Schedule Update - effective 1 August 2009 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 August 2009 Cumulative for May, June, July and August 2009 Section H for August 2009

Contents

Summary of PHARMAC decisions effective 1 August 2009 ............................ 3 Leuprorelin – new listings and access widening ............................................ 5 Adalimumab – access widening .................................................................... 5 Gabapentin – changes to subsidy.................................................................. 6 Levothyroxine – new listing ........................................................................... 6 New treatment for Hepatitis B ...................................................................... 6 Dasatinib – new cancer treatment subsidised ............................................... 7 Enoxaparin sodium – new listings ................................................................. 7 Extending eligibility for seasonal influenza vaccine ....................................... 7 Fentanyl citrate injections – new listing ......................................................... 8 Oil in water emulsion .................................................................................... 8 Pilocarpine eye drops .................................................................................... 8 Chlorpheniramine maleate oral liquid – fully subsidised................................ 8 Tender News .................................................................................................. 9 Looking Forward ........................................................................................... 9 Sole Subsidised Supply products cumulative to August 2009 ..................... 10 New Listings ................................................................................................ 16 Changes to Restrictions ............................................................................... 26 Changes to Subsidy and Manufacturer’s Price............................................. 43 Changes to Brand name .............................................................................. 52 Changes to Description ............................................................................... 52 Changes to General Rules............................................................................ 52 Changes to Section F: Part II ........................................................................ 52 Changes to Sole Subsidised Supply ............................................................. 52 Delisted Items ............................................................................................. 53 Items to be Delisted .................................................................................... 58 Section H changes to Part II ........................................................................ 61 Section H changes to Part IV ....................................................................... 63 Index ........................................................................................................... 64

Summary of PharmaC decisions

effeCtive 1 aUGUSt 2009 New listings (pages 16 to 18) • Sodium nitroprusside (Ketostix) test strip – not on a BSO • Enoxaparin sodium (Clexane) inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg and 150 mg – Special Authority – Retail pharmacy • Calamine (healthE) crm, aqueous, BP – only on a prescription and not in combination • Calamine (API) lotn, BP – only on a prescription and not in combination • Oil in water emulsion (healthE Fatty Cream) crm • Levothyroxine (Synthroid) tab 25 µg, 50 µg and 100 µg • Leuprorelin (Lucrin Depot PDS) inj prefilled syringe 3.75 mg, 11.25 mg and 30 mg – Hospital pharmacy [HP3] • Entecavir (Baraclude) tab 0.5 mg – Special Authority – Retail pharmacy • Fentanyl citrate (Hospira) inj 50 µg per ml, 2 ml and 10 ml – only on a controlled drug form and no patient co-payment payable • Thiotepa (Bedford) inj 15 mg – PCT only –Specialist – Section 29 • Amsacrine (Amsidyl) inj 75 mg – PCT only – Specialist – Section 29 • Dasatinib (Sprycel) tab 20 mg, 50 mg and 70 mg – Special Authority • Tamoxifen citrate (Tamoxifen Sandoz) tab 20 mg • Pilocarpine (Isopto Carpine) eye drops 1%, 2% and 4% - Section 29 Changes to restrictions (pages 26 to 33) • Ketone blood beta-ketone electrodes test strip – addition of not on a BSO • Leuprorelin inj 3.75 mg, 7.5 mg, 11.25 mg, 22.5 mg, 30 mg and 45 mg, and inj prefilled syringe 3.75mg, 11.25 mg and 30 mg – removal of Special Authority • Influenza vaccine – eligibility criteria amended • Adalimumab inj 40 mg per 0.8 ml prefilled pen and syringe – Special Authority amendment • Gabapentin (Neurontin) tab 600 mg, cap 100 mg, 300 mg and 400 mg – amended chemical name and new Special Authority criteria specific to the Neurontin brand of gabapentin Decreased subsidy (pages 43 to 44) • Atenolol (Pacific Atenolol) tab 50 mg and 100 mg • Hydrocortisone (m-Hydrocortisone) powder • Gabapentin (Nupentin) cap 100 mg, 300 mg and 400 mg • Clozapine (Clopine) tab 25 mg, 50 mg, 100 mg and 200 mg, and suspension 50 mg per ml

Summary of PharmaC decisions – effective 1 august 2009 (continued) • Epirubicin inj 2 mg per ml, 25 ml, 50 ml and 100 ml (Epirubicin Ebewe), and inj 1 mg for ECP (Baxter) increased subsidy (pages 43 to 44) • Lithium carbonate (Lithicarb) tab 250 mg and 400 mg • Interferon beta-1-alpha (Avonex) inj 6 million iu prefilled syringe and inj 6 million iu per vial • Interferon beta-1-beta (Betaferon) inj 8 million iu per 1 ml • Epirubicin (Epirubicin Ebewe) inj 2 mg per ml, 5 ml • Chlorpheniramine maleate (Histafen) oral liq 2 mg per 5 ml

Pharmaceutical Schedule - Update News

Leuprorelin – new listings and access widening

From 1 August 2009 three strengths of Lucrin Depot PDS prefilled syringes will be listed fully subsidised without restriction. One of the strengths, the 30 mg prefilled syringe, is a 6 month preparation. Also from 1 August 2009 the Special Authority that applies to all listings of leuprorelin will be removed, resulting in a widening of access. Widening access to leuprorelin would allow co-therapy with

anti-androgens in prostate cancer and allow uterine fibroids to be treated pre surgery. See pages 17 and 26 for further details.

Adalimumab – access widening

Access for adalimumab (Humira and HumiraPen) will be widened from 1 August 2009. This will provide fully funded access to adalimumab for the “last-line” treatment of ankylosing spondylitis, psoriatic arthritis, chronic plaque psoriasis and Crohn’s disease, subject to Special Authority criteria being met. Previously adalimumab has only been subsidised for the last-line treatment of rheumatoid arthritis.

6 Pharmaceutical Schedule - Update News

Gabapentin – changes to subsidy

From 1 August 2009 until 31 July 2012, Nupentin will be the only subsidised brand of gabapentin for all patients with neuropathic pain, and will be the only subsidised brand of gabapentin for newly initiated patients with epilepsy. All patients with an existing approval for gabapentin for epilepsy at 31 July 2009 who are taking the Neurontin brand of gabapentin will be issued a new approval for Neurontin, and Neurontin will continue to be subsidised for those patients only. No new patients will be granted Special Authority approvals for Neurontin for any indication from 1 August 2009. Nupentin will continue to be subject to the same Special Authority criteria that currently apply to it. PHARMAC will issue pharmacies with a list of NHI numbers of patients with approvals for Neurontin. The price and subsidy for Nupentin also reduces from 1 August 2009. See pages 33 and 44 for further details.

Levothyroxine – new listing

The Synthroid brand of levothyroxine tablets will be subsidised from 1 August 2009. Three strengths of Synthroid will be listed, including a lower-strength 25 µg tablet.

New treatment for Hepatitis B

From 1 August 2009, the antiviral drug entecavir (Baraclude) will be subsidised under Special Authority as a first line treatment option for patients with hepatitis B. The funding of entecavir adds to other treatment options PHARMAC has recently funded for hepatitis B. In April this year PHARMAC widened access to the antiviral treatment pegylated interferon alpha, adding to the existing funded treatments of interferon, lamivudine and adefovir.

Pharmaceutical Schedule - Update News

Dasatinib – new cancer treatment subsidised

PHARMAC is subsidising a new drug for patients with chronic myeloid leukaemia from 1 August 2009. Dasatinib (Sprycel) tablets will be subsidised under Special Authority criteria. While dasatinib is indicated for second line treatment of CML, the Special Authority allows funding of dasatinib when used as first line treatment. Prescribers must comply with Section 25 of the Medicines Act 1981 when prescribing dasatinib in the first line settng.

Enoxaparin sodium - new listings

The low molecular weight heparin Clexane injection (enoxaparin sodium) will be listed on the Pharmaceutical Schedule under Special Authority criteria from 1 August 2009. Enoxaparin sodium will be subsidised for patients requiring treatment with low molecular weight heparin during pregnancy, and the prevention and treatment of venous thromboembolism. See page 16 for further details. There will be no change to the current provisions for the use of low molecular weight heparin by hospitals, including the use of dalteparin and tinzaparin, and the use of the Discretionary Community Supply (DCS) mechanism.

Extending eligibility for seasonal influenza vaccine

The Ministry of Health has extended the seasonal influenza immunisation programme to the end of September 2009. The Ministry has purchased an extra 125,000 doses of the seasonal influenza vaccine to manage the increased demand. To further protect individuals and to ease pressure on the health system, the Ministry has decided to extend the eligibility for free immunisation to all New Zealanders. All New Zealanders are now eligible for free vaccine until the end of September or until it runs out.

8 Pharmaceutical Schedule - Update News

Pharmaceutical Schedule - Update News

Fentanyl citrate injections – new listing

From 1 August 2009 the Hospira brand of fentanyl citrate injection 50 µg per ml, 2 ml and 10 ml will be listed fully subsidised. Fentanyl citrate injections will not require a Special Authority for subsidy. These injections must be prescribed on a controlled drug form and do not attract a patient co-payment.

Oil in water emulsion

The healthE Fatty Cream brand of oil in water emulsion cream will be subsidised from 1 August 2009; however, supplies of healthE Fatty Cream are not expected to be available until the second week of August. PHARMAC has listed this product without stock being in the market so that as soon as product becomes available pharmacies can immediately dispense, and claim, for healthE Fatty Cream.

Pilocarpine eye drops

The Isopto Carpine brand of pilocarpine eye drops 1%, 2% and 4% will be subsidised from 1 August 2009. These will be listed under Section 29 of the Medicines Act as they are not registered. These listings follow the discontinuation of Pilopt eye drops by Sigma Pharmaceuticals.

Chlorpheniramine maleate oral liquid – fully subsidised

The Histafen brand of chlorpheniramine maleate oral liquid will be fully subsidised from 1 August 2009, following a price and subsidy increase. This decision makes chlorpheniramine maleate the third fully subsidised oral liquid antihistamine, along with cetirizine hydrochloride and loratadine.

tender News

Sole Subsidised Supply changes – effective 1 September 2009

Chemical Name Ropinirole hydrochloride Ropinirole hydrochloride Ropinirole hydrochloride Ropinirole hydrochloride Presentation; Pack size Tab 0.25 mg; 84 tab Tab 1 mg; 84 tab Tab 2 mg; 84 tab Tab 3 mg; 84 tab Sole Subsidised Supply brand (and supplier) Ropin (Mylan) Ropin (Mylan) Ropin (Mylan) Ropin (Mylan)

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 September 2009 • Blood glucose diagnostic test strip (CareSens II) blood glucose test strip – new listing • Blood glucose diagnostic test meter (CareSens II and CareSens POP) meter – new listing • Clopidogrel (Apo-Clopidogrel) tab 75 mg – subsidy and price decrease • Clopidogrel (Plavix) tab 75 mg – subsidy decrease • Cyclosporin A cap 25 mg, 50 mg and 100 mg, and oral liq 100 mg per ml – removal of Special Authority criteria • Insulin pen needles (SC Profi-Fine) 29 g x 12.7 mm, 31 g x 5 mm, 31 g x 6 mm and 31 g x 8 mm – new listing • Insulin pen needles (B-D Micro-Fine) 31 g x 5 mm – subsidy decrease • Insulin syringes, disposable with attached needle (DM Ject) syringe 0.3 ml with 29 g x 12.7 mm needle, syringe 0.3 ml with 31 g x 8 mm needle, syringe 0.5 ml with 29 g x 12.7 mm needle, syringe 0.5 ml with 31 g x 8 mm needle, syringe 1 ml with 29 g x 12.7 mm needle and syringe 1 ml with 31 g x 8 mm needle – new listing • Metoprolol succinate (Betaloc CR) tab long-acting 23.75 mg, 47.5 mg, 95 mg and 190 mg – subsidy decrease and removal of higher subsidy with endorsement • Potassium iodate (NeuroKare) tab 150 µg – new listing • Zuclopenthixol hydrochloride (Clopixol) tab 10 mg – new listing

Sole Subsidised Supply Products – cumulative to August 2009

Generic Name

Acarbose Acetazolamide Allopurinol Alprazolam Amantadine hydrochloride Amlodipine Amoxycillin

Presentation

Tab 50 mg & 100 mg 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 Tab amoxycillin 500 mg with potassium clavulanate 125 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% Nail soln 8% Tab 250 mg, 500 mg & 750 mg

Brand Name Expiry Date*

Glucobay Diamox Apo-Allopurinol Arrow-Alprazolam Symmetrel Apo-Amlodipine Ospamox Ibiamox Apo-Amoxi Synermox 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 Batrafen Rex Medical 2012 2011 2011 2010 2011 2011 2011 2010 2011 2011 2010 2011 2011 2011 2011 2010 2011 2010 2011 2011 2011 2010 2010 2011 2011 2010 2011 2011 2012 2011

Amoxycillin clavulanate 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 Ciclopiroxolamine Ciprofloxacin

*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 August 2009

Generic Name

Citalopram Clarithromycin Clonazepam Clotrimazole

Presentation

Tab 20 mg Tab 250 mg Grans for oral liq 125 mg per 5 ml Tab 500 µg & 2 mg 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*

Arrow-Citalopram Klamycin Klacid Paxam 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 Clexane Comtan E-Mycin E-Mycin E-Mycin Brevinor 21 Brevinor 1/21 Brevinor 1/28 2010 2010 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 Inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg & 150 mg Tab 200 mg Tab 400 mg 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

2011

Diltiazem hydrochloride

2011

Dipyridamole Doxazosin mesylate Emulsifying ointment Enoxaparin sodium (low molecular weight heparin) Entacapone Erythromycin ethyl succinate

2011 2010 2011 2012 2012 2012 2011 2010

Ethinyloestradiol with norethisterone

Sole Subsidised Supply Products – cumulative to August 2009

Generic Name

Ferrous sulphate Finasteride Flucloxacillin Fluconazole Fludarabine phosphate Fluocortolone caproate with fluocortolone pivalate and cinchocaine

Presentation

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 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 Tab 40 mg Crm 2% Oint 2% Cap 100 mg, 300 mg & 400 mg 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 Tab 200 mg Eye drops 0.5% Inj 20 mg, 1 ml Tab 20 mg Tab 200 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

Brand Name Expiry Date*

Ferodan Fintral Flucloxin Pacific Fludara Fludara Ultraproct Ultraproct 2010 2011 2011 2011 2011 2010

Fluoxetine hydrochloride Furosemide Fusidic acid Gabapentin Gliclazide Glipizide Glyceryl trinitrate

Fluox Fluox Diurin 40 Foban Foban Nupentin Apo-Gliclazide Minidiab Lycinate Nitrolingual pumpspray Nitroderm TTS 5 Nitroderm TTS 10 Serenace Serenace PSM Locoid DP Lotn HC Plaquenil Methopt Buscopan Gastrosoothe Ethics Ibuprofen Fenpaed Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Ferrum H

2010 2012 2010 31/7/12 2011 2011 2011

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

2010 2011 2010 2011 2012 2011 2011 2012 2010 2010

Iron polymaltose

2011

Sole Subsidised Supply Products – cumulative to August 2009

Generic Name

Itraconazole Ketoconazole Lactulose Levobunolol Lignocaine hydrochloride

Presentation

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 Tab 10 mg Oral liq 1 mg per ml

Brand Name Expiry Date*

Sporanox Sebizole Duphalac Betagan Xylocaine Xylocaine Xylocaine EMLA EMLA Nodia Loraclear Hayfever Relief Lorapaed Derbac M A-Lices Foremount Child’s Silicone Mask De-Worm Colofac Provera Biodone Biodone Forte Biodone Extra Forte Methatabs Methotrexate Ebewe Methotrexate Ebewe Prodopa Depo-Medrol Depo-Medrol with Lidocaine Pfizer Multichem Mayne Mayne Apo-Nadolol ReVia Sonaflam AstraZeneca 2010 2010 2010 2011 2010 2010 2010

Lignocaine with prilocaine

2010

Loperamide hydrochloride Loratadine

Malathion Maldison Mask for Spacer Device Mebendazole Mebeverine hydrochloride Medroxyprogesterone acetate Methadone hydrochloride

Liq 0.5% Shampoo 1% Device Tab 100 mg Tab 135 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml 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

2010 2010 30/9/11 2011 2011 2010 2012 2010 2011 2011 2011 2011 2011 2011 2011 2010 2010 2010 2010

Methotrexate Methyldopa Methylprednisolone acetate Methylprednisolone acetate with lignocaine Metoclopramide hydrochloride Miconazole nitrate Morphine sulphate Nadolol Naltrexone hydrochloride Naproxen sodium Neostigmine

Sole Subsidised Supply Products – cumulative to August 2009

Generic Name

Nicotine

Presentation

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

Brand Name Expiry Date*

Habitrol Habitrol Habitrol Habitrol Primolut N Norpress Nilstat Nilstat Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Zofran Zofran Zydis 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 2010

Norethisterone Nortriptyline hydrochloride Nystatin

2011 2011 2011 2010 2011

Omeprazole

Ondansetron Oxybutynin Oxycodone hydrochloride Pamidronate disodium

Tab 4 mg & 8 mg Tab disp 4 mg & 8 mg Tab 5 mg Oral liq 5 mg per 5 ml Inj 10 mg per ml, 1 ml & 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

2010 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

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

2010 2010 30/9/11 2011 2010

2010 2011 2011 2010

Sole Subsidised Supply Products – cumulative to August 2009

Generic Name

Prednisone Procaine penicillin Promethazine Quinapril Quinapril with hydroclorothiazide

Presentation

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 Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Grans eff 4 g sachets 230 ml Liq Soln 2.3%

Brand Name Expiry Date*

Apo-Prednisone Cilicaine Allersoothe Accupril Accuretic 10 Accuretic 20 Peptisoothe Mycobutin Salapin Arrow-Simva 10 mg Arrow-Simva 20 mg Arrow-Simva 40 mg Arrow-Simva 80 mg Ural Space Chamber Midwest Pinetarsol 2010 2010 2010 2011 2011 2011 2011 2011 2011

Ranitidine hydrochloride Rifabutin Salbutamol Simvastatin

Sodium citro-tartrate Spacer Device Syrup (pharmaceutical grade) Tar with triethanolamine lauryl sulphate and fluorescein sodium Temazepam Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate Triamcinolone acetonide

2010 30/9/11 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 August changes in bold

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 August 2009

32 43 SODIUM NITROPRUSSIDE ❋ Test strip – Not on a BSO ........................................................ 14.14 ENOXAPARIN SODIUM – Special Authority see SA0975 – Retail pharmacy Inj 20 mg ................................................................................ 39.20 Inj 40 mg ................................................................................ 52.30 Inj 60 mg ................................................................................ 78.85 Inj 80 mg .............................................................................. 105.12 Inj 100 mg ............................................................................ 135.20 Inj 120 mg ............................................................................ 168.00 Inj 150 mg ............................................................................ 192.00 20 strip OP ✔ Ketostix 10 10 10 10 10 10 10 ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane

➽ SA0975 Special Authority for Subsidy Initial application - (Pregnancy or Malignancy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Low molecular weight heparin treatment is required during a patients pregnancy; or 2 For the treatment of venous thromboembolism where the patient has a malignancy. Initial application - (Venous thromboembolism other than in pregnancy or malignancy) from any relevant practitioner. Approvals valid for 1 month for applications meeting the following criteria: Any of the following: 1 For the short-term treatment of venous thromboembolism prior to establishing a therapeutic INR with oral anti-coagulant treatment; or 2 For the prophylaxis and treatment of venous thromboembolism in high risk surgery; or 3 To enable cessation/re-establishment of existing warfarin treatment pre/post surgery; or 4 For the prophylaxis and treatment of venous thromboembolism in Acute Coronary Syndrome surgical intervention; or 5 To be used in association with cardioversion of atrial fibrillation. Renewal application - (Pregnancy or Malignancy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Low molecular weight heparin treatment is required during a patient’s pregnancy; or 2 For the treatment of venous thromboembolism where the patient has a malignancy. Renewal application - (Venous thromboembolism other than in pregnancy or malignancy) from any relevant practitioner. Approvals valid for 1 month for applications where low molecular weight heparin treatment or prophylaxis is required for a second or subsequent event (surgery, ACS, cardioversion, or prior to oral anticoagulation). 60 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP .................................................................... 2.78 Lotn, BP ................................................................................. 16.70

100 ml 2,000 ml

✔ healthE ✔ API ✔ healthE Fatty Cream

OIL IN WATER EMULSION ❋ Crm .......................................................................................... 2.80 500 g Note – stock is not expected to be available until approximately 12 August 2009.

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

New Listings - effective 1 August 2009 (continued)

79 82 LEVOTHYROXINE ❋ Tab 25 µg .............................................................................. 43.24 ‡ Safety cap for extemporaneously compounded oral liquid preparations. ❋ Tab 50 µg .............................................................................. 45.00 ‡ Safety cap for extemporaneously compounded oral liquid preparations. ❋ Tab 100 µg ............................................................................ 46.75 ‡ Safety cap for extemporaneously compounded oral liquid preparations. LEUPRORELIN – Hospital pharmacy [HP3] Inj 3.75 mg prefilled syringe .................................................. 221.60 Inj 11.25 mg prefilled syringe ................................................ 591.68 Inj 30 mg prefilled syringe .................................................. 1,109.40 ENTECAVIR – Special Authority see SA0977 – Retail pharmacy Tab 0.5 mg ........................................................................... 400.00 1,000 1,000 1,000 ✔ Synthroid ✔ Synthroid ✔ Synthroid

1 1 1 30

✔ Lucrin Depot PDS ✔ Lucrin Depot PDS ✔ Lucrin Depot PDS ✔ Baraclude

➽ SA0977 Special Authority for Subsidy Initial application only from a gastroenterologist or infectious disease specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 Patient is Hepatitis B nucleoside analogue treatment-naïve; and 3 Entecavir dose 0.5 mg/day; and 4 Either: 4.1 ALT greater than upper limit of normal; or 4.2 Bridging fibrosis of cirrhosis (Metavir stage 3 or greater) on liver histology; and 5 Either: 5.1 HBeAg positive; or 5.2 patient has ≥ 2,000 IU HBV DNA units per ml and fibrosis (Metavir stage 2 or greater) on liver histology; and 6 All of the following: 6.1 No continuing alcohol abuse or intravenous drug use; and 6.2 Not co-infected with HCV, HIV or HDV; and 6.3 Neither ALT nor AST greater than 10 times upper limit of normal; and 6.4 No history of hypersensitivity to entecavir; and 6.5 No previous documented lamivudine resistance (either clinical or genotypic). Notes: • Entecavir should be continued for 6 months following documentation of complete HBeAg seroconversion (defined as loss of HBeAg plus appearance of anti-HBe plus loss of serum HBV DNA) for patients who were HBeAg positive prior to commencing this agent. This period of consolidation therapy should be extended to 12 months in patients with advanced fibrosis (Metavir Stage F3 or F4). • Entecavir should be taken on an empty stomach to improve absorption. 107 FENTANYL CITRATE a) Only on a controlled drug form b) No patient co-payment payable Inj 50 µg per ml, 2 ml ............................................................... 6.10 Inj 50 µg per ml, 10 ml ........................................................... 15.65 THIOTEPA – PCT only - Specialist Inj 15 mg ............................................................................. CBS AMSACRINE – PCT only - Specialist Inj 75 mg ............................................................................. CBS

5 5 1 6

✔ Hospira ✔ Hospira ✔ Bedford S29 ✔ Amsidyl S29

132 135

▲

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 August 2009 (continued)

139 DASATINIB – Special Authority see SA0976 Tab 20 mg ........................................................................ 3,774.06 Tab 50 mg ........................................................................ 6,214.20 Tab 70 mg ........................................................................ 7,692.58 60 60 60 ✔ Sprycel ✔ Sprycel ✔ Sprycel

➽ SA0976 Special Authority for Subsidy Special Authority approved by PHARMAC. Notes: Application details may be obtained from PHARMAC’s website http://www.pharmac.govt.nz, and prescriptions should be sent to: The Coordinator Phone: (04) 460 4990 PHARMAC Facsimile: (04) 916 7571 PO Box 10 254 Email: mary.chesterfield@pharmac.govt.nz Wellington Special Authority criteria for CML – access by application to PHARMAC 1) Funded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) in blast crisis, accelerated phase, or in chronic phase. 2) Maximum dose of 140 mg/day for accelerated or blast phase and 100 mg/day for chronic phase CML. 3) Subsidised for use as monotherapy only. 4) Initial approvals valid seven months. 5) Subsequent approval(s) are granted on application and are valid for six months. The first reapplication (after seven months) should provide details of the haematological response. The third reapplication should provide details of the cytogenetic response after 14-18 months from initiating therapy. All other reapplications should provide details of haematological response, and cytogenetic response if such data is available. Applications to be made and subsequent prescriptions can be written by a haematologist or an oncologist. Note: Dasatinib is indicated for the treatment of adults with chronic, accelerated or blast phase CML with resistance or intolerance to prior therapy including imatinib. Guideline on discontinuation of treatment for patients with CML a) Prescribers should consider discontinuation of treatment if, after 6 months from initiating therapy, a patient did not obtain a haematological response as defined as any one of the following three levels of response: 1) complete haematologic response (as characterised by an absolute neutrophil count (ANC) > 1.5 × 109/L, platelets > 100 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or 2) no evidence of leukaemia (as characterised by an absolute neutrophil count (ANC) > 1.0 × 109/L, platelets > 20 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or 3) return to chronic phase (as characterised by BM and PB blasts < 15%, BM and PB blasts and promyelocytes < 30%, PB basophils < 20% and absence of extramedullary disease other than spleen and liver). b) Prescribers should consider discontinuation of treatment if, after 18 months from initiating therapy, a patient did not obtain a major cytogenetic response defined as 0-35% Ph+ metaphases. 142 156 TAMOXIFEN CITRATE ❋ Tab 20 mg ................................................................................ 6.66 PILOCARPINE ❋ Eye drops 1% ........................................................................... 4.26 ❋ Eye drops 2% ........................................................................... 5.35 ❋ Eye drops 4% ........................................................................... 7.99 60 ✔ Tamoxifen Sandoz

15 ml OP 15 ml OP 15 ml OP

✔ Isopto Carpine S29 ✔ Isopto Carpine S29 ✔ Isopto Carpine S29

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

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 SA0967 – Hospital pharmacy [HP1] Tab 62.5 mg ...................................................................... 4,585.00 Tab 125 mg ....................................................................... 4,585.00 ➽ SA0967 Special Authority for Subsidy Special Authority approved by the Pulmonary Arterial Hypertension Panel continued...

▲

60 60

✔ Tracleer ✔ Tracleer

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... 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 SA0969 – Hospital pharmacy [HP1] Nebuliser soln 10 µg per ml, 2 ml ....................................... 1,185.00 30 ✔ Ventavis

➽ SA0969 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 SA0968 – Hospital pharmacy [HP1] Tab 25 mg .............................................................................. 47.00 Tab 50 mg .............................................................................. 59.50 Tab 100 mg ............................................................................ 66.00 4 4 4 ✔ Viagra ✔ Viagra ✔ Viagra

➽ SA0968 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 76 83 CYPROTERONE ACETATE – Hospital pharmacy [HP3]-Specialist Tab 100 mg ........................................................................... 41.50 50 ✔ Siterone

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. 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)

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

▲

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)

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... 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

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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.

▲

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)

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

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

172

▲

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 August 2009

32 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 – Not on a BSO .......................................................... 8.50 10 strip OP ✔ Optium Blood Ketone Test Strips LEUPRORELIN – Special Authority see SA0837 – Hospital pharmacy [HP3] Inj 3.75 mg .......................................................................... 221.60 Inj 3.75 mg prefilled syringe .................................................. 221.60 Inj 7.5 mg ............................................................................ 184.90 Inj 11.25 mg ........................................................................ 591.68 Inj 11.25 mg prefilled syringe ................................................ 591.68 Inj 22.5 mg .......................................................................... 554.70 Inj 30 mg ............................................................................. 739.60 Inj 30 mg prefilled syringe .................................................. 1,109.40 Inj 45 mg .......................................................................... 1,109.40 1 1 1 1 1 1 1 1 1 ✔ Lucrin Depot ✔ Lucrin Depot PDS ✔ Eligard ✔ Lucrin Depot ✔ Lucrin Depot PDS ✔ Eligard ✔ Eligard ✔ Lucrin Depot PDS ✔ Eligard

➽ SA0837 Special Authority for Subsidy Initial application — (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application — (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year where the patient has advanced prostatic cancer. Note: Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiated Initial application — (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note: The maximum treatment period for a GnRH analogue is: • 3 months to assess whether surgery is appropriate • 3 months for infertile patients after surgery • 6 months for patients with symptoms of endometriosis After the first 3 months patients should be assessed to determine whether there has been a satisfactory response to the first 3 months treatment Initial application — (Precocious puberty) only from a paediatrician or endocrinologist. Approvals valid for 1 year where the patients is affected by gonadotropin dependent precocious puberty. Renewal — (Breast or prostate cancer) from any medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. Renewal — (Endometriosis) from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Either: 1 Both: 1.1 There has been a satisfactory response to the first 3 months treatment; and 1.2 Surgery is inappropriate; or 2 The first three months of therapy did not follow surgery for infertility. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. continued... 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 Restrictions - effective 1 August 2009 (continued)

continued... Renewal — (Precocious puberty) only from a paediatrician or endocrinologist. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. 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 ✔ Fluvax ✔ Fluarix 90.00 10 ✔ Vaxigrip ✔ Fluarix

▲

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 August 2009 (continued)

101 ADALIMUMAB – Special Authority see SA0974 0812 – Retail pharmacy Inj 40 mg per 0.8 ml prefilled pen ...................................... 1,799.92 Inj 40 mg per 0.8 ml prefilled syringe ................................. 1,799.92 2 2 ✔ HumiraPen ✔ Humira

➽ SA0974 0812 Special Authority for Subsidy Initial application – (rheumatoid arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and 5 Either: 5.1 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of cyclosporin alone or in combination with another agent; or 5.2 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of leflunomide alone or in combination with another agent; and 6 Either: 6.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 6.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 7 Either: 7.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 7.2 C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months. Initial application – (Crohn’s disease) only from a gastroenterologist. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Patient has severe active Crohn’s disease; and 2 Any of the following: 2.1 Patient has a Crohn’s Disease Activity Index (CDAI) score of greater than or equal to 300; or 2.2 Patient has extensive small intestine disease affecting more than 50 cm of the small intestine; or 2.3 Patient has evidence of short gut syndrome or would be at risk of short gut syndrome with further bowel resection; or 2.4 Patient has an ileostomy or colostomy and has intestinal inflammation; and 3 Patient has tried but had an inadequate response to, or has experienced intolerable side effects from, prior systemic therapy with immunomodulators at maximum tolerated doses (unless contraindicated) and corticosteroids; and 4 Surgery (or further surgery) is considered to be clinically inappropriate. Initial application – (severe chronic plaque psoriasis) only from a dermatologist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 Either: 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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2009 (continued)

continued... 1.1 Patient has “whole body” severe chronic plaque psoriasis with a Psoriasis Area and Severity Index (PASI) score of greater than 15, where lesions have been present for at least 6 months from the time of initial diagnosis; or 1.2 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and 2 Patient has tried, but had an inadequate response (see Note) to, or has experienced intolerable side effects from, at least three of the following (at maximum tolerated doses unless contraindicated): phototherapy, methotrexate, cyclosporin, or acitretin; and 3 A PASI assessment has been completed for at least the most recent prior treatment course (but preferably all prior treatment courses), preferably while still on treatment but no longer than 1 month following cessation of each prior treatment course; and 4 The most recent PASI assessment is no more than 1 month old at the time of application. Note: “Inadequate response” is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment. Initial application – (ankylosing spondylitis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has a confirmed diagnosis of ankylosing spondylitis present for more than six months; and 2 Patient has low back pain and stiffness that is relieved by exercise but not by rest; and 3 Patient has bilateral sacroiliitis demonstrated by plain radiographs, CT or MRI scan; and 4 Patient’s ankylosing spondylitis has not responded adequately to treatment with two or more nonsteroidal anti-inflammatory drugs (NSAIDs), in combination with anti-ulcer therapy if indicated, while patient was undergoing at least 3 months of an exercise regimen supervised by a physiotherapist; and 5 Either: 5.1 Patient has limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or 5.2 Patient has limitation of chest expansion by at least 2.5 cm below the average normal values corrected for age and gender (see Notes); and 6 A Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 6 on a 0-10 scale; and 7 Either: 7.1 An elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 7.2 A C-reactive protein (CRP) level greater than 15 mg per litre. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI, ESR and CRP measures must be no more than 1 month old at the time of initial application. Average normal chest expansion corrected for age and gender: 18-24 years – Male: 7.0 cm; Female: 5.5 cm 25-34 years – Male: 7.5 cm; Female: 5.5 cm 35-44 years – Male: 6.5 cm; Female: 4.5 cm 45-54 years – Male: 6.0 cm; Female: 5.0 cm 55-64 years – Male: 5.5 cm; Female: 4.0 cm 65-74 years – Male: 4.0 cm; Female: 4.0 cm 75+ years – Male: 3.0 cm; Female: 2.5 cm

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 August 2009 (continued)

continued... Initial application – (psoriatic arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has had severe active psoriatic arthritis for six months duration or longer; and 2 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 3 Patient has tried and not responded to at least three months of sulphasalazine at a dose of at least 2 g per day or leflunomide at a dose of up to 20 mg daily (or maximum tolerated doses); and 4 Either: 4.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 4.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 5 Any of the following: 5.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 5.2 Patient has an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 5.3 ESR and CRP not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months. Renewal – (rheumatoid arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Either: 3.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or 3.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician. Renewal – (Crohn’s disease) only from a gastroenterologist or Practitioner on the recommendation of a gastroenterologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Either: 1.1 Applicant is a gastroenterologist; or 1.2 Applicant is a Practitioner and confirms that a gastroenterologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 The treatment remains appropriate and the patient is benefiting from treatment. Renewal – (severe chronic plaque psoriasis) only from a dermatologist or Practitioner on the recommendation of a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Either: 1.1 Applicant is a dermatologist; or 1.2 Applicant is a Practitioner and confirms that a dermatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2009 (continued)

continued... 2 Either: 2.1 Both: 2.1.1 Patient has “whole body” severe chronic plaque psoriasis; and 2.1.2 Following each prior adalimumab treatment course the patient has a PASI score which is reduced by 75% or more, or is sustained at this level, when compared with the preadalimumab treatment baseline value; or 2.2 Both: 2.2.1 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and 2.2.2 Either: 2.2.2.1 Following each prior adalimumab treatment course the patient has a reduction in the PASI symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the treatment course baseline values; or 2.2.2.2 Following each prior adalimumab treatment course the patient has a reduction of 75% or more in the skin area affected, or sustained at this level, as compared to the pre-adalimumab treatment baseline value. Note: An adalimumab treatment course is defined as a minimum of 12 weeks of adalimumab treatment. Renewal – (ankylosing spondylitis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Following 12 weeks of adalimumab treatment, BASDAI has improved by 4 or more points from preadalimumab baseline on a 10 point scale, or by 50%, whichever is less; and 3 ESR or CRP is within the normal range; and 4 Physician considers that the patient has benefited from treatment and that continued treatment is appropriate. Renewal – (psoriatic arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Either: 2.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the treating physician; or 2.2 The patient demonstrates at least a continuing 50% improvement in active joint count from baseline and a clinically significant response to prior adalimumab treatment in the opinion of the treating physician. Initial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient is an adult who has had severe and active erosive rheumatoid arthritis for six months duration or longer; and continued...

▲

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

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

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 August 2009 (continued)

continued... 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and 5 Either: 5.1 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of cyclosporine alone or in combination with another agent; or 5.2 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of leflunomide alone or in combination with another agent; and 6 Either: 6.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 6.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 7 Either: 7.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 7.2 C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months; and 8 The patient consents to details of their treatment being held on a central registry and has signed a consent form outlining the conditions of ongoing treatment. Notes: A patient declaration form http://www.pharmac.govt.nz/special_authority_forms/SA0812-declaration.pdf must be signed by the legal guardian of the patient and the prescriber in the presence of a witness (over 18 years of age). Applicants are requested to register the treatment with the New Zealand Rheumatology Association by completing the forms and questionnaire http://www.pharmac.govt.nz/special_authority_forms/SA0812-survey. pdf . Renewal only from a rheumatologist or general physician on the recommendation of a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Either: 2.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or 2.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician.

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 Restrictions - effective 1 August 2009 (continued)

112 GABAPENTIN (NEURONTIN) – Special Authority see SA0973 0936 – Retail pharmacy ▲ Tab 600 mg ........................................................................... 79.79 100 ✔ Neurontin ▲ Cap 100 mg ........................................................................... 15.67 100 ✔ Neurontin ▲ Cap 300 mg ........................................................................... 47.00 100 ✔ Neurontin ▲ Cap 400 mg ........................................................................... 62.66 100 ✔ Neurontin ➽ SA0973 0936 Special Authority for Subsidy Subsidy for patients pre-approved by PHARMAC on 1 August 2009. Approvals valid without further renewal unless notified. Note – Special Authority SA0936 continues to apply to the Nupentin brand of gabapentin. Initial application — (Epilepsy - new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Either: 1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents. Note: “Optimal treatment with other antiepilepsy agents” is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient’s age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Initial application — (Epilepsy - patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and or quality of life from gabapentin, topiramate, vigabatrin and/or lamotrigine. Note: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient’s perspective. Initial application — (Neuropathic pain - new patients) from any relevant practitioner. Approvals valid for 3 months where the patient has tried and failed, or has been unable to tolerate, treatment with a tricyclic antidepressant. Initial application — (Neuropathic pain - patient has had an approval for gabapentin for neuropathic pain prior to 1 August 2007) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Renewal — (Epilepsy) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and or quality of life. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient’s perspective. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Renewal — (Neuropathic pain) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Note: If the patient had an approval for gabapentin for neuropathic pain prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application.

▲

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

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. Liver function tests should be performed at baseline. continued...

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 Restrictions - effective 1 July 2009 (continued)

continued... 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. 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

▲

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)

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: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or continued... 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 July 2009 (continued)

continued... 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; ii) the following chronic respiratory disease: continued... 1) asthma, if on a regular preventative therapy, or 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... 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 2 1 1 mg ✔ Mabthera ✔ Mabthera ✔ Baxter ✔ Biomed

142

➽ SA0961 0884 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 12 months for applications meeting the continued... following criteria: 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 July 2009 (continued)

continued... 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. 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. 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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2009 (continued)

continued... 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.

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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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

▲

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

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

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 August 2009

38 FERROUS SULPHATE ( price) ❋ Tab long-acting 325 mg ............................................................ 1.01 (4.26) 5.06 (15.58) FERROUS SULPHATE WITH FOLIC ACID ( price) ❋ Tab long-acting 325 mg with folic acid 350 µg .......................... 1.80 (3.73) TERAZOSIN HYDROCHLORIDE ( price) ❋ Tab 2 mg ................................................................................. 1.30 ❋ Tab 5 mg ................................................................................. 1.62 ATENOLOL ( subsidy) ❋ Tab 50 mg ................................................................................ 6.18 ❋ Tab 100 mg ............................................................................ 10.73 DIFLUCORTOLONE VALERATE ( price) Crm 0.1% ................................................................................. 8.97 (15.86) Fatty oint 0.1% ......................................................................... 8.97 (15.86) 30 Ferro-Gradumet 150 Ferro-Gradumet 30 Ferrograd-Folic 28 28 500 500 50 g OP Nerisone 50 g OP Nerisone ✔ Hytrin ✔ Hytrin ✔ Pacific Atenolol ✔ Pacific Atenolol

HYDROCORTISONE ( subsidy) ❋ Powder – Only in combination ................................................. 33.00 25 g (37.64) m-Hydrocortisone Up to 5% in a dermatological base (not proprietary Topical Corticosteriod – Plain) with or without other dermatological galenicals. Refer, page 159 BETAMETHASONE VALERATE WITH FUSIDIC ACID ( price) Crm 0.1% with fusidic acid 2% ................................................. 3.49 (9.61) a) Maximum of 15 g per prescription b) Only on a prescription OESTRADIOL – See prescribing guideline ( price) ❋ Tab 1 mg ................................................................................. 4.12 (10.55) ❋ Tab 2 mg ................................................................................. 4.12 (10.55) 15 g OP Fucicort

77 78

28 OP Estrofem 28 OP Estrofem

OESTRADIOL WITH NORETHISTERONE – See prescribing guideline ( price) ❋ Tab 1 mg with 0.5 mg norethisterone acetate ............................ 5.40 28 OP (14.52) ❋ Tab 2 mg with 1 mg norethisterone acetate ............................... 5.40 28 OP (14.52) ❋ Tab 2 mg with 1 mg norethisterone acetate (10), and 2 mg oestradiol tab (12) and 1 mg oestradiol tab (6) ...................... 5.40 28 OP (14.52) Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

Kliovance Kliogest Trisequens

▲

❋ 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 August 2009 (continued)

112 GABAPENTIN – Special Authority SA0936 – Retail pharmacy ( subsidy) ▲ Cap 100 mg .............................................................................. 7.16 ▲ Cap 300 mg ............................................................................ 11.50 ▲ Cap 400 mg ............................................................................ 14.75 CLOZAPINE – Hospital pharmacy [HP4] ( subsidy) Tab 25 mg ............................................................................... 6.69 13.37 Tab 50 mg ............................................................................... 8.67 17.33 Tab 100 mg ........................................................................... 17.33 34.65 Tab 200 mg ........................................................................... 34.65 69.30 Suspension 50 mg per ml ....................................................... 17.33 LITHIUM CARBONATE ( subsidy) Tab 250 mg ............................................................................ 36.10 Tab 400 mg ............................................................................ 13.50 INTERFERON BETA-1-ALPHA – Special Authority see SA0855 ( subsidy) Inj 6 million iu prefilled syringe ........................................... 1,329.65 Inj 6 million iu per vial ........................................................ 1,329.65 INTERFERON BETA-1-BETA – Special Authority see SA0855 ( subsidy) Inj 8 million iu per 1 ml ...................................................... 1,436.79 EPIRUBICIN – PCT only – Specialist ( subsidy) Inj 2 mg per ml, 5 ml ............................................................... 25.00 EPIRUBICIN – PCT only – Specialist ( subsidy) Inj 2 mg per ml, 25 ml ............................................................. 87.50 Inj 2 mg per ml, 50 ml ........................................................... 155.00 Inj 2 mg per ml, 100 ml ......................................................... 310.00 Inj 1 mg for ECP ........................................................................ 1.90 CHLORPHENIRAMINE MALEATE ( subsidy) ❋‡Oral liq 2 mg per 5 ml .............................................................. 8.06 FUSIDIC ACID ( price) Eye drops 1% ........................................................................... 4.50 (10.68) 100 100 100 50 100 50 100 50 100 50 100 100 ml 500 100 4 4 15 1 1 1 1 1 mg 500 ml 5 g OP Fucithalmic ✔ Nupentin ✔ Nupentin ✔ Nupentin ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Lithicarb ✔ Lithicarb ✔ Avonex ✔ Avonex ✔ Betaferon ✔ Epirubicin Ebewe ✔ Epirubicin Ebewe ✔ Epirubicin Ebewe ✔ Epirubicin Ebewe ✔ Baxter ✔ Histafen

119

125

125 137 137

146 153

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

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)

32 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 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 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 500 g OP Normacol 500 g OP Normacol Plus 100 ✔ Ferro-tab

▲

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

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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)

38 38 42 43 FERROUS FUMARATE WITH FOLIC ACID ( subsidy) Tab 310 mg with folic acid 350 µg ............................................ 4.75 60 ✔ Ferro-F-Tabs

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

76 84

CYPROTERONE ACETATE – Hospital Pharmacy [HP3] – Specialist ( subsidy) Tab 50 mg .............................................................................. 21.10 50

✔ Siterone

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

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)

85 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

▲

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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Subsidy (Mnfr’s price) $

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) 30 30 30 28 Premarin 28 Premarin ✔ Cardizem CD ✔ Cardizem CD ✔ Cardizem CD

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 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

▲

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 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 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

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)

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

▲

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 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 Section F: Part II

Effective 1 August 2009

191 NERVOUS SYSTEM GABAPENTIN (NEURONTIN)

Changes to Sole Subsidised Supply

Effective 1 August 2009

For the list of new Sole Subsidised Supply products effective 1 August 2009 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 10-15.

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 August 2009

41 43 47 84 MENADIONE SODIUM BISULPHITE ❋ Tab 10 mg ............................................................................... 4.75 HEPARINISED SALINE ❋ Inj 100 iu per ml, 2 ml .............................................................. 8.30 SIMVASTATIN – See prescribing guideline ❋ 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) MEBENDAZOLE – Only on a prescription Tab 100 mg ............................................................................. 1.26 (3.44) 2.53 (7.43) 3.79 (7.59) AMOXYCILLIN CLAVULANATE Tab amoxycillin 500 mg with potassium clavulanate 125 mg – Up to 30 tab available on a PSO ............................................. 5.02 (6.40) IBUPROFEN ❋ Tab 200 mg ............................................................................. 1.60 (1.78) CARBOPLATIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.13 CARMUSTINE – PCT only – Specialist Inj 100 mg for ECP ............................................................... 204.13 CISPLATIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.46 CYCLOPHOSPHAMIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.02 IFOSFAMIDE – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.09 OXALIPLATIN – PCT only – Specialist – Special Authority see SA0900 Inj 1 mg for ECP ....................................................................... 8.74 100 10 30 30 30 30 ✔ K-Thrombin ✔ Hospira S29 ✔ SimvaRex Lipex ✔ SimvaRex Lipex ✔ SimvaRex Lipex ✔ SimvaRex Lipex

2 Vermox 4 Vermox 6 Vermox

20 Augmentin 100 I-Profen 1 mg ✔ Biomed

99 131 131 131 131 131 132

100 mg OP ✔ Biomed 1 mg 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items – effective 1 August 2009 (continued)

132 133 133 CALCIUM FOLINATE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 CLADRIBINE – PCT only – Specialist Inj 10 mg for ECP ................................................................. 749.96 CYTARABINE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.03 Inj 100 mg intrathecal syringe for ECP – PCT only – Specialist 16.00 FLUDARABINE PHOSPHATE – PCT only – Specialist Inj 50 mg for ECP ................................................................. 286.00 FLUOROURACIL SODIUM Inj 1 mg for ECP – PCT only – Specialist ................................... 0.01 1 mg ✔ Biomed

10 mg OP ✔ Biomed 1 mg ✔ Biomed 100 mg OP ✔ Biomed 50 mg OP ✔ Biomed 1 mg ✔ Biomed

133 133 133 134 135 135 135 135 136 136 136 136 137 137

GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA0877 Inj 1 mg for ECP ....................................................................... 0.38 1 mg ✔ Biomed IRINOTECAN – PCT only – Specialist – Special Authority see SA0878 Inj 1 mg for ECP ....................................................................... 3.19 METHOTREXATE ❋ Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 ❋ Inj 5 mg intrathecal syringe for ECP – PCT only – Specialist ....... 4.73 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 1,000 iu for ECP .................................................................. 5.26 1 mg 1 mg 5 mg OP 1,000 iu ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed

COLASPASE (L-ASPARAGINASE) – PCT only – Specialist Inj 10,000 iu for ECP ............................................................ 102.32 10,000 iu OP ✔ Biomed DACARBAZINE – PCT only – Specialist Inj 200 mg for ECP ................................................................. 43.86 DACTINOMYCIN (ACTINOMYCIN D) – PCT only – Specialist Inj 0.5 mg for ECP .................................................................. 13.52 DAUNORUBICIN – PCT only – Specialist Inj 20 mg for ECP ................................................................... 99.00 DOCETAXEL – PCT only – Specialist – Special Authority see SA0880 Inj 1 mg for ECP ..................................................................... 23.81 DOXORUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.87 EPIRUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 2.74 ETOPOSIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.30 200 mg OP ✔ Biomed 0.5 mg OP ✔ Biomed 20 mg OP ✔ Biomed 1 mg 1 mg 1 mg 1 mg ✔ Biomed

✔ Biomed ✔ Biomed ✔ Biomed

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 August 2009 (continued)

137 137 137 137 137 138 138 139 139 139 142 143 170 ETOPOSIDE PHOSPHATE – PCT only – Specialist Inj 1 mg (of etoposide base) for ECP ........................................ 0.47 IDARUBICIN HYDROCHLORIDE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 37.74 MESNA – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.02 MITOMYCIN C – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 11.85 MITOZANTRONE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 12.43 PACLITAXEL – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 1.32 TENIPOSIDE – PCT only – Specialist Inj 50 mg for ECP ................................................................... 84.51 VINBLASTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................... 3.05 VINCRISTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................. 21.46 VINORELBINE – PCT only – Specialist – Special Authority see SA0901 Inj 1 mg for ECP ....................................................................... 4.75 RITUXIMAB – PCT only – Specialist – Special Authority see SA0961 Inj 1 mg for ECP ....................................................................... 6.27 TRASTUZUMAB – PCT only – Specialist – Special Authority see SA0885 Inj 1 mg for ECP ....................................................................... 9.36 1 mg 1 mg 1 mg 1 mg 1 mg 1 mg ✔ Biomed

✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed

50 mg OP ✔ Biomed 1 mg 1 mg 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed

ORAL FEED 1KCAL/ML – Special Authority see SA0594– Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.78 237 ml OP ✔ Resource Diabetic

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

▲

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 (continued)

60 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

Effective 1 May 2009

49 77 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

S29

100

✔ Apo-Doxazosin

✔ Progynova

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

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 (continued)

107 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) 150 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 October 2009

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

142

✔ Thioprine

Effective 1 November 2009

61 HYDROCORTISONE ❋ Powder – Only in combination ................................................ 33.00 25 g (37.64) m-Hydrocortisone Up to 5% in a dermatological base (not proprietary Topical Corticosteriod – Plain) with or without other dermatological galenicals 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) SODIUM NITROPRUSSIDE ❋ Urine diagnostic strips, buffered – Not on a BSO ........................ 3.39 (6.00) 3.40 (10.94) 50 strip OP

Keto-Diabur 5000 Keto-Diastix

Ketur-Test Ketostix

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)

63 64 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 500g 1,000 ml Hydroderm Lotion 84 ✔ Lemnis Fatty Cream

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 87 147 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 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab long-acting 6 mg ............................................................... 2.70 (7.73) 5.40 (12.56) PILOCARPINE ❋ Eye drops 2% ........................................................................... 4.32 250 ml OP Hydroderm Lotion

500 ml 20

✔ Trisul

Polaramine Repetab 40 Polaramine Repetab 15 ml OP ✔ Pilopt

156

▲

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 February 2010

30 52 56 93 123 GLIBENCLAMIDE ❋ Tab 2.5 mg .............................................................................. 3.78 ❋ Tab 5 mg ................................................................................. 3.31 ACEBUTOLOL ❋ Cap 100 mg ............................................................................. 9.50 TRIAMTERENE WITH HYDROCHLOROTHIAZIDE ❋ Tab 50 mg with hydrochlorothiazide 25 mg ............................... 5.00 SAQUINAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Tab 500 mg ......................................................................... 556.59 DIAZEPAM Tab 2 mg – Month Restriction.................................................... 8.40 ‡ Safety cap for extemporaneously compounded oral liquid preparations. AZATADINE MALEATE ❋ Tab 1 mg ................................................................................. 6.94 (16.90) BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 50 µg per dose ................................................ 8.54 Aerosol inhaler, 100 µg per dose ............................................ 12.50 Aerosol inhaler, 250 µg per dose ............................................ 22.67 Note – Beclazone CFC-free aerosol inhalers were listed 1 July 2009. PILOCARPINE ❋ Eye drops 6% ........................................................................... 8.56 100 100 100 100 120 500 ✔ Gliben ✔ Gliben ✔ ACB ✔ Triamizide ✔ Invirase ✔ Pro-Pam

146 147

50 Zadine 200 dose OP ✔ Beclazone 50 200 dose OP ✔ Beclazone 100 200 dose OP ✔ Beclazone 250

156

15 ml OP

✔ Pilopt

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 II

Effective 1 August 2009

ATENOLOL ( price) Tab 50 mg......................................Pacific Atenolol 6.18 500 1% Oct-09 Anselol Apo-Atenolol Atehexal Global Atenolol Anselol Apo-Atenolol Atehexal Global Atenolol

Tab 100 mg ...................................Pacific Atenolol

10.73

500

Oct-09

CLOZAPINE ( price) Oral liq 50 mg per ml ......................Clopine Tab 25 mg......................................Clopine Clopine Tab 50 mg......................................Clopine Clopine Tab 100 mg....................................Clopine Clopine Tab 200 mg....................................Clopine Clopine DASATINIB Tab 20 mg......................................Sprycel Tab 50 mg......................................Sprycel Tab 70 mg......................................Sprycel DESFLURANE Liq 240 ml bottle ............................Suprane ENOXAPARIN SODIUM Inj 20 mg .......................................Clexane Inj 40 mg .......................................Clexane Inj 60 mg .......................................Clexane Inj 80 mg .......................................Clexane Inj 100 mg .....................................Clexane Inj 120 mg .....................................Clexane Inj 150 mg .....................................Clexane ENTECAVIR Tab 0.5 mg.....................................Baraclude EPIRUBICIN Inj 2 mg per ml, 5 ml ( price) ........Epirubicin Ebewe Inj 2 mg per ml, 25 ml ( price) ......Epirubicin Ebewe Inj 2 mg per ml, 50 ml ( price) ......Epirubicin Ebewe Inj 2 mg per ml, 100 ml ( price) ....Epirubicin Ebewe Products with Hospital Supply Status (HSS) are in bold.

17.33 6.69 13.37 8.67 17.33 17.33 34.65 34.65 69.30 3,774.06 6,214.20 7,692.58 1,230.00 39.20 52.30 78.85 105.12 135.20 168.00 192.00 400.00 25.00 87.50 155.00 310.00

100 ml 50 100 50 100 50 100 50 100 60 60 60 6 10 10 10 10 10 10 10 30 1 1 1 1 1% 1% 1% 1% Oct-09 Oct-09 Oct-09 Oct-09 Hospira Pharmorubicin Hospira Pharmorubicin Hospira Pharmorubicin Hospira Pharmorubicin 1% 1% 1% 1% 1% 1% 1% 1% Nov-09 Aug-09 Aug-09 Aug-09 Aug-09 Aug-09 Aug-09 Aug-09 (B) (B) (B) (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 August 2009 (continued)

FENTANYL CITRATE (amended chemical name) Inj 50 µg per ml, 2 ml .....................Hospira Inj 50 µg per ml, 10 ml ...................Hospira 6.10 15.65 5 5

GABAPENTIN Nupentin 5% Aug-09 Neurontin Cap 100 mg ( price) .....................Nupentin 7.16 100 Cap 300 mg ( price) .....................Nupentin 11.50 100 Cap 400 mg ( price) .....................Nupentin 14.75 100 Note – The DV limit of 5% applies to the gabapentin chemical rather than each individual line item. Note – Neurontin cap 100 mg, 300 mg and 400 mg, and tab 600 mg delisted 1 August 2009. ISOFLURANE Liq 250 ml bottle ............................Aerrane 540.00 6 1% Nov-09 Forthane Rhodia

Note – Forthane liq 250 ml bottle to be delisted 1 November 2009 LEUPRORELIN Inj 3.75 mg prefilled syringe ............Lucrin Depot PDS Inj 11.25 mg prefilled syringe ..........Lucrin Depot PDS Inj 30 mg prefilled syringe...............Lucrin Depot PDS NEVIRAPINE Oral suspension 10 mg per ml ........Viramune Suspension Tab 200 mg....................................Viramune OIL IN WATER EMULSION Crm................................................healthE Fatty Cream PARAFFIN Yellow soft .....................................API SAQUINAVIR Tab 500 mg....................................Invirase Note – Invirase to be delisted 1 February 2010 221.60 591.68 1,109.40 1 1 1

134.55 319.80 2.80

240 ml 60 500 g

1% 1%

Oct-09 Oct-09

(B) (B)

1.04

10 g

Oct-09

Dal Orion

556.59

120

SEVOFLURANE Liq 250 ml bottle ............................Baxter 1,230.00 Note – Abbott Sevorane to be delisted 1 November 2009. SODIUM HYALURONATE Opthalmic inj 4 mg per ml ...............Healon GV Opthalmic soln 10 mg per ml ..........Healon Clear 50.00 35.00

Nov-09

Sevorane

1 0.85 ml 60

1% 1%

Oct-09 Oct-09

(B) Provisc

TAMOXIFEN CITRATE Tab 20 mg......................................Tamoxifen Sandoz 6.66 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 IV

Effective 1 August 2009

PEGFILGRASTIM Inj 6 mg per 0.6 ml prefilled syringe Indefinite supply for any appropriate indication for the management of patients with cancer.

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

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

Index

Pharmaceuticals and brands A Acarbose ........................................................... 49 ACB ................................................................... 60 Accu-Chek Performa .......................................... 35 Acebutolol.......................................................... 60 Acetylcysteine.................................................... 25 Actos ..................................................... 34, 44, 58 Adalimumab....................................................... 28 Aerrane .............................................................. 62 Allopurinol.......................................................... 56 Aminoacid formula with minerals without phenylalanine .................................................. 41 Amoxycillin clavulanate ................................ 50, 53 Amsacrine ......................................................... 17 Amsidyl ............................................................. 17 Apo-Doxazosin................................................... 56 Apo-Terazosin.................................................... 25 Arrow-Azithromycin ..................................... 37, 47 Arrow-Cabergoline ............................................. 20 Arrow-Diazepam ................................................ 21 Arrow-Lisinopril ................................................. 46 Arrow-Roxithromycin ......................................... 47 Arsenic trioxide .................................................. 48 Asacol ............................................................... 34 Asthalin ............................................................. 48 Atenolol ....................................................... 43, 61 Atorvastatin........................................................ 25 Augmentin ................................................... 50, 53 Avonex .............................................................. 44 Azatadine maleate .............................................. 60 Azathioprine ....................................................... 58 Azithromycin ................................................ 37, 47 B Baraclude .................................................... 17, 61 Batrafen ....................................................... 42, 50 BD Micro-Fine .................................................... 45 BD Ultra Fine ...................................................... 45 BD Ultra Fine II ................................................... 45 Beclazone 50 ............................................... 24, 60 Beclazone 100 ............................................. 24, 60 Beclazone 250 ............................................. 24, 60 Beclomethasone dipropionate....................... 24, 60 Benzathine benzylpenicillin ........................... 49, 52 Benztrop ............................................................ 47 Benztropine mesylate ......................................... 47 Betaferon ........................................................... 44 Betamethasone valerate with fusidic acid ............ 43 Bicillin LA..................................................... 49, 52 Biodone ............................................................. 51 Biodone Extra Forte ............................................ 51 Biodone Forte..................................................... 51 Bleomycin sulphate ............................................ 54 Blood glucose diagnostic test meter ............. 19, 35 Blood glucose diagnostic test strip ......... 19, 35, 45 Bosentan ........................................................... 19 Bupropion hydrochloride .................................... 21 C Cabergoline........................................................ 20 Calamine............................................................ 16 Calcium carbonate with aminoacetic acid ..... 49, 58 Calcium folinate ........................................... 49, 54 Calcium Folinate Ebewe...................................... 49 Carbamazepine .................................................. 56 Carboplatin ........................................................ 53 Carbosorb-X ...................................................... 48 Cardizem CD ...................................................... 48 Carmustine ........................................................ 53 Cefoxitin sodium ................................................ 46 Cellcept ............................................................. 38 Charcoal ............................................................ 48 Chloramphenicol ................................................ 48 Chlorpheniramine maleate .................................. 44 Chlorsig ............................................................. 48 Ciclopirox olamine.............................................. 42 Ciclopiroxolamine......................................... 42, 50 Cisplatin............................................................. 53 Cladribine........................................................... 54 Clexane ........................................................ 16, 61 Clinistix .............................................................. 50 Clinitest.............................................................. 50 Clopine ........................................................ 44, 61 Clozapine ..................................................... 44, 61 Co-trimoxazole ............................................. 25, 59 Colaspase (l-asparaginase) ................................ 54 Comtan .............................................................. 51 Copper............................................................... 50 Crotamiton ......................................................... 56 Cyclizine hydrochloride ...................................... 47 Cyclophosphamide ...................................... 47, 53 Cyproterone acetate ..................................... 20, 46 Cytarabine ......................................................... 54 D Dacarbazine ....................................................... 54 Dactinomycin (actinomycin d) ............................ 54 Daonil ................................................................ 24 Dasatinib...................................................... 18, 61 Daunorubicin ............................................... 24, 54 Deprim............................................................... 25 Desflurane ......................................................... 61 Dextrochlorpheniramine maleate ................... 24, 59 Diastix ............................................................... 50 Diazepam..................................................... 21, 60 Diflucortolone valerate ........................................ 43 Diltiazem hydrochloride ................................ 48, 56

Index

Pharmaceuticals and brands Dilzem LA .......................................................... 56 Dilzem SR .......................................................... 56 Dipyridamole................................................ 36, 46 Diurin 500 .......................................................... 42 Diurin 40 ...................................................... 42, 50 Docetaxel ........................................................... 54 Doxazosin mesylate ........................................... 56 Doxorubicin ....................................................... 54 Duolin ................................................................ 48 E Efavirenz ...................................................... 56, 59 E-Mycin ............................................................. 50 Econazole nitrate ................................................ 46 Eligard ............................................................... 26 Endoxan............................................................. 47 Enoxaparin sodium....................................... 16, 61 Entacapone ........................................................ 51 Entecavir ...................................................... 17, 61 Enteral feed with fibre 1kcal/ml ........................... 59 Epirubicin............................................... 44, 54, 61 Epirubicin Ebewe.......................................... 44, 61 Erythrocin IV ...................................................... 47 Erythromycin ethyl succinate .............................. 50 Erythromycin lactobionate .................................. 47 Estrofem ............................................................ 43 Ethinyloestradiol with levonorgestrel ................... 59 Etoposide........................................................... 54 Etoposide phosphate .......................................... 55 Eurax ................................................................. 56 F Felo 10 ER ......................................................... 46 Felo 5 ER ........................................................... 46 Felodipine .......................................................... 46 Fentanyl citrate............................................. 17, 62 Ferro-F-Tabs ...................................................... 46 Ferro-Gradumet.................................................. 43 Ferro-tab ............................................................ 45 Ferrograd-Folic................................................... 43 Ferrous fumarate ................................................ 45 Ferrous fumarate with folic acid .......................... 46 Ferrous sulphate ................................................ 43 Ferrous sulphate with folic acid .......................... 43 Fibersource ........................................................ 59 Fibersource RTH ................................................ 59 Fluarix .................................................... 21, 27, 38 Fludarabine phosphate ................................. 24, 54 Fludara Oral ....................................................... 24 Fluorometholone ................................................ 24 Fluorouracil sodium...................................... 54, 56 Fluvax .......................................................... 27, 38 FML ................................................................... 24 Fortini ................................................................ 58 Fortini Multifibre ................................................. 58 FreeStyle Lite ............................................... 19, 35 Frusemide .......................................................... 42 Fucicort ............................................................. 43 Fucithalmic ........................................................ 44 Furosemide .................................................. 42, 50 Fusidic acid........................................................ 44 G Gabapentin .................................................. 44, 62 Gabapentin (Neurontin) ................................ 33, 52 Gemcitabine hydrochloride ........................... 49, 54 Genox ................................................................ 48 Gliben ................................................................ 60 Glibenclamide .............................................. 24, 60 Glucobay ........................................................... 49 Glucose oxidase........................................... 50, 58 Gluten free pasta ................................................ 56 H Healon Clear ...................................................... 62 Healon GV.......................................................... 62 healthE............................................................... 16 healthE Fatty Cream ..................................... 16, 62 Heparinised saline .............................................. 53 Heparin sodium.................................................. 46 Histafen ............................................................. 44 Holoxan ............................................................. 48 Humira............................................................... 28 HumiraPen ......................................................... 28 Hydrocortisone ...................................... 25, 43, 58 Hydroderm Lotion .............................................. 59 Hydroxychloroquine sulphate.............................. 50 Hytrin..................................................... 43, 46, 58 I I-Profen ....................................................... 51, 53 Ibuprofen ..................................................... 51, 53 Idarubicin hydrochloride ..................................... 55 Ifosfamide.................................................... 48, 53 Iloprost .............................................................. 20 Indomethacin ..................................................... 59 Influenza vaccine.................................... 21, 27, 37 Inhaled corticosteroids with long-acting beta-adrenoceptor agonists ............................. 40 Insulin pen needles....................................... 35, 45 Insulin syringes, disposable with attached needle ............................................... 45 Interferon beta-1-alpha ....................................... 44 Interferon beta-1-beta......................................... 44 Invirase ........................................................ 60, 62 Irinotecan........................................................... 54 Isoflurane ........................................................... 62 Isopto Carpine.................................................... 18

Index

Pharmaceuticals and brands K Keto-Diabur 5000............................................... 58 Keto-Diastix ................................................. 50, 58 Ketone blood beta-ketone electrodes ............ 19, 26 Ketostix.................................................. 16, 50, 58 Ketovite ............................................................. 36 Ketovite Liquid ............................................. 36, 46 Ketur-Test .......................................................... 58 Kliogest ............................................................. 43 Kliovance ........................................................... 43 K-Thrombin........................................................ 53 L Lasix .................................................................. 42 Lemnis Fatty Cream ........................................... 59 Leuprorelin............................................. 17, 26, 62 Levocabastine .................................................... 51 Levothyroxine .................................................... 17 Lipex............................................................ 50, 53 Lipitor ................................................................ 25 Lisinopril ............................................................ 46 Lithicarb ............................................................ 44 Lithium carbonate .............................................. 44 Livostin .............................................................. 51 Lucrin Depot ...................................................... 26 Lucrin Depot PDS................................... 17, 26, 62 M m-Hydrocortisone ........................................ 43, 58 Mabthera ........................................................... 38 Mebendazole...................................................... 53 Menadione sodium bisulphite ............................. 53 Mesalazine ................................................... 34, 44 Mesna ............................................................... 55 Metabolic Mineral Mixture................................... 41 Methadone hydrochloride ............................. 47, 51 Methylphenidate hydrochloride extended-release 23 Methoblastin ...................................................... 48 Methotrexate ................................................ 48, 54 Methylphenidate hydrochloride ..................... 22, 47 Metoprolol-AFT CR............................................. 25 Metoprolol succinate .......................................... 25 Mitomycin C ...................................................... 55 Mitozantrone ...................................................... 55 Mucilaginous laxatives ....................................... 45 Mucilaginous laxatives with stimulants ............... 45 Multiparin........................................................... 46 Multivitamins ............................................... 36, 46 Mycophenolate mofetil ....................................... 38 N Natulan .............................................................. 48 Nausicalm.......................................................... 47 Navelbine ........................................................... 24 Nerisone ............................................................ 43 Neurontin ........................................................... 33 Nevirapine .......................................................... 62 Normacol ........................................................... 45 Normacol Plus ................................................... 45 Norpress ...................................................... 25, 59 Nortriptyline hydrochloride............................ 25, 59 NovoFine ..................................................... 35, 45 Nupentin ...................................................... 44, 62 NutriniDrink ........................................................ 25 NutriniDrink Multifibre ......................................... 25 Nuvelle............................................................... 59 O Oestradiol .......................................................... 43 Oestradiol valerate.............................................. 56 Oestradiol with levonorgestrel ............................. 59 Oestradiol with norethisterone ............................ 43 Oestrogens ........................................................ 48 Oestrogens with medroxyprogesterone ............... 49 Oil in water emulsion .............................. 16, 59, 62 Optium 5 second test ................................... 35, 45 Optium 10 second test ....................................... 35 Optium Blood Ketone Test Strips .................. 19, 26 Optium Xceed .................................................... 35 Oral feed 1kcal/ml .............................................. 55 Orgran ............................................................... 56 Oxaliplatin .......................................................... 53 P Pacific Atenolol ............................................ 43, 61 Paclitaxel ..................................................... 25, 55 Paclitaxel Ebewe ................................................ 25 Paediatric oral feed 1.5kcal/ml................ 25, 56, 58 Paediatric oral feed with fibre 1.5kcal/ml....... 25, 58 Paediatric Seravit ............................................... 36 Pamidronate disodium ....................................... 25 Pamisol ............................................................. 25 Panadol ............................................................. 57 Paracetamol....................................................... 57 Paraffin .............................................................. 62 Pegfilgrastim ...................................................... 63 Pentasa ....................................................... 34, 44 Persantin ..................................................... 36, 46 Pethidine hydrochloride ...................................... 47 Pevaryl .............................................................. 46 Pilocarpine ............................................. 18, 59, 60 Pilopt ........................................................... 59, 60 Pioglitazone ..................................... 19, 34, 44, 58 Pizaccord..................................................... 19, 34 Plaquenil ............................................................ 50 Polaramine Colour-Free Repetab ........................ 24 Polaramine Repetab ........................................... 59 Premarin ............................................................ 48 Premia 2.5 Continuous ....................................... 49

Index

Pharmaceuticals and brands Premia 5 Continuous .......................................... 49 Progynova ......................................................... 56 Pro-Pam ............................................................ 60 Procarbazine hydrochloride ................................ 48 Progout.............................................................. 56 Promethazine hydrochloride ............................... 48 Pytazen SR ........................................................ 36 R Requip ............................................................... 49 Requip Follow-on Pack....................................... 49 Requip Starter Pack............................................ 49 Resource Diabetic .............................................. 55 Resource Just for Kids ....................................... 56 Rheumacin ........................................................ 59 Ritalin ................................................................ 22 Ritalin LA ........................................................... 23 Ritalin SR ........................................................... 22 Rituximab .................................................... 38, 55 Ropinirole hydrochloride..................................... 49 Roxithromycin.................................................... 47 Rubifen .............................................................. 47 S Salbutamol......................................................... 48 Salbutamol with ipratropium bromide.................. 48 Saquinavir .................................................... 60, 62 SensoCard ................................................... 19, 35 Sevoflurane ........................................................ 62 Sildenafil ............................................................ 20 SimvaRex .................................................... 50, 53 Simvastatin .................................................. 50, 53 Siterone ....................................................... 20, 46 Sodium hyaluronate ........................................... 62 Sodium nitroprusside ............................. 16, 50, 58 Sotalol ............................................................... 52 Space Chamber ................................................. 41 Spacer device .............................................. 24, 41 Sprycel ........................................................ 18, 61 Stocrin ......................................................... 56, 59 Suprane ............................................................. 61 Synthroid ........................................................... 17 T Tamoxifen citrate.................................... 18, 48, 62 Tamoxifen Sandoz........................................ 18, 62 Tegretol ............................................................. 56 Teniposide ......................................................... 55 Terazosin hydrochloride ................... 25, 43, 46, 58 Thioprine ........................................................... 58 Thiotepa............................................................. 17 Titralac ........................................................ 49, 58 Tobramycin........................................................ 47 Tracleer ............................................................. 19 Trastuzumab ...................................................... 55 Triamizide .......................................................... 60 Triamterene with hydrochlorothiazide.................. 60 Triquilar ED ........................................................ 59 Trisequens ......................................................... 43 Trisul ................................................................. 59 V Valaciclovir ........................................................ 20 Valtrex ............................................................... 20 Vaxigrip ....................................................... 27, 38 Ventavis ............................................................. 20 Vermox .............................................................. 53 Viagra ................................................................ 20 Vinblastine sulphate ........................................... 55 Vincristine sulphate ............................................ 55 Vinorelbine ................................................... 24, 55 Viramune ........................................................... 62 Viramune Suspension ........................................ 62 Volumatic .................................................... 24, 41 W Water ........................................................... 19, 55 Wool fat with mineral oil ..................................... 59 Z Zadine................................................................ 60 Zyban ................................................................ 21

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 August 2009

Abstract

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

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