA0938 0435 Special Authority for Manufacturers Price Initial application from any relevant medical practitioner. Approvals valid for 6 months where the patient is terminally ill and requires control of nausea and vomiting. Renewal from any relevant medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Three months or six months, as applicable, dispensed all-at-once
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
31
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
116
HYOSCINE (SCOPOLAMINE) – Special Authority see SA0939 0727 – Hospital pharmacy [HP3] Patches, 1.5 mg ....................................................................... 9.56 2 (12.40) Scopoderm TTS ➽ SA0939 0727 Special Authority for Subsidy Initial application from any relevant medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Control of intractable nausea, vomiting, or inability to swallow saliva in the treatment of malignancy or chronic disease; and 2 Patient cannot tolerate or does not adequately respond to oral anti-nausea agents; and 3 The applicant must specify the underlying malignancy or chronic disease. Renewal from any relevant medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. PERGOLIDE – Retail pharmacy-Specialist Tab 0.25 mg .......................................................................... 48.00 Tab 1 mg ............................................................................. 170.00 CLOZAPINE – Hospital pharmacy [HP4]-Specialist prescription Tab 25 mg ............................................................................. 17.60 35.20 Tab 50 mg ............................................................................. 22.80 45.60 Tab 100 mg ........................................................................... 45.60 91.20 Tab 200 mg ........................................................................... 72.96 145.92 100 100 50 100 50 100 50 100 50 100 ✔ Permax ✔ Permax ✔ Clopine ✔ Clozaril ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clozaril ✔ Clopine ✔ Clopine ✔ Clopine
118
119
152
SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices also available to paediatricians employed by a DHB on a wholesale supply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via a hospital pharmacy. 2) Only available for children aged six years and under. 3) For Space Chamber and Foremount Child’s Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. 4) Distributed by Airflow Products. Forward orders to: Airflow Products Telephone: 04 499 1240 or 0800 AIR FLOW PO Box 1485, Wellington Facsimile: 04 499 1245 or 0800 323 270 230 ml (autoclavable) – Subsidy by endorsement ................... 11.60 1 ✔ Space Chamber Available where the prescriber requires a spacer device that is capable of sterilisation in an autoclave and the WSO is endorsed accordingly
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
32
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
25 108
DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE Tab 2.5 with atropine sulphate 25 mcg ..................................... 3.90
100
✔ Diastop S29
METHADONE HYDROCHLORIDE a) Only on a controlled drug form b) No patient co-payment payable c) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets). d) For methadone hydrochloride oral liquid refer, page 162 Inj 10 mg per ml, 1 ml ............................................................ 52.00 10 ✔ AFT S29 RISPERIDONE Oral liquid 1 mg per ml ........................................................... 45.92 30 ml OP ✔ Risperdal
120 121
RISPERIDONE – Special Authority see SA0926 below – Retail pharmacy Subject to budgetary cap. Applications will be considered and approved subject to funding availability. Microspheres for injection 25 mg .......................................... 175.00 1 ✔ Risperdal Consta Microspheres for injection 37.5 mg ....................................... 230.00 1 ✔ Risperdal Consta Microspheres for injection 50 mg .......................................... 280.00 1 ✔ Risperdal Consta
29
ACARBOSE - Special Authority see SA04900925 – Retail pharmacy Tab 50 mg .............................................................................. 22.00 90 ✔ Glucobay Tab 100 mg ............................................................................ 31.00 90 ✔ Glucobay ➽ SA08740925 Special Authority for Subsidy Initial application only from a relevant practioner specialist. Approvals valid for 2 years without renewal for applications meeting the following criteria: 1 The patient has type 2 diabetes; and 2 Either: 2.1 Metformin is not tolerated, or is contraindicated; or 2.2 The patient has not responded to the maximum appropriate dose of metformin. Any of the following: 1 Requires but is not able to tolerate metformin therapy; or 2 Requires metformin but metformin is contraindicated; or 3 Has not responded to or tolerated the maximum appropriate dose of metformin. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. ERYTHROPOIETIN ALPHA – Special Authority see SA09220626 – Hospital pharmacy [HP3] ➽ SA0626 Special Authority for Subsidy Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or continued... Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. Three months or six months, as applicable, dispensed all-at-once
43
33
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued...
4.3 Dependent on regular blood transfusion but cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either: 4.6.2.1 Heart failure (low cardiac output, LV ejection fraction <40%); or 4.6.2.2 Persistent angina Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
➽ SA0922 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin ≤ 100g/L; and 2 Any of the following: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate ≤ 30ml/min; or 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate ≤ 45ml/min; or 2.3 patient is on haemodialysis or peritoneal dialysis. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Notes: Erythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over: GFR (ml/min) (male) = (140 - age) × Ideal Body Weight (kg) / 814 × serum creatinine (mmol/l) GFR (ml/min) (female) = Estimated GFR (male) × 0.85 84 GROWTH HORMONE BIOSYNTHETIC HUMAN – Special Authority see SA0755 (addition of stat dispensing) Cartridge 16 iu per vial........................................................ 1,600.00 5 ✔ Genotropin Cartridge 36 iu per vial........................................................ 3,600.00 5 ✔ Genotropin RECOMBINANT HUMAN GROWTH HORMONE – Special Authority see SA0755 (addition of stat dispensing) Inj 5 mg ................................................................................ 300.00 1 ✔ Norditropin SimpleXx 5mg Inj 10 mg .............................................................................. 600.00 1 ✔ Norditropin SimpleXx 10mg Inj 15 mg .............................................................................. 900.00 1 ✔ Norditropin SimpleXx 15mg
85
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
34
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
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Per
Brand or Generic Mnfr fully subsidised
114
TOPIRAMATE – Special Authority see SA0874 – Retail pharmacy ➽ SA0874 Special Authority for Subsidy Initial application — (new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Both: 1 Patient has epilepsy; and 2 Either: 2.1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2.2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatmentwith other antiepilepsy agents. Note: “Optimal treatment with other antiepilepsy agents” is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given 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 — (patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy priorto 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient hasdemonstrated a significant and sustained improvement in seizure rate or severity and or quality of life from gabapentin, topiramate,vigabatrin and or lamotrigine. Note: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success withanticonvulsant therapy and have assessed quality of life from the patient’s perspective. Renewal from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrateda significant and sustained improvement in seizure rate or severity and or quality of life. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success withanticonvulsant therapy and have assessed quality of life from the patient’s perspective. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application.
120
RISPERIDONE – Retail Pharmacy – Speciaist Tab 0.5 mg ............................................................................... 5.20 Tab 1 mg ................................................................................ 30.77 Tab 2 mg ............................................................................... 61.53 Tab 3 mg ............................................................................... 92.32 Tab 4 mg ............................................................................. 123.05 Oral liquid 1 mg per ml ............................................................ 45.92
20 60 60 60 60 30 ml OP
✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Risperdal
121
RISPERIDONE – Special Authority see SA09260792 – Retail pharmacy Subject to budgetary cap. Applications will be considered and approved subject to funding availability. Microspheres for injection 25 mg........................................... 175.00 1 ✔ Risperdal Consta Microspheres for injection 37.5 mg........................................ 230.00 1 ✔ Risperdal Consta Microspheres for injection 50mg............................................ 280.00 1 ✔ Risperdal Consta ➽ SA09260792 Special Authority for Subsidy Initial application only from a psychiatrist from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has schizophrenia or other psychotic disorder; and 2 Has tried but failed to comply with treatment using oral atypical antipsychotic agents; and continued...
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
35
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
continued... 3 Has been admitted to hospital or treated in respite care, or intensive outpatient or home-based treatment for 30 days or more in last 12 months. Renewal only from a psychiatrist from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had less than 12 months treatment with risperidone microspheres; and 1.2 There is no clinical reason to discontinue treatment; or 2 The initiation of risperidone microspheres has been associated with fewer days of intensive intervention than was the case during a corresponding period of time prior to the initiation of risperidone microspheres. Note: Risperidone microspheres should ideally be used as monotherapy (i.e. without concurrent use of any other antipsychotic medication). In some cases, it may be clinically appropriate to attempt to treat a patient with typical antipsychotic agents in depot injectable form before trialing risperidone microspheres. 122 RISPERIDONE – Special Authority see SA09270794 – Retail pharmacy Orally-disintegrating tablets 0.5 mg .......................................... 21.42 Orally-disintegrating tablets 1 mg ............................................. 42.84 Orally-disintegrating tablets 2 mg ............................................. 85.71 28 28 28 ✔ Risperdal Quicklet ✔ Risperdal Quicklet ✔ Risperdal Quicklet
➽ SA09270794 Special Authority for Subsidy Initial application - (Acute situations) only from a psychiatrist from any relevant practitioner. Approvals valid for 6 weeks for applications meeting the following criteria: Both: 1 For a non-adherent patient on oral therapy with standard risperidone tablets or risperidone oral liquid; and 2 The patient is under direct supervision for administration of medicine. Initial application - (Chronic situations) only from a psychiatrist from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid; and 2 The patient is under direct supervision for administration of medicine. Renewal only from a psychiatrist from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid; and 2 The patient is under direct supervision for administration of medicine. Note: Initial prescriptions to be written by psychiatrists and subsequent prescriptions can be written by psychiatric registrars or General Practitioners. Risperdal Quicklets cost significantly more than risperidone tablets and should only be used where necessary. 127 METHYLPHENIDATE HYDROCHLORIDE – Special Authority see SA0908 – Retail Pharmacy Only on a controlled drug form Tab immediate-release 5 mg.................................................... 3.20 30 ✔ Rubifen Tab immediate-release 10 mg.................................................. 4.29 30 ✔ Rubifen Tab immediate-release 20 mg.................................................. 7.85 30 ✔ Rubifen Tab long acting sustained-release 20 mg ............................... 10.95 30 ✔ Rubifen SR
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
36
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
43
ERYTHROPOIETIN BETA (ê subsidy) Inj 1,000 iu, pre-filled syringe .................................................. 48.68 Inj 2,000 iu, pre-filled syringe ................................................ 120.18 Inj 3,000 iu, pre-filled syringe ................................................ 166.87 Inj 4,000 iu, pre-filled syringe ................................................ 193.13 Inj 5,000 iu, pre-filled syringe ................................................ 243.26 Inj 6,000 iu, pre-filled syringe ................................................ 291.29 Inj 10,000 iu, pre-filled syringe .............................................. 395.18 DILTIAZEM HYDROCHLORIDE (è subsidy) Tab 30 mg ............................................................................... 4.60 DILTIAZEM hydrochloride (ê subsidy) Cap long-acting 120 mg (once per day) ..................................... 4.72 Cap long-acting 180 mg ............................................................ 7.08 Cap long-acting 240 mg ............................................................ 9.44 FLUOROURACIL SODIUM (è subsidy) Crm 5% ................................................................................... 26.49
6 6 6 6 6 6 6 100 30 30 30 20 g OP
✔ Recormon ✔ NeoRecormon ✔ NeoRecormon ✔ NeoRecormon ✔ NeoRecormon ✔ NeoRecormon ✔ NeoRecormon ✔ Dilzem ✔ Cardizem CD ✔ Cardizem CD ✔ Cardizem CD ✔ Efudix
58 58
70 89
CEFAZOLIN SODIUM – Hospital pharmacy [HP3] – Subsidy by endorsement (ê subsidy) Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly Inj 500 mg .............................................................................. 10.00 10 ✔ m-Cefazolin Inj 1 g ..................................................................................... 16.00 10 ✔ m-Cefazolin FLUCLOXACILLIN SODIUM (ê subsidy and price) Inj 250 mg ................................................................................ 4.50 (4.66) Inj 500 mg ................................................................................ 5.20 (5.45) Inj 1 g - Up to 5 inj available on a PSO ....................................... 7.00 (7.54) CLONAZEPAM (è subsidy) Inj 1 mg per ml, 1 ml ............................................................... 19.00 PROCHLORPERAZINE (è subsidy) Inj 12.5 mg per ml, 1 ml – Up to 5 inj available on a PSO ......... 25.81 Suppos 25 mg......................................................................... 23.87 5 Flucloxin 5 Flucloxin 5 Flucloxin 5 10 5 ✔ Rivotril ✔ Stemetil ✔ Stemetil
92
111 117
47
HEPARIN SODIUM (è subsidy) Inj 5,000 iu per ml, 5 ml ......................................................... 37.45 Inj 25,000 iu per ml, 0.2 ml ....................................................... 9.50 QUINAPRIL (ê subsidy) Tab 5 mg ................................................................................. 1.60 Tab 10 mg ............................................................................... 1.75 Tab 20 mg ............................................................................... 2.35 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
10 5 30 30 30
✔ Multiparin ✔ Mayne ✔ Accupril ✔ Accupril ✔ Accupril
54
Three months or six months, as applicable, dispensed all-at-once
37
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
80 126 132 133 148
PREDNISONE (ê subsidy) Tab 20 mg ............................................................................. 29.03 ZOPICLONE – Month Restriction (ê subsidy) Tab 7.5 mg ............................................................................ 21.02 FLUDARABINE PHOSPHATE – PCT only – Specialist (ê subsidy) Inj 50 mg for ECP ................................................................. 286.00 METHOTREXATE (ê subsidy) Inj 1 mg for ECP – PCT only – Specialist ................................... 0.09 PROMETHAZINE HYDROCHLORIDE (ê subsidy) Tab 10 mg ............................................................................... 2.72 Tab 25 mg ............................................................................... 4.44 POLYVINYL ALCOHOL (ê price) Eye drops 1.4% ........................................................................ 2.68 Eye drops 3% ........................................................................... 3.75
500 500
✔ Apo-Prednisone ✔ Apo-Zopiclone
50 mg OP ✔ Baxter 1 mg 50 50 15 ml OP 15 ml OP ✔ Baxter ✔ Allersoothe ✔ Allersoothe ✔ Liquifilm Tears ✔ Liquifilm Forte
157
182
PHENYL FREE PASTA – Special Authority see SA0733 – Hospital pharmacy [HP3] (ê subsidy) See prescribing guideline Animal shapes ........................................................................ 10.65 500 g OP (11.91) Loprofin Penne...................................................................................... 10.65 500 g OP (11.91) Loprofin Lasagne ................................................................................... 5.32 250 g OP (5.95) Loprofin
27
HYOSCINE N-BUTYLBROMIDE (è subsidy) Tab 10 mg ............................................................................... 1.62 Inj 20 mg, 1 ml – Up to 5 inj available on a PSO ......................... 8.04 MEBEVERINE HYDROCHLORIDE (è subsidy) Tab 135 mg ........................................................................... 18.00 POLOXAMER – Only on a prescription (ê subsidy) Oral drops 10% ........................................................................ 3.78 NYSTATIN (è subsidy) Oral liq 100,000 u per ml .......................................................... 3.19 ZINC SULPHATE (è subsidy) Cap 220 mg ........................................................................... 10.00
20 5 90 30 ml OP 24 ml OP 100
✔ Gastrosoothe ✔ Buscopan ✔ Colofac ✔ Coloxyl ✔ Nilstat ✔ Zincaps
27 34 36 38 45
CLOPIDOGREL – Special Authority see SA0867– Retail pharmacy (ê subsidy) Tab 75 mg ............................................................................. 35.00 28 (73.38)
Plavix
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
38
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
47
HEPARIN SODIUM (è price) Inj 25,000 iu per ml, 0.2 ml – Hospital pharmacy [HP3]Specialist .............................................................................. 7.50 (9.50) POTASSIUM BICARBONATE – Retail pharmacy-Specialist (è subsidy) Tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg ............................................... 82.50 BEZAFIBRATE (è subsidy) Tab 200 mg ............................................................................. 9.75 METHYLDOPA (è subsidy) Tab 125 mg ........................................................................... 12.00 Tab 250 mg ........................................................................... 13.10 Tab 500 mg ........................................................................... 20.85 TRIAMCINOLONE ACETONIDE (è subsidy) Crm 0.02% ................................................................................ 6.63 Oint 0.02% ................................................................................ 6.69 WOOL FAT WITH MINERAL OIL – Only on a prescription (è price) Lotn hydrous 3% with mineral oil .............................................. 1.40 (3.50) 5.60 (10.90)
5
Mayne
48
100 90 100 100 100 100 g OP 100 g OP 250 ml OP
✔ Phosphate-Sandoz ✔ Fibalip ✔ Prodopa ✔ Prodopa ✔ Prodopa ✔ Aristocort ✔ Aristocort
49 59
65
67
DP Lotion 1,000 ml DP Lotion
69
TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN – Only on a prescription (è subsidy) Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ............................................................... 2.90 500 ml ✔ Pinetarsol 5.54 1,000 ml ✔ Pinetarsol KETOCONAZOLE (ê subsidy) Shampoo 2% ............................................................................ 3.48 a) Maximum of 100 ml per prescription b) Only on a prescription CALCITONIN – Hospital pharmacy [HP3]-Specialist (è subsidy) Inj 100 iu per ml, 1 ml .......................................................... 110.00 PREDNISONE (è subsidy) Tab 1 mg ............................................................................... 10.68 Tab 2.5 mg ............................................................................ 12.09 ERYTHROMYCIN ETHYL SUCCINATE (è subsidy) Grans for oral liq 200 mg per 5 ml – Up to 200 ml available on a PSO ................................................................. 4.35 Grans for oral liq 400 mg per 5 ml – Up to 200 ml Available on a PSO ................................................................ 5.85 BENZYLPENICILLIN SODIUM (PENICILLIN G) (è subsidy) Inj 1 mega u – Up to 5 inj available on a PSO ........................... 10.49 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 100 ml OP ✔ Ketopine
70
79 80
5 500 500
✔ Miacalcic ✔ Apo-Prednisone ✔ Apo-Prednisone
90
100 ml 100 ml 10
✔ E-Mycin ✔ E-Mycin ✔ Sandoz
91
Three months or six months, as applicable, dispensed all-at-once
39
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
92 93 93
PROCAINE PENICILLIN (è subsidy) Inj 1.5 mega u – Up to 5 inj available on a PSO ........................ 50.86 TRIMETHOPRIM (è subsidy) Tab 300 mg – Up to 30 tab available on a PSO .......................... 8.69
5 50
✔ Cilicaine ✔ TMP
VANCOMYCIN HYDROCHLORIDE – Hospital pharmacy [HP3] – Subsidy by endorsement (è subsidy) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudomembranous colitis or for prophylaxis of endocarditis and the prescription is endorsed accordingly. Inj 50 mg per ml, 10 ml ............................................................ 5.04 1 ✔ Pacific NORTRIPTYLINE HYDROCHLORIDE (è subsidy) Tab 10 mg ............................................................................... 5.94 Tab 25 mg ............................................................................. 20.06 CLONAZEPAM (è subsidy) Tab 500 μg .............................................................................. 6.26 Tab 2 mg ............................................................................... 11.15 MIDAZOLAM (è price) Tab 7.5 mg – Month Restriction............................................... 10.38 (25.00) TEMAZEPAM – Month Restriction (è subsidy) Tab 10 mg ................................................................................ 0.83 PACLITAXEL – PCT only – Specialist (ê subsidy) Inj 1 mg for ECP ....................................................................... 1.32 MASK FOR SPACER DEVICE (ê subsidy) Only on a WSO Size 2........................................................................................ 3.28 PEAK FLOW METER (ê subsidy) Only on a WSO Low range ............................................................................... 13.75 Normal range .......................................................................... 13.75 SPACER DEVICE (ê subsidy) Only on a WSO 230 ml (autoclavable) .............................................................. 11.60 ACETAZOLAMIDE (è subsidy) Tab 250 mg ........................................................................... 10.40 ATROPINE SULPHATE (è subsidy) Eye drops 1% ........................................................................... 4.40 100 250 100 100 100 Hypnovel 25 1 mg ✔ Normison ✔ Baxter ✔ Norpress ✔ Norpress ✔ Paxam ✔ Paxam
110
112
125
126 136 152
1
✔ Foremount Child’s Silicone Mask
152
1 1
✔ Breath-Alert ✔ Breath-Alert
152
1 100 15 ml OP
✔ Space Chamber ✔ Diamox ✔ Atropt
156 157
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
40
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
182
AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital pharmacy [HP3] (è subsidy) Tabs ....................................................................................... 99.00 75 OP ✔ Phlexy 10 Sachets (pineapple/vanilla) 29 g ........................................... 330.10 30 OP ✔ Minaphlex Sachets (tropical) ................................................................. 324.00 30 ✔ Phlexy 10 Infant formula ....................................................................... 174.72 400 g OP ✔ XP Analog LCP Powder (orange) .................................................................. 221.00 500 g OP ✔ XP Maxamaid 320.00 ✔ XP Maxamum Powder (unflavoured) ........................................................... 221.00 500 g OP ✔ XP Maxamaid 320.00 ✔ XP Maxamum Liquid (forest berries) ............................................................. 30.00 250 ml OP ✔ Easiphen Liquid Liquid (tropical) ...................................................................... 30.00 250 ml OP ✔ Easiphen
38
CALCIUM CARBONATE (ê subsidy) Tab dispersible 2.5 g ................................................................. 4.36 IRON POLYMALTOSE (ê subsidy) Inj 50 mg per ml, 2 ml ............................................................. 20.95 (29.95)
20 OP
✔ Calci-Tab Effervescent
38
5 Ferrosig
43
ERYTHROPOIETIN ALPHA – Special Authority see SA0922 – Hospital pharmacy [HP3] (ê subsidy) Inj human recombinant 1,000 iu, pre-filled syringe ................... 48.68 6 ✔ Eprex Inj human recombinant 2,000 iu, pre-filled syringe ................. 120.18 6 ✔ Eprex Inj human recombinant 3,000 iu, pre-filled syringe ................. 166.87 6 ✔ Eprex Inj human recombinant 4,000 iu, pre-filled syringe ................. 193.13 6 ✔ Eprex Inj human recombinant 10,000 iu, pre-filled syringe ............... 395.18 6 ✔ Eprex POTASSIUM BICARBONATE – Retail pharmacy – Specialist (è price) Tab eff 315 mg with sodium acid phosphate with 1.937 g and sodium bicarbonate 350 mg ................................................ 75.00 (82.50) PHENTOLAMINE MESYLATE (è price) Inj 10 mg per ml, 1 ml ............................................................. 17.97 (31.65) NITROFURANTOIN (è subsidy) Tab 50 mg .............................................................................. 17.90 Tab 100 mg ............................................................................ 30.25 PARACETAMOL (ê subsidy) Oral liq 120 mg per 5ml ............................................................ 6.80 Oral liq 250 mg per 5 ml ............................................................ 7.00
48
100 5
Phosphate-Sandoz
53
Regitine 100 100 1,000 ml 1,000 ml ✔ Nifuran ✔ Nifuran ✔ Junior Parapaed ✔ Six Plus Parapaed
99
107
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
41
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
114
TOPIRAMATE (ê subsidy) Tab 25 mg .............................................................................. 26.04 Tab 50 mg .............................................................................. 44.26 Tab 100 mg ............................................................................ 75.25 Tab 200 mg .......................................................................... 129.85 Sprinkle cap 15 mg ................................................................. 20.84 Sprinkle cap 25 mg ................................................................. 26.04 LITHIUM CARBONATE (è subsidy) Tab long–acting 400 mg .......................................................... 16.05 RISPERIDONE (ê subsidy) Tab 0.5 mg ............................................................................... 5.20 Tab 1 mg ................................................................................ 30.77 Tab 2 mg ................................................................................ 61.53 Tab 3 mg ................................................................................ 92.32 Tab 4 mg .............................................................................. 123.05 CALCIUM FOLINATE (ê subsidy) Inj 1 mg for ECP – PCT only – Specialist .................................... 0.10 FLUDARABINE PHOSPHATE – PCT only – Specialist (è subsidy) Tab 10 mg ............................................................................ 650.25 FLUDARABINE PHOSPHATE – PCT only – Specialist (ê subsidy) Inj 50 mg ............................................................................ 1430.00 METHOTREXATE – PCT – Hospital pharmacy [HP1] – Specialist (ê subsidy) Inj 100 mg per ml, 10 ml – PCT Only – Specialist .................... 27.50 Inj 100 mg per ml, 50 ml – PCT Only – Specialist .................. 135.00 POLYVINYL ALCOHOL (ê subsidy) Eye drops 1.4% ........................................................................ 2.68 Eye drops 3% ........................................................................... 3.75
60 60 60 60 60 60 100 20 60 60 60 60 1 mg 15 5 1 1
✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax ✔ Priadel ✔ Risperdal ✔ Risperdal ✔ Risperdal ✔ Risperdal ✔ Risperdal ✔ Baxter ✔ Fludara ✔ Fludara ✔ Methotrexate Ebewe ✔ Methotrexate Ebewe ✔ Vistil ✔ Vistil Forte
119 120
131 132 132 133
154
15 ml OP 15 ml OP
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
42
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
76
CYPROTERONE ACETATE WITH ETHINYLOESTRADIOL Tab 2 mg with ethinyloestradiol 35 μg and 7 inert tablets ........... 6.30
84
✔ Estelle 35-ED ✔ Estelle 35
91
BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u – Up to 5 inj available on a PSO ............................. 6.99
10
✔ Sandoz ✔ Novartis
43
ERYTHROPOIETIN BETA – Special Authority SA0922 – Hospital pharmacy [HP3) Inj 2,000 iu pre-filled syringe ................................................. 152.04 6 Inj 3,000 iu pre-filled syringe ................................................. 228.06 Inj 4,000 iu pre-filled syringe ................................................. 304.08 Inj 5,000 iu pre-filled syring ................................................... 380.10 Inj 6,000 iu pre-filled syringe ................................................. 456.12 Inj 10,000 iu pre-filled syringe ............................................... 760.20 6 6 6 6 6
✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon
84
THYROXINE LEVOTHYROXINE
152
PEAK FLOW METER Peak flow meters-low range Low range Peak flow meters-normal range Normal range SPACER DEVICES AND MASKS Spacer device 230 ml (autoclavable) SPACER DEVICES AND MASK FOR SPACER DEVICE Mask, size 2 Size 2
153 153
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
43
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
ALIMENTARY TRACT AND METABOLISM INSULIN ASPART INSULIN GLARGINE INSULIN ISOPHANE INSULIN ISOPHANE WITH INSULIN NEUTRAL INSULIN LISPRO INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE INSULIN NEUTRAL
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
44
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
12
“Authority to Substitute” means an authority for the dispensing pharmacist to change a prescribed medicine in accordance with regulation 42(4) of the Medicines Regulations 1984. An authority to substitute letter, which may be used by Practitioners, is available on the final page of the Schedule. 4.7 Substitution Where a Practitioner has prescribed a brand of a Community Pharmaceutical that has no Subsidy or has a Manufacturer’s Price that is greater than the Subsidy and there is an alternative fully subsidised Community Pharmaceutical available, a Contractor may dispense the fully subsidised Community Pharmaceutical, subject to: a) the Contractor having received a general Authority to Substitute from the Practitioner in relation to the particular medicine or medicines in general; or b) the Practitioner having indicated their Authority to Substitute on the prescription; or c) the Practitioner having given their Authority to Substitute in relation to the particular prescription. Such an Authority to Substitute is valid whether or not there is a financial implication for the Pharmaceutical Budget. When dispensing a subsidised alternative brand, the Contractor must annotate and initial the prescription. 4.8 Alteration to Presentation of Pharmaceutical Dispensed A Contractor, when dispensing a Community Pharmaceutical, may alter the presentation of a Pharmaceutical dispensed but may not alter the total daily dose. If the change will result in additional cost to the DHBs, then: a) the Practitioner must authorise and initial the alteration; or b) in cases where PHARMAC has approved and notified in writing such a change in dispensing of a named Pharmaceutical due to an out of stock event or short supply, the Contractor must annotate and initial the alteration. 4.9 4.7 Amendment of the 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. 4.10 4.8 Conflict of 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.
23
For the list of new Sole Subsidised Supply products effective 1 December 2008 refer to the bold entries in the cumulative Sole Subsidised Supply table pages xx-xx.
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
45
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
38 38
CALCIUM Tab eff 1 g................................................................................. 6.54 CALCIUM CARBONATE Tab dispersible 2.5 g ................................................................. 4.36 (4.98) IRON POLYMALTOSE Inj 50 mg per ml, 2 ml ............................................................. 20.95 (29.95) ZINC AND CASTOR OIL Ointment BP .............................................................................. 5.11 PARACETAMOL ‡ Oral liq 120 mg per 5 ml.......................................................... 6.80 a) Up to 200 ml available on a PSO b) Not in combination ...................................................................... ‡ Oral liq 250 mg per 5 ml.......................................................... 7.00 a) Up to 200 ml available on a PSO b) Not in combination
30 20 OP
Calcium-Sandoz 1000
Calci-Tab Effervescent 5 Ferrosig 500 g 1,000 ml 1,000 ml Multichem Junior Parapaed Six Plus Parapaed
38
66 107
44
APROTININ – Hospital pharmacy [HP3]-Specialist Inj 10,000 μg per ml 50 ml ..................................................... 63.60 (73.40) VERAPAMIL HYDROCHLORIDE Tab 80 mg ............................................................................... 6.00
1 Trasylol 100 Verpamil
59 90
CEFUROXIME SODIUM – Hospital pharmacy [HP3] Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ................................................................... 21.42 10 (56.47) Mayne Inj 1.5 g – Hospital pharmacy [HP3]-Specialist – Subsidy by endorsement ....................................................................... 40.40 10 (123.55) Mayne Only if prescribed for a dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. RITONAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 100 mg .......................................................................... 242.55 Note – the 84 pack size continues to be listed fully subsidised. 168 Norvir
98
106
NEFOPAM HYDROCHLORIDE Inj 20 mg per ml, 1 ml .............................................................. 9.10 (72.50)
5 Acupan
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
46
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
136
PACLITAXEL – PCT only – Specialist Inj 30 mg ................................................................................ 90.00 Inj 100 mg ............................................................................ 299.70 SALBUTAMOL Tab long-acting 8 mg ............................................................. 15.30
1 1 56
Taxol Taxol Volmax
150 180
GLUTEN FREE PASTA – Special Authority see SA0722 – Hospital pharmacy [HP3] Tomato and Basil Spirals .......................................................... 2.00 250 g OP (2.63)
Orgran
37
ASCORBIC ACID AND SODIUM ASCORBATE a) No more than 100 mg per dose b) Only on a prescription Tab 100 mg ............................................................................. 2.60 PERMETHRIN Lotion 5% .................................................................................. 4.50 (7.00) ECONAZOLE NITRATE Pessaries 150 mg with applicators ........................................... 2.75 (9.71) BENZATHINE BENZYLPENICILLIN Inj 1.2 mega u per 2 ml – Up to 5 inj available on a PSO........... 16.00 160 Note: Bicillin LA continues to be listed fully subsidised ACICLOVIR Tab 200 mg ............................................................................. 7.92 Tab 400 mg ........................................................................... 11.86 SAQUINAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 200 mg ......................................................................... 271.00
100 50 ml OP
Healtheries Vitamin C
68
Quellada-P 3 Pevaryl Ovules 1 10 Bicillin Bicillin
76
91
95
100 100 180
Apo-Acyclovir Apo-Acyclovir Fortovase
99 106
ASPIRIN Tab dispersible 300 mg – Up to 30 tab available on a PSO ...... 21.50 (22.50) 1000 Ethics Aspirin Tab EC 650 mg ........................................................................ 6.88 100 Ecotrin Note: the 100 tablet pack of Ethics Aspirin, tab dispersible 300 mg will continue to be listed fully subsidised ORAL SUPPLEMENT 1KCAL/ML – Special Authority see SA0583 – Hospital pharmacy [HP3] Powder (vanilla) sachet 54 g ..................................................... 6.91 10 OP Fortisip Powder
170
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
47
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
70
KETOCONAZOLE Shampoo 2% ............................................................................ 3.48 a) Maximum of 100 ml per prescription b) Only on a prescription
100 ml OP
Ketopine
157
POLYVINYL ALCOHOL Eye drops 1.4% ........................................................................ 2.68 (3.62) Eye drops 3% ........................................................................... 3.75 (3.88)
15 ml OP Liquifilm Tears 15 ml OP Liquifilm Forte
43 47 54 56
ERYTHROPOIETIN BETA – Special Authority see SA0922 – Hospital pharmacy [HP3] Inj 1,000 iu, pre-filled syringe ................................................. 76.02 6 HEPARINISED SALINE Inj 100 iu per ml, 5 ml .......................................................... 103.76 LOSARTAN Tab 25 mg .............................................................................. 20.31 ATENOLOL Tab 50 mg ............................................................................... 6.50 Tab 100 mg ........................................................................... 11.30 VERAPAMIL HYDROCHLORIDE Tab 40 mg ................................................................................ 4.75 NICOTINE – Only on a Quitcard Gum 2mg (Fruit) ...................................................................... 23.41 Gum 2mg (Mint)...................................................................... 23.41 Gum 4mg (Fruit) ...................................................................... 23.41 Gum 4mg (Mint)...................................................................... 23.41 50 28 500 500 100 96 96 96 96
Recormon Mayne Cozaar Loten Loten Verpamil Nicotinell Nicotinell Nicotinell Nicotinell
59 61
89
CEFAZOLIN SODUM - Hospital pharmacy [HP3] – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg .............................................................................. 10.00 10 m-Cefazolin m-Cefazolin Inj 1g ...................................................................................... 16.00 10 FLUCLOXACILLIN SODIUM Inj 250 mg ............................................................................... 4.66 Inj 500 mg ................................................................................ 5.45 ERYTHROMYCIN LACTOBIONATE Inj 300 mg ............................................................................. 70.97 5 5 5 Flucloxin Flucloxin Mayne
92
90
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
48
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
99 109 125
SAQUINAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 200 mg .......................................................................... 519.75 AMITRIPTYLINE Tab 10 mg ................................................................................ 3.00 NITRAZEPAM – Month Restriction Tab 5 mg .................................................................................. 2.00 (3.90) SALBUTAMOL Tab long-acting 4 mg .............................................................. 11.18 DIBROMOPROPAMIDINE ISETHIONATE Eye oint 0.15% ......................................................................... 2.97 (7.99)
270 100 100
Invirase Amitrip
Insoma 56 5 g OP Brolene Volmax
150 154
76 92
CLOTRIMAZOLE Vaginal crm 2% with applicators ................................................ 3.99 CIPROFLOXACIN Tab 250 mg - Up to 5 tab available on a PSO ............................. 5.10 Tab 500 mg- Up to 5 tab available on a PSO .............................. 8.31 Tab 750 mg- Retail pharmacy - Specialist................................ 19.30 DOXEPIN HYDROCHLORIDE Cap 75 mg ............................................................................. 10.99
25 g OP 28 28 28 100
Clotrimaderm 2% Cipflox Cipflox Cipflox Anten
109 182
PHENYL FREE PASTA – Special Authority see SA0733 – Hospital pharmacy [HP3] Macaroni ................................................................................. 10.65 500 g OP (11.91)
Loprofin
28
OMEPRAZOLE Cap 10 mg ............................................................................. 17.37 Cap 20 mg ............................................................................. 24.81 Cap 40 mg ............................................................................. 29.05 Inj 40 mg ............................................................................... 12.50 DOXAZOSIN MESYLATE Tab 2 mg ................................................................................. 4.81 Note – the 500 tablet pack listed 1 November 2008 HYDROCORTISONE BUTYRATE Crm 0.1% .................................................................................. 5.00 15.00
30 30 30 1 100
Losec Losec Losec Losec Apo-Doxazosin
53
56
30 g OP 100 g OP
Locoid Locoid
Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.
Three months or six months, as applicable, dispensed all-at-once
49
Check your Schedule for full details Schedule page ref
Subsidy (Mnfr’s price) $
Per
Brand or Generic Mnfr fully subsidised
82 107
OESTRADIOL VALERATE – See prescribing guideline Tab 2 mg ................................................................................. 4.12 PARACETAMOL Tab 500 mg – Up to 30 tab available on a PSO .......................... 1.38 13.23 137.81 MORPHINE SULPHATE a) Only on a controlled drug form b) No patient co-payment payable Suppos 30 mg ........................................................................ 31.39 CETIRIZINE HYDROCHLORIDE Tab 10 mg ................................................................................ 3.32 ‡ Oral liq 1 mg per ml................................................................. 2.75
28 150 1440 15,000
Progynova Panadol Panadol Panadol
108
12 90 100 ml OP
Martindale S29 Razene Allerid-C
147
53 58
DOXAZOSIN MESYLATE Tab 4 mg .................................................................................. 6.37 DILTIAZEM HYDROCHLORIDE Cap long-acting 90 mg .............................................................. 7.65 Cap long-acting 120 mg (twice per day) .................................. 18.00 Tab long-acting 180 mg ............................................................ 7.65 Tab long-acting 240 mg .......................................................... 10.20 EFAVIRENZ - Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 100 mg .......................................................................... 158.33 CARBAMAZEPINE Tab 200 mg ........................................................................ 29.06 Note – the 100 tablet pack size listed 1 December 2008
100 60 100 30 30 30 200
Apo-Doxazosin Dilzem SR Dilzem SR Dilzem LA Dilzem LA Stocrin Tegretol
97 112
Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy
50
S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply
Contracted Pharmaceutical Description
Brand
Price ($) (ex man. excl. GST)
Per
DV Limit
DV Limit DV applies Pharmaceutical from
ADRENALINE (new listing) Inj 1,000, 1 ml ................................Aspen-Adrenaline AMISULPRIDE (new listing) Tab 100 mg....................................Solian Tab 200 mg....................................Solian Tab 400 mg....................................Solian Oral liquid 100 mg per ml ...............Solian AMLODIPINE (new listing) Tab 5 mg........................................Apo-Amlodipine
4.98 22.52 97.03 185.44 55.44 7.33
5 30 60 60 60 ml 100 100 1% 1% Feb-09 Feb-09 Calvasc Norvasc Calvasc Norvasc
Tab 10 mg......................................Apo-Amlodipine 11.79 ANASTROZOLE-DP (new listing) Tab 1 mg........................................DP-Anastrozole CEFAZOLIN SODIUM (delisting) Inj 500 mg......................................m-Cefazolin Inj 1 g.............................................m-Cefazolin CETIRIZINE HYDROCHLORIDE (new listing) Tab 10 mg......................................Zetop
29.50 13.60 18.60 2.21
30 10 10 100 1% Feb-09 Apo-Cetirizine Allerid-C Cetirizine Histaclear Razene Allerid-C Zyrtec
Oral Liquid 1 mg per 1 ml ..............Cetirizine-AFT Note – Allerid-C to be delisted 1 Feb 2009 DILTIAZEM HYDROCHLORIDE (new listing) Tab 30 mg......................................Dilzem Tab 60 mg......................................Dilzem Cap long-acting 120 mg .................Cardizem CD Cap long-acting 180 mg .................Cardizem CD Cap long-acting 240 mg .................Cardizem CD
3.50
200 ml
1%
Feb-09
4.50 8.50 4.72 7.08 9.44
100 100 30 30 30
5% 5% 5% 5% 5% 1%
Jun-09 Jun-09 Jun-09 Jun-09 Jun-09 Jan-09
(B) (B) (B) Dilzem LA Dilzem LA Dosan
DOXAZOSIN MESYLATE (new listing) Tab 4 mg........................................Apo-Doxazosin 30.26 500 Note – Apo-Doxazosin tab 4 mg 100 tablet pack size to be delisted 1 Feb 2009 FLUOROURACIL SODIUM (new listing) Crm 5% ..........................................Efudix POTASSIUM CHLORIDE (delisting) Inj 75 mg per ml, 10 ml ..................AstraZeneca Inj 150 mg per ml, 10 ml ................AstraZeneca Products with Hospital Supply Status (HSS) are in bold. 26.49 26.00 26.00 20 g 50 50
(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”
51
Chemical and presentation
Brand
SPECIAL FOOD SUPPLEMENT Liquid, 237 ml Impact Advanced Recovery Vanilla and Chocolate Three packs of 237 mls per days for 5 to 7 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”
52
Pharmaceuticals and brands A Acarbose ........................................................... 33 Acipimox ........................................................... 27 Acupan .............................................................. 46 Aldara ................................................................ 23 Accupril ............................................................. 37 Acetazolamide ................................................... 40 Aciclovir ............................................................ 47 Adrenaline.................................................... 17, 51 AFT-Leflunomide ................................................ 29 Alimentary tract and metabolism ........................ 44 Allerid-C............................................................. 50 Allersoothe......................................................... 38 Amiloride ........................................................... 28 Aminoacid formula without phenylalanine ..... 22, 41 Amirol ................................................................ 23 Amisulpride.................................................. 17, 51 Amitrip ............................................................... 49 Amitriptyline ................................................. 23, 49 Amlodipine................................................... 17, 51 Amoxycillin ........................................................ 18 Anagrelide hydrochloride .................................... 17 Anastrozole-DP ...................................... 17, 25, 51 Anten ................................................................. 49 Apo-Acyclovir .................................................... 47 Apo-Amlodipine ........................................... 17, 51 Apo-Clopidogrel ................................................. 22 Apo-Doxazosin................................. 17, 49, 50, 51 Apo-Prednisone ........................................... 38, 39 Apo-Zopiclone.................................................... 38 Aprotinin ............................................................ 46 Aqueous cream .................................................. 18 Arava ................................................................. 29 Arimidex ............................................................ 25 Aristocort ........................................................... 39 Arrow-Citalopram ............................................... 18 Ascorbic acid and sodium ascorbate .................. 47 Aspen Adrenaline ............................................... 17 Aspen-Adrenaline ............................................... 51 Aspirin ............................................................... 47 Atacand ............................................................. 27 Atenolol ................................................. 17, 23, 48 Atropine sulphate ............................................... 40 Atropt ................................................................ 40 B Benzathine benzylpenicillin ................................. 47 Benzylpenicillin sodium (penicillin g) ............ 39, 43 Betahistine dihydrochloride................................. 31 Bezafibrate ......................................................... 39 Bicalox............................................................... 20 Bicalutamide ...................................................... 20 Bicillin ................................................................ 47 Bleomycin sulphate ............................................ 19 Breath-Alert........................................................ 40 Brolene .............................................................. 49 Buscopan .......................................................... 38 C Calci-Tab Effervescent ................................. 41, 46 Calcitonin........................................................... 39 Calcium ............................................................. 46 Calcium-Sandoz 1000 ........................................ 46 Calcium carbonate ....................................... 41, 46 Calcium folinate ........................................... 18, 42 Calcium polystyrene sulphonate ......................... 27 Calcium Resonium ............................................. 27 Candesartan....................................................... 27 Carbamazepine ............................................ 17, 50 Carboplatin ........................................................ 18 Cardizem CD ................................................ 37, 51 Carmustine ........................................................ 18 Cefazolin sodium ............................. 21, 37, 48, 51 Cefuroxime sodium ............................................ 46 Cetirizine-AFT............................................... 17, 51 Cetirizine hydrochloride .......................... 17, 50, 51 Chlorothiazide .................................................... 28 Cilicaine ............................................................. 40 Cipflox ............................................................... 49 Ciprofloxacin ................................................ 18, 49 Cisplatin............................................................. 18 Citalopram hydrobromide ................................... 18 Cladribine........................................................... 18 Clindamycin ....................................................... 25 Clomazol............................................................ 18 Clonazepam ................................................. 37, 40 Clopidogrel .................................................. 22, 38 Clopine ........................................................ 21, 32 Clotrimaderm 2% ............................................... 49 Clotrimazole ................................................. 18, 49 Clozapine ..................................................... 21, 32 Clozaril .............................................................. 32 Concerta ............................................................ 24 Colaspase (l-asparaginase) ................................ 19 Colofac .............................................................. 38 Coloxyl .............................................................. 38 Cozaar ......................................................... 22, 48 Cyclophosphamide ............................................ 18 Cyproterone acetate with ethinyloestradiol .......... 43 Cytarabine ......................................................... 19 D Depo-Provera ..................................................... 24 Diastop ........................................................ 25, 33 Diltiazem ............................................................ 37 Diltiazem hydrochloride .......................... 37, 50, 51 Dilzem ......................................................... 37, 51
53
Pharmaceuticals and brands Dilzem LA .......................................................... 50 Dilzem SR .......................................................... 50 Diphenoxylate hydrochloride with atropine sulphate....................................... 25, 33 Domperidone ..................................................... 31 Doxepin hydrochloride........................................ 49 DP-Anastrozole ............................................ 17, 51 Dacarbazine ....................................................... 19 Dactinomycin (actinomycin D) ........................... 19 Dalacin C ........................................................... 25 Daunorubicin ..................................................... 19 Diamox .............................................................. 40 Dibromopropamidine isethionate ........................ 49 Dipyridamole...................................................... 26 Diurin 500 .......................................................... 28 Docetaxel ........................................................... 19 Doxazosin mesylate ......................... 17, 49, 50, 51 Doxorubicin ....................................................... 19 DP-Anastrozole ...................................... 17, 25, 51 DP Lotion ........................................................... 39 Durogesic .......................................................... 29 E Easiphen ............................................................ 41 Ecotrin ............................................................... 47 Efavirenz ...................................................... 17, 50 E-Mycin ............................................................. 39 Easiphen Liquid.................................................. 41 Econazole nitrate ................................................ 47 Efudix .................................................... 25, 37, 51 Enteral feed 1kcal/ml .......................................... 22 Enteral feed with fibre 1kcal/ml ........................... 22 Epirubicin........................................................... 19 Eprex ........................................................... 22, 41 Erythromycin ethyl succinate .............................. 39 Erythromycin lactobionate .................................. 48 Erythropoietin alpha................................ 22, 33, 41 Erythropoietin beta ................................. 37, 43, 48 Estelle 35-ED ..................................................... 43 Ethics Aspirin ..................................................... 47 Etoposide........................................................... 19 Etoposide phosphate .......................................... 19 F Femara .............................................................. 25 Fentanyl ............................................................. 29 Ferrosig ....................................................... 41, 46 Fibalip ................................................................ 39 Fibersource HN - Unflavoured ............................. 22 Finasteride ......................................................... 21 Fintral ................................................................ 21 Flucloxacillin sodium .............................. 21, 37, 48 Flucloxin ................................................ 21, 37, 48 Fludara............................................................... 42 Fludarabine phosphate ........................... 19, 38, 42 Fluorouracil sodium.......................... 19, 25, 37, 51 Folic acid ........................................................... 26 Foremount Child’s Silicone Mask ........................ 40 Fortisip Powder .................................................. 47 Fortovase ........................................................... 47 Frusemide .......................................................... 28 G Gabapentin ........................................................ 29 Gastrosoothe ..................................................... 38 Gemcitabine hydrochloride ................................. 19 Genotropin ......................................................... 34 Glucobay ........................................................... 33 Gluten free pasta ................................................ 47 Goldshield.......................................................... 18 Growth hormone biosynthetic human ................. 34 Gutron ............................................................... 28 H Habitrol .............................................................. 23 Healtheries Vitamin C ......................................... 47 Heparinised saline .............................................. 48 Heparin sodium...................................... 27, 37, 39 Humalog Mix 25................................................. 17 Humalog Mix 50................................................. 17 Hydrocortisone butyrate ..................................... 49 Hyoscine (scopolamine)..................................... 32 Hyoscine n-butylbromide ................................... 38 Hypnovel ........................................................... 40 I Imiquimod ......................................................... 23 Impact Advanced Recovery Vanilla and Chocolate 52 Insoma .............................................................. 49 Insulin Glargine .................................................. 44 Insulin lispro with insulin lispro protamine ..... 17, 44 Ibiamox.............................................................. 18 Idarubicin hydrochloride ..................................... 20 Ifosfamide.......................................................... 18 Insulin aspart ..................................................... 44 Insulin glargine ................................................... 22 Insulin isophane ................................................. 44 Insulin isophane with insulin neutral.................... 44 Insulin lispro ...................................................... 44 Insulin neutral .................................................... 44 Invirase .............................................................. 49 Irinotecan........................................................... 19 Iron polymaltose .......................................... 41, 46 Isosource HN - Unflavoured................................ 22 J Junior Parapaed ........................................... 41, 46
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Pharmaceuticals and brands K Ketoconazole ............................................... 39, 48 Ketopine ...................................................... 39, 48 L Lantus SoloStar ................................................. 22 Lasix .................................................................. 28 Leflunomide ....................................................... 29 Letrozole ............................................................ 25 Levothyroxine .................................................... 43 Liquifilm Forte .............................................. 38, 48 Liquifilm Tears ............................................. 38, 48 Lithium carbonate .............................................. 42 Locoid ............................................................... 49 Lophlex LQ......................................................... 22 Loprofin ................................................. 22, 38, 49 Losartan ...................................................... 22, 48 Losec ................................................................ 49 Loten ................................................................. 48 M Mask for spacer device ...................................... 40 m-Cefazolin ................................................. 37, 48 Medroxyprogesterone acetate............................. 24 Methylphenidate hydrochloride extended release . 24 Mebeverine hydrochloride .................................. 38 Mesna ............................................................... 20 Methadone hydrochloride ................................... 33 Methotrexate .......................................... 19, 38, 42 Methotrexate Ebewe ........................................... 42 Methyldopa ........................................................ 39 Methylphenidate hydrochloride ........................... 36 Methylphenidate hydrochloride extended release . 24 Miacalcic ........................................................... 39 Midazolam ......................................................... 40 Midodrine .......................................................... 28 Minaphlex .......................................................... 41 Mitomycin C ...................................................... 20 Mitozantrone ...................................................... 20 Morphine sulphate.............................................. 50 Motilium ............................................................ 31 Multiparin........................................................... 37 N Nefopam hydrochloride ...................................... 46 NeoRecormon .............................................. 37, 43 Neurontin ........................................................... 29 Nicotine ....................................................... 23, 48 Nicotinell ............................................................ 48 Nifuran ............................................................... 41 Nilstat ................................................................ 38 Nitrazepam......................................................... 49 Nitrofurantoin ..................................................... 41 Norditropin SimpleXx 10mg ................................ 34 Norditropin SimpleXx 15mg ................................ 34 Norditropin SimpleXx 5mg .................................. 34 Normison ........................................................... 40 Norpress ............................................................ 40 Nortriptyline hydrochloride.................................. 40 Norvir ................................................................ 46 Noten ................................................................. 17 Nupentin ............................................................ 29 Nystatin ............................................................. 38 O Octreotide (somatostatin analogue) .................... 20 Oestradiol valerate........................................ 18, 50 Olbetam ............................................................. 27 Omeprazole........................................................ 49 Oral supplement 1kcal/ml ................................... 47 Orgran ............................................................... 47 Ospamox ........................................................... 18 Oxaliplatin .......................................................... 18 P Pacific Atenolol .................................................. 23 Paclitaxel ............................................... 20, 40, 47 Paediatric oral feed 1kcal/ml............................... 22 Panadol ............................................................. 50 Paracetamol..................................... 17, 41, 46, 50 Paxam ............................................................... 40 Peak flow meter ........................................... 40, 43 Pediasure........................................................... 22 Pergolide ........................................................... 32 Permax .............................................................. 32 Permethrin ......................................................... 47 Persantin ........................................................... 26 Pevaryl Ovules ................................................... 47 Pharmacare ....................................................... 17 Phentolamine mesylate ...................................... 41 Phenyl free pasta ................................... 22, 38, 49 Phlexy 10........................................................... 41 Phosphate-Sandoz ................................. 27, 39, 41 Pinetarsol........................................................... 39 Plavix ................................................................. 38 Poloxamer ......................................................... 38 Polyvinyl alcohol .................................... 38, 42, 48 Potassium bicarbonate ........................... 27, 39, 41 Potassium chloride ............................................ 51 Pravachol........................................................... 27 Pravastatin ......................................................... 27 Prednisone................................................... 38, 39 Priadel ............................................................... 42 Procaine penicillin .............................................. 40 Prochlorperazine ................................................ 37 Prodopa ............................................................. 39 Progynova ................................................... 18, 50
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Pharmaceuticals and brands Promethazine hydrochloride ............................... 38 Pytazen SR ........................................................ 26 Q Quellada-P ......................................................... 47 Quinapril ............................................................ 37 R Razene .............................................................. 50 Recombinant human growth hormone ................ 34 Recormon .................................................... 37, 48 Regitine ............................................................. 41 Resonium-A ....................................................... 27 Rex Medical ....................................................... 18 Ridal ............................................................ 21, 35 Risperdal ............................................... 33, 35, 42 Risperdal Consta .......................................... 33, 35 Risperdal Quicklet .............................................. 36 Risperidone................................ 21, 33, 35, 36, 42 Ritonavir ............................................................ 46 Rituximab .......................................................... 20 Rivotril ............................................................... 37 Rubifen .............................................................. 36 Rubifen SR ........................................................ 36 S Sabril ................................................................. 30 Salbutamol................................................... 47, 49 Sandoz ........................................................ 39, 43 Saquinavir .................................................... 47, 49 Scopoderm TTS ................................................. 32 SimvaRex .......................................................... 21 Simvastatin ........................................................ 21 Six Plus Parapaed ........................................ 41, 46 Sodium polystyrene sulphonate .......................... 27 Solian .......................................................... 17, 51 Space Chamber ..................................... 21, 32, 40 Spacer device ........................................ 21, 32, 40 Spacer devices .................................................. 43 Spacer devices and masks ................................. 43 Special food supplement .................................... 52 Spironolactone ................................................... 28 Stemetil ............................................................. 37 Stocrin ......................................................... 17, 50 T Tar with triethanolamine lauryl sulphate and fluorescein ............................................... 39 Taxol ................................................................. 47 Tegretol ....................................................... 17, 50 Temazepam ....................................................... 40 Teniposide ......................................................... 20 Teva .................................................................. 17 Thyroxine ..................................................... 18, 43 TMP................................................................... 40 Topamax............................................................ 42 Topiramate................................................... 35, 42 Trastuzumab ...................................................... 20 Trasylol.............................................................. 46 Triamcinolone acetonide .................................... 39 Trimethoprim ..................................................... 40 V Vancomycin hydrochloride ................................. 40 Verapamil hydrochloride ............................... 46, 48 Vergo 16 ............................................................ 31 Verpamil ...................................................... 46, 48 Vigabatrin .......................................................... 30 Vinblastine sulphate ........................................... 20 Vincristine sulphate ............................................ 20 Vinorelbine ......................................................... 20 Vistil .................................................................. 42 Vistil Forte .......................................................... 42 Volmax ........................................................ 47, 49 W Wool fat with mineral oil ..................................... 39 X XP Analog LCP ................................................... 41 XP Maxamaid ..................................................... 41 XP Maxamum .................................................... 41 Z Zetop ........................................................... 17, 51 Zinc and castor oil .............................................. 46 Zincaps .............................................................. 38 Zinc sulphate...................................................... 38 Zopiclone ........................................................... 38
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Pharmaceutical Management Agency Level 9, Cigna House, 40 Mercer Street, PO Box 10-254, Wellington 6143, New Zealand Phone: 64 4 460 4990 - Fax: 64 4 460 4995 - www.pharmac.govt.nz Freephone Information line (9am-5pm weekdays) 0800 66 00 50
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.
Metadata
Title
Schedule Update - effective 1 December 2008
Abstract
Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 December 2008 Cumulative for September, October, November and December 2008 Section H cumulative for December 2008 Contents 2 Summary of PHARMAC decisions EFFECTIVE 1 DECEMBER 2008 New listings (page 17)…
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