Schedule Update - effective 1 July 2009 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 July 2009 Cumulative for May, June and July 2009. Section H cumulative for April, May, June and July 2009

Contents

Summary of PHARMAC decisions effective 1 July 2009 ................................. 3 Rituximab Access Widening........................................................................... 6 Mycophenolate Mofetil Access Widening ...................................................... 6 New Methylphenidate Listings: Ritalin, Ritalin SR and Ritalin LA ................... 7 Funding of Multivitamin Preparations as Supplement to Ketogenic Diet ....... 7 Dipyridamole Widened Access ...................................................................... 8 Discontinuation of Triamizide (triamterene with hydrochlorothiazide) .......... 8 Pioglitazone Changes .................................................................................... 8 Changes to Diabetes Management Products ................................................. 9 Propofol Injection for Section H .................................................................. 10 Treatments Now Funded for Pulmonary Arterial Hypertension .................... 10 Bupropion (Zyban) Now Fully Subsidised .................................................... 10 Valaciclovir (Valtrex) New Listing ................................................................. 10 Changes to Spacer Devices .......................................................................... 11 In Brief ........................................................................................................ 11 Tender News ................................................................................................ 12 Looking Forward ......................................................................................... 13 Sole Subsidised Supply Products Cumulative to July 2009 .......................... 14 New Listings ................................................................................................ 20 Changes to Restrictions ............................................................................... 27 Changes to Subsidy and Manufacturer’s Price............................................. 36 Changes to Brand name .............................................................................. 43 Changes to Description ............................................................................... 43 Changes to General Rules............................................................................ 43 Changes to Sole Subsidised Supply ............................................................. 43 Delisted Items ............................................................................................. 44 Items to be Delisted .................................................................................... 46 Section H changes to Part I ......................................................................... 49 Section H changes to Part II ........................................................................ 50 Section H changes to Part IV ....................................................................... 69 Index ........................................................................................................... 70

Summary of Pharmac decisions

effective 1 July 2009 New listings (pages 20 to 25) • Pioglitazone (Pizaccord) tab 15 mg, 30 mg and 45 mg – Special Authority – Retail pharmacy • Glucose blood diagnostic test meter (FreeStyle Lite) – Subsidy by endorsement • Glucose blood diagnostic test strip (FreeStyle Lite, SensoCard) blood glucose test strips – access restriction • Ketone blood beta-ketone electrodes (Optium Blood Ketone Test Strips) test strip – access restriction • Water (AstraZeneca) purified for inj 5 ml and 10 ml – Only on a PSO, BSO or when used in the extemporaneous compounding of eye drops • Bosentan (Tracleer) tab 62.5 mg and 125 mg – Special Authority – Hospital Pharmacy [HP1] • Iloprost (Ventavis) nebuliser soln 10 µg per ml, 2 ml – Special Authority – Hospital Pharmacy [HP1] • Sildenafil (Viagra) tab 25 mg, 50 mg and 100 mg - Special Authority – Hospital Pharmacy [HP1] • Cyproterone acetate (Siterone) tab 100 mg - Hospital pharmacy [HP3] Specialist • Cabergoline (Arrow-Cabergoline) tab 0.5 mg – Maximum of 2 tab per prescription, can be waived by Special Authority • Valaciclovir (Valtrex) tab 500 mg – Special Authority – Retail pharmacy • Influenza vaccine (Fluarix) – Hospital pharmacy [Xpharm] • Diazepam (Arrow-Diazepam) tab 2 mg and 5 mg – Month Restriction • Bupropion hydrochloride (Zyban) tab modified-release 150 mg • Methylphenidate hydrochloride (Ritalin, Ritalin SR) tab immediate-release 10 mg and sustained release 20 mg – Special Authority – Retail pharmacy – Only on a controlled drug form • Methylphenidate hydrochloride extended release (Ritalin LA) cap modifiedrelease 20 mg, 30 mg and 40 mg – Special Authority – Retail pharmacy – Only on a controlled drug form • Fludarabine phosphate (Fludara Oral) tab 10 mg – PCT only – Specialist • Daunorubicin (Pfizer) (Section 29) inj 2 mg per ml, 10 ml – PCT only – Specialist • Beclomethasone diproprionate (Beclazone 50, 100 and 250) aerosol inhaler 50 µg, 100 µg and 250 µg per dose CFC-free • Dextrochlorpheniramine maleate (Polaramine Colour-Free Repetabs) tab longacting 6 mg • Spacer device (Volumatic) 800 ml – Max of 20 dev per WSO, Only on a WSO • Fluorometholone (FML) eye drops 0.1%

Summary of Pharmac decisions – effective 1 July 2009 (continued) • Vinorelbine (Navelbine) inj 10 mg per ml, 1 ml and 2 ml – PCT only – Special – Special Authority changes to restriction (pages 27 to 34) • Mesalazine tab 400 mg, tab long-acting 500 mg and enema 1 g per 100 ml – Removal of Retail pharmacy –Specialist • Pioglitazone tab 15 mg, 30 mg and 45 mg – amendment of Special Authority criteria • Insulin pen needles (NovoFine) – Removal of restriction to children under 12 years of age • Blood glucose diagnostic test meter – Access widened for pregnant women with diabetes • Glucose dehydrogenase blood glucose test strips – nomenclature change to glucose blood diagnostic test strip • Multivitamins tab, powder and oral liquid – Special Authority amendment • Dipyridamole tab 25 mg and tab long-acting 150 mg – removal of Special Authority • Azithromycin (Arrow-Azithromycin) tab 500 mg – addition of Special Authority for waiver of rule • Influenza vaccine – extension of availability period end date from June to September • Mycophenolate mofetil tab 500 mg, cap 250 mg – amendment of Special Authority criteria • Rituximab inj 100 mg per 10 ml vial, inj 500 mg per 50 ml vial, inj 1 mg for ECP – amendment of Special Authority criteria • Inhaled corticosteroids with long-acting beta-adrenoreceptor agonists – Special Authority applicant amendment • Spacer device 230 ml • Aminoacid formula with minerals without phenylalanine (Metabolic Mineral Mixture) powder – amendment of Special Authority criteria Decreased subsidy (pages 36 to 39) • Mesalazine (Pentasa) enema 1 g per 100 ml • Pioglitazone (Actos) tab 15 mg, 30 mg and 45 mg • Blood glucose diagnostic test strip (Optium 5 second test) blood glucose test strips, 50 test OP and 25 test OP • Insulin pen needles (ABM, BD Micro-Fine and NovoFine) 29 g x 12.7 mm, 31 g x 6 mm and 31 g x 8 mm • Insulin syringes, disposable with attached needle (ABM, BD Ultra Fine, BD Ultra Fine II) all currently subsidised presentations • Terazosin hydrochloride (Hytrin) tab 2 mg and 5 mg

Summary of Pharmac decisions – effective 1 July 2009 (continued) • Lisinopril (Arrow-Lisinopril) tab 5 mg, 10 mg and 20 mg • Felodipine (Felo 5 ER and Felo 10 ER) tab long-acting 5 mg and 10 mg • Cyproterone acetate (Siterone) tab 50 mg • Azithromycin (Arrow-Azithromycin) tab 500 mg • Roxithromycin (Arrow-Roxithromycin) tab 150 mg and 300 mg • Cyclizine hydrochloride (Nausicalm) tab 50 mg • Methylphenidate hydrochloride (Rubifen) tab immediate-release 10 mg • Methotrexate (Methoblastin) tab 2.5 • Salbutamol (Asthalin) nebuliser soln, 1 mg per ml, 2.5 ml and 2 mg per ml, 2.5 ml • Salbutamol with ipratropium bromide (Duolin) nebuliser soln, 2.5 mg with ipratropium bromide, 0.5 mg per vial, 2.5 ml • Chloramphenicol (Chlorsig) eye oint 1% increased subsidy (pages 36 to 39) • Ferrous fumarate (Ferro-tab) tab 200 mg • Ferrous fumarate with folic acid (Ferro-F-tabs) tab 310 mg with folic acid 350 µg • Multivitamins (Ketovite Liquid) oral liq • Dipyridamol (Persantin) tab 25 mg • Heparin sodium inj 1000 iu per ml, 35 ml (Mayne), inj 5000 iu per ml, 1 ml (Mayne) and 5 ml (Multiparin) • Cefoxitin sodium (Mayne) inj 1 g • Erythromycin lactobionate (Erythrocin IV) inj 1 g • Tobramycin (Mayne) inj 40 mg per ml, 2 ml • Methadone hydrochloride (AFT) inj 10 mg per ml, 1 ml • Pethidine hydrochloride (Mayne) inj 50 mg per ml, 1 ml and 2 ml • Benztropine mesylate (Benztrop) tab 2 mg • Cyclophosphamide inj 1 g and 2 g (Endoxan) and inj 1 mg for ECP (Baxter) • Ifosfamide inj 1 g and 2 g (Holoxan) and inj 1 mg for ECP (Baxter) • Arsenic trioxide (AFT) inj 10 mg • Procarbazine hydrochloride (Natulan) cap 50 mg • Tamoxifen citrate (Genox) tab 10 mg and 20 mg • Promethazine hydrochloride (Mayne) inj 25 mg per ml, 2 ml • Charcoal (Carbosorb-X) oral liq 50 g per 250 ml

6 Pharmaceutical Schedule - Update News

Rituximab Access Widening

From 1 July 2009 the Special Authority criteria for rituximab (Mabthera) will be widened to include the first-line treatment of patients with indolent, low-grade NHL for a maximum of 6 cycles and patients with large B-cell NHL being treated with a nonanthracycline containing chemotherapy regimen given with curative intent. Some other minor changes have also been made to the rituximab Special Authority criteria including the addition of notes which clarify nomenclature and which conditions are/are not funded, see page 31 of this Update for the complete Special Authority criteria. Rituximab is a Pharmaceutical Cancer Treatment (PCT) administered in DHB hospitals. Currently, PCTs are funded from

DHB budgets, the widening of access to rituximab is therefore a cost to DHB hospitals. The provisional agreement with the supplier includes a confidential rebate on all sales of rituximab for use in DHB hospitals. This rebate would replace the discount on invoice that DHB Hospital pharmacies currently receive on rituximab purchases.

Mycophenolate Mofetil Access Widening

From 1 July 2009 mycophenolate mofetil (CellCept) will be funded, via Special Authority, for patients who have received a liver transplant. Approximately 40 liver transplants are performed in New Zealand every year, but around 10% of these patients may suffer late-onset kidney failure which is difficult to treat and can lead to the need for kidney transplantation or even death. Mycophenolate mofetil permits dose reduction of calcineurin phosphatase inhibitors (other treatments taken by transplant patients), which preserves kidney function. Various presentations and strengths of mycophenolate mofetil are subsidised.

Pharmaceutical Schedule - Update News

New Methylphenidate Listings: Ritalin, Ritalin SR and Ritalin LA

The Ritalin, Ritalin SR and Ritalin LA brands of the Attention Deficit/Hyperactivity Disorder (ADHD) treatment methylphenidate hydrochloride will be fully subsidised subject to Special Authority criteria from 1 July 2009. Ritalin and Ritalin SR will be listed under the same Special Authority criteria that apply to methylphenidate hydrochloride immediaterelease and sustained-release preparations (Rubifen and Rubifen SR), and Ritalin LA will be listed under the same Special Authority criteria that apply to methylphenidate hydrochloride extended-release (Concerta). All patients with a valid approval for Ritalin SR Special Access funding at 1 July 2009 will be issued Special Authority approvals for methylphenidate hydrochloride (immediaterelease and sustained-release) with the same expiry date, and no new Ritalin SR Special Access applications will be accepted after 1 July 2009.

Funding of Multivitamin Preparations as Supplement to Ketogenic Diet

PHARMAC has approved the funding of multivitamin preparations for use as a supplement to a ketogenic diet in children with epilepsy, from 1 July 2009. Several changes will occur as a result of this decision. These changes are: • the Special Authority criteria applying to multivitamins (Ketovite, Paediatric Seravit, Ketovite Liquid) will be amended • Ketovite Liquid will become fully subsidised • new Special Authority criteria will apply to the listing of aminoacid formula with minerals without phenylalanine (Metabolic Mineral Mixture). The new criteria will apply to patients who require dietary management of phenylketonuria (PKU) and patients with epilepsy who require a supplement to a ketogenic diet. Approvals under the new criteria will be valid without the need for renewal. The current Special Authority (SA0733) for use in the dietary management of PKU will continue to apply to the listings of Foods for PKU and Supplements for PKU, but not Metabolic Mineral Mixture – with the exception of patients with a current SA0733 approval at 1 July 2009, who will be issued an approval for the new Special Authority for Metabolic Mineral Mixture.

8 Pharmaceutical Schedule - Update News

Dipyridamole Widened Access

The Special Authority criteria for the funding of dipyridamole on both the Tab 25 mg and Tab long-acting 150 mg will be removed from 1 July 2009. The subsidy for dipyridamole tab 25 mg will increase so that it will be fully subsidised. This means that both presentations of dipyridamole will be fully funded without restriction.

Discontinuation of Triamizide (triamterene with hydrochlorothiazide)

Mylan New Zealand Limited (formerly Pacific Pharmaceuticals) has advised that Triamizide is to be discontinued with remaining stock having an expiry date of July 2009. There are two other subsidised potassium sparing combination diuretics available, Amizide (amiloride with hydrochlorothiazide) and Frumil (amiloride with frusemide).

Pioglitazone Changes

From 1 July 2009, the Special Authority for pioglitazone will be amended to allow wider access for patients and to remove the need for renewal of Special Authority applications. In addition the Special Authority criteria have been significantly simplified (see page 27). Related to the widening of access from 1 July 2009 is the listing of Pizaccord, a new brand of pioglitazone tablets. In transition to a sole supply arrangement for Pizaccord, the subsidy and price will be reduced for the current Actos brand of pioglitazone from 1 July 2009 followed by a further reduction in subsidy (to the same level as Pizaccord) from 1 October 2009. A manufacturers’ surcharge may apply to Actos from 1 October 2009. Pizaccord will be the sole subsidised brand in the community and have Hospital Supply Status in the hospital from 1 December 2009 until at least 30 June 2012.

Pharmaceutical Schedule - Update News

Changes to Diabetes Management Products

PHARMAC is pleased to announce the funding of blood glucose test strips, blood glucose diagnostic test meters, blood ketone test strips, urine ketone test strips, insulin pen needles and disposable insulin syringes from 1 July 2009 (unless otherwise stated). In relation to blood glucose test strips and blood glucose diagnostic test meters • Three new brands of blood glucose test strips and blood glucose diagnostic test meters (in addition to those already listed) will be fully subsidised: o FreeStyle Lite (as supplied by Medica Pacifica); • SensoCard blood glucose test strips (as supplied by Point of Care Diagnostics) will be fully subsidised for patients who are severely visually impaired; and • Funded access to blood glucose diagnostic test meters will be widened to include people with gestational diabetes. In relation to ketone testing • Optium blood ketone test strips (as supplied by Medica Pacifica) will be fully subsidised via an endorsement restriction for people with type 1 diabetes; • Ketostix urine ketone test strips (individual foiled strips as supplied by Bayer) will be fully subsidised from 1 August 2009; and • The current, partially subsidised, glucose and/or ketones/urine testing brands will be delisted from the Pharmaceutical Schedule from 1 December 2009. In relation to insulin pen needles and disposable insulin syringes • The subsidy and price for ABM insulin pen needles and disposable insulin syringes (as supplied by ABM Pharma) will reduce and will remain fully subsidised); • SC Profi-Fine insulin pen needles (as supplied by Pharmaco) and DM Ject disposable insulin syringes (as supplied by Pharmaco) will be listed, fully subsidised, from 1 September 2009; • The subsidies for the B-D (as supplied by Becton Dickinson) and NovoFine (as supplied by Novo Nordisk) brands of insulin pen needles and disposable insulin syringes will reduce, through reference pricing, to match that of ABM or SC Profi-Fine (where applicable). Becton Dickinson has notified that it will reduce its price to match the lower subsidies however Novo Nordisk is not reducing its price so a manufacturers’ surcharge will apply.

10 Pharmaceutical Schedule - Update News

Propofol Injection for Section H

From 1 July 2009, a new brand of propofol (Provive 1%) will be listed alongside the current brand (Diprivan) in Part II of Section H of the Pharmaceutical Schedule. Provive 1% will be supplied in glass vials (and not glass ampoules as notified in April in error). The current Hospital Supply Status for Diprivan expired on 1 July 2009 and neither brand will have Hospital Supply Status.

Treatments Now Funded for Pulmonary Arterial Hypertension

From 1 July 2009, a range of products will be subsidised for the management of pulmonary arterial hypertension (PAH). Bosentan (Tracleer), iloprost (Ventavis) and sildenafil (Viagra) will be available for patients with PAH. Subsidy is via application to the Pulmonary Arterial Hypertension Panel. See pages 20-21 of this Update for full details.

Bupropion (Zyban) Now Fully Subsidised

Bupropion (Zyban) will be subsidised without prescribing restrictions from 1 July 2009. The unrestricted listing of bupropion will provide another option for smoking cessation treatments alongside nicotine and nortriptyline.

Valaciclovir (Valtrex) New Listing

Valaciclovir (Valtrex) will be listed from 1 July 2009 under Special Authority restriction for patients with recurrent genital herpes, ophthalmic zoster, and for cytomegalovirus infection prophylaxis. See page 21 for the complete Special Authority criteria.

Pharmaceutical Schedule - Update News

Changes to Spacer Devices

A new spacer device will be available on Wholesale Supply Order from 1 July 2009. The large volume spacer (Volumatic) supplied by GlaxoSmithKline will be fully subsidised, and the age restriction applying to spacer devices has been removed.

In Brief

• The CFC-propelled version of Beclazone (beclomethasone aerosol inhalers) is being phased out and replaced with a CFC-free version. The new product is available from July 2009, and the older product will be discontinued over the next few months. The CFC-free version of Beclazone has been registered at a 1:1 dose relationship to the existing product. • From 1 July 2009, all mesalazine presentations (tablets and enemas) will no longer be subject to a “Retail pharmacySpecialist” restriction. This means that prescriptions written by other types of practitioners will no longer require a specialist endorsement for subsidy. • Fludara (fludarabine phosphate) is changing from a 15 tablet pack size to a 20 tablet pack size. The new 20 tablet pack size is listed fully subsidised from 1 July 2009 and the old 15 tablet pack size will be delisted from 1 December 2009. • The Pfizer brand of daunorubicin inj 2 mg per ml, 10 ml will be listed fully subsidised from 1 July 2009. This product will be listed under Section 29 of the Medicines Act. It will be listed at the same price and subsidy as the currently listed Mayne daunorubicin inj 5 mg per ml, 4 ml.

tender News

Sole Subsidised Supply changes – effective 1 August 2009

Chemical Name Acarbose Acarbose Amoxycillin clavulanate Ciclopiroxolamine Entacapone Erythromycin ethyl succinate Furosemide Hydroxychloroquine sulphate Ibuprofen Mebendazole Methadone hydrochloride Methadone hydrochloride Methadone hydrochloride Simvastatin Simvastatin Simvastatin Simvastatin Presentation; Pack size Tab 50 mg; 90 tab Tab 100 mg; 90 tab Tab amoxycillin 500 mg with potassium clavulanate 125 mg; 100 tab Nail soln 8%; 3.5 ml OP Tab 200 mg; 100 tab Tab 400 mg; 100 tab Tab 40 mg; 1000 tab Tab 200 mg; 100 tab Tab 200 mg; 1000 tab Tab 100 mg; 24 tab Oral liq 2 mg per ml; 200 ml Oral liq 5 mg per ml; 200 ml Oral liq 10 mg per ml; 200 ml Tab 10 mg; 90 tab Tab 20 mg; 90 tab Tab 40 mg; 90 tab Tab 80 mg; 90 tab Sole Subsidised Supply brand (and supplier) Glucobay (Bayer) Glucobay (Bayer) Synermox (Douglas) Batrafen (Sanofi-Aventis) Comtan (Novartis) E-Mycin (Mylan) Diurin 40 (Mylan) Plaquenil (Sanofi-Aventis) Ethics Ibuprofen (Multichem) De-Worm (Multichem) Biodone (Biomed) Biodone Forte (Biomed) Biodone Extra Forte (Biomed) Arrow-Simva 10 mg (Arrow) Arrow-Simva 20 mg (Arrow) Arrow-Simva 40 mg (Arrow) Arrow-Simva 80 mg (Arrow)

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 august 2009 • Adalimumab (Humira) – widening funded access, via amendment of Special Authority criteria • Dasatinib (Sprycel) - new listing under Special Authority criteria • Enoxaparin (Clexane) – new listing under Special Authority criteria • Entecavir (Baraclude) - new listing under Special Authority criteria • Fentanyl (Hospira) inj 50 µg per ml, 2 ml and 10 ml – new listing • Gabapentin (Nupentin) cap 100 mg, 300 mg and 400 mg – subsidy and price decrease • Gabapentin (Neurontin) cap 100 mg, 300 mg, 400 mg and tab 600 mg – amended Special Authority criteria (only subsidised for patients with a valid approval for Neurontin for epilepsy at 31 July 2009) • Insulin glargine (Lantus) – removal of Special Authority • Leuprorelin (Lucrin Depot, Eligard) – removal of Special Authority criteria • Leuprorelin (Lucrin PDS Depot) soln for inj (prefilled syringe) 3.75 mg, 11.25 mg and 30 mg – new listing • Levothyroxine (Synthroid) tab 25 µg, 50 µg and 100 µg – new listing • Lithium carbonate (Lithicarb) tab 250 mg and 400 mg – subsidy and price increase • Nicotine replacement therapy – widening of access • Povidone iodine (Betadine) oint 10% – increase in subsidy to match price • Povidone iodine (Betadine) skin preparation 10% with 30% alcohol – subsidy and price increase. • Sodium nitroprusside (Ketostix) test strip 20 strip OP – new listing

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Acetazolamide Allopurinol Alprazolam Amantadine hydrochloride Amlodipine Amoxycillin

Presentation

Tab 250 mg Tab 100 mg & 300 mg Tab 250 µg, 500 µg & 1 mg Cap 100 mg Tab 5 mg & 10 mg Drops 100 mg per ml Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg Crm 500 g Tab dispersible 300 mg Tab 100 mg Eye drops 1% Inj 1 mega u Tab 200 mg Tab 50 mg Tab 5 mg Eye drops 0.2% Inj 0.5%, 4 ml Inj 0.5%, 8% glucose, 4 ml Inj 100 iu per ml, 1 ml Tab eff 1 g Inj 50 mg Tab 12.5 mg, 25 mg & 50 mg Cap 250 mg Grans for oral liq 125 mg per 5 ml Inj 500 mg & 1 g Inj 750 mg & 1.5 g Crm BP Tab 10 mg Oral liq 1 mg per ml Soln 4% Tab 250 mg, 500 mg & 750 mg Tab 20 mg Tab 250 mg Grans for oral liq 125 mg per 5 ml Tab 500 µg & 2 mg

Brand Name Expiry Date*

Diamox Apo-Allopurinol Arrow-Alprazolam Symmetrel Apo-Amlodipine Ospamox Ibiamox Apo-Amoxi AFT Ethics Aspirin Ethics Aspirin EC Atropt Sandoz Fibalip Bicalox Lax-Tab AFT Marcain Isobaric Marcain Heavy Miacalcic Calsource Calcium Folinate Ebewe Apo-Captopril Ranbaxy Cefaclor Ranbaxy Cefaclor Hospira Zinacef PSM Zetop Cetirizine-AFT Orion Rex Medical Arrow-Citalopram Klamycin Klacid Paxam 2011 2011 2010 2011 2011 2011 2010 2011 2010 2011 2011 2011 2011 2010 2011 2010 2011 2011 2011 2010 2010 2011 2011 2010 2011 2011 2011 2010 2010 2011

Aqueous cream Aspirin Atropine sulphate Benzylpenicillin sodium (Penicillin G) Bezafibrate Bicalutamide Bisacodyl Brimonidine tartrate Bupivicaine hydrochloride Calcitonin Calcium Calcium folinate Captopril Cefaclor monohydrate Cefazolin sodium Cefuroxime sodium Cetomacrogol Cetirizine hydrochloride Chlorhexidine gluconate Ciprofloxacin Citalopram Clarithromycin Clonazepam

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated unless otherwise stated. Please note that Sole Subsidised Supply may have been awarded for a wider scope than just those presentation(s) listed in the above table.

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Clotrimazole

Presentation

Vaginal crm 2% 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 Inj 500 mg Nasal spray 10 mcg per dose Tab 5 mg Inj 50%, 10 ml Oral soln with electrolytes

Brand Name Expiry Date*

Clomazol Clomazol Clomazol PSM Colgout Colestid Colistin-Link Enerlyte Cycloblastin Mayne Desmopressin-PH&T PSM Biomed Pedialyte – Plain Pedialyte – Bubblegum Pedialyte – Fruit Voltaren Ophtha Voltaren Voltaren Dilzem Cardizem CD Pytazen SR Apo-Doxazosin AFT E-Mycin E-Mycin Brevinor 21 Brevinor 1/21 Brevinor 1/28 Ferodan Fintral Flucloxin Pacific Fludara Fludara 2010 2011 2011 2011 2011 2010

Codeine phosphate Colchicine Colestipol hydrochloride Colistin sulphomethate Compound electrolytes Cyclophosphamide Desferrioxamine mesylate Desmopressin Dexamphetamine sulphate Dextrose Dextrose with electrolytes

2010 2010 2010 2010 2010 2010 2010 2011 2010 2011 2010

Diclofenac sodium

Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab 30 mg & 60 mg Cap long-acting 120 mg, 180 mg & 240 mg Tab long-acting 150 mg Tab 2 mg & 4 mg Oint BP Grans for oral liq 200 mg per 5 ml Grans for oral liq 400 mg per 5 ml 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 Oral liq 150 mg per 5 ml Tab 5 mg Inj 250 mg, 500 mg & 1 g Cap 50 mg, 150 mg & 200 mg Inj 50 mg Tab 10 mg

2011

Diltiazem hydrochloride

2011

Dipyridamole Doxazosin mesylate Emulsifying ointment Erythromycin ethyl succinate Ethinyloestradiol with norethisterone

2011 2010 2011 2011 2010

Ferrous sulphate Finasteride Flucloxacillin Fluconazole Fludarabine phosphate

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Fluocortolone caproate with fluocortolone pivalate and cinchocaine

Presentation

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 Cap 20 mg Tab disp 20 mg, scored Crm 2% Oint 2% Tab 80 mg Tab 5 mg Tab 600 µg 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 Crm 1% Scalp lotn 0.1% Lotn 1% with wool fat hydrous 3% and mineral oil Eye drops 0.5% Inj 20 mg, 1 ml Tab 20 mg Oral liq 100 mg per 5 ml 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 Cap 100 mg Shampoo 2% Oral liq 10 g per 15 ml Eye drops 0.25% & 0.5% 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 2 mg

Brand Name Expiry Date*

Ultraproct Ultraproct 2010

Fluoxetine hydrochloride Fusidic acid Gliclazide Glipizide Glyceryl trinitrate

Fluox Fluox Foban Foban Apo-Gliclazide Minidiab Lycinate Nitrolingual pumpspray Nitroderm TTS 5 Nitroderm TTS 10 Serenace Serenace PSM Locoid DP Lotn HC Methopt Buscopan Gastrosoothe Fenpaed Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Ferrum H Sporanox Sebizole Duphalac Betagan Xylocaine Xylocaine Xylocaine EMLA EMLA Nodia

2010 2010 2011 2011 2011

Haloperidol Hydrocortisone Hydrcortisone butyrate Hydrocortisone with wool fat and mineral oil Hypromellose Hysocine N-butylbromide Ibuprofen Ipratropium bromide

2010 2011 2010 2011 2011 2011 2010 2010

Iron polymaltose Itraconazole Ketoconazole Lactulose Levobunolol Lignocaine hydrochloride

2011 2010 2011 2010 2010 2010

Lignocaine with prilocaine

2010

Loperamide hydrochloride

2010

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Loratadine

Presentation

Tab 10 mg Oral liq 1 mg per ml

Brand Name Expiry Date*

Loraclear Hayfever Relief Lorapaed Derbac M A-Lices Foremount Child’s Silicone Mask Colofac Provera Methatabs Methotrexate Ebewe Methotrexate Ebewe Prodopa Depo-Medrol Depo-Medrol with Lidocaine Pfizer Multichem Mayne Mayne Apo-Nadolol ReVia Sonaflam AstraZeneca Habitrol Habitrol Habitrol Habitrol Primolut N Norpress Nilstat Nilstat Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Zofran Zofran Zydis 2010

Malathion Maldison Mask for Spacer Device Mebeverine hydrochloride Medroxyprogesterone acetate Methadone hydrochloride Methotrexate Methyldopa Methylprednisolone acetate Methylprednisolone acetate with lignocaine Metoclopramide hydrochloride Miconazole nitrate Morphine sulphate Nadolol Naltrexone hydrochloride Naproxen sodium Neostigmine Nicotine

Liq 0.5% Shampoo 1% Device Tab 135 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Tab 5 mg Inj 100 mg per ml, 10 ml Inj 100 mg per ml, 50 ml Tab 125 mg, 250 mg, 500 mg Inj 40 mg per ml, 1 ml Inj 40 mg per ml with lignocaine 1 ml Inj 5 mg per ml, 2 ml Crm 2% Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Tab 40 mg & 80 mg Tab 50 mg Tab 275 mg Inj 2.5 mg per ml, 1 ml Patch 7 mg, 14 mg and 21 mg Lozenge 1 mg and 2 mg Gum 2 mg & 4 mg (Fruit) Gum 2 mg & 4 mg (Mint) Tab 5 mg Tab 10 mg & 25 mg Oral liq 100,000 u per ml, 24 ml OP Cap 500,000 u Tab 500,000 u Cap 10 mg, 20 mg & 40 mg Inj 40 mg

2010 2010 30/9/11 2011 2010 2010 2011 2011 2011 2011 2011 2011 2011 2010 2010 2010 2010 2010

Norethisterone Nortriptyline hydrochloride Nystatin

2011 2011 2011 2010 2011

Omeprazole

Ondansetron

Tab 4 mg & 8 mg Tab disp 4 mg & 8 mg

2010

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Oxybutynin Oxycodone hydrochloride Pamidronate disodium

Presentation

Tab 5 mg Oral liq 5 mg per 5 ml Inj 10 mg per ml, 1 ml & 2 ml Oral liq 5 mg per 5 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml Inj 40 mg Tab 20 mg & 40 mg Tab 500 mg Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml

Brand Name Expiry Date*

Apo-Oxybutynin Apo-Oxybutynin OxyNorm OxyNorm Pamisol Pamisol Pamisol Pantocid IV Dr Reddy’s Pantoprazole Pharmacare Paracetamol Paracare Junior Paracare Double Strength Lacri-Lube Loxamine Breath-Alert Permax AFT AFT Cilicaine VK Prefrin Coloxyl Vistil Vistil Forte Apo-Prazo Apo-Prednisone Cilicaine Allersoothe Accupril Accuretic 10 Accuretic 20 Peptisoothe Mycobutin Salapin Ural Space Chamber 2010 2010 2010 2010 30/9/11 2010 2010 2011

Pantoprazole

2010

Paracetamol

2011

Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak Flow Meter Pergolide Phenoxymethylpenicillin (Penicillin V) Phenylephrine hydrochloride Poloxamer Polyvinyl alcohol Prazosin hydrochloride Prednisone Procaine penicillin Promethazine Quinapril Quinapril with hydroclorothiazide

Eye oint with soft white paraffin Tab 20 mg Low range and Normal range Tab 0.25 mg & 1 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap potassium salt 250 mg & 500 mg Eye drops 0.12% Oral drops 10% Eye drops 1.4% Eye drops 3% Tab 1 mg, 2 mg & 5 mg Tab 1 mg, 2.5 mg, 5 mg & 20 mg Inj 1.5 mega u Tab 10 mg & 25 mg Tab 5 mg; 10 mg & 20 mg Tab 10 mg with hydroclorothiazide 12.5 mg Tab 20 mg with hydroclorothiazide 12.5 mg Oral liq 150 mg per 10 ml Cap 150 mg Oral liq 2 mg per 5 ml Grans eff 4 g sachets 230 ml

2010 2010 30/9/11 2011 2010

2010 2011 2011 2010 2011 2011 2011 2011 2011

Ranitidine hydrochloride Rifabutin Salbutamol Sodium citro-tartrate Spacer Device

Sole Subsidised Supply Products – cumulative to July 2009

Generic Name

Syrup (pharmaceutical grade) Tar with triethanolamine lauryl sulphate and fluorescein sodium Temazepam Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate Triamcinolone acetonide

Presentation

Liq Soln 2.3%

Brand Name Expiry Date*

Midwest Pinetarsol 2010 2011

Tab 10 mg 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% & 0.5% Crm 0.02% Oint 0.02% Inj 40 mg per ml, 1 ml 0.1% in Dental Paste USP Tab 300 mg Cap 300 mg Inj 50 mg per ml, 10 ml Ointment BP Cap 220 mg Tab 7.5 mg

Normison Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timop Aristocort Aristocort Kenacort-A40 Oracort TMP Actigall Pacific PSM Zincaps Apo-Zopiclone

2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011

Trimethoprim Ursodeoxycholic acid Vancomycin hydrochloride Zinc and castor oil Zinc sulphate Zopiclone

There are no additions for July 2009

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 July 2009

30 PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy Tab 15 mg ............................................................................... 2.61 Tab 30 mg ............................................................................... 5.23 Tab 45 mg ............................................................................... 7.80 28 28 28 ✔ Pizaccord ✔ Pizaccord ✔ Pizaccord

➽ SA0959 Special Authority for Subsidy Initial application – (Patients with type 2 diabetes) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1. Patient has not achieved glycaemic control on maximum doses of metformin and/or a sulfonylurea or where either or both are contraindicated or not tolerated. 2. Patient is on insulin. 32 BLOOD GLUCOSE DIAGNOSTIC TEST METER – Subsidy by endorsement a) Maximum of 1 meter per prescription. b) A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005 or is prescribed for a pregnant woman with diabetes. c) Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly. Meter ........................................................................................ 9.00 1 ✔ FreeStyle Lite BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. SensoCard blood glucose test strips are subsidised only if prescribed for a patient who is severely visually impaired and is using a SensoCard Plus Talking Blood Glucose Monitor. Blood glucose test strips ........................................................ 21.65 50 test OP ✔ FreeStyle Lite 26.20 ✔ SensoCard KETONE BLOOD BETA-KETONE ELECTRODES Patient has type 1 diabetes and has had one or more episodes of ketoacidosis (excluding first presentation). Maximum quantity of 2 packs per annum. No further prescriptions will be subsidised. Test strip ................................................................................... 8.50 10 strip OP ✔ Optium Blood Ketone Test Strips WATER 1) On a prescription or Practitioner’s Supply Order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent; or 2) On a bulk supply order; or 3) When used in the extemporaneous compounding of eye drops. Purified for inj 5 ml – Up to 5 inj available on a PSO ................. 10.51 50 ✔ AstraZeneca Purified for inj 10 ml – Up to 5 inj available on a PSO ............... 11.32 50 ✔ AstraZeneca BOSENTAN – Special Authority see SA0956 – Hospital pharmacy [HP1] Tab 62.5 mg ...................................................................... 4,585.00 Tab 125 mg ....................................................................... 4,585.00 60 60 ✔ Tracleer ✔ Tracleer

➽ SA0956 Special Authority for Subsidy continued... Special Authority approved by the Pulmonary Arterial Hypertension Panel Patients pay a manufacturer’s surcharge when S29 Unapproved medicine supplied under Section 29 the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supply

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 July 2009 (continued)

continued... Notes: Application details may be obtained from PHARMAC’s website http://www.pharmac.govt.nz or: The Coordinator, PAH Panel Phone: (04) 916 7512 PHARMAC, PO Box 10 254 Facsimile: (04) 974 4858 Wellington Email: PAH@pharmac.govt.nz 57 ILOPROST – Special Authority see SA0956 – Hospital pharmacy [HP1] Nebuliser soln 10 µg per ml, 2 ml ....................................... 1,185.00 30 ✔ Ventavis

➽ SA0956 Special Authority for Subsidy Special Authority approved by the Pulmonary Arterial Hypertension Panel Notes: Application details may be obtained from PHARMAC’s website http://www.pharmac.govt.nz or: The Coordinator, PAH Panel Phone: (04) 916 7512 PHARMAC, PO Box 10 254 Facsimile: (04) 974 4858 Wellington Email: PAH@pharmac.govt.nz 57 SILDENAFIL – Special Authority see SA0956 – Hospital pharmacy [HP1] Tab 25 mg .............................................................................. 47.00 Tab 50 mg .............................................................................. 59.50 Tab 100 mg ............................................................................ 66.00 4 4 4 ✔ Viagra ✔ Viagra ✔ Viagra

CABERGOLINE Tab 0.5 mg – Maximum of 2 tab per prescription; can be waived by Special Authority see SA0175.............................. 26.26 2 ✔ Arrow-Cabergoline 105.03 8 ✔ Arrow-Cabergoline ➽ SA0175 Special Authority for Waiver of Rule Initial application only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where the patient has pathological hyperprolactinemia. Renewal only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. VALACICLOVIR – Special Authority see SA0957 – Retail pharmacy Tab 500 mg .......................................................................... 102.72 30 ✔ Valtrex

➽ SA0957 Special Authority for Subsidy Initial application – (recurrent genital herpes) from any medical practitioner. Approvals valid for 12 months where the patient has genital herpes with 2 or more breakthrough episodes in any 6 month period while treated with aciclovir 400 mg twice daily. Renewal – (recurrent genital herpes) from any medical practitioner. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. Initial application – (ophthalmic zoster) from any medical practitioner. Approvals valid without further renewal unless notified where the patient has previous history of ophthalmic zoster and the patient is at risk of vision impairment. Initial application – (CMV prophylaxis) from any medical practitioner. Approvals valid for 3 months where the patient has undergone organ transplantation.

▲

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 July 2009 (continued)

98 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] A) is available between 1 March and 30 September each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii)diabetes; iv)chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi)the following other conditions: a) autoimmune disease, b) immune suppression, c) HIV, d) transplant recipients, e) neuromuscular and CNS diseases, f) haemoglobinopathies, or g) children on long term aspirin. The following conditions are excluded from funding: a) asthma not requiring regular preventative therapy, b) hypertension and/or dyslipidaemia without evidence of end-organ disease, c) pregnancy in the absence of another risk factor. B) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. C) Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor. D) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. Inj.......................................................................................... 9.00 1 ✔ Fluarix 90.00 10 ✔ Fluarix DIAZEPAM Tab 2 mg – Month Restriction.................................................. 11.44 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 5 mg – Month Restriction.................................................. 13.71 ‡ Safety cap for extemporaneously compounded oral liquid preparations. BUPROPION HYDROCHLORIDE Tab modified-release 150 mg .................................................. 65.00 500 500 ✔ Arrow-Diazepam ✔ Arrow-Diazepam

123

127

✔ Zyban

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

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

New Listings - effective 1 July 2009 (continued)

128 METHYLPHENIDATE HYDROCHLORIDE – Special Authority see SA0908 – Retail pharmacy Only on a controlled drug form Tab immediate-release 10 mg ................................................... 3.00 30 ✔ Ritalin Tab sustained-release 20 mg ................................................... 50.00 100 ✔ Ritalin SR ➽ SA0908 Special Authority for Subsidy Initial application — (ADHD in patients 5 or over – new patients) only from a paediatrician, psychiatrist or 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) patients aged 5 years or over; 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. Initial application — (ADHD in patients 5 or over - patient has had an approval for methylphenidate for ADHD prior to 1 April 2008) only from a paediatrician, psychiatrist or 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. Initial application — (ADHD in patients under 5 – new patients) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficit and Hyperactivity Disorder) patients under 5 years of age; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Initial application — (ADHD in patients under 5 - patient has had an approval for methylphenidate for ADHD in patients under 5 prior to 1 April 2008) only from a paediatrician or psychiatrist. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. Initial application — (Narcolepsy – new patients) only from a neurologist or respiratory specialist. Approvals valid for 24 months where the patient suffers from narcolepsy. Initial application — (Narcolepsy - patient has had an approval for methylphenidate for narcolepsy prior to 1 April 2008) only from a neurologist or respiratory specialist. Approvals valid for 24 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal — (ADHD in patients 5 or over) only from a paediatrician, psychiatrist or 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: 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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 July 2009 (continued)

continued... 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.

Note: If the patient had an approval for methylphenidate for ADHD prior to 1 April 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone the Contact Centre on 0800 243 666 for clarification if needed. Renewal — (ADHD in patients under 5) only from a paediatrician or psychiatrist. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. Note: If the patient had an approval for methylphenidate for ADHD in patients under 5 prior to 1 April 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone the Contact Centre on 0800 243 666 for clarification if needed. Renewal — (Narcolepsy) only from a neurologist or respiratory specialist. Approvals valid for 24 months where the treatment remains appropriate and the patient is benefiting from treatment. Note: If the patient had an approval for methylphenidate for narcolepsy prior to 1 April 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone the Contact Centre on 0800 243 666 for clarification if needed. 129 METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE – Special Authority see SA0924 – Retail pharmacy Only on a controlled drug form Cap modified-release 20 mg ................................................... 25.50 30 ✔ Ritalin LA Cap modified-release 30 mg ................................................... 31.90 30 ✔ Ritalin LA Cap modified-release 40 mg ................................................... 38.25 30 ✔ Ritalin LA ➽ SA0924 Special Authority for Subsidy Initial application only from a paediatrician, psychiatrist or 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 (immediate-release or sustainedrelease) 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 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. Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 July 2009 (continued)

133 136 139 FLUDARABINE PHOSPHATE – PCT only – Specialist Tab 10 mg ........................................................................... 867.00 DAUNORUBICIN – PCT only – Specialist Inj 2 mg per ml, 10 ml ............................................................ 99.00 VINORELBINE – PCT only – Specialist – Special Authority see SA0901 Inj 10 mg per ml, 1 ml ............................................................. 24.00 Inj 10 mg per ml, 5 ml ........................................................... 120.00 BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 50 µg per dose CFC-free ................................... 8.54 Aerosol inhaler, 100 µg per dose CFC-free ............................... 12.50 Aerosol inhaler, 250 µg per dose CFC-free ............................... 22.67 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab long-acting 6 mg ............................................................... 5.40 (12.56) 2.70 (7.73) 152 20 1 1 1 ✔ Fludara Oral ✔ Pfizer S29 ✔ Navelbine ✔ Navelbine

147

200 dose OP ✔ Beclazone 50 200 dose OP ✔ Beclazone 100 200 dose OP ✔ Beclazone 250 40 Polaramine ColourFree Repetab 20 Polaramine ColourFree Repetab

147

SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices and masks 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) 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. 3) Space Chamber 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 4) Volumatic Distributed by GlaxoSmithKline. Forward orders to: Telephone: 0800 877 789 Facsimile: 0800 877 785 800 ml ...................................................................................... 8.50 1 ✔ Volumatic FLUOROMETHOLONE ❋ Eye drops 0.1% ........................................................................ 4.05 5 ml OP ✔ FML

154

Effective 1 June 2009

30 GLIBENCLAMIDE ❋ Tab 5 mg .................................................................................. 5.00 100 ✔ Daonil

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 June 2009 (continued)

53 METOPROLOL SUCCINATE ❋ Tab long-acting 23.75 mg ...................................................... 2.73 ❋ Tab long-acting 47.5 mg .......................................................... 3.41 ❋ Tab long-acting 95 mg ........................................................... 5.88 ❋ Tab long-acting 190 mg ....................................................... 10.63 30 30 30 30 ✔ Metoprolol-AFT CR ✔ Metoprolol-AFT CR ✔ Metoprolol-AFT CR ✔ Metoprolol-AFT CR

Note – the endorsement requirement for full funding does not apply to the Metoprolol-AFT CR brand of metoprolol succinate long-acting tablets as they are listed fully subsidised. 61 104 163 HYDROCORTISONE ❋ Powder – Only in combination ................................................. 33.00 PAMIDRONATE DISODIUM Inj 9 mg per ml, 10 ml ........................................................... 112.50 ACETYLCYSTEINE – Hospital pharmacy [HP1]-Specialist Inj 200 mg per ml, 10 ml ....................................................... 137.06 (219.75) 25 g 1 10 Martindale Acetylcysteine ✔ ABM ✔ Pamisol

Effective 1 May 2009

46 ATORVASTATIN – Additional subsidy by Special Authority see SA0788 below – Retail pharmacy See prescribing guideline on the preceding page ❋ Tab 80 mg .............................................................................. 16.28 30 (110.50) Lipitor TERAZOSIN HYDROCHLORIDE ❋ Tab 1 mg .................................................................................. 2.50 ❋ Tab 2 mg ................................................................................ 23.30 ❋ Tab 5 mg ................................................................................ 29.00 CO-TRIMOXAZOLE ❋ Oral liq trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml – Up to 200 ml available on a PSO ........................................... 2.15 NORTRIPTYLINE HYDROCHLORIDE Tab 25 mg .............................................................................. 14.44 PACLITAXEL – PCT only – Specialist Inj 30 mg .............................................................................. 189.75 28 500 500 ✔ Apo-Terazosin ✔ Apo-Terazosin ✔ Apo-Terazosin

49 87 110 138 172

100 ml 180 5

✔ Deprim ✔ Norpress ✔ Paclitaxel Ebewe

PAEDIATRIC ORAL FEED 1.5KCAL/ML – Special Authority see SA0896 above – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.60 200 ml OP ✔ NutriniDrink Liquid (vanilla)........................................................................... 1.60 200 ml OP ✔ NutriniDrink

PAEDIATRIC ORAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0896 above – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre Liquid (chocolate) ..................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre Liquid (vanilla) .......................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre Patients pay a manufacturer’s surcharge when S29 Unapproved medicine supplied under Section 29 the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supply

172

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions

Effective 1 July 2009

26 MESALAZINE Tab 400 mg – Retail pharmacy-Specialist ................................ 49.50 Tab long-acting 500 mg – Retail pharmacy-Specialist .............. 69.06 Enema 1 g per 100 ml – Retail pharmacy-Specialist................. 45.96 100 100 7 ✔ Asacol ✔ Pentasa ✔ Pentasa

PIOGLITAZONE – Special Authority see SA0959 0859 below – Retail pharmacy Tab 15 mg ............................................................................... 2.61 28 ✔ Pizaccord 45.78 ✔ Actos Tab 30 mg ............................................................................... 5.23 28 ✔ Pizaccord 70.43 ✔ Actos Tab 45 mg ................................................................................ 7.80 28 ✔ Pizaccord 89.39 ✔ Actos ➽ SA0959 0859 Special Authority for Subsidy Initial application – (Patients with type 2 diabetes) from any relevant practitioner. Approvals valid for 1 year without further renewal unless notified for applications meeting the following criteria: Either: 1 Patient has not achieved glycaemic control on maximum doses of metformin and/or a sulfonylurea or where either or both are contraindicated or not tolerated. 2 Patient is on insulin. Any of the following: Monotherapy 1 All of the following: 1.1 To be used as monotherapy for patients who after six months of diet and lifestyle changes have inadequate glycaemic control (defined as HbA1c > 7.0% in tests carried out at least two months apart); and 1.2 Metformin is contraindicated or not tolerated after a minimum of a four-week trial period; and 1.3 Sulphonylurea is contraindicated or not tolerated or the patient is obese; or In combination with sulphonylurea 2 Both: 2.1 For use in combination with a sulphonylurea for patients who after diet and lifestyle changes and a six month trial of sulphonylurea have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six-month period); and 2.2 Metformin is contraindicated or not tolerated after a minimum of a four-week trial period; or In combination with metformin 3 Both: 3.1 For use in combination with metformin for patients who after diet and lifestyle changes and a six-month trial of the maximum tolerated dose of metformin have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six-month period); and 3.2 Sulphonylurea is contraindicated or not tolerated, or the patient is obese; or In combination with metformin after a trial of metformin and sulphonylurea 4 For use in combination with metformin for patients who after diet and lifestyle changes and a six-month trial of a combination of metformin and sulphonylurea at maximum tolerated doses have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six month period); or In combination with Insulin 5 For use in combination with insulin in patients requiring more than 1.5 units per kilogram of insulin a day for at least 6 months in conjunction with metformin if tolerated. Renewal — (Patients with type 2 diabetes) from any relevant practitioner. Approvals valid for 1 year where patient is continuing to derive benefit from treatment. Notes: Pioglitazone is not to be used in triple oral combination (defined as a combination of metformin, sulphonylurea and pioglitazone). Pioglitazone should not be used in patients with heart failure. 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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... Liver function tests should be performed at baseline. Gastrointestinal side effects are relatively common when initiating metformin therapy. Upward titration of metformin dose over several weeks and taking metformin with food will help to minimize these side effects. Intolerance and contraindications for metformin include: serum creatinine ≥ 0.15 or creatinine clearance < 60 ml/min; significant liver impairment; severe left ventricular dysfunction; and intolerable gastrointestinal side effects that persist beyond 4 weeks duration. Intolerance for sulphonylurea includes: nausea; diarrhoea; rash; blood disorders (thrombocytopenia, agranulocytosis, aplastic anaemia); erythema multiforme, exfoliative dermatitis, hepatitis; and syndrome of inappropriate antidiuretic hormone secretion (SIADH) with water retention and hyponatraemia. Maximum tolerated dose of metformin defined as: A dose up to a maximum of 3 g daily. Maximum tolerated dose of sulphonylurea defined as: A dose up to a maximum of glibenclamide 20 mg daily or glipizide 20 mg daily or gliclazide 320 mg daily. For the purposes of these criteria “obese” is defined as body mass index (BMI) greater than 33 kg/m2. However, as ethnic differences between patients may vary BMI scores, practitioners may use discretion as to whether the patient meets this criterion. It is considered that when applying, that the patient may have initiated “six months diet and lifestyle changes” from the date of diagnosis of type 2 diabetes. 32 BLOOD GLUCOSE BLOOD DIAGNOSTIC TEST METER – Subsidy by endorsement a) Maximum of 1 meter per prescription b) A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005 or is prescribed for a pregnant woman with diabetes. c) Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly. Meter ........................................................................................ 9.00 1 ✔ Optium Xceed ✔ FreeStyle Lite 19.00 ✔ Accu-Chek Performa BLOOD GLUCOSE DEHYDROGENASE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. SensoCard blood glucose test strips are subsidised only if prescribed for a patient who is severely visually impaired and is using a SensoCard Plus Talking Blood Glucose Monitor. Blood glucose test strips ........................................................ 22.00 50 test OP ✔ Accu-Chek Performa ✔ Optium 10 second test 21.65 ✔ Optium 5 second test ✔ FreeStyle Lite 26.20 ✔ SensoCard INSULIN PEN NEEDLES – Maximum of 100 dev per prescription NovoFine pen needles 31 g × 6 mm are subsidised for children under 12 years of age. ❋ 31 g × 6 mm ......................................................................... 10.50 100 (26.00)

NovoFine

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

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

Changes to Restrictions - effective 1 July 2009 (continued)

38 MULTIVITAMINS – Special Authority see SA06000963 – Hospital pharmacy [HP3] Retail pharmacy Tab ......................................................................................... 19.65 100 ✔ Ketovite Powder ................................................................................... 36.00 100 g OP ✔ Paediatric Seravit Oral liq .................................................................................... 13.50 150 ml OP ✔ Ketovite Liquid ➽ SA0963 0600 Special Authority for Subsidy Initial application only from a relevant specialist from any relevant practitioner. Approvals valid for 3 years without further renewal unless notified for applications meeting the following criteria: Either: 1 The patient has where inborn errors of metabolism; or 2 For use as a supplement to a ketogenic diet in patients diagnosed with epilepsy. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted. Note: use of Paediatric Seravit is not recommended as a supplement to a ketogenic diet. 42 DIPYRIDAMOLE ❋ Tab 25 mg – Additional subsidy by Special Authority see SA0930 – Retail pharmacy ........................................................ 8.36 84 ✔ Persantin ❋ Tab long-acting 150 mg – Special Authority see SA0929 – Retail pharmacy ..................................................................... 11.52 60 ✔ Pytazen SR ➽ SA0930 Special Authority for Manufacturers Price Initial application - (Conditions other than transient ischaemic episodes) 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 anaphylaxis, or those with significant aspirin induced bleeding, excluding bruising Initial application - (Transient ischaemic episodes) only from a neurologist, neurosurgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant. Note Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxis, or those with significant aspirin induced bleeding, excluding bruising Renewal - (Existing 2 year approvals) 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 Special Authority for Manufacturers Price Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... 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 anaphylaxis, or those with significant aspirin induced bleeding, excluding bruising Initial application - (Transient ischaemic episodes) only from a neurologist, neurosurgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant. Note Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxis, or those with significant aspirin induced bleeding, excluding bruising Renewal - (Existing 2 year approvals) 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. 85 AZITHROMYCIN – Subsidy by endorsement a) Maximum of 2 tab per prescription b) Up to 4 tab available on a PSO c) Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly. d) Maximum of 2 tablets per prescription can be waived by Special Authority see SA0964 below Tab 500 mg ............................................................................. 5.95 2 OP ✔ Arrow-Azithromycin ➽ SA0964 Special Authority for Waiver of Rule Initial application only from a respiratory specialist or paediatrician. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The applicant is part of a multidisciplinary team experienced in the management of cystic fibrosis; and 2 The patient has been definitively diagnosed with cystic fibrosis*; and 3 The patient has chronic infection with Pseudomonas aeruginosa or Pseudomonas related gram negative organisms as defined by two positive respiratory tract cultures at least three months apart*; and 4 The patient has negative cultures for non-tuberculous mycobacteria. Note Caution is advised if using azithromycin as an antibiotic in the treatment of cystic fibrosis patients with pneumonia. Testing for non-tuberculosis mycobacteria should occur annually. Indications marked with * are Unapproved Indications (refer to Section A: General Rules, Part I (Interpretations and Definitions) and Part IV (Miscellaneous Provisions) rule 4.6). INFLUENZA VACCINE – Hospital pharmacy [Xpharm] A) is available between 1 March and 30 September 30 June each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; continued...

S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

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

Check your Schedule for full details Schedule page ref

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii)diabetes; iv)chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi)the following other conditions: a) autoimmune disease, b) immune suppression, c) HIV, d) transplant recipients, e) neuromuscular and CNS diseases, f) haemoglobinopathies, or g) children on long term aspirin. The following conditions are excluded from funding: a) asthma not requiring regular preventative therapy, b) hypertension and/or dyslipidaemia without evidence of end-organ disease, c) pregnancy in the absence of another risk factor. B) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. C) Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor. D) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. Inj ............................................................................................. 9.00 1 ✔ Fluvax ✔ Fluarix 90.00 10 ✔ Vaxigrip ✔ Fluarix

142

MYCOPHENOLATE MOFETIL – Special Authority see SA0960 0893 – Hospital pharmacy [HP3] Tab 500 mg ......................................................................... 206.66 50 ✔ Cellcept Cap 250 mg ......................................................................... 206.66 100 ✔ Cellcept Powder for oral liq 1 g per 5 ml – Subsidy by endorsement .... 285.00 165 ml OP ✔ Cellcept Mycophenolate powder for oral liquid is subsidised only for patients unable to swallow tablets and capsules, and when the prescription is endorsed accordingly. ➽ SA0960 0893 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Renal transplant recipient; or 2 Heart transplant recipient; or 3 Liver transplant recipient; or 34 Patient has an organ transplant and has severe tophaceous gout making azathioprine unsuitable. RITUXIMAB – PCT only – Specialist – Special Authority see SA0884 0961 Inj 100 mg per 10 ml vial ................................................... 1,195.00 Inj 500 mg per 50 ml vial ................................................... 2,987.00 Inj 1 mg for ECP ....................................................................... 6.27 ➽ SA0961 0884 Special Authority for Subsidy 2 1 1 mg ✔ Mabthera ✔ Mabthera ✔ Baxter ✔ Biomed continued... ❋ Three months or six months, as applicable, dispensed all-at-once

142

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... Initial application — (Post-transplant) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has B-cell post-transplant lymphoproliferative disorder*; and 2 To be used for a maximum of 8 treatment cycles. Initial application – (Indolent, low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has indolent, low grade NHL with relapsed disease following prior chemotherapy; and 1.2 To be used for a maximum of 4 treatment cycles; or 2 Both: 2.1 The patient has indolent, low grade lymphoma requiring first-line systemic chemotherapy; and 2.2 To be used for a maximum of 6 treatment cycles. Note: ‘Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for Chronic lymphocytic leukaemia/small lymphocytic lymphoma. Initial application – (Aggressive CD20 positive NHL) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following: 1 The patient has treatment-naive aggressive CD20 positive NHL; and 2 To be used with a multi-agent chemotherapy regimen given with curative intent; and 3 To be used for a maximum of 8 treatment cycles. Note: ‘Aggressive CD20 positive NHL’ includes large B-cell lymphoma and Burkitt’s lymphoma/leukaemia Renewal – (Indolent, low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has indolent, low-grade NHL with relapsed disease following prior chemotherapy; and 3 To be used for a maximum of 4 treatment cycles. Note: ‘Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for Chronic lymphocytic leukaemia/small lymphocytic lymphoma. Renewal — (Post-transplant) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has B-cell post-transplant lymphoproliferative disorder*; and 3 To be used for a maximum of 6 treatment cycles Indications marked with * are Unapproved Indications. ➽ SA0884 Special Authority for Subsidy Initial application - (Post-transplant) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 6 months where the patient has B-cell posttransplant lymphoproliferative disorder*. Note: for no more than 8 treatment cycles. 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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... Initial application - (Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 6 months where the patient has low grade NHL relapsed disease following prior chemotherapy. Note: for no more than 4 treatment cycles. Initial application - (Large cell lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has treatment naive large B-cell NHL; and 2 To be used with CHOP (or alternative anthracycline containing multi-agent chemotherapy regime given with curative intent). Note for no more than 8 treatment cycles. Renewal - (Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 The patient has had a treatment-free interval of 6 months or more; and 2 Either: 2.1 Has B-cell post-transplant lymphoproliferative disorder*; or 2.2 Has low grade NHL - relapsed disease following prior chemotherapy. Note for no more than 4 treatment cycles. Indications marked with * are Unapproved Indications. 148 INHALED CORTICOSTEROIDS WITH LONG-ACTING BETA-ADRENOCEPTOR AGONISTS ➽ SA0958 0838 Special Authority for Subsidy Initial application only from any a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient is a child under the age of 12; and 1.2 All of the following: Has, for 3 months of more, been treated with: 1.2.1 An inhaled long-acting beta adrenoceptor agonist; and 1.2.2 Inhaled corticosteroids at a dose of at least 400 µg per day beclomethasone or budesonide, or 200 µg per day fluticasone; and 1.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product; or 2 All of the following: 2.1 Patient is over the age of 12; and 2.2 All of the following: Has, for 3 months of more, been treated with: 2.2.1 An inhaled long-acting beta adrenoceptor agonist; and 2.2.2 Inhaled corticosteroids at a dose of at least 800 µg per day beclomethasone or budesonide, or 500 µg per day fluticasone; and 2.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product. Renewal only from any a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

152 SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices and masks 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. 2)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. 3)4) Space Chamber Ddistributed 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 4) Volumatic Distributed by GlaxoSmithKline. Forward orders to: Telephone: 0800 877 789 Facsimile: 0800 877 785 230 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. 230 ml (single patient) .............................................................. 8.38 1 ✔ Space Chamber 800 ml ...................................................................................... 8.50 1 ✔ Volumatic AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA07330962 – Retail pharmacy See prescribing guideline Powder ................................................................................... 58.44 250 g OP ✔ Metabolic Mineral Mixture ➽ SA0962 0733 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Dietary management of phenylketonuria (PKU); or 2 For use as a supplement to a ketogenic diet in patients diagnosed with epilepsy ➽ SA0733 Special Authority for Subsidy Initial application - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 dietary management of PKU; and 2 blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Initial application - (Patient aged 16 or under) only from a relevant specialist. Approvals valid for 3 years where dietary management of PKU. Renewal - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Renewal - (Patient aged 16 or under) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.

181

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

S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 May 2009

55 59 FRUSEMIDE FUROSEMIDE ❋ Tab 40 mg – Up to 30 tab available on a PSO .......................... 10.75 ❋ Tab 500 mg ............................................................................ 12.00 ❋‡ Oral liq 10 mg per ml............................................................. 10.66 ❋ Infusion ................................................................................. 481.40 ❋ Inj 10 mg per ml, 2 ml – Up to 5 inj available on a PSO ............ 29.50 CICLOPIROX OLAMINE CICLOPIROXOLAMINE a) Only on a prescription b) not in combination Nail soln 8% ........................................................................... 19.85 1,000 100 30 ml OP 5 50 ✔ Diurin 40 ✔ Diurin 500 ✔ Lasix ✔ Lasix ✔ Mayne

3.5 ml OP ✔ Batrafen

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 July 2009

26 30 MESALAZINE ( subsidy) Enema 1 g per 100 ml ............................................................. 45.96 7 ✔ Pentasa ✔ Actos ✔ Actos ✔ Actos

PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy ( subsidy) Tab 15 mg .............................................................................. 45.78 28 Tab 30 mg .............................................................................. 70.43 28 Tab 45 mg .............................................................................. 89.39 28 BLOOD GLUCOSE DIAGNOSTIC TEST STRIP ( subsidy) Blood glucose test strips ......................................................... 21.65 10.82

50 test OP ✔ Optium 5 second test 25 test OP ✔ Optium 5 second test 100 30 100 100 30 ✔ ABM ✔ BD Micro-Fine ✔ BD Micro-Fine ✔ ABM NovoFine ✔ ABM ✔ BD Micro-Fine ✔ BD Micro-Fine

INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ( subsidy) ❋ 29 g x 12.7 mm ...................................................................... 10.50 3.15 ❋ 31 g x 6 mm ........................................................................... 10.50 (26.00) ❋ 31 g x 8 mm ........................................................................... 10.50 3.15

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE –Maximum of 100 dev per prescription ( subsidy) ❋ Syringe 0.3 ml with 29 g x 12.7 mm needle ............................. 13.00 100 ✔ ABM ✔ BD Ultra Fine 1.30 10 (1.99) BD Ultra Fine ❋ Syringe 0.3 ml with 31 g x 8 mm needle ................................. 13.00 100 ✔ ABM ✔ BD Ultra Fine II 1.30 10 (1.99) BD Ultra Fine II ❋ Syringe 0.5 ml with 29 g x 12.7 mm needle ............................. 13.00 100 ✔ ABM ✔ BD Ultra Fine 1.30 10 (1.99) BD Ultra Fine ❋ Syringe 0.5 ml with 31 g x 8 mm needle .................................. 13.00 100 ✔ ABM ✔ BD Ultra Fine II 1.30 10 (1.99) BD Ultra Fine II ❋ Syringe 1 ml with 29 g x 12.7 mm needle ................................ 13.00 100 ✔ ABM ✔ BD Ultra Fine 1.30 10 (1.99) BD Ultra Fine ❋ Syringe 1 ml with 31 g x 8 mm needle ..................................... 13.00 100 ✔ ABM ✔ BD Ultra Fine II 1.30 10 (1.99) BD Ultra Fine II

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

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

Changes to Subsidy and Manufacturer’s Price - effective 1 July 2009 (continued)

34 MUCILAGINOUS LAXATIVES – only on a prescription ( price) ❋ Dry............................................................................................ 8.80 (16.49) MUCILAGINOUS LAXATIVES WITH STIMULANTS ( price) ❋ Dry............................................................................................ 8.80 (16.49) FERROUS FUMARATE ( subsidy) Tab 200 mg .............................................................................. 4.35 FERROUS FUMARATE WITH FOLIC ACID ( subsidy) Tab 310 mg with folic acid 350 µg ............................................ 4.75 500 g OP Normacol 500 g OP Normacol Plus 100 60 ✔ Ferro-tab ✔ Ferro-F-Tabs

38 38 38 42 43

MULTIVITAMINS – Special Authority see SA0963 – Retail pharmacy ( subsidy) Oral Liq ................................................................................... 13.50 150 ml OP ✔ Ketovite Liquid DIPYRIDAMOLE ( subsidy) ❋ Tab 25 mg ................................................................................ 8.36 HEPARIN SODIUM ( subsidy) Inj 1,000 iu per ml, 35 ml ........................................................ 16.00 Inj 5,000 iu per ml, 1 ml .......................................................... 14.00 Inj 5,000 iu per ml, 5 ml ......................................................... 43.67 TERAZOSIN HYDROCHLORIDE ( subsidy) Tab 2 mg .................................................................................. 1.30 (4.66) Tab 5 mg .................................................................................. 1.62 (5.60) LISINOPRIL ( subsidy) ❋ Tab 5 mg .................................................................................. 2.06 ❋ Tab 10 mg ................................................................................ 2.36 ❋ Tab 20 mg ................................................................................ 2.87 FELODIPINE ( subsidy) ❋ Tab long-acting 5 mg .............................................................. 10.73 ❋ Tab long-acting 10 mg ............................................................ 15.60 ECONAZOLE NITRATE ( price) ❋ Crm 1% ..................................................................................... 1.00 (7.48) a) Only on a prescription b) Not in combination Foaming soln 1%, 10 ml sachets ............................................... 9.89 (17.23) a) Only on a prescription b) Not in combination 84 1 5 10 28 Hytrin 28 Hytrin 30 30 30 90 90 20 g OP Pevaryl 3 Pevaryl ✔ Arrow-Lisinopril ✔ Arrow-Lisinopril ✔ Arrow-Lisinopril ✔ Felo 5 ER ✔ Felo 10 ER ✔ Persantin ✔ Mayne ✔ Mayne ✔ Multiparin

54 59

CYPROTERONE ACETATE – Hospital Pharmacy [HP3] – Specialist ( subsidy) Tab 50 mg .............................................................................. 21.10 50 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

✔ Siterone

▲

❋ Three months or six months, as applicable, dispensed all-at-once

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 July 2009 (continued)

84 CEFOXITIN SODIUM – Hospital Pharmacy [HP3]- Specialist – Subsidy by endorsement ( subsidy) Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 1 g ..................................................................................... 55.00 5 ✔ Mayne AZITHROMYCIN – Subsidy by endorsement ( subsidy) a) Maximum of 2 tab per prescription b) Up to 4 tab available on a PSO c) Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly. d) Maximum of 2 tablets per prescription can be waived by Special Authority see SA0964 Tab 500 mg ............................................................................. 5.95 2 OP ✔ Arrow-Azithromycin ERYTHROMYCIN LACTOBIONATE ( subsidy) Inj 1 g ..................................................................................... 10.93 ROXITHROMYCIN ( subsidy) Tab 150 mg .............................................................................. 8.98 Tab 300 mg ............................................................................ 16.48 1 50 50 ✔ Erythrocin IV ✔ Arrow-Roxithromycin ✔ Arrow-Roxithromycin

85 85

TOBRAMYCIN ( subsidy) Inj 40 mg per ml, 2 ml – Hospital pharmacy [HP3] – Subsidy by endorsement ...................................................................... 34.50 5 ✔ Mayne Note – only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. METHADONE HYDROCHLORIDE ( subsidy) 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 ............................................................. 61.00 10 ✔ AFT PETHIDINE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Inj 50 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.20 Inj 50 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 5.50 CYCLIZINE HYDROCHLORIDE ( subsidy) Tab 50 mg ................................................................................ 1.59 BENZTROPINE MESYLATE ( subsidy) Tab 2 mg .................................................................................. 7.99

108

109

5 5 10 60

✔ Mayne ✔ Mayne ✔ Nausicalm ✔ Benztrop

116 118 128

METHYLPHENIDATE HYDROCHLORIDE – Special Authority see SA0908 – Retail pharmacy ( subsidy) Only on a controlled drug form Tab immediate-release 10 mg.................................................... 3.00 30 ✔ Rubifen CYCLOPHOSPHAMIDE ( subsidy) Inj 1 g – PCT – Retail pharmacy - Specialist ............................. 23.65 Inj 2 g – PCT only - Specialist .................................................. 47.30 Inj 1 mg for ECP ........................................................................ 0.03 1 1 1 ✔ Endoxan ✔ Endoxan ✔ Baxter

131

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

S29 Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 July 2009 (continued)

131 IFOSFAMIDE – PCT only - Specialist ( subsidy) Inj 1 g ..................................................................................... 96.00 Inj 2 g ................................................................................... 180.00 Inj 1 mg for ECP ........................................................................ 0.10 ARSENIC TRIOXIDE – PCT only – Specialist ( subsidy) Inj 10 mg ........................................................................... 4,817.00 METHOTREXATE ( subsidy) ❋ Tab 2.5 mg – PCT – Hospital pharmacy [HP3] – Specialist ........ 5.22 PROCARBAZINE HYDROCHLORIDE – PCT only – Specialist ( subsidy) Cap 50 mg ............................................................................ 225.00 TAMOXIFEN CITRATE ( subsidy) ❋ Tab 10 mg .............................................................................. 10.80 ❋ Tab 20 mg .............................................................................. 11.10 PROMETHAZINE HYDROCHLORIDE ( subsidy) ❋ Inj 25 mg per ml, 2 ml – Up to 5 inj available on a PSO ............ 11.00 SALBUTAMOL ( subsidy) Nebuliser soln, 1 mg per ml, 2.5 ml – Up to 30 neb available on a PSO ............................................................................... 3.52 Nebuliser soln, 2 mg per ml, 2.5 ml – Up to 30 neb available on a PSO ............................................................................... 3.70 SALBUTAMOL WITH IPRATROPIUM BROMIDE ( subsidy) Nebuliser soln, 2.5 mg with ipratropium bromide, 0.5 mg per vial, 2.5 ml – Up to 20 neb available on a PSO ....................... 4.29 CHLORAMPHENICOL ( subsidy) Eye oint 1% ............................................................................... 2.37 CHARCOAL ( subsidy) ❋ Oral liq 50 g per 250 ml ........................................................... 43.50 a) Up to 250 ml available on a PSO b) Only on a PSO 1 1 1 mg 10 30 50 100 100 5 ✔ Holoxan ✔ Holoxan ✔ Baxter ✔ AFT S29 ✔ Methoblastin ✔ Natulan S29 ✔ Genox ✔ Genox ✔ Mayne

135 135 138 142 147 149

20 20

✔ Asthalin ✔ Asthalin

150

20 4 g OP

✔ Duolin ✔ Chlorsig

153 158

250 ml OP ✔ Carbosorb-X

Effective 1 June 2009

54 DILTIAZEM HYDROCHLORIDE ( subsidy) ❋ Cap 120 mg .............................................................................. 4.34 ❋ Cap 180 mg .............................................................................. 6.50 ❋ Cap 240 mg .............................................................................. 8.67 OESTROGENS – See prescribing guideline on the preceding page ( price) ❋ Conjugated, equine tab 300 µg .................................................. 3.01 (11.48) ❋ Conjugated, equine tab 625 µg .................................................. 4.12 (11.48) Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 30 30 30 28 Premarin 28 Premarin ✔ Cardizem CD ✔ Cardizem CD ✔ Cardizem CD

▲

❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 June 2009 (continued)

78 OESTROGENS WITH MEDROXYPROGESTERONE – See prescribing guideline on page 76 ( price) ❋ Tab Conjugated 625 µg conjugated equine with 2.5 mg medroxyprogesterone acetate tab (28) ................................... 5.40 28 OP (22.96) Premia 2.5 Continuous ❋ Tab Conjugated 625 µg conjugated equine with 5 mg medroxyprogesterone acetate tab (28) ................................... 5.40 28 OP (22.96) Premia 5 Continuous BENZATHINE BENZYLPENICILLIN ( subsidy) Inj 1.2 mega µ per 2 ml – Up to 5 inj available on a PSO ........ 315.00 ROPINIROLE HYDROCHLORIDE ( subsidy) ▲ Tab 0.25 mg ........................................................................... 19.75 (31.50) ▲ Tab 0.25 mg x 42, 0.5 mg x 42, and 1 mg x 21 ....................... 21.92 (35.70) ▲ Tab 0.25 mg x 42, 1 mg x 42, and 2 mg x 63 .......................... 73.60 (122.11) ▲ Tab 1 mg ................................................................................ 40.32 (67.20) ▲ Tab 2 mg ................................................................................ 60.72 (101.21) ▲ Tab 5 mg ................................................................................ 90.00 (150.00) 132 10 210 Requip 105 OP Requip Starter Pack 147 OP Requip Follow-on Pack 84 Requip 84 Requip 84 Requip ✔ Calcium Folinate Ebewe ✔ Calcium Folinate Ebewe ✔ Calcium Folinate Ebewe ✔ Baxter ✔ Biomed ✔ Bicillin LA

86 118

CALCIUM FOLINATE – PCT – Hospital pharmacy [HP3]-Specialist ( subsidy) Inj 100 mg – PCT only – Specialist ............................................ 9.75 1 Inj 300 mg – PCT only – Specialist ......................................... 30.00 Inj 1 g – PCT only – Specialist .............................................. 100.00 1 1

133

GEMCITABINE HYDROCHLORIDE ( subsidy) Inj 1 mg for ECP ........................................................................ 0.26

1 mg

Effective 1 May 2009

25 CALCIUM CARBONATE WITH AMINOACETIC ACID ( alternate subsidy) ❋ Tab 420 mg with aminoacetic acid 180 mg - Higher subsidy of $6.30 per 100 with Endorsement ........................................... 3.00 100 (6.30) Titralac Additional subsidy by endorsement is available for pregnant women. The prescription must be endorsed accordingly ACARBOSE ( subsidy) – Special Authority see SA0925 – Retail pharmacy ❋ Tab 50 mg .............................................................................. 16.50 ❋ Tab 100 mg ............................................................................ 26.70 90 90 ✔ Glucobay ✔ Glucobay

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

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

Changes to Subsidy and Manufacturer’s Price - effective 1 May 2009 (continued)

31 COPPER ( price) ❋ Tab Diagnostic – Not on a BSO .................................................. 5.02 (31.80) GLUCOSE OXIDASE ( price) Urine diagnostic test with peroxidase – Not on a BSO ................. 4.13 (8.65) 4.11 (6.26) GLUCOSE OXIDASE ( price) Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid – Not on a BSO ......................................................................... 4.53 (14.87) SODIUM NITROPRUSSIDE ( price) ❋ Urine diagnostic strip, buffered – Not on a BSO .......................... 3.40 (10.94) SIMVASTATIN ( subsidy)– See prescribing guidelines on page 45 ❋ Tab 10 mg ................................................................................ 0.68 (11.37) ❋ Tab 20 mg ................................................................................ 1.00 (11.67) ❋ Tab 40 mg ................................................................................ 1.78 (12.41) ❋ Tab 80 mg ................................................................................ 3.88 (14.39) SIMVASTATIN ( subsidy)– See prescribing guidelines on page 45 ❋ Tab 80 mg ................................................................................ 3.88 FUROSEMIDE ( subsidy) ❋ Tab 40 mg - Up to 30 tab available on a PSO ........................... 10.75 CICLOPIROXOLAMINE ( subsidy) a) Only on a prescription b) not in combination Nail soln 8% ........................................................................... 19.85 ERYTHROMYCIN ETHYL SUCCINATE ( subsidy) Tab 400 mg - Up to 30 tab available on a PSO ........................ 16.95 AMOXYCILLIN CLAVULANATE ( subsidy) Tab amoxycillin 500 mg with potassium clavulanate 125 mg - Up to 30 tab available on a PSO ........................................... 5.02 (6.40) HYDROXYCHLOROQUINE SULPHATE ( subsidy) ❋ Tab 200 mg ............................................................................ 22.50 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 36 OP Clinitest 50 strip OP Clinistix Diastix

50 strip OP Keto-Diastix 50 strip OP Ketostix 30 30 30 30 Lipex 30 1,000 ✔ SimvaRex ✔ Diurin 40 ✔ SimvaRex Lipex ✔ SimvaRex Lipex ✔ SimvaRex Lipex

47 55 59

3.5 ml OP ✔ Batrafen 100 ✔ E-Mycin

85 86

20 Augmentin 100 ✔ Plaquenil

▲

❋ Three months or six months, as applicable, dispensed all-at-once

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 May 2009 (continued)

99 IBUPROFEN ( subsidy) ❋ Tab 200 mg .............................................................................. 1.60 (1.78) 100 I-Profen

108

METHADONE HYDROCHLORIDE ( subsidy) 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 ‡ Oral liq 2 mg per ml ................................................................... 5.95 200 ml ✔ Biodone ‡ Oral liq 5 mg per ml ................................................................... 5.55 200 ml ✔ Biodone Forte ‡ Oral liq 10 mg per ml .................................................................. 8.95 200 ml ✔ Biodone Extra Forte ENTACAPONE ( subsidy) ▲ Tab 200 mg .......................................................................... 116.00 LEVOCABASTINE ( price) Eye drops 0.5 mg per ml ........................................................... 8.71 (10.34) 100 4 ml OP Livostin ✔ Comtan

117 154

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

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

Changes to Brand name

Effective 1 July 2009

53 SOTALOL ❋ Tab 80 mg ............................................................................. 27.50 ❋ Tab 160 mg ........................................................................... 10.50 500 100 ✔ Mylan Pacific ✔ Mylan Pacific

Changes to Description

Effective 1 May 2009

86 BENZATHINE BENZYLPENICILLIN Inj 1.2 mega u per 2 2.3 ml – Up to 5 inj available on a PSO... 200.00 10 ✔ Bicillin LA

Changes to General Rules

Effective 1 July 2009

17 “Unapproved Indication” means, for a Pharmaceutical, an indication for which it is not approved under the Medicines Act 1981. Pracititioners prescribing Pharmaceuticals for Unapproved Indications should be aware of, and comply with, their obligations under Section 25 and/or Section 29 of the Medicines Act 1981 and as set out in Section A: General Rules, Part IV (Miscellaneous Provisions) rule 4.6.

Changes to Sole Subsidised Supply

Effective 1 July 2009

For the list of new Sole Subsidised Supply products effective 1 July 2009 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 14-19.

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 July 2009

44 WATER 1) on a prescription or Practitioner’s Supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent; or 2) on a bulk supply order; or 3) When used in the extemporaneous compounding of eye drops. Purified for inj 2 ml – Up to 5 inj available on a PSO ................... 2.19 5 ✔ Baxter Purified for inj 2 ml – Up to 5 inj available on a PSO ................. 21.90 50 ✔ Baxter CROTAMITON a) Only on a prescription b) Not in combination Lotn 10% ................................................................................. 7.56 (7.70) FLUOROURACIL SODIUM Inj 500 mg per 20 ml – PCT only – Specialist........................... 55.60

50 ml Eurax 10 ✔ Mayne

133 172

PAEDIATRIC ORAL FEED 1.5KCAL/ML –Special Authority see SA0986 – Hospital pharmacy [HP3] Liquid (chocolate) ..................................................................... 1.27 200 ml OP ✔ Resource Just for Kids Liquid (vanilla)........................................................................... 1.27 200 ml OP ✔ Resource Just for Kids GLUTEN FREE PASTA – Special Authority see SA0722 – Hospital pharmacy [HP3] Corn and Parsley fettucine ......................................................... 2.00 250 g OP (2.63)

184

Orgran

Effective 1 June 2009

53 54 97 104 DOXAZOSIN MESYLATE ❋ Tab 4 mg .................................................................................. 6.37 Note – the 500 tablet pack size remains listed 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 ALLOPURINOL Tab 100 mg ............................................................................ 10.88 (11.45) Tab 300 mg ............................................................................ 20.15 (21.20) CARBAMAZEPINE ❋ Tab 200 mg ........................................................................... 29.06 Note – the 100 tablet pack size remains listed 10 ✔ Apo-Doxazosin

60 100 30 30 30 500

✔ Dilzem SR ✔ Dilzem SR ✔ Dilzem LA ✔ Dilzem LA ✔ Stocrin

Progout 500 Progout 200 ✔ Tegretol

112

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

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

Delisted Items – effective 1 May 2009

49 77 107 DOXAZOSIN MESYLATE ❋ Tab 2 mg ................................................................................. 4.81 Note – the 500 tablet pack listed 1 November 2008 OESTRADIOL VALERATE – See prescribing guideline ❋ Tab 2 mg ................................................................................. 4.12 PARACETAMOL ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 1.38 (14.67) PARACETAMOL ❋ Tab 500 mg ......................................................................... 137.81 (1,467.00) 100 ✔ Apo-Doxazosin

28 150

✔ Progynova

Panadol 15,000 Panadol

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 August 2009

84 MEBENDAZOLE Tab 100 mg .............................................................................. 2.53 (7.43) 4 Vermox

Effective 1 October 2009

49 TERAZOSIN HYDROCHLORIDE ❋ Tab 2 mg .................................................................................. 1.30 (4.66) ❋ Tab 5 mg .................................................................................. 1.62 (5.60) AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg .............................................................................. 25.00 28 Hytrin 28 Hytrin 100

142

✔ Thioprine

Effective 1 November 2009

172 PAEDIATRIC ORAL FEED 1.5KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.60 200 ml OP ✔ Fortini Liquid (vanilla)........................................................................... 1.60 200 ml OP ✔ Fortini PAEDIATRIC ORAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid (chocolate) ..................................................................... 1.60 200 ml OP ✔ Fortini Multifibre Liquid (strawberry) .................................................................... 1.60 200 ml OP ✔ Fortini Multifibre Liquid (vanilla)........................................................................... 1.60 200 ml OP ✔ Fortini Multifibre

172

Effective 1 December 2009

25 CALCIUM CARBONATE WITH AMINOACETIC ACID ❋ Tab 420 mg with aminoacetic acid 180 mg – Higher subsidy of $38.73 per 1000 with Endorsement ................................. 30.00 (38.73) PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy Tab 15 mg ............................................................................. 45.78 Tab 30 mg ............................................................................. 70.43 Tab 45 mg ............................................................................. 89.39

1,000 Titralac 28 28 28 ✔ Actos ✔ Actos ✔ Actos

GLUCOSE OXIDASE Urine diagnostic test with peroxidase, sodium nitroprusside and aminoacetic acid – Not on a BSO .................................... 4.53 50 stick OP (8.00) Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid – Not on a BSO ... 4.53 50 strip OP (14.87)

Keto-Diabur 5000 Keto-Diastix

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

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

Items to be delisted - effective 1 December 2009 (continued)

32 SODIUM NITROPRUSSIDE ❋ Urine diagnostic strips, buffered – Not on a BSO ........................ 3.39 (6.00) 3.40 (10.94) OIL IN WATER EMULSION ❋ Crm........................................................................................... 2.80 WOOL FAT WITH MINERAL OIL – Only on a prescription ❋ Lotn hydrous 3% with mineral oil ............................................... 5.60 (9.54) ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab ........................................................................................... 6.62 (9.45) OESTRADIOL WITH LEVONORGESTREL ❋ Tab 2 mg with 75 µg levonorgestrel (36) and tab 2 mg Oestradiol (48) .................................................................... 16.20 EFAVIRENZ – Special Authority see SA0779 – Hospital pharmacy [HP1] Tab 50 mg ............................................................................ 158.33 Tab 200 mg .......................................................................... 474.99 INDOMETHACIN ❋ Cap 25 mg ................................................................................ 5.90 NORTRIPTYLINE HYDROCHLORIDE Tab 25 mg .............................................................................. 20.06 Note: Norpress tab 25 mg 180 tablet pack size listed 1 May 2009 PILOCARPINE ❋ Eye drops 0.5% ......................................................................... 3.19 50 strip OP Ketur-Test Ketostix 500g 1,000 ml Hydroderm Lotion 84 ✔ Lemnis Fatty Cream

63 64

Triquilar ED

84 30 90 100 250

✔ Nuvelle

✔ Stocrin ✔ Stocrin

100 110

✔ Rheumacin ✔ Norpress

156 176

15 ml OP

✔ Pilopt

ENTERAL FEED WITH FIBRE 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ........................................................................................ 1.24 250 ml OP ✔ Fibersource 5.29 1,000 ml OP ✔ Fibersource RTH

Effective 1 January 2010

64 87 WOOL FAT WITH MINERAL OIL – Only on a prescription ❋ Lotn hydrous 3% with mineral oil .............................................. 1.40 (2.92) CO-TRIMOXAZOLE ❋ Oral liq sugar-free trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml – Up to 200 ml available on a PSO .................. 5.90 250 ml OP Hydroderm Lotion

500 ml

✔ Trisul

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be delisted - effective 1 January 2010 (continued)

147 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab long-acting 6 mg ............................................................... 2.70 (7.73) 5.40 (12.56) PILOCARPINE ❋ Eye drops 2% ........................................................................... 4.32 20 Polaramine Repetab 40 Polaramine Repetab 15 ml OP ✔ Pilopt

156

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

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

Section H changes to Part I

Effective 1 May 2009

14 Discretionary Community Supply Pharmaceuticals 8.1 Discretionary Community Supply Pharmaceuticals are deemed to include every medicine, therapeutic medical device, or related product or related thing listed in Section H Part IV of the Schedule. 8.2 PHARMAC may, in its discretion, list any pharmaceutical that is not a Community Pharmaceutical as a Discretionary Community Supply Pharmaceutical, including a pharmaceutical that PHARMAC is made aware of by HPAC, the Exceptional Circumstances Panel, a DHB Hospital or relevant hospital personnel. 8.3 A DHB Hospital may use its discretion to purchase Discretionary Community Supply Pharmaceuticals for use in the community, provided that, if the patient being treated with a Discretionary Community Supply Pharmaceutical usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. 8.4 The funding of a Discretionary Community Supply Pharmaceutical for use in the community will be sourced from the relevant DHBs own budget. For the avoidance of doubt, the Discretionary Community Supply Pharmaceutical is not a Community Pharmaceutical and funding is not available for Discretionary Community Supply Pharmaceuticals from the Pharmaceutical Budget. 8.5 Subject to rule 8.6, DHB Hospitals must not fund for use in the community, any pharmaceuticals that are not Discretionary Community Supply Pharmaceuticals unless they have been approved under Hospital Exceptional Circumstances. 8.6 DHB Hospitals may fund from their own budgets, any Pharmaceutical that is listed in Sections A-G of the Pharmaceutical Schedule without Hospital Exceptional Circumstances (HEC) approval provided that: (a) the condition for which that Pharmaceutical is supplied is consistent with any restrictions applying to that Pharmaceutical in Section A-G of the Pharmaceutical Schedule; and (ba) (i) up to 5 days treatment, or one original pack, (where inappropriate to provide less); or (ii) more than 5 days treatment, provided that the relevant DHB Hospital has a dispensing for discharge policy and the quantity supplied is in accordance with that policy; and (b) the Pharmaceutical is supplied consistent with any restrictions applying to that Pharmaceutical in Section A-G of the Pharmaceutical Schedule. Note dispensing for discharge as described in rule 8.6 is at the discretion of individual DHBs.

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II

Effective 1 July 2009

ACICLOVIR (expiry of HSS) Tab dispersible 200 mg ..................Lovir 1.98 25 1% Jun-07 Acicvir Alpha-Aciclovir Global Aciclovir Zovirax Acicvir Alpha-Aciclovir Global Aciclovir Zovirax Acicvir Alpha-Aciclovir Global Aciclovir Zovirax

Tab dispersible 400 mg ..................Lovir

6.64

Jun-07

Tab dispersible 800 mg ..................Lovir

7.38

Jun-07

ACITRETIN (new listing) Cap 10 mg .....................................Neotigason Cap 25 mg .....................................Neotigason ACTIVATED CHARCOAL ( price) Oral liq 50 g per 250 ml ..................Carbosorb-X ALPROSTADIL (continuation of HSS) Inj 0.5 mg per ml, 1 ml ...................Prostin VR AMIKACIN SULPHATE Inj 5 mg per ml, 5 ml (expiry of HSS) ..........................Biomed Inj 250 mg per ml, 2 ml (delisted 1 July 2009) ................Amikin

75.80 162.96 43.50 1,417.50

100 100 250 ml 5 1% Sept-09 (B)

88.00 15.00

10 1

1% 1%

Nov-06 Sept-06 Sept-09 Oct-06

(B) (B) (B) (B)

LIPOSOMAL AMPHOTERICIN B (amended description and continuation of HSS) Liposomal inj 50 mg vial ................AmBisome 3,450.00 10 1% APOMORPHINE HYDROCHLORIDE (expiry of HSS) Inj 10 mg per ml, 1 ml ....................Mayne ARSENIC TRIOXIDE (new listing) Inj 10 mg........................................AFT ATENOLOL (expiry of HSS) Tab 50 mg......................................Pacific Atenolol Tab 100 mg....................................Pacific Atenolol 50.43 4,817.00 6.50 11.30 5 10 500 500 1% 1% 1%

Sept-06 Sept-06

Anselol Apo-Atenolol Global Atenolol Anselol Apo-Atenolol Global Atenolol

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

ATRACURIUM BESYLATE ( price and addition of HSS) Inj 10 mg per ml, 2.5 ml .................Tracrium 12.55 5 1% Sept-09 Hospira Inj 10 mg per ml, 5 ml ....................Tracrium 26.04 5 1% Sept-09 Hospira Note – Mayne’s brand of atracurium besylate inj 10 mg per ml, 2.5 ml and 5 ml to be delisted 1 September 2009 ATROPINE SULPHATE (expiry of HSS) Inj 600 µg, 1 ml..............................AstraZeneca Inj 1200 µg, 1 ml............................AstraZeneca AZITHROMYCIN ( price and continuation of HSS) Tab 500 mg....................................ArrowAzithromycin BECLOMETHASONE DIPROPIONATE (new listing) Aerosol inhaler, 50 µg per dose CFC-free ............................Beclazone 50 Aerosol inhaler, 100 µg per dose CFC-free ............................Beclazone 100 Aerosol inhaler, 250 µg per dose CFC-free ............................Beclazone 250 BECLOMETHASONE DIPROPIONATE (expiry of HSS) Metered aqueous nasal spray, 50 µg per dose ..........................Alanase Metered aqueous nasal spray, 100 µg per dose ........................Alanase BENZTROPINE MESYLATE (new listing) Tab 2 mg........................................Benztrop BETAMETHASONE VALERATE (expiry of HSS) Scalp app 0.1% .............................Beta Scalp BEZAFIBRATE ( price and expiry of HSS) Tab long-acting 400 mg..................Bezalip Retard 26.00 32.00 5.95 50 50 2 1% 1% 1% Dec-06 Dec-06 Sept-09 Pfizer (B) Zithromax

8.54 12.50 22.67

200 dose 200 dose 200 dose

2.35

200 doses 200 doses 60 100 ml 30 50 25 50

Dec-06

Aldecin Atomase Beconase Atomase Beconase

2.46

Dec-06

7.99 5.25 5.70

1% 5%

Dec-06 Apr-08

(B) (B)

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP (new listing) Blood glucose test strips.................FreeStyle Lite 21.65 Optium 5 10.82 second test Optium 5 21.65 second test BLOOD GLUCOSE DIAGNOSTIC TEST METER (new listing) Meter .............................................FreeStyle Lite 9.00 BOSENTAN (new listing) Tab 62.5 mg...................................Tracleer Tab 125 mg....................................Tracleer Products with Hospital Supply Status (HSS) are in bold. 4,585.00 4,585.00

1 60 60 (B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

BUPIVACAINE HYDROCHLORIDE (amended description and continuation of HSS) Inj 0.25%, per 20 ml ( price) .........Marcain 35.00 5 1% Inj 0.5%, per 10 ml theatre pack......Marcain 28.00 5 1% Inj 0.5%, per 10 ml ( price) ...........Marcain 35.00 50 1% Inj 0.5%, per 20 ml theatre pack ( price).....................................Marcain 25.00 5 1% Sept-09 Sept-09 Sept-09 Sept-09 Pfizer Pfizer Pfizer (B)

BUPIVACAINE HYDROCHLORIDE WITH ADRENALINE (new listing and addition of HSS) Inj 0.25% with 1:400,000 adrenaline, 10 ml .......................Marcain with 134.76 5 1% Sept-09 Adrenaline Inj 0.5% with 1:200,000 adrenaline, 20 ml .......................Marcain with 115.40 5 1% Sept-09 Adrenaline BUPROPION HYDROCHLORIDE (new listing) Tab modified-release 150 mg .........Zyban CAFFEINE CITRATE (expiry of HSS) Inj 10 mg per ml, 2.5 ml .................Biomed Oral liq 10 mg per ml ......................Biomed CALCITRIOL (expiry of HSS) Cap 0.25 µg ..................................Calcitriol-AFT Cap 0.5 µg .....................................Calcitriol-AFT CARBOPLATIN (expiry of HSS) Inj 10 mg per ml, 5 ml ....................Carboplatin Ebewe Inj 10 mg per ml, 15 ml ..................Carboplatin Ebewe Inj 10 mg per ml, 45 ml ..................Carboplatin Ebewe CEFOXITIN SODIUM ( price) Powder for inj 1 g ...........................Mayne CHLORAMPHENICOL (expiry of HSS) Eye drops 0.5% .............................Chlorsig CHLORAMPHENICOL ( price and continuation of HSS) Eye oint 1% ...................................Chlorsig CHLORHEXIDINE (expiry of HSS) Crm 1% obstetric ............................Orion CHLORTHALIDONE (expiry of HSS) Tab 25 mg......................................Hygroton 65.00 50.70 13.50 13.45 24.95 12.00 18.70 55.50 30 5 25 ml 100 100 1 1 1 1% 1% 1% 1% 1% 1% 1% Nov-06 Nov-06 Feb-07 Feb-07 Jan-07 Jan-07 Jan-07

(B) (B)

(B) (B) Rocaltrol Rocaltrol (B) Mayne Mayne

55.00 1.40 2.37 1.70 8.00

5 10 ml 4g 50 g 50 1% 1% 1% 1% Dec-06 Sept-09 Sept-06 Nov-06 (B) (B) PSM (B)

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

CIPROFLOXACIN (expiry of HSS) Inj 2 mg per ml, 100 ml ..................Aspen Ciprofloxacin 75.00 10 1% Sept-07 Ciproxin Ciprofloxacin (AFT) m-Ciprofloxacin Topistin Ufexil Dermovate (B) (B) Marzine

CLOBETASOL PROPIONATE (expiry of HSS) Crm 0.05% ....................................Dermol CLOSTRIDUM BOTULINUM (expiry of HSS) Inj 500 u.........................................Dysport COCAINE (expiry of HSS) Soln 4%, 2 ml .................................Biomed

2.35 1,295.00 25.46

30 g 2 1 10 1 1 10

1% 1% 1% 1%

Dec-06 Sept-06 Nov-06 Sept-09

CYCLIZINE HYDROCHLORIDE ( price and continuation of HSS) Tab 50 mg......................................Nausicalm 1.59 CYCLOPHOSPHAMIDE ( price) Inj 1 g.............................................Endoxan Inj 2 g.............................................Endoxan CYCLOSPORIN (addition of HSS) Inf 50 mg per ml, 5 ml ....................Sandimmun CYPROTERONE ACETATE Tab 50 mg ( price and continuation of HSS) Siterone Tab 100 mg (new listing) ................Siterone DACARBAZINE (expiry of HSS) Inj 200 mg......................................Mayne DACLIZUMAB (expiry of HSS) Inj 25 mg per 5 ml vial ....................Zenapax DALTEPARIN SODIUM (expiry of HSS) Inj 2,500 iu per 0.2 ml prefilled syringe..........................Fragmin Inj 5,000 iu per 0.2 ml prefilled syringe..........................Fragmin Inj 7,500 iu per 0.75 ml graduated syringe ......................Fragmin Inj 10,000 iu per 1 ml graduated syringe ......................Fragmin Inj 12,500 iu per 0.5 ml prefilled syringe..........................Fragmin Products with Hospital Supply Status (HSS) are in bold. 23.65 47.30 276.30

Sept-09

(B)

21.10 41.50 43.86 635.00

50 50 1 1

1% 1% 1% 5%

Sept-09 Sept-09 Aug-06 Apr-06

Pacific Cyproterone Procur Procur (B) (B)

49.00 52.30 78.85 105.12 84.50

10 10 10 10 5

1% 1% 1% 1% 1%

Nov-06 Nov-06 Nov-06 Nov-06 Nov-06

(B) (B) (B) (B) (B) continued...

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

continued... Inj 15,000 iu per 0.6 ml prefilled syringe..........................Fragmin Inj 18,000 iu per 0.72 ml prefilled syringe..........................Fragmin DANTROLENE SODIUM (expiry of HSS) Cap 25 mg .....................................Dantrium Cap 50 mg .....................................Dantrium Inj 1 mg per ml, 20 ml ....................Dantrium IV DAUNORUBICIN (new listing) Inj 2 mg per ml, 10 ml ....................Pfizer 105.00 125.00 32.96 51.70 800.00 99.00 5 5 100 100 6 1 5 5 1 500 500 2.5 ml 2.5 ml 1% 1% Sept-06 Sept-06 (B) (B) 1% 1% 1% Aug-06 Aug-06 Dec-06 (B) (B) (B) 1% 1% 1% 1% 1% Nov-06 Nov-06 Sept-06 Sept-06 Nov-06 (B) (B) (B) (B) (B)

DEXAMETHASONE SODIUM PHOSPHATE (expiry of HSS) Inj 4 mg per ml, 1 ml ......................Mayne 21.50 Inj 4 mg per ml, 2 ml ......................Mayne 31.00 DEXTROSE (expiry of HSS) Inj 50%, 90 ml ................................Biomed 11.25

DIAZEPAM (new listing) 2 mg ..............................................Arrow-Diazepam 11.44 5 mg ..............................................Arrow-Diazepam 13.71 DINOPROSTONE (expiry of HSS) Gel 1 mg ........................................Prostin E2 Gel 2 mg ........................................Prostin E2 52.65 64.60

DOCUSATE SODIUM WITH SENNOSIDES (expiry of HSS) Tab 50 mg with total sennosides 8 mg.........Laxsol 7.98 DOPAMINE HYDROCHLORIDE (expiry of HSS) Inj 40 mg per ml, 5 ml ....................Mayne DOXORUBICIN (expiry of HSS) Inj 10 mg........................................Doxorubicin Ebewe Inj 50 mg........................................Doxorubicin Ebewe Inj 100 mg......................................Doxorubicin Ebewe Inj 200 mg......................................Doxorubicin Ebewe EPHEDRINE SULPHATE (expiry of HSS) Inj 30 mg per ml, 1 ml ....................Mayne 54.00 8.80 39.40 81.00 162.00

200 5 1 1 1 1

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

Sept-06 Oct-06 Sept-06 Sept-06 Sept-06 Sept-06

(B) (B) Adriamycin Asta Medica Mayne Adriamycin Asta Medica Mayne Mayne Adriamycin Mayne (B)

44.00

Oct-06

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

EPIRUBICIN Inj 2 mg per ml, 5 ml ......................Epirubicin Ebewe Inj 2 mg per ml, 25 ml ....................Epirubicin Ebewe Inj 2 mg per ml, 50 ml ....................Epirubicin Ebewe Inj 2 mg per ml, 100 ml ..................Epirubicin Ebewe ERGOMETRINE MALEATE (expiry of HSS) Inj 500 µg per ml, 1 ml ...................Mayne ERYTHROMYCIN LACTOBIONATE ( price) Inj 1 g.............................................Erythrocin IV ERYTHROPOIETIN BETA (expiry of HSS) Inj 2,000 iu prefilled syringe ............NeoRecormon Inj 3,000 iu prefilled syringe ............NeoRecormon Inj 4,000 iu prefilled syringe ............NeoRecormon Inj 5,000 iu prefilled syringe ............NeoRecormon Inj 6,000 iu prefilled syringe ............NeoRecormon Inj 10,000 iu prefilled syringe ..........NeoRecormon ETOPOSIDE (expiry of HSS) Cap 50 mg .....................................Vepesid Cap 100 mg ...................................Vepesid FELODIPINE ( price and addition of HSS) Tab long-acting 5 mg......................Felo 5 ER Tab long-acting 10 mg....................Felo 10 ER FERROUS FUMARATE ( price) Tab 200 mg....................................Ferro-tab FERROUS FUMARATE WITH FOLIC ACID ( price) Tab 310 mg with folic acid 350 µg........................Ferro-F-Tabs FLUCLOXACILLIN (expiry of HSS) Grans for oral liq 125 mg per 5 ml ........................AFT Grans for oral liq 250 mg per 5 ml ........................AFT 24.70 123.50 247.00 494.00 1 1 1 1 1% 1% 1% 1% Sept-06 Sept-06 Sept-06 Sept-06 Mayne Pharmorubicin Mayne Pharmorubicin (B) Pharmorubicin

11.60 10.93 152.04 228.06 304.08 380.10 456.12 760.20 340.73 340.73 10.73 15.60 4.35

5 1 6 6 6 6 6 6 20 10 90 90 100

Sept-06

(B)

5% 5% 5% 5% 5% 5% 1% 1% 1% 1%

Apr-06 Apr-06 Apr-06 Apr-06 Apr-06 Apr-06 Sept-06 Sept-06 Sept-09 Sept-09

(B) (B) (B) (B) (B) (B) (B) (B) Plendil ER Plendil ER

4.75

2.05

100 ml

Sept-06

Floxapen Flucloxin Staphlex Floxapen Flucloxin Staphlex

2.72

100 ml

Sept-06

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

FLUCLOXACILLIN SODIUM (expiry of HSS) Cap 250 mg ...................................Staphlex Cap 500 mg ...................................Staphlex FLUCONAZOLE (expiry of HSS) Inj 2 mg per ml, 50 ml ....................m-Fluconazole Oral liq 10 mg per ml ......................Diflucan POS FLUDARABINE PHOSPHATE (pack size change) Tab 10 mg......................................Fludara Oral 18.50 57.90 250 500 1% 1% Sept-06 Sept-06 AFT Flucloxin AFT Flucloxin Diflucan IV (B) (B)

7.10 34.56

1 35 ml

1% 1%

Feb-07 Nov-06 Nov-08

867.00 20 15 1% 650.25 Note – Fludara tab 10 mg 20 tab pack replaces the 15 tab pack from 1 July 2009. FLUOROMETHOLONE (new listing and addition of HSS) Eye drops 0.1% ..............................FML 4.05 Note – Flucon eye drops 0.1% to be delisted 1 September 2009. GENTAMICIN SULPHATE (expiry of HSS) Inj 40 mg per ml, 2 ml ...................Pfizer GLYCERYL TRINITRATE (expiry of HSS) Inj 1 mg per ml, 5 ml ......................Nitronal Inj 1 mg per ml, 50 ml ....................Nitronal Inj 5 mg per ml, 10 ml ....................Mayne HEPARINISED SALINE (expiry of HSS) Inj 10 iu per ml, 5 ml ......................AstraZeneca HEPARIN SODIUM Inj 1,000 iu per ml, 1 ml (expiry of HSS) ..........................Mayne Inj 5,000 iu per ml, 1 ml ( price)....Mayne HYDRALAZINE (expiry of HSS) Inj 20 mg per ml, 1 ml ....................Apresoline HYDROCORTISONE (expiry of HSS) Tab 5 mg........................................Douglas Tab 20 mg......................................Douglas HYDROCORTISONE ACETATE (expiry of HSS) Rectal foam 10%, CFC-Free (14 applications) .......................Colifoam IDARUBICIN HYDROCHLORIDE (expiry of HSS) Cap 5 mg .......................................Zavedos Cap 10 mg .....................................Zavedos Inj 5 mg..........................................Zavedos Inj 10 mg........................................Zavedos Products with Hospital Supply Status (HSS) are in bold. 4.56 21.00 80.01 40.00 18.00 5 ml 1%

Sept-09

Flucon

10 10 10 5 50

1% 1% 1% 1% 1%

Aug-06 Nov-06 Nov-06 Sept-06 Sept-06

Mayne (B) (B) (B) Baxter Pfizer

66.80 14.20 25.90 7.95 19.95

50 5 5 100 100

Oct-06

(B)

1% 1% 1%

Sept-06 Dec-06 Dec-06

(B) (B) (B)

21.10 80.75 144.50 170.00 340.00

21.1 g 1 1 1 1

1% 1% 1% 1% 1%

Dec-06 Aug-06 Aug-06 Aug-06 Aug-06

(B) (B) (B) (B) (B)

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

IFOSFAMIDE ( price) Inj 1 g.............................................Holoxan Inj 2 g.............................................Holoxan ILOPROST (new listing) Inf 100 µg per ml, 0.5 ml ................Ilomedin Nebuliser soln 10 µg per ml, 2 ml ...Ventavis IMIPRAMINE HYDROCHLORIDE (expiry of HSS) Tab 10 mg......................................Tofranil Tab 25 mg......................................Tofranil INDAPAMIDE (expiry of HSS) Tab 2.5 mg.....................................Napamide INSULIN PEN NEEDLES ( price) 29 g x 12.7 mm..............................ABM 31 g x 6 mm...................................ABM 31 g x 8 mm...................................ABM 96.00 180.00 925.00 1,185.00 5.48 8.80 4.00 10.50 10.50 10.50 1 1 5 30 50 50 100 100 100 100 1% 1% 1% Dec-06 Dec-06 Dec-06 (B) (B) Naplin

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE ( price) Syringe 0.3 ml with 29 g x 12.7 mm needle ..............ABM 13.00 100 Syringe 0.3 ml with 31 g x 8 mm needle ...................ABM 13.00 100 Syringe 0.5 ml with 29 g x 12.7 mm needle ..............ABM 13.00 100 Syringe 0.5 ml with 31 g x 8 mm needle ...................ABM 13.00 100 Syringe 1 ml with 29 g x 12.7 mm needle ..............ABM 13.00 100 Syringe 1 ml with 31 g x 8 mm needle ...................ABM 13.00 100 IODIXANOL (expiry of HSS) Inj 270 mg per ml (iodine equivalent), 50 ml ...........Visipaque Inj 270 mg per ml (iodine equivalent), 100 ml .........Visipaque Inj 320 mg per ml (iodine equivalent), 50 ml ...........Visipaque Inj 320 mg per ml (iodine equivalent), 100 ml .........Visipaque Inj 320 mg per ml (iodine equivalent), 200 ml .........Visipaque

235.60 471.30 235.60 471.30 565.56

10 10 10 10 6

5% 5% 5% 5% 5%

Mar-07 Mar-07 Mar-07 Mar-07 Mar-07

(B) (B) (B) (B) (B)

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

IOHEXOL (expiry of HSS) Inj 240 mg per ml (iodine equivalent), 50 ml ......................Omnipaque 88.00 10 5% Mar-07 Iomeron Isovue 50 ml & 100 ml Optiray Ultravist Iomeron Isovue Optiray 20 ml & 30 ml Ultravist Iomeron Isovue Optiray Ultraject 50 ml & 75 ml Ultravist Iomeron Isovue Optiray 100 ml, 150 ml & 200 ml Ultraject 125 ml Ultravist (B) Iomeron Isovue Optiray 20 ml & 30 ml Ultraject 30 ml Ultravist 30 ml Iomeron Isovue Optiray Ultraject Ultravist Iomeron Optiray Ultraject Iomeron Isovue Optiray Ultraject 100 ml & 125 ml continued...

Inj 300 mg per ml (iodine equivalent), 20 ml ......................Omnipaque

35.40

Mar-07

Inj 300 mg per ml (iodine equivalent), 50 ml ......................Omnipaque

88.00

Mar-07

Inj 300 mg per ml (iodine equivalent), 100 ml ....................Omnipaque

176.00

Mar-07

Inj 300 mg per ml (iodine equivalent), 500 ml ....................Omnipaque Inj 350 mg per ml (iodine equivalent), 20 ml ......................Omnipaque

527.88 35.40

6 6

5% 5%

Mar-07 Mar-07

Inj 350 mg per ml (iodine equivalent), 50 ml ......................Omnipaque

88.00

Mar-07

Inj 350 mg per ml (iodine equivalent), 75 ml ......................Omnipaque Inj 350 mg per ml (iodine equivalent), 100 ml ....................Omnipaque

132.00

Mar-07

176.00

Mar-07

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

continued... Inj 350 mg per ml (iodine equivalent), 200 ml ....................Omnipaque 211.20 6 5% Mar-07 Ultravist Iomeron Isovue Optiray Ultravist (B) (B) (B) Aerrane Rhodia Imtrate Oratane Roaccutane Oratane Roaccutane

Inj 350 mg per ml (iodine equivalent), 500 ml ....................Omnipaque IRINOTECAN (expiry of HSS) Inj 20 mg per ml, 2 ml ....................Camptosar Inj 20 mg per ml, 5 ml ....................Camptosar ISOFLURANE (expiry of HSS) Liq 250 ml bottle ...........................Forthane ISOSORBIDE MONONITRATE (expiry of HSS) Tab long-acting 60 mg....................Duride ISOTRETINOIN (expiry of HSS) Cap 10 mg .....................................Isotane 10 Cap 20 mg .....................................Isotane 20

879.80 124.00 310.00 99.00

10 1 1 250 ml

5% 1% 1% 1%

Mar-07 Sept-06 Sept-06 Jan-07

4.15 36.00 47.50

90 100 100

1% 1% 1%

Sept-06 Sept-06 Sept-06

KETONE BLOOD BETA-KETONE ELECTRODES (new listing) Test strips ......................................Optium Blood 8.50 Ketone Test Strips LEVODOPA WITH BENSERAZIDE (expiry of HSS) Cap 50 mg with benserazide 12.5 mg..................Madopar 62.5 Tab dispersible 50 mg with benserazide 12.5 mg..................Madopar Dispersible Cap 100 mg with benserazide 25 mg.....................Madopar 125 Cap long-acting 100 mg with benserazide 25 mg.....................Madopar HBS Cap 200 mg with benserazide 50 mg.....................Madopar 250 LIGNOCAINE (expiry of HSS) Gel 2% ..........................................Orion

8.00 10.00 12.50 17.00 25.00 6.10

100 100 100 100 100 20 g

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

Oct-06 Oct-06 Oct-06 Oct-06 Oct-06 Dec-06

(B) (B) (B) (B) (B) Xylocaine

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

LIGNOCAINE HYDROCHLORIDE (continuation of HSS) Inj 1%, 2 ml ( price) ......................Xylocaine Inj 1%, 5 ml ( price) ......................Xylocaine Inj 1%, 20 ml ( price) ....................Xylocaine Inj 2%, 2 ml ( price) ......................Xylocaine Inj 2%, 5 ml ( price) ......................Xylocaine Inj 2%, 20 ml ( price) ....................Xylocaine LIGNOCAINE WITH CHLORHEXIDINE (expiry of HSS) Gel 2% with 0.05% chlorhexidine ....Pfizer LISINOPRIL (new listing) Tab 5 mg........................................Arrow-Lisinopril Tab 10 mg......................................Arrow-Lisinopril Tab 20 mg......................................Arrow-Lisinopril LORAZEPAM (expiry of HSS) Tab 1 mg........................................Ativan Tab 2.5 mg.....................................Ativan MAGNESIUM SULPHATE (expiry of HSS) Inj 49.3%, 5 ml ...............................Mayne 57.60 35.00 20.00 62.40 23.00 15.00 50 50 5 50 50 5 1% 1% 1% 1% 1% 1% Sept-09 Sept-09 Sept-09 Sept-09 Sept-09 Sept-09 (B) (B) (B) (B) MIN-I-JET Lignocaine Delta West (B) Apo-Lisinopril Lisopress Apo-Lisinopril Lisopress Apo-Lisinopril Lisopress Lorapam Lorzem Lorapam Lorzem (B)

43.26 2.06 2.36 2.87

10 30 30 30

1% 1% 1% 1%

Nov-06 Sept-09 Sept-09 Sept-09

6.28 4.12

250 100

1% 1%

Dec-06 Dec-06

26.60

Oct-06

MEGLUMINE DIATRIZOATE WITH SODIUM AMIDOTRIZOATE (expiry of HSS) Oral soln 660 mg per ml with sodium amidotrizoate 100 mg per ml, 100 ml ...........................Gastrografin 190.00 10 MEGLUMINE GADOPENTETATE (expiry of HSS) Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 10 ml prefilled Syringe ......................................Magnevist Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 20 ml .................Magnevist

Mar-07

Gastroview 120 ml

84.64

Mar-07

Dotarem Omniscan 5 ml & 10 ml Dotarem 15 ml & 20 ml Omniscan 15 ml & 20 ml Asacol

33.85

Mar-07

MESALAZINE ( price and continuation of HSS) Enema 1 g per 100 ml ....................Pentasa

45.96

Sept-09

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

METFORMIN HYDROCHLORIDE (expiry of HSS) Tab 500 mg....................................Arrow-Metformin 9.75 500 1% Oct-07 3M Metformin Apo-Metformin Glucomet Metomin 3M Metformin Apo-Metformin Glucomet Metomin

Tab 850 mg....................................Arrow-Metformin

8.00

250

Oct-07

METHADONE HYDROCHLORIDE ( price) Inj 10 mg per ml, 1 ml ....................AFT METHOTREXATE (continuation of HSS) Tab 2.5 mg ( price).......................Methoblastin Tab 10 mg......................................Methoblastin METHYLPHENIDATE HYDROCHLORIDE (new listing) Tab immediate-release 10 mg.........Ritalin Tab immediate-release 20 mg.........Ritalin

61.00 5.22 40.93

10 30 50 1% 1% Sept-09 Sept-09 Hospira Emthexate Hospira

3.00 50.00

30 100 30 30 30 30 1% 1% 1% 1% Jan-07 Oct-06 Jan-07 Jan-07 (B) Ritalin (B) Ritalin SR

METHYLPHENIDATE HYDROCHLORIDE (expiry of HSS) Tab 5 mg........................................Rubifen 3.20 Tab 10 mg ( price)........................Rubifen 3.00 Tab 20 mg......................................Rubifen 7.85 Tab long-acting 20 mg....................Rubifen SR 10.95

METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE (new listing) Cap modified-release 20 mg ...........Ritalin LA 25.50 30 Cap modified-release 30 mg ...........Ritalin LA 31.90 30 Cap modified-release 40 mg ...........Ritalin LA 38.25 30 METHYLPREDNISOLONE (continuation of HSS) Tab 4 mg........................................Medrol Tab 100 mg....................................Medrol METHYLPREDNISOLONE ACEPONATE (expiry of HSS) Crm 0.1% ......................................Advantan Oint 0.1% ......................................Advantan 48.57 166.52 4.95 4.95 100 20 15 g 15 g 25 25 28 10 5 1% 1% 1% 1% 1% 1% 1% 5% 5% Sept-09 Sept-09 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Apr-06 Apr-06 (B) (B) (B) (B) Mayne Mayne (B) Mayne Mayne

METHYLPREDNISOLONE SODIUM SUCCINATE (expiry of HSS) Inj 40 mg per ml, 1 ml ....................Solu-Medrol 151.40 Inj 62.5 mg per ml, 2 ml .................Solu-Medrol 412.59 METOPROLOL TARTRATE (expiry of HSS) Tab long-acting 200 mg..................Slow-Lopresor MIDAZOLAM (expiry of HSS) Inj 1 mg per ml, 5 ml ......................Hypnovel Inj 5 mg per ml, 3 ml ......................Hypnovel Products with Hospital Supply Status (HSS) are in bold. 18.40 10.75 11.90

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

MORPHINE HYDROCHLORIDE (expiry of HSS) Oral liq 1 mg per ml ........................RA-Morph Oral liq 2 mg per ml ........................RA-Morph Oral liq 5 mg per ml ........................RA-Morph Oral liq 10 mg per ml ......................RA-Morph MORPHINE SULPHATE (expiry of HSS) Cap long-acting 10 mg ...................m-Eslon Cap long-acting 30 mg ...................m-Eslon Cap long-acting 60 mg ...................m-Eslon Cap long-acting 100 mg .................m-Eslon Cap long-acting 200 mg .................m-Eslon Tab immediate release 10 mg .........Sevredol Tab immediate release 20 mg .........Sevredol Inj 5 mg per ml, 1 ml ......................Mayne Inj 15 mg per ml, 1 ml ....................Mayne MORPHINE TARTRATE (expiry of HSS) Inj 80 mg per ml, 5 ml ....................Mayne NEVIRAPINE (expiry of HSS) Oral suspension 10 mg per ml ........Viramune Suspension NIFEDIPINE (expiry of HSS) Tab long-acting 20 mg....................Nyefax Retard OXYTOCIN (expiry of HSS) Inj 5 iu per ml, 1 ml ........................Syntocinon Inj 10 iu per ml, 1 ml ......................Syntocinon 8.06 8.56 9.61 12.56 1.80 2.64 7.20 7.85 17.00 2.64 5.10 5.17 4.70 67.37 134.55 200 ml 200 ml 200 ml 200 ml 10 10 10 10 10 10 10 5 5 5 240 ml 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% Nov-06 Nov-06 Nov-06 Nov-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Oct-06 Oct-06 Oct-06 Nov-06 (B) (B) (B) (B) Kapanol Kapanol Kapanol Kapanol Kapanol (B) (B) (B) (B) (B) (B)

7.30 5.40 6.80

100 5 5

1% 1% 1%

Nov-06 May-07 May-07

(B) (B) (B)

OXYTOCIN WITH ERGOMETRINE MALEATE (expiry of HSS) Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ...................Syntometrine 9.20 PANCURONIUM BROMIDE (expiry of HSS) Inj 2 mg per ml, 2 ml ......................AstraZeneca PARACETAMOL (expiry of HSS) Suppos 25 mg................................Biomed Suppos 50 mg................................Biomed 125.00 56.35 56.35

5 50 20 20 16 100 5 5

1% 1% 1% 1% 10% 1%

May-07 Sept-06 Nov-06 Nov-06 Nov-06 Dec-06

(B) Mayne (B) (B) Voluven Pexcid

PENTASTARCH (expiry of HSS) Inf 6% per 500 ml bag ....................StarQuin 200 6% 239.68 PERHEXILINE MALEATE (expiry of HSS) Tab 100 mg....................................Pexsig PETHIDINE HYDROCHLORIDE ( price) Inj 50 mg per ml, 1 ml ....................Mayne Inj 50 mg per ml, 2 ml ....................Mayne Products with Hospital Supply Status (HSS) are in bold. 62.90 5.20 5.50

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

PIOGLITAZONE ( price) Tab 15 mg......................................Actos Tab 30 mg......................................Actos Tab 45 mg......................................Actos 45.78 70.43 89.39 28 28 28 Dec-09 Dec-09 Dec-09 Actos Actos Actos

PIOGLITAZONE (new listing) Tab 15 mg......................................Pizaccord 2.61 28 1% Tab 30 mg......................................Pizaccord 5.23 28 1% Tab 45 mg......................................Pizaccord 7.80 28 1% Note – Actos tab 15 mg, 30 mg and 45 mg to be delisted from 1 December 2009 POTASSIUM CHLORIDE (expiry of HSS) Tab long-acting 600 mg..................Span-K 5.20 200 1%

Dec-06

Slow-K K-SR (B)

PREDNISOLONE SODIUM PHOSPHATE (addition of HSS) Oral liq 5 mg per ml ........................Redipred 9.95 PROCARBAZINE HYDROCHLORIDE (new listing) Cap 50 mg .....................................Natulan PROMETHAZINE HYDROCHLORIDE ( price) Inj 25 mg per ml, 2 ml ....................Mayne PROPOFOL (new listing) Inj 1%, 20 ml ..................................Provive 1% Inj 1%, 50 ml ..................................Provive 1% Inj 1%, 100 ml ................................Provive 1% PROPOFOL (expiry of HSS) Inj 1%, 20 ml ( price) ....................Diprivan 225.00 11.00 13.62 7.41 12.37 13.62

30 ml 50 5 5 1 1 5

Sept-09

Dec-06

Inj 1%, 50 ml ( price) ....................Diprivan

7.41

Dec-06

Inj 1%, 100 ml ( price) ..................Diprivan

12.37

Dec-06

Inj 1%, 50 ml prefilled syringe .........Diprivan Inj 2%, 50 ml prefilled syringe .........Diprivan QUININE SULPHATE (expiry of HSS) Tab 200 mg....................................Q 200 Tab 300 mg....................................Q 300

14.19 15.43 15.95 34.75

1 1 250 500

1% 1% 1% 1%

Dec-06 Dec-06 Sept-06 Sept-06

Fresenius InterMed Mayne Recofol Fresenius InterMed Mayne Recofol Fresenius InterMed Mayne Recofol (B) (B) Apo-Quinine Quinoc-F Quinoc-S Apo-Quinine Quinoc-F Quinoc-S

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

RETEPLASE (expiry of HSS) Inj 10 iu vial ....................................Rapilysin RITUXIMAB (expiry of HSS) Inj 100 mg per 10 ml vial ................Mabthera Inj 500 mg per 50 ml vial ................Mabthera 1,850.00 1,195.00 2,987.00 2 2 1 5% 5% 5% Apr-06 Apr-06 Apr-06 (B) (B) (B)

ROXITHROMYCIN ( price and continuation of HSS) Tab 150 mg....................................ArrowRoxithromycin Tab 300 mg....................................ArrowRoxithromycin SALBUTAMOL ( price and continuation of HSS) Nebuliser soln, 1 mg per ml, 2.5 ml ........................................Asthalin Nebuliser soln, 2 mg per ml, 2.5 ml ........................................Asthalin

8.98 16.48

50 50

1% 1%

Sept-09 Sept-09

Romicin Rulide Romicin Rulide

3.52 3.70

20 20

1% 1%

Sept-09 Sept-09

(B) (B)

SALBUTAMOL WITH IPRATROPIUM BROMIDE (new listing) Nebuliser soln 2.5 mg with ipratropium bromide 0.5 mg per vial, 2.5 ml ...........................Duolin 4.29 SEVOFLURANE (expiry of HSS) Liq 250 ml bottle ............................Abbott Sevorane SODIUM CHLORIDE (expiry of HSS) Inj 0.9% per 5 ml ............................AstraZeneca Inj 0.9% per 10 ml ..........................AstraZeneca Inj 23.4%, 20 ml .............................Biomed SODIUM HYALURONATE (expiry of HSS) Inj 10 mg per ml, 0.35 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.4 ml....Duovisc Inj 10 mg per ml, 0.5 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.55 ml..Duovisc Ophthalmic inj 14 mg per ml ...........Healon GV Ophthalmic soln 10 mg per ml ........Healon Clear SOTALOL (amend brand name and addition of HSS) Tab 80 mg......................................Mylan Pacific Tab 160 mg....................................Mylan Pacific 325.88

20 250 ml

1% 1%

Sept-09 Jan-07

(B) Baxter

8.77 8.77 26.50

50 50 5

1% 1% 1%

Sept-06 Sept-06 Dec-06

Pharmacia Pharmacia (B)

64.00 74.00 50.00 35.00 27.50 10.50

0.75 ml 1.05 ml 1 0.85 ml 500 100

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

Oct-06 Oct-06 Oct-06 Oct-06 Sept-09 Sept-09

(B) (B) (B) Provisc Apo-Sotalol Sotacor Sotahexal Apo-Sotalol Sotacor Sotahexal

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 July 2009 (continued)

SPACER DEVICE (new listing) 800 ml ...........................................Volumatic TAMOXIFEN CITRATE ( price) Tab 10 mg......................................Genox Tab 20 mg......................................Genox TOBRAMYCIN ( price) Inj 40 mg per ml, 2 ml ....................Mayne TRANEXAMIC ACID (continuation of HSS) Inj 100 mg per ml, 5ml ...................Cyklokapron 8.50 10.80 11.10 34.50 124.73 1 100 100 5 10 1% Sept-09 (B)

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN (expiry of HSS) Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g ..........................................Kenacomb 3.35 7.5 ml 1% Feb-07 TROPISETRON (expiry of HSS) Cap 5 mg .......................................Navoban VALACICLOVIR (new listing) Tab 500 mg....................................Valtrex VINCRISTINE SULPHATE (expiry of HSS) Inj 1 mg per ml, 1 ml ......................Mayne Inj 1 mg per ml, 2 ml ......................Mayne VINORELBINE (new listing) Inj 10 mg per ml, 1 ml ....................Navelbine Inj 10 mg per ml, 5 ml ....................Navelbine 77.41 102.72 99.00 199.00 24.00 120.00 5 30 5 5 1 1 1% 1% 1% 1% Aug-06 Aug-06 Sept-09 Sept-09 1% Sept-06

(B) (B)

(B) (B) Vinorelbine Ebewe Hospira Vinorelbine Ebewe Hospira

Note – Vinorelbine Ebewe inj 10 mg per ml, 1 ml and 5 ml to be delisted 1 September 2009. WATER Purified for inj 5 ml (new listing) .....AstraZeneca Purified for inj 5 ml (expiry of HSS) .Multichem Purified for inj 10 ml (new listing) ...AstraZeneca Purified for inj 10 ml (expiry of HSS)Multichem ZINC AND CASTOR OIL (expiry of HSS) Ointment ........................................Orion 10.51 9.31 11.32 10.38 1.20 50 50 50 50 20 g

1% 1% 1%

Feb-07 Feb-07 Sept-06

Pharmacia Pharmacia Douglas PSM M&C Care and Health Midwest Multichem Sigma

Note - Pack sizes larger than 30 g are not considered DV Pharmaceuticals. Products with Hospital Supply Status (HSS) are in bold. (B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 June 2009

ACETYLCYSTEINE (new listing) Inj 200 mg per ml, 10 ml ................Martindale 219.75 Acetylcysteine BENZATHINE BENZYLPENICILLIN ( price) Inj 1.2 mega u per 2.3 ml................Bicillin LA DILTIAZEM HYDROCHLORIDE ( price) Cap long-acting 120 mg .................Cardizem CD Cap long-acting 180 mg .................Cardizem CD Cap long-acting 240 mg .................Cardizem CD ERYTHROPOIETIN BETA (delisting) Inj 1,000 iu prefilled syringe ............Recormon Inj 2,000 iu prefilled syringe ............Recormon Inj 3,000 iu prefilled syringe ............Recormon Inj 4,000 iu prefilled syringe ............Recormon Inj 5,000 iu prefilled syringe ............Recormon Inj 6,000 iu prefilled syringe ............Recormon Inj 10,000 iu prefilled syringe ..........Recormon HYDROCORTISONE (new listing and HSS) Powder ..........................................ABM 315.00 4.34 6.50 8.67 48.68 120.18 166.87 193.13 243.26 291.92 760.20 33.00 10

10 30 30 30 6 6 6 6 6 6 6 25 g 1% Aug-09 Apo-Hydrocortisone m-Hydrocortisone Pharmacia 5% 5% 5% Jun-09 Jun-09 Jun-09 (B) Dilzem LA Dilzem LA

METOPROLOL SUCCINATE (new listing) Tab long-acting 23.75 mg ..............Metoprolol-AFT CR Tab long-acting 47.5 mg.................Metoprolol-AFT CR Tab long-acting 95 mg....................Metoprolol-AFT CR Tab long-acting 190 mg ...............Metoprolol-AFT CR

2.73 3.41 5.88 10.63

30 30 30 30

ROPINIROLE HYDROCHLORIDE (delisting) Tab 0.25 mg...................................Requip 31.50 Tab 0.25 mg x 42, 0.5 mg x 42, and 1 mg x 21 ...........................Requip Starter 35.70 Pack Tab 0.25 mg x 42, 1 mg x 42, and 2 mg x 63 ...........................Requip 122.11 Follow-on Pack Tab 1 mg .......................................Requip 67.20 Tab 2 mg........................................Requip 101.21 Tab 5 mg........................................Requip 150.00

210 105 OP 147 OP

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 May 2009

ACARBOSE (new listing and HSS) Tab 50 mg......................................Glucobay Tab 100 mg....................................Glucobay CO-TRIMOXAZOLE (new listing) Oral liq 240 mg per 5 ml .................Deprim ENTACAPONE (new listing and HSS) Tab 200 mg....................................Comtan 16.50 26.70 2.15 116.00 90 90 100 ml 100 100 1% 1% 1% Jul-09 Jul-09 Jul-09 (B) (B) Apo-Frusemide Frusehexal Frusid (B) 1% 1% Jul-09 Jul-09 (B) (B)

ERYTHROMYCIN ETHYL SUCCINATE ( price and HSS) Tab 400 mg ...................................E-Mycin 16.95

FRUSEMIDE FUROSEMIDE (Change in chemical name,  price and HSS) Tab 40 mg......................................Diurin 40 10.75 1,000

HYDROXYCHLOROQUINE SULPHATE ( price and HSS) Tab 200 mg....................................Plaquenil 22.50 LIGNOCAINE WITH PRILOCAINE (delisting) Patch 2.5% with prilocaine 2.5% .....EMLA 10.40

100 2 200 ml 200 ml 200 ml 30 30 30

Jul-09

METHADONE HYDROCHLORIDE ( price and HSS) Oral liq 2 mg per ml ........................Biodone 5.95 Oral liq 5 mg per ml ........................Biodone Forte 5.55 Oral liq 10 mg per ml .....................Biodone Extra Forte8.95 OMEPRAZOLE (addition of HSS) Cap 10 mg .....................................Dr Reddy’s Omeprazole Cap 20 mg .....................................Dr Reddy’s Omeperazole Cap 40 mg .....................................Dr Reddy’s Omeprazole OMEPRAZOLE (delisting) Inf 40 mg .......................................Losec IV 2.14 3.05 3.59

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

Jul-09 Jul-09 Jul-09 May-09 May-09 May-09

(B) (B) (B) Losec Omezol Losec Omezol Losec Omezol

38.65

5 3.50 237 ml

SPECIAL FOOD SUPPLEMENT (new listing) Liquid, 237 ml ................................Impact Advanced Recovery Vanilla and Chocolate SPECIAL FOOD SUPPLEMENT (delisting) Powder, sachet 74 g.......................Oral Impact 17.50

Effective 1 April 2009

AMIKACIN SULPHATE (delisting date) Inj 250 mg per ml, 2 ml ..................Amikin Note- This product will be delisted 1 July 2009 Products with Hospital Supply Status (HSS) are in bold. 15.00 1 1% Sept-06 (B)

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II - effective 1 April 2009 (continued)

APOMORPHINE HYDROCHLORIDE (new listing) Inj 10 mg per ml, 2 ml ....................Apomine 50.43 5 Note – The Mayne brand of Apomorphine hydrochloride inj 10 mg per ml, 1 ml will be delisted from 1 October 2009. ATOMOXETINE HYDROCHLORIDE (new listing) Cap 10 mg .....................................Strattera Cap 18 mg .....................................Strattera Cap 25 mg .....................................Strattera Cap 40 mg .....................................Strattera Cap 60 mg .....................................Strattera Cap 80 mg .....................................Strattera Cap 100 mg ...................................Strattera CLOZAPINE (new listing) Tab 25 mg......................................Clozaril Tab 100 mg ...................................Clozaril 107.03 107.03 107.03 107.03 107.03 139.11 139.11 26.74 69.30 28 28 28 28 28 28 28 100 100

DANAZOL (new listing) Cap 100 mg ...................................Azol 56.66 100 Note - D Zol brand of Danazol cap 100 mg 30 pack size to be delisted 1 October 2009 DIAZEPAM ( price) Rectal tubes 5 mg ..........................Stesolid Rectal tubes 10 mg ........................Stesolid 25.05 30.50 5 5 1 1 1% 1% Jun-09 Jun-09 Gemzar Hospira Gemzar Hospira Losec Losec IV

GEMCITABINE HYDROCHLORIDE (new listing and HSS) Inj 200 mg......................................Gemcitabine Ebewe49.00 Inj 1 g.............................................Gemcitabine Ebewe245.00 OMEPRAZOLE (addition of HSS) Inj 40 mg........................................Dr Reddy’s Omeprazole Inf 40 mg .......................................Dr Reddy’s Omeprazole PARACETAMOL ( price) Suppos 125 mg..............................Panadol Suppos 250 mg..............................Panadol

38.20 38.65

5 5

1% 1%

May-09 May-09

7.49 14.40

20 20

ROPINIROLE (new listing and HSS) Tab 0.25 mg ..................................Ropin 7.90 84 1% June-09 Requip Tab 1 mg .......................................Ropin 40.32 84 1% June-09 Requip Tab 2 mg .......................................Ropin 60.72 84 1% June-09 Requip Tab 5 mg .......................................Ropin 90.00 84 1% June-09 Requip Note – Requip tab 0.25mg, 1 mg, 2 mg and 5mg and Requip Starter pack and Follow-on pack will all be delisted 1 September 2009 VERAPAMIL (delisting) Tab 40 mg .....................................Verpamil Products with Hospital Supply Status (HSS) are in bold. 4.75 100 (B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part IV

Effective 1 June 2009

HYDRALAZINE Tab 25 mg S29 For patients with congestive heart failure: (1) who have not responded to treatment with ACE inhibitors and/or ARBs; or (2) in whom treatment with ACE inhibitors and/or ARBs is not tolerated due to renal impairment INDOMETHACIN Cap 25 mg S29 For any indication approved by the hospital service METOLAZONE S29 Tabs 5 mg For patients with congestive heart failure: (1) who have not responded to treatment with ACE inhibitors and/or ARBs; or (2) in whom treatment with ACE inhibitors and/or ARBs is not tolerated due to renal impairment L-ORNITHINE L-ASPARTATE (LOLA) S29 Sach 5 mg For patients with chronic hepatic encephalopathy who have not responded to treatment with lactulose

Effective 1 May 2009

INDOMETHACIN Cap 50 mg S29 For any indication approved by the hospital service SPECIAL FOOD SUPPLEMENT (delisting) Powder, sachet 74 g Oral Impact Three sachets per day for 5-7 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”

Index

Pharmaceuticals and brands A Abbot Sevorane ................................................. 64 Acarbose ..................................................... 40, 67 Accu-Chek Performa .......................................... 28 Acetylcysteine.............................................. 26, 66 Aciclovir ............................................................ 50 Acitretin ............................................................. 50 Activated charcoal.............................................. 50 Actos ............................................... 27, 36, 46, 63 Advantan ........................................................... 61 Alanase.............................................................. 51 Allopurinol.......................................................... 44 Alprostadil.......................................................... 50 AmBisome ......................................................... 50 Amikacin sulphate ........................................ 50, 67 Amikin ......................................................... 50, 67 Aminoacid formula with minerals without phenylalanine .................................................. 34 Amoxycillin clavulanate ...................................... 41 Apo-Doxazosin............................................. 44, 45 Apomine ............................................................ 68 Apomorphine hydrochloride ......................... 50, 68 Apo-Terazosin.................................................... 26 Apresoline.......................................................... 56 Arrow-Azithromycin ............................... 30, 38, 51 Arrow-Cabergoline ............................................. 21 Arrow-Diazepam .......................................... 22, 54 Arrow-Lisinopril ........................................... 37, 60 Arrow-Metformin................................................ 61 Arrow-Roxithromycin ................................... 38, 64 Arsenic trioxide ............................................ 39, 50 Asacol ............................................................... 27 Aspen Ciprofloxacin ........................................... 53 Asthalin ....................................................... 39, 64 Atenolol ............................................................. 50 Ativan ................................................................ 60 Atomoxetine hydrochloride ................................. 68 Atorvastatin........................................................ 26 Atracurium besylate ........................................... 51 Atropine sulphate ............................................... 51 Augmentin ......................................................... 41 Azathioprine ....................................................... 46 Azithromycin .......................................... 30, 38, 51 Azol ................................................................... 68 B Batrafen ....................................................... 35, 41 BD Micro-Fine .................................................... 36 BD Ultra Fine ...................................................... 36 BD Ultra Fine II ................................................... 36 Beclazone 50 ............................................... 25, 51 Beclazone 100 ............................................. 25, 51 Beclazone 250 ............................................. 25, 51 Beclomethasone dipropionate....................... 25, 51 Benzathine benzylpenicillin ..................... 40, 43, 66 Benztrop ...................................................... 38, 51 Benztropine mesylate ................................... 38, 51 Betamethasone valerate ..................................... 51 Beta Scalp ......................................................... 51 Bezafibrate ......................................................... 51 Bezalip Retard .................................................... 51 Bicillin LA............................................... 40, 43, 66 Biodone ....................................................... 42, 67 Biodone Extra Forte ...................................... 42, 67 Biodone Forte............................................... 42, 67 Blood glucose diagnostic test meter ....... 20, 28, 51 Blood glucose diagnostic test strip ... 20, 28, 36, 51 Bosentan ..................................................... 20, 51 Bupivacaine hydrochloride.................................. 52 Bupivacaine hydrochloride with adrenaline .......... 52 Bupropion hydrochloride .............................. 22, 52 C Cabergoline........................................................ 21 Caffeine citrate ................................................... 52 Calcitriol ............................................................ 52 Calcitriol-AFT ..................................................... 52 Calcium carbonate with aminoacetic acid ..... 40, 46 Calcium folinate ................................................. 40 Calcium Folinate Ebewe...................................... 40 Camptosar ......................................................... 59 Carbamazepine .................................................. 44 Carboplatin ........................................................ 52 Carboplatin Ebewe ............................................. 52 Carbosorb-X ................................................ 39, 50 Cardizem CD ................................................ 39, 66 Cefoxitin sodium .......................................... 38, 52 Cellcept ............................................................. 31 Charcoal ............................................................ 39 Chloramphenicol .......................................... 39, 52 Chlorhexidine ..................................................... 52 Chlorsig ....................................................... 39, 52 Chlorthalidone .................................................... 52 Ciclopirox olamine.............................................. 35 Ciclopiroxolamine......................................... 35, 41 Ciprofloxacin ...................................................... 53 Clinistix .............................................................. 41 Clinitest.............................................................. 41 Clobetasol propionate......................................... 53 Clostridum botulinum ......................................... 53 Clozapine ........................................................... 68 Clozaril .............................................................. 68 Cocaine ............................................................. 53 Colifoam ............................................................ 56 Comtan ........................................................ 42, 67 Copper............................................................... 41

Index

Pharmaceuticals and brands Co-trimoxazole ....................................... 26, 47, 67 Crotamiton ......................................................... 44 Cyclizine hydrochloride ................................ 38, 53 Cyclophosphamide ...................................... 38, 53 Cyclosporin........................................................ 53 Cyklokapron ....................................................... 65 Cyproterone acetate ............................... 21, 37, 53 D Dacarbazine ....................................................... 53 Daclizumab ........................................................ 53 Dalteparin sodium .............................................. 53 Danazol.............................................................. 68 Dantrium ............................................................ 54 Dantrium IV ........................................................ 54 Dantrolene sodium ............................................. 54 Daonil ................................................................ 25 Daunorubicin ............................................... 25, 54 Deprim......................................................... 26, 67 Dermol............................................................... 53 Dexamethasone sodium phosphate .................... 54 Dextrochlorpheniramine maleate ................... 25, 48 Dextrose ............................................................ 54 Diastix ............................................................... 41 Diazepam............................................... 22, 54, 68 Diflucan POS...................................................... 56 Diltiazem hydrochloride .......................... 39, 44, 66 Dilzem LA .......................................................... 44 Dilzem SR .......................................................... 44 Dinoprostone ..................................................... 54 Diprivan ............................................................. 63 Dipyridamole................................................ 29, 37 Diurin 40 ................................................ 35, 41, 67 Diurin 500 .......................................................... 35 Docusate sodium with sennosides ..................... 54 Dopamine hydrochloride .................................... 54 Doxazosin mesylate ..................................... 44, 45 Doxorubicin ....................................................... 54 Doxorubicin Ebewe ............................................ 54 Dr Reddy’s Omeprazole................................ 67, 68 Duolin .......................................................... 39, 64 Duovisc ............................................................. 64 Duride ................................................................ 59 Dysport .............................................................. 53 E Econazole nitrate ................................................ 37 Efavirenz ...................................................... 44, 47 EMLA................................................................. 67 E-Mycin ....................................................... 41, 67 Endoxan....................................................... 38, 53 Entacapone .................................................. 42, 67 Enteral feed with fibre 1kcal/ml ........................... 47 Ephedrine sulphate ............................................. 54 Epirubicin........................................................... 55 Epirubicin Ebewe................................................ 55 Ergometrine maleate .......................................... 55 Erythrocin IV ................................................ 38, 55 Erythromycin ethyl succinate ........................ 41, 67 Erythromycin lactobionate ............................ 38, 55 Erythropoietin beta ....................................... 55, 66 Ethinyloestradiol with levonorgestrel ................... 47 Etoposide........................................................... 55 Eurax ................................................................. 44 F Felo 5 ER ..................................................... 37, 55 Felo 10 ER ................................................... 37, 55 Felodipine .................................................... 37, 55 Ferro-F-Tabs ................................................ 37, 55 Ferro-tab ...................................................... 37, 55 Ferrous fumarate .......................................... 37, 55 Ferrous fumarate with folic acid .................... 37, 55 Fibersource ........................................................ 47 Fibersource RTH ................................................ 47 Fluarix .......................................................... 22, 31 Flucloxacillin ...................................................... 55 Flucloxacillin sodium .......................................... 56 Fluconazole ........................................................ 56 Fludarabine phosphate ................................. 25, 56 Fludara Oral ................................................. 25, 56 Fluorometholone .......................................... 25, 56 Fluorouracil sodium............................................ 44 Fluvax ................................................................ 31 FML ............................................................. 25, 56 Forthane ............................................................ 59 Fortini ................................................................ 46 Fortini Multifibre ................................................. 46 Fragmin ....................................................... 53, 54 FreeStyle Lite ......................................... 20, 28, 51 Frusemide .................................................... 35, 67 Furosemide ............................................ 35, 41, 67 G Gastrografin ....................................................... 60 Gemcitabine Ebewe............................................ 68 Gemcitabine hydrochloride ........................... 40, 68 Genox .......................................................... 39, 65 Gentamicin sulphate ........................................... 56 Glibenclamide .................................................... 25 Glucobay ..................................................... 40, 67 Glucose oxidase........................................... 41, 46 Gluten free pasta ................................................ 44 Glyceryl trinitrate ................................................ 56 H Healon Clear ...................................................... 64 Healon GV.......................................................... 64 Heparinised saline .............................................. 56

Index

Pharmaceuticals and brands Heparin sodium............................................ 37, 56 Holoxan ....................................................... 39, 57 Hydralazine .................................................. 56, 69 Hydrocortisone ...................................... 26, 56, 66 Hydrocortisone acetate ...................................... 56 Hydroderm Lotion .............................................. 47 Hydroxychloroquine sulphate........................ 41, 67 Hygroton............................................................ 52 Hypnovel ........................................................... 61 Hytrin........................................................... 37, 46 I Ibuprofen ........................................................... 42 Idarubicin hydrochloride ..................................... 56 Ifosfamide.................................................... 39, 57 Ilomedin............................................................. 57 Iloprost ........................................................ 21, 57 Imipramine hydrochloride ................................... 57 Impact Advanced Recovery Vanilla and Chocolate ....................................................... 67 Indapamide ........................................................ 57 Indomethacin ............................................... 47, 69 Influenza vaccine.......................................... 22, 30 Inhaled corticosteroids with long-acting beta-adrenoceptor agonists ............................. 33 Insulin pen needles................................. 28, 36, 57 Insulin syringes, disposable with attached needle ......................................... 36, 57 Iodixanol ............................................................ 57 Iohexol ............................................................... 58 I-Profen ............................................................. 42 Irinotecan........................................................... 59 Isoflurane ........................................................... 59 Isosorbide mononitrate....................................... 59 Isotane 10.......................................................... 59 Isotane 20.......................................................... 59 Isotretinoin ......................................................... 59 K Kenacomb ......................................................... 65 Keto-Diabur 5000............................................... 46 Keto-Diastix ................................................. 41, 46 Ketone blood beta-ketone electrodes ............ 20, 59 Ketostix........................................................ 41, 47 Ketovite ............................................................. 29 Ketovite Liquid ............................................. 29, 37 Ketur-Test .......................................................... 47 L Lasix .................................................................. 35 Laxsol ................................................................ 54 Lemnis Fatty Cream ........................................... 47 Levocabastine .................................................... 42 Levodopa with benserazide ................................ 59 Lignocaine ......................................................... 59 Lignocaine hydrochloride ................................... 60 Lignocaine with chlorhexidine ............................. 60 Lignocaine with prilocaine .................................. 67 Lipex.................................................................. 41 Lipitor ................................................................ 26 Liposomal amphotericin b .................................. 50 Lisinopril ...................................................... 37, 60 Livostin .............................................................. 42 Lorazepam ......................................................... 60 L-ornithine l-aspartate (lola) ............................... 69 Losec IV ............................................................ 67 Lovir .................................................................. 50 M Mabthera ..................................................... 31, 64 Madopar 62.5 .................................................... 59 Madopar 125 ..................................................... 59 Madopar 250 ..................................................... 59 Madopar Dispersible .......................................... 59 Madopar HBS .................................................... 59 Magnesium sulphate .......................................... 60 Magnevist .......................................................... 60 Marcain ............................................................. 52 Marcain with Adrenaline ..................................... 52 Mebendazole...................................................... 46 Medrol ............................................................... 61 Meglumine diatrizoate with sodium amidotrizoate .................................................. 60 Meglumine gadopentetate................................... 60 Mesalazine ............................................. 27, 36, 60 m-Eslon ............................................................. 62 Metabolic Mineral Mixture................................... 34 Metformin hydrochloride .................................... 61 Methadone hydrochloride ................. 38, 42, 61, 67 Methoblastin ................................................ 39, 61 Methotrexate ................................................ 39, 61 Methylphenidate hydrochloride ............... 23, 38, 61 Methylphenidate hydrochloride extended-release ....................................... 24, 61 Methylprednisolone ............................................ 61 Methylprednisolone aceponate ........................... 61 Methylprednisolone sodium succinate ................ 61 Metolazone ........................................................ 69 Metoprolol-AFT CR....................................... 26, 66 Metoprolol succinate .................................... 26, 66 Metoprolol tartrate .............................................. 61 m-Fluconazole ................................................... 56 Midazolam ......................................................... 61 Morphine hydrochloride...................................... 62 Morphine sulphate.............................................. 62 Morphine tartrate ................................................ 62 Mucilaginous laxatives ....................................... 37 Mucilaginous laxatives with stimulants ............... 37

Index

Pharmaceuticals and brands Multiparin........................................................... 37 Multivitamins ............................................... 29, 37 Mycophenolate mofetil ....................................... 31 N Napamide .......................................................... 57 Natulan ........................................................ 39, 63 Nausicalm.................................................... 38, 53 Navelbine ........................................................... 25 Navelbine ........................................................... 65 Navoban ............................................................ 65 NeoRecormon .................................................... 55 Neotigason ........................................................ 50 Nevirapine .......................................................... 62 Nifedipine........................................................... 62 Nitronal .............................................................. 56 Normacol ........................................................... 37 Normacol Plus ................................................... 37 Norpress ...................................................... 26, 47 Nortriptyline hydrochloride............................ 26, 47 NovoFine ..................................................... 28, 36 NutriniDrink ........................................................ 26 NutriniDrink Multifibre ......................................... 26 Nuvelle............................................................... 47 Nyefax Retard .................................................... 62 O Oestradiol valerate.............................................. 45 Oestradiol with levonorgestrel ............................. 47 Oestrogens ........................................................ 39 Oestrogens with medroxyprogesterone ............... 40 Oil in water emulsion .......................................... 47 Omeprazole.................................................. 67, 68 Omnipaque .................................................. 58, 59 Optium 5 second test ............................. 28, 36, 51 Optium 10 second test ....................................... 28 Optium Blood Ketone Test Strips .................. 20, 59 Optium Xceed .................................................... 28 Oral Impact .................................................. 67, 69 Orgran ............................................................... 44 Oxytocin ............................................................ 62 Oxytocin with ergometrine maleate ..................... 62 P Pacific Atenolol .................................................. 50 Paclitaxel ........................................................... 26 Paclitaxel Ebewe ................................................ 26 Paediatric oral feed 1.5kcal/ml................ 26, 44, 46 Paediatric oral feed with fibre 1.5kcal/ml....... 26, 46 Paediatric Seravit ............................................... 29 Pamidronate disodium ....................................... 26 Pamisol ............................................................. 26 Panadol ....................................................... 45, 68 Pancuronium bromide ........................................ 62 Paracetamol........................................... 45, 62, 68 Pentasa ................................................. 27, 36, 60 Pentastarch........................................................ 62 Perhexiline maleate ............................................ 62 Persantin ..................................................... 29, 37 Pethidine hydrochloride ................................ 38, 62 Pevaryl .............................................................. 37 Pexsig................................................................ 62 Pilocarpine ................................................... 47, 48 Pilopt ........................................................... 47, 48 Pioglitazone ............................... 20, 27, 36, 46, 63 Pizaccord............................................... 20, 27, 63 Plaquenil ...................................................... 41, 67 Polaramine Colour-Free Repetab ........................ 25 Polaramine Repetab ........................................... 48 Potassium chloride ............................................ 63 Prednisolone sodium phosphate ......................... 63 Premarin ............................................................ 39 Premia 2.5 Continuous ....................................... 40 Premia 5 Continuous .......................................... 40 Procarbazine hydrochloride .......................... 39, 63 Progout.............................................................. 44 Progynova ......................................................... 45 Promethazine hydrochloride ......................... 39, 63 Propofol ............................................................. 63 Prostin E2 .......................................................... 54 Prostin VR ......................................................... 50 Provive 1%......................................................... 63 Pytazen SR ........................................................ 29 Q Q 200 ................................................................ 63 Q 300 ................................................................ 63 Quinine sulphate ................................................ 63 R RA-Morph .......................................................... 62 Rapilysin ............................................................ 64 Recormon .......................................................... 66 Redipred ............................................................ 63 Requip ......................................................... 40, 66 Requip Follow-on Pack................................. 40, 66 Requip Starter Pack...................................... 40, 66 Resource Just for Kids ....................................... 44 Reteplase ........................................................... 64 Rheumacin ........................................................ 47 Ritalin .......................................................... 23, 61 Ritalin LA ..................................................... 24, 61 Ritalin SR ........................................................... 23 Rituximab .................................................... 31, 64 Ropin ................................................................. 68 Ropinirole .......................................................... 68 Ropinirole hydrochloride............................... 40, 66 Roxithromycin.............................................. 38, 64 Rubifen ........................................................ 38, 61

Index

Pharmaceuticals and brands Rubifen SR ........................................................ 61 S Salbutamol................................................... 39, 64 Salbutamol with ipratropium bromide............ 39, 64 Sandimmun ....................................................... 53 SensoCard ................................................... 20, 28 Sevoflurane ........................................................ 64 Sevredol ............................................................ 62 Sildenafil ............................................................ 21 SimvaRex .......................................................... 41 Simvastatin ........................................................ 41 Siterone ................................................. 21, 37, 53 Slow-Lopresor ................................................... 61 Sodium chloride ................................................. 64 Sodium hyaluronate ........................................... 64 Sodium nitroprusside ................................... 41, 47 Solu-Medrol ....................................................... 61 Sotalol ......................................................... 43, 64 Space Chamber ................................................. 34 Spacer device ........................................ 25, 34, 65 Span-K .............................................................. 63 Special food supplement .............................. 67, 69 Staphlex ............................................................. 56 StarQuin 200 6% ................................................ 62 Stesolid ............................................................. 68 Stocrin ......................................................... 44, 47 Strattera ............................................................. 68 Syntocinon......................................................... 62 Syntometrine...................................................... 62 T Tamoxifen citrate.......................................... 39, 65 Tegretol ............................................................. 44 Terazosin hydrochloride ......................... 26, 37, 46 Thioprine ........................................................... 46 Titralac ........................................................ 40, 46 Tobramycin.................................................. 38, 65 Tofranil .............................................................. 57 Tracleer ....................................................... 20, 51 Tracrium ............................................................ 51 Tranexamic acid ................................................. 65 Triamcinolone acetonide with gramicidin, neomycin and nystatin .................................... 65 Triquilar ED ........................................................ 47 Trisul ................................................................. 47 Tropisetron ........................................................ 65 V Valaciclovir .................................................. 21, 65 Valtrex ......................................................... 21, 65 Vaxigrip ............................................................. 31 Ventavis ....................................................... 21, 57 Vepesid.............................................................. 55 Verapamil .......................................................... 68 Vermox .............................................................. 46 Verpamil ............................................................ 68 Viagra ................................................................ 21 Vincristine sulphate ............................................ 65 Vinorelbine ................................................... 25, 65 Viramune Suspension ........................................ 62 Visipaque ........................................................... 57 Volumatic .............................................. 25, 34, 65 W Water ..................................................... 20, 44, 65 Wool fat with mineral oil ..................................... 47 X Xylocaine ........................................................... 60 Z Zavedos ............................................................. 56 Zenapax ............................................................. 53 Zinc and castor oil .............................................. 65 Zyban .......................................................... 22, 52

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

PHARMAC is the Government agency responsible for deciding which medicines are subsidised for New Zealanders. It manages spending on pharmaceuticals for the District Health Boards, and ensures that a comprehensive list of medicines (the Pharmaceutical Schedule) is subsidised for New Zealanders, and that the list of medicines continues to grow to meet the needs of patients.

Metadata

Title

Schedule Update - effective 1 July 2009

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 July 2009 Cumulative for May, June and July 2009. Section H cumulative for April, May, June and July 2009 Contents Summary of PHARMAC decisions effective 1 July 2009 … 3…

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