This is the text extract for Notification of atorvastatin 80 mg listing, browse documents here.

30 April 2009

Listing of an 80 mg strength of atorvastatin (Lipitor)

PHARMAC is pleased to announce the listing of an 80 mg strength of atorvastatin (Lipitor) on the Pharmaceutical Schedule from 1 May 2009. Details of the Decision From 1 May 2009 Pfizer’s brand of atorvastatin 80 mg (Lipitor) will: • • • be listed in Section B of the Pharmaceutical Schedule at a price of $110.50 per 30 tablet pack; be fully funded for patients who qualify under the current atorvastatin Special Authority criteria (for these patients the subsidy would be $110.50); and, have a subsidy of $16.28 for patients who do not qualify under the current atorvastatin Special Authority criteria (a surcharge would apply).

A rebate arrangement will apply to Lipitor 80 mg which would have the effect of reducing the price of the 80 mg tablet to less than the price of two 40 mg atorvastatin tablets. Feedback Received regarding the Proposal The listing of the 80 mg Lipitor tablet was the subject of a consultation letter dated 26 March 2009. We appreciated all the feedback that was received as a result of this consultation and acknowledge the time that people took to respond. Support for the proposal noted that listing the 80 mg tablet is appropriate as an 80 mg dose is required for some patients with high lipid levels. In addition, it was noted that an 80 mg tablet would reduce the number of tablets patients who are receiving an 80 mg dose would have to take potentially increasing compliance. Concerns regarding the proposal noted that: • having a higher strength tablet available will increase patients dose, and the overall cost, as they will try to achieve target cholesterol levels stated in the guidelines that would not be achievable in a patient with any combination of lipid lowering agents at maximal doses; from a rational use of medicines perspective the shape of the dose response curve for atorvastatin is such that the difference in lipid lowering between 40 and 80 mg of atorvastatin is at best modest while the difference in side effects (such as muscle aches and worse) in contrast is significant; and, increasing the dose from 40 mg to 80 mg is an illogical and outmoded strategy as a 60 mg dose may have the same benefit as the 80 mg dose.

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With respect to these concerns the 80 mg dose is currently being prescribed to patients via two 40 mg tablets, it is a registered dose, and the Cardiovascular Subcommittee of PTAC (August 2008) considered that patients should be titrated up to an 80 mg dose if required. In addition the 60 mg dose is currently available and this proposal would not prevent it being used. More information If you have any queries about these changes please contact the PHARMAC helpline on 0800 66 00 50 (9 am to 5 pm weekdays).

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