This is the text extract for Proposal to remove restriction from DP-Anastrozole - Closed, browse documents here.

17 June 2009

Proposal to remove the restriction from DP-Anastrozole

Proposal PHARMAC proposes to remove the restriction (endorsement criteria) which applies to the prescribing and dispensing of Douglas Pharmaceuticals Ltd’s brand of the aromatase inhibitor anastrozole (DP-Anastrozole). The current subsidy payable for AstraZeneca’s brand of anastrozole (Arimidex) would remain unchanged. This proposal would result in both DP-Anastrozole and Arimidex being fully funded without restriction. Further background information can be found on the following page.

Feedback sought We welcome your feedback on this proposal. To provide feedback please submit an email, fax or letter by 4 pm, Wednesday 1 July 2009 to: Jackie Evans Therapeutic Group Manager PHARMAC PO Box 10-254 Wellington 6143 Email: jackie.evans@pharmac.govt.nz Fax: (04) 460 4995

All feedback received before the closing date will be considered by PHARMAC’s Board (or Chief Executive acting under delegated authority) prior to making a decision on this proposal.

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Background to the proposal Douglas Pharmaceuticals Ltd’s brand of the aromatase inhibitor anastrozole (DPAnastrozole) was listed in December 2008, at a price and subsidy of $29.50 per pack subject to the following restriction:

“Subsidy by endorsement – subsidised only for patients with hormone receptor positive advanced breast cancer and the prescription is endorsed accordingly”

At the same time the Special Authority restriction applying to AstraZeneca’s brand of anastrozole (Arimidex) was amended, such that a higher subsidy (up to the manufacturers’ price of $240 per pack) was payable only for women with early breast cancer who were intolerant of tamoxifen or for whom tamoxifen was contraindicated. A subsidy of $146.46 applied to other patients without Special Authority. In January 2009 AstraZeneca reduced the price of Arimidex to $146.46 per pack; therefore, from 1 February 2009 PHARMAC removed the Special Authority for higher subsidy on this product as it was no longer relevant. This has created an unusual situation whereby the lower priced anastrozole brand (DP-Anastrozole priced at $29.50 per pack) is subject to a restriction, whereas the more expensive brand (Arimidex priced at $146.46 per pack) is not. PHARMAC considers that the endorsement requirement on DP-Anastrozole may be acting as a barrier to the prescribing and dispensing of this brand for the treatment of patients with advanced breast cancer; with the result being prescribing of the more expensive and unrestricted Arimidex brand of anastrozole for this indication – this additional expenditure could instead be used to fund other community pharmaceuticals. It should be noted that although both products contain the same active ingredient, anastrozole, the Medsafe approved indications are different: · · DP-Anastrozole is indicated for the treatment of advanced breast cancer in post-menopausal women. Arimidex is indicated for the treatment of early breast cancer in hormone receptor positive post-menopausal women, adjuvant treatment of early breast cancer in hormone receptor positive postmenopausal women who have received 2 to 3 years of adjuvant tamoxifen, reduction in the incidence of contralateral breast cancers in post menopausal women receiving anastrozole as adjuvant treatment for early breast cancer, and treatment of advanced breast cancer in post-menopausal women.

If this proposal is approved prescribers should be aware of this difference.

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