Schedule Update - effective 1 November 2009 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 November 2009 Cumulative for September, October and November 2009 Section H cumulative for August, September, October and November 2009

Contents

Summary of PHARMAC decisions effective 1 November 2009 ....................... 3 Mirtazapine – new listing .............................................................................. 4 Phenobarbitone sodium powder – new pack size subsidised ........................ 4 Pharmaceutical Subsidy Eligibility and Delivery Review ................................. 5 Blood glucose test meters, strips and lancets (On Call Advanced) – Delay in previously notified listing .............................................................................. 5 Supply of clomipramine tablets ..................................................................... 5 Tender News .................................................................................................. 6 Looking Forward ........................................................................................... 6 Sole Subsidised Supply products cumulative to November 2009 .................. 7 New Listings ................................................................................................ 14 Changes to Restrictions ............................................................................... 18 Changes to Subsidy and Manufacturer’s Price............................................. 27 Changes to Brand Name ............................................................................. 32 Changes to Sole Subsidised Supply ............................................................. 32 Delisted Items ............................................................................................. 33 Items to be Delisted .................................................................................... 36 Section H changes to Part II ........................................................................ 39 Section H changes to Part IV ....................................................................... 52 Index ........................................................................................................... 53

Summary of PharmaC decisions

effeCtIve 1 NOvemBer 2009 New listings (pages 14 to 17) • Metformin hydrochloride (Apotex) tab immediate-release 500 mg and 850 mg • Mometasone furoate (m-Mometasone) crm 0.1% and oint 0.1%, 15 g OP and 45 g OP • Cyproterone acetate with ethinyloestradiol (Ginet 84) tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs • Amoxycillin clavulanate (Curam) grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml and grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml – available on a PSO • Etidronate disodium (Arrow-Etidronate) tab 200 mg • Mirtazapine (Avanza) tab 30 mg and 45 mg – Special Authority – Retail pharmacy • Oxaliplatin (Oxaliplatin Ebewe) inj 50 mg and 100 mg – PCT only – Specialist Special Authority • Dextrochlorpheniramine maleate (Polaramine) tab 2 mg • Phenobarbitone sodium (Midwest) powder, 10 g – Only in combination and only for use in children up to 12 years Changes to restrictions (pages 18 to 26) • Metformin hydrochloride (Apotex, Arrow-Metformin) tab immediate-release 500 mg and 850 mg – description amendment • Multivitamins (Ketovite, Paediatric Seravit and Ketovite Liquid) tab, powder and oral liquid – Special Authority criteria amendment • Influenza vaccine (Fluvax, Fluarix and Vaxigrip) inj – availability period end date amendment • Anastrozole (DP-Anastrozole) tab 1 mg – amendment to chemical description • Aminoacid formula with minerals without phenylalanine (Metabolic Mineral Mixture) – Special Authority criteria amendment Decreased subsidy (page 27) • Mesalazine (Pentasa) tab long-acting 500 mg • Lansoprazole (Solox) cap 15 mg and 30 mg • Isotretinoin (Isotane 10 and 20) cap 10 mg and 20 mg Increased subsidy (page 27) • Lithium carbonate (Douglas) cap 250 mg • Idarubicin hydrochloride (Zavedos) cap 5 mg

4 Pharmaceutical Schedule - Update News

Mirtazapine – new listing

The antidepressant mirtazapine (Avanza) will be subsidised from 1 November 2009. Mirtazapine tablets will be subsidised subject to Special Authority criteria. See page 14 for further information.

Phenobarbitone sodium powder – new pack size subsidised

From 1 November 2009 a 10 g pack size of phenobarbitone sodium powder will be subsidised. Subsidy is only available when phenobarbitone sodium powder is used in combination with another subsidised medicine and only for use in children up to 12 years of age. Phenobarbitone sodium powder 100 g pack size will remain available and subsidised. It is important that pharmacies claim under the pharmacode for the pack size they purchased. Random audits will be conducted on purchases against claims.

Pharmaceutical Schedule - Update News

Pharmaceutical Subsidy Eligibility and Delivery Review

PHARMAC is reviewing the ways in which people receive subsidised pharmaceuticals in New Zealand, and has released a discussion document as part of the review process. We are seeking feedback on a number of issues highlighted in the document, such as which health professionals should be able to generate a subsidy for pharmaceuticals, and whether the delivery mechanisms and dispensing restrictions that are used could be improved. The discussion document is available on our website www.pharmac.govt.nz, and feedback is due late December.

Blood glucose test meters, strips and lancets (On Call Advanced) – Delay in previously notified listing

The earlier notified listing for On Call Advanced has been delayed by at least one month. We will notify you once the listing date has been confirmed.

Supply of clomipramine tablets

Mylan New Zealand Limited has notified of its intention to discontinue its brand of clomipramine (Clopress) tablets 10 mg and 25 mg later this year. It expects to run out of Clopress 10 mg tablets in November 2009 and Clopress 25 mg tablets in December 2009. PHARMAC is working with suppliers to maintain a supply of clomipramine tablets and will be listing an alternative brand in the coming months.

tender News

Sole Subsidised Supply changes – effective 1 December 2009

Chemical Name Fluorometholone Pioglitazone Pioglitazone Pioglitazone Presentation; Pack size Eye drops 0.1%; 5 ml OP Tab 15 mg; 28 tab Tab 30 mg; 28 tab Tab 45 mg; 28 tab Sole Subsidised Supply brand (and supplier) FML (Allergan) Pizaccord (Douglas) Pizaccord (Douglas) Pizaccord (Douglas)

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for implementation 1 December 2009 • Quetiapine (Quetapel) tab 25 mg, 100 mg, 200 mg and 300 mg – price and subsidy decrease • Risperidone (Dr Reddy’s Risperidone) tab 1 mg, 2 mg, 3 mg and 4 mg – new listing • Tenofovir disoproxil fumarate (Viread) tab 300 mg – subsidy by endorsement for patients with HIV/AIDS – Special Authority for patients with drug-resistant chronic hepatitis B

Sole Subsidised Supply Products – cumulative to November 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 125 mg per 1.25 ml Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg

Brand Name Expiry Date*

Glucobay Diamox Apo-Allopurinol Arrow-Alprazolam Symmetrel Apo-Amlodipine Ospamox Paediatric Drops Ibiamox Apo-Amoxi Synermox AFT Ethics Aspirin Ethics Aspirin EC Pacific Atenolol Atropt Arrow-Azithromycin Sandoz Fibalip Bicalox Lax-Tabs AFT Marcain Isobaric Marcain Heavy Miacalcic Calsource Calcium Folinate Ebewe Apo-Captopril Ranbaxy-Cefaclor Ranbaxy-Cefaclor Hospira Zinacef PSM Zetop Cetirizine-AFT Chlorsig 2012 2011 2011 2010 2011 2011 2011 2010 2011 2011 2010 2012 2011 2012 2011 2011 2011 2010 2011 2010 2011 2011 2011 2010 2010 2011 2011 2010 2011 2012

Amoxycillin clavulanate Aqueous cream Aspirin Atenolol Atropine sulphate Azithromycin 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 Chloramphenicol

Tab amoxycillin 500 mg with potassium clavulanate 125 mg Crm 500 g Tab dispersible 300 mg Tab 100 mg Tab 50 mg & 100 mg Eye drops 1% Tab 500 mg 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 Eye oint 1%

*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 November 2009

Generic Name

Chlorhexidine gluconate Ciclopiroxolamine Ciprofloxacin Citalopram Clarithromycin Clonazepam Clotrimazole

Presentation

Soln 4% Nail soln 8% Tab 250 mg, 500 mg & 750 mg Tab 20 mg Tab 250 mg Grans for oral liq 125 mg per 5 ml Tab 500 µg & 2 mg Vaginal crm 2% with applicators(s) Crm 1% Vaginal crm 1% with applicator(s) Tab 15 mg, 30 mg & 60 mg Tab 500 µg Sach 5 g Inj 150 mg Powder for soln for oral use Tab 50 mg Tab 50 mg Tab 50 mg & 100 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*

Orion Batrafen Rex Medical Arrow-Citalopram Klamycin Klacid Paxam Clomazol Clomazol Clomazol PSM Colgout Colestid Colistin-Link Enerlyte Nausicalm Cycloblastin Siterone 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 2011 2012 2011 2010 2010 2011 2010

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

2010 2010 2010 2010 2010 2012 2010 2012 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

2011

Diltiazem hydrochloride

2011

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

2011 2010 2011 2012 2012

Sole Subsidised Supply Products – cumulative to November 2009

Generic Name

Erythromycin ethyl succinate

Presentation

Tab 400 mg Grans for oral liq 200 mg per 5 ml Grans for oral liq 400 mg per 5 ml Tab 10 µg Tab 35 µg with norethisterone 500 µg Tab 35 µg with norethisterone 1 mg Tab 35 µg with norethisterone 1 mg and 7 inert tab Tab long-acting 5 mg Tab long-acting 10 mg 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 & 10 mg

Brand Name Expiry Date*

E-Mycin E-Mycin E-Mycin NZ Medical and Scientific Brevinor 21 Brevinor 1/21 Brevinor 1/28 Felo 5 ER Felo 10 ER Ferodan Fintral Flucloxin Pacific Fludara Fludara Oral Ultraproct Ultraproct 2012 2010 2011 2011 2011 2011 2010 2012 2011 2012 2010

Ethinyloestradiol Ethinyloestradiol with norethisterone

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

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 Serenace Serenace ABM PSM Locoid DP Lotn HC

2010 2012 2010 31/7/12 2011 2011 2011

Haloperidol Hydrocortisone Hydrcortisone butyrate Hydrocortisone with wool fat and mineral oil

Oral liq 2 mg per ml Tab 500 µg, 1.5 mg & 5 mg Powder Crm 1% Scalp lotn 0.1% Lotn 1% with wool fat hydrous 3% and mineral oil

2010 2011 2010 2011

Sole Subsidised Supply Products – cumulative to November 2009

Generic Name

Hydroxychloroquine sulphate Hypromellose Hysocine N-butylbromide Ibuprofen Ipratropium bromide

Presentation

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 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 5 mg, 10 mg & 20 mg Tab 2 mg Tab 10 mg Oral liq 1 mg per ml

Brand Name Expiry Date*

Plaquenil Methopt Buscopan Gastrosoothe Ethics Ibuprofen Fenpaed Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Ferrum H Sporanox Sebizole Duphalac Betagan Xylocaine Xylocaine Xylocaine EMLA EMLA Arrow-Lisinopril Nodia Loraclear Hayfever Relief Lorapaed Derbac M A-Lices Foremount Child’s Silicone Mask De-Worm Colofac Provera Pentasa Biodone Biodone Forte Biodone Extra Forte Methatabs Methoblastin Methotrexate Ebewe Methotrexate Ebewe 2012 2010 2010 2012 2011 2011 2012 2010 2010

Iron polymaltose Itraconazole Ketoconazole Lactulose Levobunolol Lignocaine hydrochloride

2011 2010 2011 2010 2010 2010

Lignocaine with prilocaine

2010

Lisinopril Loperamide hydrochloride Loratadine

Malathion Mask for Spacer Device Mebendazole Mebeverine hydrochloride Medroxyprogesterone acetate Mesalazine 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 Enema 1 g per 100 ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Tab 5 mg Tab 2.5 mg & 10 mg Inj 100 mg per ml, 10 ml Inj 100 mg per ml, 50 ml

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

Methotrexate

Sole Subsidised Supply Products – cumulative to November 2009

Generic Name

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

Presentation

Tab 125 mg, 250 mg, 500 mg Tab 4 mg & 100 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 Oral suspension 10 mg per ml Tab 200 mg

Brand Name Expiry Date*

Prodopa Medrol Depo-Medrol Depo-Medrol with Lidocaine Pfizer Multichem Mayne Mayne Apo-Nadolol ReVia Sonaflam AstraZeneca Viramune Suspension Viramune Habitrol Habitrol Habitrol Habitrol Noriday 28 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 2011 2012 2011 2011 2011 2011 2011 2010 2010 2010 2010 2012

Nicotine

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 350 µg Tab 5 mg Tab 10 mg & 25 mg Oral liq 100,000 u per ml, 24 ml OP Cap 500,000 u Tab 500,000 u Cap 10 mg, 20 mg & 40 mg Inj 40 mg

2010

Norethisterone Nortriptyline hydrochloride Nystatin

2012 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

2010 2010 2010 2011

Pantoprazole

2010

Sole Subsidised Supply Products – cumulative to November 2009

Generic Name

Paracetamol

Presentation

Tab 500 mg Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml Eye oint with soft white paraffin Tab 20 mg Low range and Normal range Tab 0.25 mg & 1 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap potassium salt 250 mg & 500 mg Eye drops 0.12% Oral drops 10% Eye drops 1.4% Eye drops 3% Tab 1 mg, 2 mg & 5 mg Tab 1 mg, 2.5 mg, 5 mg & 20 mg Oral liq 5 mg per ml 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 Tab 0.25 mg, 1 mg, 2 mg and 5 mg Tab 150 mg & 300 mg Nebuliser soln, 1 mg per ml, 2.5 ml Nebuliser soln, 2 mg per ml, 2.5 ml Oral liq 2 mg per 5 ml Nebuliser soln, 2.5 mg with ipratopium bromide 0.5 mg per vial, 2.5 ml Tab 5 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg

Brand Name Expiry Date*

Pharmacare Paracare Junior Paracare Double Strength Lacri-Lube Loxamine Breath-Alert Permax AFT AFT Cilicaine VK Prefrin Coloxyl Vistil Vistil Forte Apo-Prazo Apo-Prednisone Redipred Cilicaine Allersoothe Accupril Accuretic 10 Accuretic 20 Peptisoothe Mycobutin Ropin ArrowRoxithromycin Asthalin Asthalin Salapin Duolin 2010 2010 2010 2012 2012 2010 2012 2011

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

2010 2010 30/9/11 2011 2010

2010 2011 2011 2010 2011 2012 2011 2011 2011 2011

Ranitidine hydrochloride Rifabutin Ropinirole hydrochloride Roxithromycin Salbutamol

Salbutamol with ipratropium bromide Selegiline hydrochloride Simvastatin

Apo-Selegiline Arrow-Simva 10 mg Arrow-Simva 20 mg Arrow-Simva 40 mg Arrow-Simva 80 mg

2012 2011

Sole Subsidised Supply Products – cumulative to November 2009

Generic Name

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

Presentation

Grans eff 4 g sachets Tab 80 mg & 160 mg 230 ml Liq Soln 2.3% Tab 10 mg Tab 2 mg & 5 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Inj 250 mcg Inj 1 mg per ml, 1 ml Tab 10 mg 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

Brand Name Expiry Date*

Ural Mylan Space Chamber Midwest Pinetarsol Normison Apo-Terazosin Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timol Apo-Timop Aristocort Aristocort Kenacort-A40 Oracort TMP Actigall Pacific PSM Zincaps Apo-Zopiclone 2010 2012 30/9/11 2010 2011 2011 2010 2011 2011 2011 2012 2011 2011 2011 2011 2011 2011 2011 2011 2011

Trimethoprim Ursodeoxycholic acid Vancomycin hydrochloride Zinc and castor oil Zinc sulphate Zopiclone November changes in bold

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 November 2009

30 62 METFORMIN HYDROCHLORIDE ❋ Tab immediate–release 500 mg ................................................ 8.09 ❋ Tab immediate–release 850 mg ................................................ 6.67 MOMETASONE FUROATE Crm 0.1% ................................................................................. 2.38 4.55 Oint 0.1% ................................................................................. 2.38 4.55 CYPROTERONE ACETATE WITH ETHINYLOESTRADIOL ❋ Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs .............. 4.91 AMOXYCILLIN CLAVULANATE Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml – Up to 200 ml available on a PSO............ 2.20 Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml – Up to 200 ml available on a PSO.............. 3.85 500 250 15 g OP 45 g OP 15 g OP 45 g OP 84 ✔ Apotex ✔ Apotex ✔ m-Mometasone ✔ m-Mometasone ✔ m-Mometasone ✔ m-Mometasone ✔ Ginet 84

72 85

100 ml 100 ml

✔ Curam ✔ Curam

107

ETIDRONATE DISODIUM ❋ Tab 200 mg ........................................................................... 23.95 100 ✔ Arrow-Etidronate Prescribing Guidelines Etidronate for osteoporosis should be prescribed for 14 days (400 mg in the morning) and repeated every three months. It should not be taken at the same time of the day as any calcium supplementation (minimum dose – 500 mg per day of elemental calcium). Etidronate should be taken at least 2 hours before or after any food or fluid, except water. MIRTAZAPINE – Special Authority see SA0994– Retail pharmacy Tab 30 mg .............................................................................. 22.00 Tab 45 mg .............................................................................. 35.00 30 30 ✔ Avanza ✔ Avanza

112

➽ SA0994 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has a severe major depressive episode; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and was unable to tolerate the treatments or failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and either could not tolerate it or failed to respond to an adequate dose over an adequate period of time. Renewal from any relevant practitioner. Approvals valid for 2 years where the patient has a high risk of relapse (prescriber determined). 134 OXALIPLATIN – PCT only – Specialist – Special Authority see SA0900 Inj 50 mg ............................................................................... 65.00 Inj 100 mg ........................................................................... 130.00 1 1 ✔ Oxaliplatin Ebewe ✔ Oxaliplatin Ebewe

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 November 2009 (continued)

151 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab 2 mg ................................................................................. 1.01 (4.93) 2.02 (7.99) 20 Polaramine 40 Polaramine ✔ MidWest

167

PHENOBARBITONE SODIUM Powder – Only in combination ................................................ 52.50 10 g a) Only in children up to 12 years b) ‡ Safety cap for extemporaneously compounded oral liquid preparations.

Effective 13 October 2009

112 MOCLOBEMIDE Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. Tab 150 mg ............................................................................. 8.31 60 ✔ GenRx Moclobemide Tab 300 mg ........................................................................... 18.80 60 ✔ GenRx Moclobemide

Effective 1 October 2009

27 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 23.30 14 ✔ Klamycin a) Maximum of 14 tablets per prescription b) Subsidised only if prescribed for helicobacter pylori eradication and prescription is endorsed accordingly. Note: the prescription is considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxycillin or metronidazole. BLOOD GLUCOSE DIAGNOSTIC TEST METER – Subsidy by endorsement a) Maximum of 1 meter per prescription b) 1) 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. 2) Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly. Meter ....................................................................................... 6.00 1 ✔ CareSens POP 9.00 ✔ CareSens II 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. Blood glucose test strips x 50 and lancets x 5 .......................... 19.60 1 OP ✔ CareSens HEPARIN SODIUM Inj 1,000 iu per ml, 5 ml ......................................................... 11.44 46.30 Inj 5,000 iu per ml, 5 ml ....................................................... 118.50 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 10 50 50 ✔ Pfizer ✔ Pfizer ✔ Pfizer

▲

❋ 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

New listings - effective 1 October 2009 (continued)

42 93 99 106 117 HEPARINISED SALINE ❋ Inj 10 iu per ml, 5 ml .............................................................. 32.50 50 ✔ Pfizer

RALTEGRAVIR POTASSIUM – Special Authority see SA0779 – Hospital pharmacy [HP1] Tab 400 mg ....................................................................... 1,350.00 60 ✔ Isentress DICLOFENAC SODIUM ❋ Tab EC 25 mg .......................................................................... 1.63 ❋ Tab EC 50 mg .......................................................................... 2.13 ❋ Tab long-acting 75 mg ............................................................. 3.10 19.60 50 50 30 100 ✔ Diclohexal ✔ Diclohexal ✔ Diclax SR ✔ Voltaren SR

ALENDRONATE SODIUM WITH CHOLECALCIFEROL – Special Authority see SA0990 – Retail pharmacy Tab 70 mg with cholecalciferol 5600 iu ................................... 35.91 4 ✔ Fosamax Plus APREPITANT – Special Authority see SA0987 – Retail pharmacy Cap 2 x 80 mg and 1 x 125 mg ............................................. 116.00 3 OP ✔ Emend Tri-Pack ➽ SA0987 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 12 months where the patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy. Renewal from any relevant practitioner. Approvals valid for 12 months where the patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy.

123 159 186

RISPERIDONE Oral liq 1 mg per ml ................................................................ 18.35 LATANOPROST – Retail pharmacy-Specialist See prescribing guideline ▲ Eye drops 50 µg per ml, 2.5ml ................................................. 9.75

30 ml

✔ Risperon

2.5 ml OP ✔ Hysite

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital pharmacy [HP3] See prescribing guideline Infant formula ........................................................................ 174.72 400 g OP ✔ PKU Anamix Infant Liquid (berry) .......................................................................... 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ Liquid (citrus) .......................................................................... 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ Liquid (orange) ........................................................................ 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ ELEMENTAL FORMULA – Special Authority see SA0603 – Hospital pharmacy [HP3] Powder ................................................................................... 11.72 450 g OP (15.21)

187

Pepti Junior Gold

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 September 2009

32 32 40 58 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ❋ 29 g × 12.7 mm .................................................................... 11.75 ❋ 31 g × 5 mm ......................................................................... 11.75 ❋ 31 g × 8 mm ......................................................................... 11.75 100 100 100 ✔ SC Profi-Fine ✔ SC Profi-Fine ✔ SC Profi-Fine

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE – Maximum of 100 dev per prescription ❋ Syringe 0.3 ml with 29 g × 12.7 mm needle .......................... 13.00 100 ✔ DM Ject ❋ Syringe 0.3 ml with 31 g × 8 mm needle ............................... 13.00 100 ✔ DM Ject ❋ Syringe 0.5 ml with 29 g × 12.7 mm needle .......................... 13.00 100 ✔ DM Ject ❋ Syringe 0.5 ml with 31 g × 8 mm needle ............................... 13.00 100 ✔ DM Ject ❋ Syringe 1 ml with 29 g × 12.7 mm needle ............................. 13.00 100 ✔ DM Ject ❋ Syringe 1 ml with 31 g × 8 mm needle .................................. 13.00 100 ✔ DM Ject CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy Tab 75 mg .............................................................................. 25.00 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg .............................................................................. 48.48 Cap 20 mg ............................................................................. 69.70 TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist Cap 40 mg .............................................................................. 60.71 BROMOCRIPTINE MESYLATE ❋ Cap 5 mg ............................................................................... 60.43 ZUCLOPENTHIXOL HYDROCHLORIDE Tab 10 mg .............................................................................. 31.45 28 180 180 60 100 ✔ Arrow-Clopidogrel ✔ Oratane ✔ Oratane ✔ Andriol Testocaps ✔ Apo-Bromocriptine

S29

76 119 123

100

✔ Clopixol

▲

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 Restrictions

Effective 1 November 2009

30 37 METFORMIN HYDROCHLORIDE ❋ Tab immediate–release 500 mg .............................................. 8.09 9.75 ❋ Tab immediate–release 850 mg .............................................. 6.67 8.00 500 250 ✔ Apotex ✔ Arrow-Metformin ✔ Apotex ✔ Arrow-Metformin

MULTIVITAMINS – Special Authority see SA0963 – 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 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 The patient has inborn errors of metabolism; or 2 For use as a supplement to a ketogenic diet in patients diagnosed with epilepsy. Note: Use of Paediatric Seravit is not recommended as a supplement to a ketogenic diet. Renewal application from any relevant practitioner. Approvals valid without further renewal unless notified for applications where the patient has had a previous approval for multivitamins. INFLUENZA VACCINE – Hospital pharmacy [Xpharm] 1) Subsidy is available between 1 March and 30 June 30 September of 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. continued...

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

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

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continued... 2) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under (1) above for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. 3) 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. 43) 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 ✔ Fluarix ✔ Vaxigrip 143 186 ANASTROZOLE-DP Tab 1 mg ............................................................................... 29.50 30 ✔ DP-Anastrozole

Changes to Restrictions - effective 1 November 2009 (continued)

AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA0962 – Retail pharmacy See prescribing guideline Powder .................................................................................. 58.44 250 g OP ✔ Metabolic Mineral Mixture ➽ SA0962 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 the ketogenic diet in patients diagnosed with epilepsy; or 3 Patient has had a previous approval for metabolic mineral mixture.

Effective 1 October 2009

40 PHYTOMENADIONE Inj 2 mg per 0.2 ml – Up to 5 inj available on a PSO ................... 8.00 May be administered orally Inj 10 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 9.21 May be administered orally 5 5 ✔ Konakion MM ✔ Konakion MM

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA0988 0657 Tab 250 mg ............................................................................. 7.75 14 ✔ Klamycin Grans for oral liquid 125 mg per 5 ml ...................................... 23.12 70 ml ✔ Klacid ➽ SA0988 0657 Special Authority for Waiver of Rule Initial application — (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. Note: Maximum of two prescriptions (two courses) per patient. Initial application — (Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2009 (continued)

continued... 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count ≤ 50 cells/mm3. Renewal —(Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. 105 ALENDRONATE FOR OSTEOPOROSIS ➽ SA0990 0948 Special Authority for Subsidy Initial application — (Underlying cause – Osteoporosis) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5); or 2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 3 History of two significant osteoporotic fractures demonstrated radiologically; or 4 Documented T-Score ≤ -3.0; or 5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Dubbo) which incorporates BMD measurements. Initial application — (Underlying cause – glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is receiving systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents) and has already received or is expected to receive therapy for at least three months; and 2 Either: 2.1 The patient has documented BMD ≥ 1.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -1.5); or 2.2 The patient has a history of one significant osteoporotic fracture demonstrated radiologically. Renewal —(Underlying cause was, and remains, glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year where the patient is continuing systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents). Renewal — (Underlying cause was glucocorticosteroid therapy but patient now meets the ’Underlying cause osteoporosis’ criteria) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5); or 2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 3 History of two significant osteoporotic fractures demonstrated radiologically; or 4 Documented T-Score ≤ -3.0; or 5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Dubbo) which incorporates BMD measurements. 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2009 (continued)

continued... Notes: a) Evidence used by National Institute for Health and Clinical Excellence (NICE) guidance indicates that patients aged 75 years and over who have a history of significant osteoporotic fracture demonstrated radiologically are very likely to have a T-Score ≤ -2.5, and therefore do not require BMD measurement for treatment with bisphosphonates. b) Osteoporotic fractures are the incident events for severe (established) osteoporosis, and can be defined using the WHO definitions of osteoporosis and fragility fracture. The WHO defines severe (established) osteoporosis as a T-score below -2.5 with one or more associated fragility fractures. Fragility fractures are fractures that occur as a result of mechanical forces that would not ordinarily cause fracture (minimal trauma). The WHO has quantified this as forces equivalent to a fall from a standing height or less. c) In line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. 119 156 LEVODOPA WITH CARBIDOPA ❋ Tab long-acting 200 mg with carbidopa 50 mg – Retail pharmacy-Specialist ................................................................ 47.50

100

✔ Sinemet CR

MASK FOR 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. 12) Only available for children aged six years and under. 23) 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. 34) 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 Size 2 ........................................................................................ 3.28 1 ✔ Foremount Child’s Silicone Mask 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. 12) 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. Space Chamber distributed by Airflow Products. Forward orders to: Airflow Products - PO Box 1485, Wellington Telephone: 04 499 1240 or 0800 AIR FLOW, Facsimile: 04 499 1245 or 0800 323 270 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 ❋ Three months or six months, as applicable, dispensed all-at-once

156

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2009

31 KETONE BLOOD BETA-KETONE ELECTRODES – Subsidy by endorsement 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. The prescription must be endorsed accordingly. Test strip – Not on a BSO .......................................................... 8.50 10 strip OP ✔ Optium Blood Ketone Test Strips METOPROLOL SUCCINATE Additional subsidy by endorsement for Betaloc CR is available for patients who: 1) were being prescribed metoprolol succinate prior to 1 October 2007; or 2) have experienced a myocardial infarction; or 3) have experienced heart failure and are either intolerant of carvedilol or it is contra-indicated. Pharmacists may annotate prescriptions for patients who were being prescribed metoprolol succinate prior to 1 October 2007 in which case the prescription is deemed to be endorsed. The pharmacist must be able to show a clear documented dispensing history for the patient. The prescription must be endorsed accordingly. ❋ Tab long-acting 23.75 mg – Higher subsidy of up to $6.20 per 30 with Endorsement ............................................................. 3.61 30 ✔ Betaloc CR ❋ Tab long-acting 47.5 mg – Higher subsidy of up to $7.80 per 30 with Endorsement ............................................................. 4.50 30 ✔ Betaloc CR ❋ Tab long-acting 95 mg – Higher subsidy of up to $13.20 per 30 with Endorsement ............................................................. 7.40 30 ✔ Betaloc CR ❋ Tab long-acting 190 mg – Higher subsidy of up to $21.00 per 30 with Endorsement ........................................................... 12.50 30 ✔ Betaloc CR NICOTINE – Only on a Quitcard a) Maximum of 28 patch per dispensing b) Maximum of 56 patch per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Patch 7 mg ............................................................................ 10.53 7 OP ✔ Habitrol Patch 14 mg .......................................................................... 11.63 7 OP ✔ Habitrol Patch 21 mg .......................................................................... 12.32 7 OP ✔ Habitrol NICOTINE – Only on a Quitcard a) Maximum of 216 loz per dispensing b) Maximum of 432 loz per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Lozenge 1 mg ........................................................................ 11.08 36 OP ✔ Habitrol Lozenge 2 mg ........................................................................ 11.08 36 OP ✔ Habitrol NICOTINE – Only on a Quitcard a) Maximum of 384 piece per dispensing b) Maximum of 768 piece per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Gum 2 mg (Fruit) .................................................................... 14.97 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 2 mg (Mint) .................................................................... 14.97 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 4 mg (Fruit) .................................................................... 20.02 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 4 mg (Mint) .................................................................... 20.02 96 OP ✔ Habitrol 23.41 ✔ Nicotinell

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 September 2009 (continued)

81 GOSERELIN ACETATE – Special Authority see SA0839 – Hospital pharmacy [HP3] Inj 3.6 mg ............................................................................. 221.60 1 ✔ Zoladex Inj 10.8 mg .......................................................................... 554.70 1 ✔ Zoladex ➽ SA0839 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 for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or 2 Neoadjuvant or adjuvant treatment of locally 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 patient 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. 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. AZITHROMYCIN – Subsidy by endorsement a) Maximum of 2 tab per prescription; can be waived by Special Authority see SA0964 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; can be waived by Special Authority see SA0964. Tab 500 mg ............................................................................. 5.95 2 OP ✔ Arrow-Azithromycin 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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Changes to Restrictions - effective 1 September 2009 (continued)

89 ENTECAVIR – Special Authority see SA0977 – Retail pharmacy Tab 0.5 mg ........................................................................... 400.00 30 ✔ 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: All of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 Patient is Hepatitis B nucleoside analogue treatment-naive; 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 or 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 No continuing alcohol abuse or intravenous drug use; and 7 Not co-infected with HCV, HIV or HDV; and 8 Neither ALT nor AST greater than 10 times upper limit of normal; and 9 No history of hypersensitivity to entecavir; and 10 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. TRANYLCYPROMINE SULPHATE Tab 10 mg ............................................................................. 22.94 Note – removal of Section 29 annotation 50 ✔ Parnate S29 S29

112

143

ANASTROZOLE-DP – Subsidy by endorsement Subsidised only for patients with hormone receptor positive advanced breast cancer and the prescription is endorsed accordingly. Tab 1 mg ............................................................................... 29.50 30 ✔ DP-Anastrozole

147

CYCLOSPORIN A – Special Authority see SA0470 – Hospital pharmacy [HP3] Cap 25 mg ............................................................................. 85.00 50 ✔ Neoral Cap 50 mg ........................................................................... 169.34 50 ✔ Neoral Cap 100 mg ......................................................................... 338.69 50 ✔ Neoral Oral liq 100 mg per ml .......................................................... 377.38 50 ml OP ✔ Neoral ➽ SA0470 Special Authority for Subsidy Initial application — (Organ transplant) only from a relevant specialist. Approvals valid without further renewal unless notified where the patient is an organ transplant recipient. Initial application — (Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Bone marrow transplant; or 2 Graft v host disease. Initial application — (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: continued... 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2009 (continued)

continued... Both: 1 Psoriasis; and 2 Applicant must state which systemic and topical therapies have failed. Initial application — (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not responsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application — (Nephrotic Syndrome) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Nephrotic Syndrome; and 2 Corticosteroid dependent patients who have failed on cytotoxic therapy. Initial application — (Endogenous uveitis) only from a relevant specialist. Approvals valid for 2 years where the patient suffers from endogenous uveitis. Initial application — (Severe rheumatoid arthritis) only from a rheumatologist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe rheumatoid arthritis; and 2 The patient must be either unresponsive to or unable to tolerate, both sulphasalazine and methotrexate; and 3 Patients must have 2 serum creatinine test results within the normal range within the three months prior to initiation of therapy. Renewal — (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal — (Indications other than severe atopic dermatitis) only from a dermatologist, rheumatologist or relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Guidelines for use of cyclosporin A in rheumatoid arthritis Monitoring: All patients require frequent monitoring for creatinine levels and blood pressure: • fortnightly, in the first three months of therapy and then monthly, if results are stable; • if dose is increased or there is a rise in serum creatinine or blood pressure, then more frequent monitoring is required. Contraindications: Cyclosporin A is contraindicated in patients with the following conditions: • current or past malignancy; • uncontrolled hypertension; • renal dysfunction (abnormal serum creatinine for age and sex); • immunodeficiency and neutropenia; • abnormally low white blood cell count or platelet count; or • liver function tests more than twice the upper limit of normal. Caution in use: • age above 65 years; • controlled hypertension; • use of anti-epileptic medications; • use of ketoconazole, fluconazole, trimethoprim, erythromycin, verapamil, and diltiazem; • concurrent or previous use of alkylating agents such as cyclophosphamide; • use of any experimental drug within the past three months; • premalignant conditions such as leukoplakia, monoclonal paraproteinaemia, myelodysplastic syndrome and dysplastic naevi; • active infection may necessitate temporary discontinuation; • pregnancy and lactation. 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 September 2009 (continued)

continued... Therapy should be discontinued if there has been no improvement after 6 months with the patient on the maximum tolerated dose. For further information please consult the data sheet. 166 PILOCARPINE ORAL LIQUID Pilocarpine 4% 6% eye drops qs Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days.)

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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Changes to Subsidy and Manufacturer’s Price

Effective 1 November 2009

26 27 58 MESALAZINE ( subsidy) Tab long-acting 500 mg ......................................................... 59.05 LANSOPRAZOLE ( subsidy) ❋ Cap 15 mg ............................................................................... 3.50 ❋ Cap 30 mg ............................................................................... 4.65 100 28 28 ✔ Pentasa ✔ Solox ✔ Solox ✔ Isotane 10 ✔ Isotane 20

ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy ( subsidy) Cap 10 mg ............................................................................. 26.93 100 Cap 20 mg ............................................................................. 38.72 100 ZINC ( price) Crm BP .................................................................................... 6.55 (12.00) 500 g

PSM

SUNSCREENS, PROPRIETARY – Subsidy by endorsement ( price) Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Crm .......................................................................................... 1.28 50 g OP (5.50) Aquasun Oil Free Faces SPF30+ Lotn ......................................................................................... 3.19 125 ml OP (6.94) Aquasun 30+ LITHIUM CARBONATE ( subsidy) Cap 250 mg ............................................................................. 7.73 OXAZEPAM – Month Restriction ( price) Tab 10 mg ............................................................................... 1.98 (5.89) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 15 mg ............................................................................... 2.45 (8.13) ‡ Safety cap for extemporaneously compounded oral liquid preparations. NITRAZEPAM – Month Restriction ( price) Tab 5 mg ................................................................................. 2.00 (4.98) ‡ Safety cap for extemporaneously compounded oral liquid preparations. IDARUBICIN HYDROCHLORIDE - PCT only - Specialist ( subsidy) Cap 5 mg .............................................................................. 115.00 100 100 Ox-Pam 100 Ox-Pam ✔ Douglas

122 126

128

100 Nitrados

139 167

✔ Zavedos

CODEINE PHOSPHATE ( price) Powder – Only in combination ................................................ 63.09 25 g (90.09) Douglas a) Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric. b) ‡ Safety cap for extemporaneously compounded oral liquid preparations.

▲

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 Subsidy and Manufacturer's Price – effective 1 October 2009

26 27 30 HYDROCORTISONE ACETATE ( subsidy) Rectal foam 10 %, CFC-Free (14 applications) ........................ 23.00 ATROPINE SULPHATE ( subsidy) ❋ Inj 600 µg, 1 ml – Up to 5 inj available on a PSO...................... 52.00 21.1 g OP ✔ Colifoam 50 ✔ AstraZeneca

PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy ( subsidy) Tab 15 mg ............................................................................... 2.61 28 (45.78) Tab 30 mg ............................................................................... 5.23 28 (70.43) Tab 45 mg ............................................................................... 7.80 28 (89.39)

Actos Actos Actos

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP ( subsidy) 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. Blood glucose test strips ........................................................ 21.65 50 test OP ✔ Accu-Chek Performa VITAMIN A WITH VITAMINS D AND C ( subsidy and  price) Soln 1000 u with Vitamin D 400 u and ascorbic acid 30 mg per 10 drops ......................................................................... 4.50 HEPARIN SODIUM ( subsidy) Inj 5,000 iu per ml, 1 ml ......................................................... 14.20 POTASSIUM CHLORIDE ( subsidy) ❋ Tab long-acting 600 mg ........................................................... 7.00 CLONIDINE ( subsidy) ❋ TDDS 2.5 mg, 100 µg per day – Only on a prescription............ 23.30 ❋ TDDS 5 mg, 200 µg per day – Only on a prescription............... 32.80 ❋ TDDS 7.5 mg, 300 µg per day – Only on a prescription............ 41.20 CLONIDINE HYDROCHLORIDE ( subsidy) ❋ Tab 150 µg ............................................................................ 33.00 ❋ Inj 150 µg per ml, 1 ml ........................................................... 15.45 CALAMINE ( subsidy) a) Only on a prescription b) Not in combination Crm, aqueous, BP .................................................................... 2.78 (3.02) Lotn, BP ................................................................................. 16.70 (19.44)

10 ml OP 5 200 4 4 4 100 5

✔ Vitadol C ✔ Mayne ✔ Span-K ✔ Catapres-TTS-1 ✔ Catapres-TTS-2 ✔ Catapres-TTS-3 ✔ Catapres ✔ Catapres

42 44 54 54 60

100 g ABM 2,000 ml ABM

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 October 2009 (continued)

61 64 66 66 73 CLOBETASOL PROPIONATE ( subsidy) ❋ Crm 0.05% ............................................................................... 3.48 ❋ Oint 0.05% ............................................................................... 3.48 WOOL FAT WITH MINERAL OIL – Only on a prescription ( price) ❋ Lotn hydrous 3% with mineral oil .............................................. 5.60 (20.53) BETAMETHASONE VALERATE ( subsidy) ❋ Scalp app 0.1% ........................................................................ 7.22 CLOBETASOL PROPIONATE ( subsidy) ❋ Scalp app 0.05% ...................................................................... 6.36 OXYTOCIN – Up to 5 inj available on a PSO ( subsidy) Inj 5 iu per ml, 1 ml .................................................................. 5.94 Inj 10 iu per ml, 1 ml ................................................................ 7.48 Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ............. 10.12 HYDROCORTISONE ( subsidy) ❋ Tab 5 mg ................................................................................. 8.35 ❋ Tab 20 mg ............................................................................. 20.95 30 g OP 30 g OP 1,000 ml Alpha-Keri Lotion 100 ml OP ✔ Beta Scalp 30 ml OP 5 5 5 100 100 ✔ Dermol ✔ Syntocinon ✔ Syntocinon ✔ Syntometrine ✔ Douglas ✔ Douglas ✔ Dermol ✔ Dermol

75 75 82

METHYLPREDNISOLONE SODIUM SUCCINATE – Retail pharmacy-Specialist ( subsidy) Inj 500 mg ............................................................................. 20.80 1 ✔ Solu-Medrol LEUPRORELIN – Hospital pharmacy [HP3] ( subsidy) Inj 7.5 mg ............................................................................ 166.20 Inj 22.5 mg .......................................................................... 443.76 Inj 30 mg ............................................................................. 591.68 Inj 45 mg ............................................................................. 832.05 FLUCLOXACILLIN SODIUM ( subsidy) Grans for oral liq 125 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 3.12 Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 3.55 1 1 1 1 ✔ Eligard ✔ Eligard ✔ Eligard ✔ Eligard

100 ml 100 ml

✔ AFT ✔ AFT

GENTAMICIN SULPHATE ( subsidy) Inj 40 mg per ml, 2 ml – Hospital pharmacy [HP3] – Subsidy by endorsement ..................................................................... 9.00 10 ✔ Pfizer Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly. NAPROXEN ( subsidy) ❋ Tab 250 mg ........................................................................... 23.70 ❋ Tab 500 mg ........................................................................... 24.88 BACLOFEN ( subsidy) ❋ Tab 10 mg ............................................................................... 4.75 500 250 100 ✔ Noflam 250 ✔ Noflam 500 ✔ Pacifen

100 107

▲

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

Changes to Subsidy and Manufacturer's Price – effective 1 October 2009 (continued)

107 110 QUININE SULPHATE ( subsidy) ❋ Tab 300 mg ........................................................................... 54.06 ‡ Safety cap for extemporaneously compounded oral liquid preparations. MORPHINE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable ‡ Oral liq 1 mg per ml .................................................................. 8.84 ‡ Oral liq 2 mg per ml ................................................................ 11.62 ‡ Oral liq 5 mg per ml ................................................................ 14.65 ‡ Oral liq 10 mg per ml .............................................................. 21.55 MORPHINE SULPHATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Tab immediate-release 10 mg ................................................... 2.80 Tab immediate-release 20 mg ................................................... 5.52 500 ✔ Q 300

200 ml 200 ml 200 ml 200 ml

✔ RA-Morph ✔ RA-Morph ✔ RA-Morph ✔ RA-Morph

110

10 10

✔ Sevredol ✔ Sevredol

112

MOCLOBEMIDE ( subsidy) Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. Tab 150 mg ........................................................................... 69.23 500 ✔ Apo-Moclobemide Tab 300 mg ........................................................................... 31.33 100 ✔ Apo-Moclobemide CLONIDINE HYDROCHLORIDE ( subsidy) ❋ Tab 25 µg .............................................................................. 19.25 LEVODOPA WITH CARBIDOPA ( subsidy) ❋ Tab long-acting 200 mg with carbidopa 50 mg ....................... 47.50 ❋ Tab 250 mg with carbidopa 25 mg ......................................... 40.00 CARBOPLATIN – PCT only – Specialist Inj 10 mg per ml, 5 ml ( subsidy) ........................................... 20.00 Inj 10 mg per ml, 15 ml ( subsidy) ......................................... 22.50 Inj 10 mg per ml, 45 ml ( subsidy) ......................................... 55.00 Inj 10 mg per ml, 100 ml ( subsidy) ..................................... 120.00 Inj 1 mg for ECP ( subsidy) ...................................................... 0.15 SODIUM CROMOGLYCATE ( subsidy) Nasal spray, 4% ..................................................................... 15.85 DORZOLAMIDE HYDROCHLORIDE WITH TIMOLOL MALEATE ( subsidy) ❋ Eye drops 2% with timolol maleate 0.5% ................................. 15.50 100 100 100 1 1 1 1 1 mg 22 ml OP 5 ml OP ✔ Dixarit ✔ Sinemet CR ✔ Sinemet ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Baxter ✔ Rex ✔ Cosopt

117 119 134

155 159

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 September 2009

32 40 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ( subsidy) ❋ 31 g × 5 mm ......................................................................... 11.75 100 ✔ B-D Micro-Fine ✔ Apo-Clopidogrel Plavix ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR

CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy ( subsidy) Tab 75 mg ............................................................................. 25.00 28 (73.38) METOPROLOL SUCCINATE ( subsidy) ❋ Tab long-acting 23.75 mg ......................................................... 3.61 ❋ Tab long-acting 47.5 mg ........................................................... 4.50 ❋ Tab long-acting 95 mg .............................................................. 7.40 ❋ Tab long-acting 190 mg .......................................................... 12.50 POVIDONE IODINE ( subsidy) Skin preparation, povidone iodine 10% with 30% alcohol ....................................................................... 10.00 DANAZOL – Retail pharmacy-Specialist ( subsidy) Cap 100 mg ........................................................................... 20.50 68.33 Cap 200 mg ........................................................................... 29.35 BETAHISTINE DIHYDROCHLORIDE ( subsidy) ❋ Tab 16 mg ............................................................................... 9.26 30 30 30 30

52 64

500 ml 30 100 30 84

✔ Betadine Skin Prep ✔ D-Zol ✔ Azol ✔ D-Zol ✔ Vergo 16 ✔ Baxter ✔ Flutamin

117 141 143 155

VINORELBINE – PCT only – Specialist – Special Authority see SA0901 ( subsidy) Inj 1 mg for ECP ....................................................................... 2.71 1 mg FLUTAMIDE – Hospital pharmacy [HP3]-Specialist ( subsidy) Tab 250 mg ........................................................................... 48.30 100

BUDESONIDE ( price) Metered aqueous nasal spray, 50 µg per dose .......................... 2.35 200 dose OP (4.00) Metered aqueous nasal spray, 100 µg per dose ........................ 2.61 200 dose OP (4.81) FLUOROMETHOLONE ( subsidy) ❋ Eye drops 0.1% ........................................................................ 4.05 (4.30) 5 ml OP

Butacort Aqueous Butacort Aqueous

158 175

Flucon

ORAL FEED 1KCAL/ML – Special Authority see SA0589 – Hospital pharmacy [HP3] ( subsidy) Liquid ........................................................................................ 1.90 200 ml OP ✔ Fortimel

▲

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 November 2009

172 PROTEIN SUPPLEMENT – Special Authority see SA0582 – Hospital pharmacy [HP3] Powder .................................................................................... 7.90 225 g OP ✔ Protifar Protifar 90

Effective 1 October 2009

137 AMSACRINE – PCT only – Specialist Inj 75 mg ............................................................................. CBS 6 ✔ Amsidine Amsidyl

S29

Changes to Sole Subsidised Supply

Effective 1 November 2009

For the list of new Sole Subsidised Supply products effective 1 November 2009 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 7-13.

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 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

176

Effective 1 October 2009

48 TERAZOSIN HYDROCHLORIDE ❋ Tab 2 mg .................................................................................. 1.30 ❋ Tab 5 mg .................................................................................. 1.62 CILAZAPRIL Tab 2.5 mg ............................................................................... 4.39 Tab 5 mg .................................................................................. 6.44 INDOMETHACIN ❋ Cap 50 mg ................................................................................ 6.95 APOMORPHINE HYDROCHLORIDE ▲ Inj 10 mg per ml, 2 ml ............................................................. 50.43 ▲ Inj 10 mg per ml, 1 ml ............................................................. 50.53 AZATHIOPRINE – Retail pharmacy – Specialist ❋ Tab 50 mg .............................................................................. 25.00 28 28 30 30 100 5 5 100 ✔ Hytrin ✔ Hytrin ✔ Inhibace ✔ Inhibace ✔ Rheumacin ✔ APO-go S29 ✔ Mayne ✔ Thioprine

100 119 145 170

CARBOHYDRATE SUPPLEMENT – Special Authority – Hospital pharmacy [HP3] Powder ..................................................................................... 1.14 350 g OP (7.85)

Polycose

176

PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.27 237 ml OP ✔ Pediasure Liquid (chocolate) ..................................................................... 1.27 237 ml OP ✔ Pediasure

▲

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 September 2009

32 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. Blood glucose test strips ........................................................ 22.00 50 test OP ✔ Optium 10 second test 11.00 25 test OP ✔ Optium 10 second test GLYCEROL ❋ Suppos 2.55 g – Only on a prescription .................................... 3.12 LABETALOL ❋ Inj 5 mg per ml, 5 ml .............................................................. 14.77 (22.15) 12 ✔ Fleet Glycerin Suppositories

34 52 62

Trandate S29

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN Oint 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g – Only on a prescription............. 3.00 15 g OP ETHINYLOESTRADIOL WITH GESTODENE ❋ Tab 30 µg with gestodene 75 µg and 7 inert tab ....................... 6.62 84 (14.49) a) Higher subsidy of $14.49 per 84 with Special Authority see SA0500 above b) Up to 84 tab available on a PSO

✔ Kenacomb

Minulet 28

ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab ethinyloestradiol 30 µg with levonorgestrel 50 µg (6) and tab ethinyloestradiol 40 µg with levonorgestrel 75 µg (5), and tab ethinyloestradiol 30 µg with levonorgestrel 125 µg (10) and 7 inert tab ............................................................... 6.62 84 (14.49) Triphasil 28 a) Higher subsidy of up to $14.49 per 84 with Special Authority see SA0500 on the preceding page b) Up to 84 tab available on a PSO TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 5 ml ............................................................ 10.31 DICLOXACILLIN Cap 250 mg ............................................................................. 2.47 (4.35) Cap 500 mg ............................................................................. 3.83 (8.65) 1 24 Diclocil 24 Diclocil ✔ Kenacort-A

76 85

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 September 2009 (continued)

120 ROPINIROLE HYDROCHLORIDE ▲ Tab 0.25 mg .......................................................................... 19.75 (31.50) ▲ Tab 0.25 mg × 42, 0.5 mg × 42 and 1 mg × 21 .................. 21.92 (35.70) ▲ Tab 0.5 mg × 42, 1 mg × 42 and 2 mg × 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) 210 Requip 105 Requip Starter Pack 147 Requip Follow-on Pack 84 Requip 84 Requip 84 Requip

174

DIABETIC ENTERAL FEED 1KCAL/ML – Special Authority see SA0594 – Hospital pharmacy [HP3] Liquid ........................................................................................ 7.50 1,000 ml OP ✔ Resource Diabetic TF RTH

▲

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 December 2009

158 FLUOROMETHOLONE ❋ Eye drops 0.1% ........................................................................ 4.05 (4.30) 5 ml OP Flucon

Effective 1 January 2010

60 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP .................................................................... 2.78 (3.02) Lotn, BP ................................................................................. 16.70 (19.44)

100 g ABM 2,000 ml ABM

Effective 1 February 2010

58 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg ............................................................................. 26.93 Cap 20 mg ............................................................................. 38.72 100 100 ✔ Isotane 10 ✔ Isotane 20

Effective 1 March 2010

97 PEGYLATED INTERFERON ALPHA-2B WITH RIBAVIRIN – Special Authority see SA0953 – Hospital pharmacy [HP3] See prescribing guideline Inj 50 µg × 4 with ribavirin cap 200 mg × 112 ................. 1,080.40 1 OP ✔ Pegatron Combination Therapy Inj 50 µg × 4 with ribavirin cap 200 mg × 84 ...................... 976.80 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 140 ................. 1,583.60 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 168 ................. 1,687.20 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 84 ................... 1,376.40 1 OP ✔ Pegatron Combination Therapy Inj 100 µg × 4 with ribavirin cap 200 mg × 112 ............... 1,746.40 1 OP ✔ Pegatron Combination Therapy Inj 100 µg × 4 with ribavirin cap 200 mg × 84 ................. 1,642.80 1 OP ✔ Pegatron Combination Therapy Inj 120 µg × 4 with ribavirin cap 200 mg × 140 ............... 2,116.40 1 OP ✔ Pegatron Combination Therapy continued...

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted – effective 1 March 2010 (continued)

continued... Inj 120 µg × 4 with ribavirin cap 200 mg × 84 ................. 1,909.20 Inj 150 µg × 4 with ribavirin cap 200 mg × 140 ............... 2,516.00 Inj 150 µg × 4 with ribavirin cap 200 mg × 168 ............... 2,619.60 Inj 150 µg × 4 with ribavirin cap 200 mg × 84 ................. 2,308.80 1 OP 1 OP 1 OP 1 OP ✔ Pegatron Combination Therapy ✔ Pegatron Combination Therapy ✔ Pegatron Combination Therapy ✔ Pegatron Combination Therapy ✔ Tripress ✔ Mogine ✔ Alpha-Bromocriptine ✔ Pro-Pam

112 115 119 125

TRIMIPRAMINE MALEATE Cap 25 mg ............................................................................... 6.20 LAMOTRIGINE ▲ ab dispersible 200 mg ........................................................ 101.80 T BROMOCRIPTINE MESYLATE ❋ Tab 10 mg ........................................................................... 120.86 DIAZEPAM Tab 5 mg – Month Restriction.................................................... 5.00 ‡ Safety cap for extemporaneously compounded oral liquid preparations. PACLITAXEL – PCT only – Specialist Inj 30 mg ............................................................................... 37.95 Note – Paclitaxel Ebewe inj 30 mg, 5 inj pack remains listed. PILOCARPINE ❋ Eye drops 1% ........................................................................... 3.24

100 56 100 250

140

✔ Paclitaxel Ebewe

160 183

15 ml OP

✔ Pilopt

GLUTEN FREE PASTA – Special Authority see SA0722 – Hospital pharmacy [HP3] Corn and Spinach Rigatini.......................................................... 2.00 250 g OP (2.92) Garlic and Parsley Shells ........................................................... 2.00 250 g OP (2.92) Rice and Corn Garden Herb Pasta .............................................. 2.00 250 g OP (2.92)

Orgran Orgran Orgran

Effective 1 April 2010

40 42 125 PHYTOMENADIONE Tab 10 mg ............................................................................... 5.60 HEPARINISED SALINE ❋ Inj 10 iu per ml, 5 ml .............................................................. 18.00 DIAZEPAM Tab 10 mg – Month Restriction.................................................. 3.45 ‡ Safety cap for extemporaneously compounded oral liquid preparations. 10 50 100 ✔ Konakion ✔ AstraZeneca ✔ Pro-Pam

▲

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 April 2010 (continued)

160 178 PILOCARPINE ❋ Eye drops 4% ............................................................................ 6.57 15 ml OP ✔ Pilopt

SEMI-ELEMENTAL ENTERAL FEED 1KCAL/ML - Special Authority – Hospital pharmacy [HP3] Liquid ........................................................................................ 6.02 500 ml OP ✔ Peptisorb

Effective 1 May 2010

64 WOOL FAT WITH MINERAL OIL – Only on a prescription ❋ Lotn hydrous 3% with mineral oil .............................................. 1.12 (5.00) 2.10 (9.38) 200 ml OP Alpha-Keri Lotion 375 ml OP Alpha-Keri Lotion

SUNSCREENS, PROPRIETARY – Subsidy by endorsement Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Lotn ......................................................................................... 3.19 125 ml OP (8.82) Aquasun Sensitive SPF 30+ LAMOTRIGINE ▲ Tab dispersible 200 mg ........................................................ 101.80 TENIPOSIDE – PCT only – Specialist Inj 10 mg per ml, 5 ml .......................................................... 845.11 Inj 50 mg for ECP ................................................................... 84.51 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab 2 mg ................................................................................. 1.26 (5.60) 2.52 (9.99) 56 ✔ Arrow-Lamotrigine

115 140

10 ✔ Vumon 50 mg OP ✔ Baxter 25 Polaramine 50 Polaramine

151

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 November 2009

AMOXYCILLIN CLAVULANATE (amended description and new listing with HSS) Grans for oral liq Gran 125 mg with potassium clavulanate 31.25 mg clavulanic acid per 5 ml..............Curam 2.20 100 ml Grans for oral liq Gran 250 mg with potassium clavulanate 62.5 mg clavulanic acid per 5 ml..............Curam Inj 600 mg, 500 mg with 100 mg clavulanic acid ...........................Curam Inj 1.2 g, 1000 mg with 200 mg clavulanic acid ...........................Curam

Jan-10

Alpha-Amoxyclav Augmentin Synermox Alpha-Amoxyclav Augmentin Synermox Augmentin Synermox Augmentin Synermox

3.85

100 ml

Jan-10

12.67 16.50

10 10

1% 1%

Jan-10 Jan-10

Note – Augmentin grans for oral liq and injection to be delisted 1 January 2010 CHLORHEXIDINE Soln 0.02% for irrigation, 100 ml ....Baxter Soln 0.05% for irrigation, 100 ml ....Baxter Soln 0.05% for irrigation, 500 ml ....Baxter Soln 0.1% for irrigation, 100 ml ......Baxter Soln 0.5% for irrigation, 500 ml ......Baxter CHLORHEXIDINE WITH CETRIMIDE Soln 0.015% with 0.15% cetrimide for irrigation, 100 ml ..................Baxter Soln 0.015% with 0.15% cetrimide for irrigation, 500 ml ..................Baxter Soln 0.015% with 0.15% cetrimide for irrigation, 1,000 ml ...............Baxter Soln 0.05% with 0.5% cetrimide for irrigation, 100 ml ..................Baxter Soln 0.05% with 0.5% cetrimide for irrigation, 500 ml ..................Baxter Soln 0.1% with 1% cetrimide for irrigation, 100 ml ..................Baxter Soln 0.1% with 1% cetrimide for irrigation, 500 ml ..................Baxter DIAZEPAM Tab 2 mg........................................Pro-Pam Note – Pro-Pam tab 2 mg to be delisted 1 January 2010 DILTIAZEM HYDROCHLORIDE ( price) Tab 30 mg......................................Dilzem 2.92 3.02 3.63 3.10 4.69 1 1 1 1 1

3.21 3.47 4.17 4.20 3.87 4.38 5.81 8.40

1 1 1 1 1 1 1 500

4.60

100

Jun-09

(B)

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

ETIDRONATE DISODIUM Tab 200 mg....................................Arrow-Etidronate 23.95 100 1% Jan-10 Didronel Etidrate

Note – Didronel and Etidrate tab 200 mg to be delisted 1 January 2010 GLUCOSE ( price) Inf 5%, 100 ml ................................Baxter Inf 5%, 250 ml ................................Baxter Inf 5%, 500 ml ................................Baxter Inf 5%, 1,000 ml .............................Baxter Inf 10%, 500 ml ..............................Baxter Inf 10%, 1,000 ml ...........................Baxter Inf 50%, 500 ml ..............................Baxter 2.84 3.87 1.77 1.80 3.70 5.29 6.84 1 1 1 1 1 1 1

GLUCOSE WITH SODIUM, POTASSIUM, MAGNESIUM, CHLORIDE, ACETATE AND GLUCONATE ( price) Inf 50 g with 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 1,000 ml ...................Baxter 7.00 1 GLYCINE Soln 1.5% for irrigation, 2,000 ml ...Baxter Soln 1.5% for irrigation, 3,000 ml ...Baxter IDARUBICIN HYDROCHLORIDE (addition of HSS) Cap 5 mg ( price) .........................Zavedos Cap 10 mg .....................................Zavedos Inj 5 mg..........................................Zavedos Inj 10 mg........................................Zavedos 11.38 14.44 115.00 144.50 170.00 340.00 1 1 1 1 1 1 1% 1% 1% 1% Jan-10 Jan-10 Jan-10 Jan-10 (B) (B) (B) (B)

LAMOTRIGINE Tab dispersible 200 mg ..................Arrow-Lamotrigine 101.80 56 Note – Arrow-Lamotrigine tab dispersible 200 mg to be delisted 1 January 2010 LANSOPRAZOLE ( price) Cap 15 mg .....................................Solox Cap 30 mg .....................................Solox MANNITOL ( price) Inf 10%, 1,000 ml ...........................Baxter Inf 15%, 500 ml ..............................Baxter Inf 20%, 500 ml ..............................Baxter MESALAZINE Tab long-acting 500 mg..................Pentasa 3.50 4.65 14.21 9.84 10.80 59.05 28 28 1 1 1 100

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

METFORMIN HYDROCHLORIDE (amended description and new listing with HSS) Tab immediate-release 500 mg .....Apotex 8.09 500 1% Tab immediate-release 850 mg .....Apotex 6.67 250 1% Jan-10 Jan-10 Arrow-Metformin Glucomet Metomin Arrow-Metformin Glucomet Metomin

Note – Arrow-Metformin tab immediate-release 500 mg and 850 mg to be delisted 1 January 2010 MIRTAZAPINE Tab 30 mg......................................Avanza Tab 45 mg......................................Avanza MOCLOBEMIDE Tab 150 mg....................................GenRx Moclobemide Tab 300 mg....................................GenRx Moclobemide 22.00 35.00 8.31 18.80 30 30 60 60

MOCLOBEMIDE Tab 150 mg....................................Apo69.23 500 1% Dec-09 (B) Moclobemide Tab 300 mg....................................Apo31.33 100 1% Dec-09 (B) Moclobemide Note – HSS for Apo-Moclobemide tab 150 mg and 300 mg has been suspended due to an out-of-stock MOMETASONE FUROATE Crm 0.1% ......................................m-Mometasone 2.38 15 g 1% Jan-10 Crm 0.1% ......................................m-Mometasone 4.55 45 g 1% Jan-10 Oint 0.1% ......................................m-Mometasone 2.38 15 g 1% Jan-10 Oint 0.1% ......................................m-Mometasone 4.55 45 g 1% Jan-10 Note – Elocon crm 0.1%, 15 g and 45 g, and oint 0.1% 15 g and 45 g to be delisted 1 January 2010 OXALIPLATIN Inj 50 mg........................................Oxaliplatin Ebewe Inj 100 mg......................................Oxaliplatin Ebewe 65.00 1 1% Jan-10 Elocon Elocon Elocon Elocon

130.00

Jan-10

Hospira Eloxatin Oxaliplatin Dakota Oxaliplatin Winthrop Hospira Eloxatin Oxaliplatin Dakota Oxaliplatin Winthrop Rex Medical

Note – Eloxatin inj 50 mg and 100 mg to be delisted 1 January 2010 POTASSIUM CHLORIDE WITH GLUCOSE ( price) Inf 20 mmol.L-1 with 5% glucose, 1,000 ml ................Baxter

7.36

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

POTASSIUM CHLORIDE WITH GLUCOSE AND SODIUM CHLORIDE (new listing) Inf 20 mmol.L-1 with 2.5% glucose and 0.45% sodium chloride, 1,000 ml ....................................Baxter 9.99 1 POTASSIUM CHLORIDE WITH GLUCOSE AND SODIUM CHLORIDE ( price) Inf 20 mmol.L-1 with 4% glucose and 0.18% sodium chloride, 1,000 ml ....................................Baxter 4.30 1 POTASSIUM CHLORIDE WITH SODIUM CHLORIDE ( price) Inf 20 mmol.L-1 with 0.9% sodium chloride, 1,000 ml .........Baxter 3.85 POTASSIUM CHLORIDE WITH SODIUM CHLORIDE (new listing) Inf 40 mmol.L-1 with 0.9% sodium chloride, 1,000 ml .........Baxter 6.62 SODIUM CHLORIDE ( price) Inf 0.45%, 500 ml ...........................Baxter Inf 0.9%, 50 ml ...............................Baxter Inf 0.9%,100 ml ..............................Baxter Inf 0.9%, 250 ml .............................Baxter Inf 0.9%, 500 ml .............................Baxter Inf 0.9%, 1,000 ml ..........................Baxter Inf 3%, 1,000 ml .............................Baxter SODIUM CHLORIDE (new listings) Soln 0.9% for irrigation, 100 ml ......Baxter Soln 0.9% for irrigation, 500 ml ......Baxter Soln 0.9% for irrigation, 1,000 ml ...Baxter Soln 0.9% for irrigation, 2,000 ml ...Baxter Soln 0.9% for irrigation, 3,000 ml ...Baxter SODIUM CHLORIDE WITH GLUCOSE ( price) Inf 0.18%, with glucose 4%, 500 ml .......................................Baxter Inf 0.18%, with glucose 4%, 1,000 ml ....................................Baxter Inf 0.45%, with glucose 2.5%, 500 ml .......................................Baxter Inf 0.45%, with glucose 5%, 500 ml .......................................Baxter WATER ( price) Inf 1,000 ml ...................................Baxter 5.50 3.01 2.28 3.60 1.77 1.80 5.69 2.49 2.88 2.96 10.00 12.67

1 1 1 1 1 1 1 1 1 1 1 1 1

1.77 1.80 4.95 9.87 4.50

1 1 1 1 1

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

WATER Soln for irrigation, 100 ml ...............Baxter Soln for irrigation, 500 ml ...............Baxter Soln for irrigation, 1,000 ml ............Baxter Soln for irrigation, 2,000 ml ............Baxter Soln for irrigation, 3,000 ml ............Baxter 2.68 2.61 2.75 9.71 15.80 1 1 1 1 1

WATER WITH SODIUM, POTASSIUM, CALCIUM, BICARBONATE AND CHLORIDE ( price) Inf 131 mmol.L-1 sodium, 5 mmol.L-1 potassium, 2 mmol.L-1 calcium, 29 mmol.L-1 bicarbonate and 111 mmol.L-1 chloride, 500 ml ...Baxter 1.77 1 Inf 131 mmol.L-1 sodium, 5 mmol.L-1 potassium, 2 mmol.L-1 calcium, 29 mmol.L-1 bicarbonate and 111 mmol.L-1 chloride, 1,000 ml ....................................Baxter 1.80 1 WATER WITH SODIUM, POTASSIUM, CALCIUM AND CHLORIDE ( price) Inf 147 mmol.L-1 sodium, 4 mmol.L-1 potassium, 2.2 mmol.L-1 calcium and 156 mmol.L-1 chloride, 1,000 ml ....................................Baxter 5.13 1 WATER WITH SODIUM, POTASSIUM, MAGNESIUM, CHLORIDE, ACETATE AND GLUCONATE ( price) Inf 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 500 ml ......................Baxter 5.00 1 Inf 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 1,000 ml ...................Baxter 3.10 1

Effective 1 October 2009

ALENDRONATE SODIUM Tab 40 mg......................................Fosamax ALENDRONATE SODIUM WITH CHOLECALCIFEROL Tab 70 mg with cholecalciferol 5,600 iu .....................................Fosamax Plus APREPITANT Cap 2 x 80 mg and 1 x 125 mg.......Emend Tri-Pack 133.00 30

35.91 116.00

4 3

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

ATROPINE SULPHATE ( price and addition of HSS) Inj 600 µg, 1 ml..............................AstraZeneca BACLOFEN ( price and addition of HSS) Tab 10 mg......................................Pacifen 52.00 4.75 50 100 100 ml 1 1 1 1% 1% 1% Dec-09 Dec-09 Dec-09 (B) Alpha-Baclofen (B)

BETAMETHASONE VALERATE ( price and addition of HSS) Scalp app 0.1% .............................Beta Scalp 7.22 BLOOD GLUCOSE DIAGNOSTIC TEST METER Meter .............................................CareSens II CareSens POP Accu-Chek Performa BLOOD GLUCOSE DIAGNOSTIC TEST STRIP Blood glucose test strips.................Accu-Chek Performa Blood glucose test strips x 50 and lancets x 5 .................................CareSens CARBOPLATIN (addition of HSS) Inj 10 mg per ml, 5 ml ( price) ......Carboplatin Ebewe Inj 10 mg per ml, 15 ml ( price) ....Carboplatin Ebewe Inj 10 mg per ml, 45 ml ( price) ....Carboplatin Ebewe Inj 10 mg per ml, 100 ml ( price) ..Carboplatin Ebewe 9.00 6.00 19.00

21.65 19.60 20.00 22.50 55.00 120.00

50 1 1 1 1 1 1% 1% 1% 1% Dec-09 Dec-09 Dec-09 Dec-09 Hospira Pfizer Hospira Pfizer Hospira Pfizer Hospira Pfizer (B) (B) Clobex Shampoo (B) (B) (B) (B) (B) (B)

CLOBETASOL PROPIONATE ( price and addition of HSS) Crm 0.05% ....................................Dermol 3.48 CLOBETASOL PROPIONATE Oint 0.05% ....................................Dermol Scalp app 0.05% ............................Dermol CLONIDINE ( price and addition of HSS) TDDS 2.5 mg, 100 µg per day ........Catapres-TTS-1 TDDS 5 mg, 200 µg per day ...........Catapres-TTS-2 TDDS 7.5 mg, 300 µg per day ........Catapres-TTS-3 CLONIDINE HYDROCHLORIDE Tab 25 µg ......................................Dixarit 3.48 6.36 23.30 32.80 41.20 19.25

30 g 30 g 30 ml 4 4 4 100

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

Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09

CLONIDINE HYDROCHLORIDE (amended description,  price and addition of HSS) Inj 150 µg per ml, 1 ml ...................Catapres 15.45 5 1% Tab 150 µg ....................................Catapres 33.00 100 1%

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

DIAZEPAM Tab 10 mg......................................Pro-Pam 3.45 Note – Pro-Pam tab 10 mg to be delisted 1 December 2009 DORZOLAMIDE HYDROCHLORIDE WITH TIMOLOL MALEATE Eye drops 2% with timolol maleate 0.5% .............................Cosopt 15.50 100

5 ml

FLUCLOXACILLIN SODIUM (amended description,  price and addition of HSS) Grans for oral liq 125 mg per 5 ml ........................AFT 3.12 100 ml Grans for oral liq 250 mg per 5 ml ........................AFT 3.55 100 ml FLUTICASONE Aerosol inhaler, 50 µg per dose CFC-free ....................................Flixotide Aerosol inhaler, 125 µg per dose CFC-free ....................................Flixotide Aerosol inhaler, 250 µg per dose CFC-free ....................................Flixotide Powder for inhalation, 50 µg per dose ....................................Flixotide Accuhaler Powder for inhalation, 100 µg per dose ....................................Flixotide Accuhaler Powder for inhalation, 250 µg per dose ....................................Flixotide Accuhaler GENTAMICIN SULPHATE ( price and addition of HSS) Inj 40 mg per ml, 2 ml ...................Pfizer GLYCERYL TRINITRATE ( price and addition of HSS) Inj 1 mg per ml, 5 ml ......................Nitronal Inj 1 mg per ml, 50 ml ....................Nitronal HEPARIN SODIUM Inj 1,000 iu per ml, 5 ml .................Pfizer Inj 5,000 iu per ml, 5 ml .................Pfizer HEPARINISED SALINE Inj 10 iu per ml, 5 ml ......................Pfizer

1% 1%

Dec-09 Dec-09

(B) (B)

7.50 13.60 27.20 8.67 13.87 24.51

120 dose 120 dose 120 dose 60 dose 60 dose 60 dose

9.00 22.70 86.60 11.44 46.30 118.50 32.50

10 10 10 10 50 50 50

1% 1% 1%

Dec-09 Dec-09 Dec-09

Hospira (B) (B)

HEPARINISED SALINE Inj 10 iu per ml, 5 ml ......................AstraZeneca 18.00 50 Note – AstraZeneca’s brand of heparinised saline inj 10 iu per ml, 5 ml to be delisted 1 December 2009

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

HYDROCORTISONE ( price and addition of HSS) Tab 5 mg........................................Douglas Tab 20 mg......................................Douglas 8.35 20.95 100 100 1% 1% Dec-09 Dec-09 (B) (B)

HYDROCORTISONE ACETATE ( price and addition of HSS) Rectal foam 10%, CFC-Free (14 applications) .......................Colifoam 23.00

21.1 g

Dec-09

(B)

HYDROXYETHYL STARCH 200/0.5 PENTASTARCH (amended description,  price and addition of HSS) Inj Inf 6%, 500 ml bag ....................StarQuin 200 296.00 16 1% Dec-09 HAES-steril 6% 6% LEUPRORELIN ( price) Inj 7.5 mg.......................................Eligard Inj 22.5 mg.....................................Eligard Inj 30 mg........................................Eligard Inj 45 mg........................................Eligard LEVODOPA WITH CARBIDOPA Tab 100 mg with carbidopa 25 mg .Sinemet Tab 250 mg with carbidopa 25 mg .Sinemet Tab long-acting 200 mg with carbidopa 50 mg........................Sinemet CR 166.20 443.76 591.68 832.05 20.00 40.00 47.50 1 1 1 1 100 100 100 25 25 1 1 500 100 1% 1% 1% 1% 1% 1% Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 (B) (B) Hospira Hospira (B) (B)

METHYLPREDNISOLONE SODIUM SUCCINATE (addition of HSS) Inj 40 mg per ml, 1 ml ....................Solu-Medrol 151.40 Inj 62.5 mg per ml, 2 ml .................Solu-Medrol 412.59 Inj 500 mg ( price)........................Solu-Medrol 20.80 Inj 1 g.............................................Solu-Medrol 42.57 MOCLOBEMIDE Tab 150 mg....................................ApoMoclobemide Tab 300 mg....................................ApoMoclobemide 69.23 31.33

MORPHINE HYDROCHLORIDE ( price and addition of HSS) Oral liq 1 mg per ml ........................RA-Morph 8.84 Oral liq 2 mg per ml ........................RA-Morph 11.62 Oral liq 5 mg per ml ........................RA-Morph 14.65 Oral liq 10 mg per ml ......................RA-Morph 21.55 MORPHINE SULPHATE ( price and addition of HSS) Tab immediate release 10 mg .........Sevredol Tab immediate release 20 mg .........Sevredol NAPROXEN Tab 250 mg....................................Noflam 250 Tab 500 mg....................................Noflam 500 2.80 5.52 23.70 24.88

200 ml 200 ml 200 ml 200 ml 10 10 500 250

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

Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09 Dec-09

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

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

OXYTOCIN ( price and addition of HSS) Inj 5 iu per ml, 1 ml ........................Syntocinon Inj 10 iu per ml, 1 ml ......................Syntocinon 5.94 7.48 5 5 1% 1% Dec-09 Dec-09 (B) (B)

OXYTOCIN WITH ERGOMETRINE MALEATE ( price and addition of HSS) Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ...................Syntometrine 10.12 5 PANCURONIUM BROMIDE ( price and addition of HSS) Inj 2 mg per ml, 2 ml ......................AstraZeneca 128.00 PHYTOMENADIONE Tab 10 mg......................................Konakion 5.60 Note – Konakion tab 10 mg to be delisted 1 December 2009. POTASSIUM CHLORIDE ( price and addition of HSS) Tab long-acting 600 mg..................Span-K QUININE SULPHATE ( price and addition of HSS) Tab 300 mg....................................Q 300 RALTEGRAVIR POTASSIUM Tab 400 mg....................................Isentress RISPERIDONE Oral liq 1 mg per ml ........................Risperon TIMOLOL MALEATE Eye drops 0.25%, gel forming .........Timoptol XE Eye drops 0.5%, gel forming ...........Timoptol XE 7.00 50 10

1% 1%

Dec-09 Dec-09

(B) (B)

200

Dec-09

Slow-K K-SR Apo-Quinine

54.06 1,350.00 18.35 3.30 3.78

500 60 30 ml 2.5 ml 2.5 ml

Dec-09

Effective 1 September 2009

ACICLOVIR Inj 250 mg 25 mg per ml, 10 ml .....Pfizer 25.50 5 1% Nov-09 Acihexal Hospira Lovir m-Aciclovir Zovirax

Note – Mayne brand of aciclovir inj 250 mg to be delisted 1 November 2009. BACLOFEN Inj 10 mg........................................Lioresal Intrathecal BETAHISTINE DIHYDROCHLORIDE ( price) Tab 16 mg......................................Vergo 16 BLOOD GLUCOSE DIAGNOSTIC TEST METER Meter .............................................Optium Xceed Products with Hospital Supply Status (HSS) are in bold. 190.08 1 1% Nov-09 (B)

9.26 9.00

84 1 (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 September 2009 (continued)

BUDESONIDE ( price) Metered aqueous nasal spray, 50 µg per dose ..........................Butacort Aqueous 4.00 Metered aqueous nasal spray, 100 µg per dose ........................Butacort Aqueous 4.81 CASPOFUNGIN Inj 50 mg........................................Cancidas Inj 70 mg........................................Cancidas CHLORHEXIDINE Crm 1 % obstetric ...........................healthE 667.50 862.50 1.36

200 doses 200 doses 1 1 50 g 1% 1% 1% Nov-09 Nov-09 Nov-09 (B) (B) Hibitane Orion PSM

Note – Orion brand of chlorhexidine crm 1% obstetric to be delisted 1 November 2009. CLONAZEPAM ( price) Inj 1 mg per ml, 1 ml ......................Rivotril CLOPIDOGREL Tab 75 mg ( price)........................Apo-Clopidogrel Tab 75 mg (new listing) ..................Arrow -Clopidogrel 19.00 25.00 25.00 5 28 28

DANAZOL ( price) Cap 100 mg ...................................D-Zol 20.50 30 Azol 68.33 100 Cap 200 mg ...................................D-Zol 29.35 30 Note – D-Zol brand of danazol cap 100 mg 30 pack size to be delisted 1 October 2009 DIAZEPAM Tab 5 mg........................................Pro-Pam 5.00 Note – Pro-Pam tab 5 mg to be delisted 1 November 2009. FLUTAMIDE ( price) Tab 250 mg ...................................Flutamin HYDROXYETHYL STARCH 130/0.4 Inj 6 %............................................Voluven INSULIN PEN NEEDLES 29 g x 12.7 mm..............................SC Profi-Fine 31 g x 5 mm...................................SC Profi-Fine 31 g x 8 mm...................................SC Profi-Fine 48.30 198.00 11.75 11.75 11.75 250

100 20 100 100 100 1% Nov-09 Venofundin 6%

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE Syringe 0.3 ml with 29 g x 12.7 mm needle ......................DM Ject 13.00 Syringe 0.3 ml with 31 g x 8 mm needle ...........................DM Ject 13.00 Syringe 0.5 ml with 29 g x 12.7 mm needle ......................DM Ject 13.00 Syringe 0.5 ml with 31 g x 8 mm needle ...........................DM Ject 13.00 Syringe 1 ml with 29 g x 12.7 mm needle ......................DM Ject 13.00 Syringe 1 ml with 31 g x 8 mm needle ...........................DM Ject 13.00 ISOTRETINOIN Cap 10 mg .....................................Oratane Cap 20 mg .....................................Oratane 48.48 69.70

100 100 100 100 100 100 180 180 1% 1% Nov-09 Nov-09 Isotane 10 Roaccutane Isotane 20 Roaccutane

Note – Isotane 10 and Isotane 20 to be delisted 1 November 2009. LAMOTRIGINE Tab dispersible 200 mg ..................Mogine 101.80 56 Note – Mogine tab dispersible 200 mg to be delisted 1 November 2009 LIGNOCAINE Gel 2% ...........................................Xylocaine Jelly 6.00 30 ml Note – Orion brand of lignocaine gel 2% to be delisted 1 November 2009. METOPROLOL SUCCINATE Tab long-acting 23.75 mg...............Betaloc CR Tab long-acting 47.5 mg.................Betaloc CR Tab long-acting 95 mg....................Betaloc CR Tab long-acting 190 mg..................Betaloc CR ONDANSETRON HYDROCHLORIDE ( price) Inj 2 mg per ml, 2 ml ......................Zofran 3.61 4.50 7.40 12.50 14.40 30 30 30 30 5 1% Nov-09 1% Nov-09 Orion

Hospira Ondansetron Sandoz Onsetron Inj 2 mg per ml, 4 ml ......................Zofran 23.20 5 1% Nov-09 Hospira Ondansetron Sandoz Onsetron Note – The Mayne brand of ondansetron inj 2 mg per ml, 2 ml and 4 ml to be delisted 1 November 2009. Anzatax Taxol Note – Paclitaxel Ebewe inj 30 mg, 1 inj pack, to be delisted 1 November 2009. Please note that the 5 inj pack remains listed. (B) – Subject only to part (b) of the definition of “DV Pharmaceutical” 1 1% Oct-08

PACLITAXEL Inj 30 mg........................................Paclitaxel Ebewe 37.95

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

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 September 2009 (continued)

POVIDONE IODINE Alcohol skin preparation 10% with 30 % alcohol ( price).........Betadine Skin Prep Antiseptic soln 10% ( price) ..........Betadine Oint 10 % ( price) .........................Betadine ZUCLOPENTHIXOL HYDROCHLORIDE Tab 10 mg......................................Clopixol

10.00 6.20 3.27 31.45

500 ml 500 ml 25 g 100

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 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

100 ml 50 100 50 100 50 100 50 100 60 60 60 6 10 10 10 10 10 10 10 30 (B) – Subject only to part (b) of the definition of “DV Pharmaceutical” 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)

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)

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 FENTANYL CITRATE (amended chemical name) Inj 50 µg per ml, 2 ml .....................Hospira Inj 50 µg per ml, 10 ml ...................Hospira 25.00 87.50 155.00 310.00 1 1 1 1 1% 1% 1% 1% Oct-09 Oct-09 Oct-09 Oct-09 Hospira Pharmorubicin Hospira Pharmorubicin Hospira Pharmorubicin Hospira Pharmorubicin

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

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

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

Contracted Pharmaceutical Description

Brand

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

Per

DV Limit

DV Limit DV applies Pharmaceutical from

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

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 6 1% 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

Section H changes to Part IV

Effective 1 October 2009

L-ORNITHINE L-ASPARTATE (LOLA) S29 Sach 5 g mg For patients with chronic hepatic encephalopathy who have not responded to treatment with lactulose Note – correction of pack size only. Pamisol Aredia Inj 6 mg per ml, 10 ml Pamisol Inj 9 mg per ml, 10 ml Pamisol For malignant hypercalcaemia, metastatic breast cancer – predominant lytic bone metastases, myeloma with lytic bone metastases, control of pain due to lytic bone metastases in addition to standard care (analgesics + radiotherapy), Gaucher disease with established bone disease. PAMIDRONATE DISODIUM Inj 3 mg per ml, 10 ml

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 Accu-Chek Performa .................................... 28, 44 Aciclovir ............................................................ 47 Actos ................................................................. 28 Aerrane .............................................................. 51 Alendronate for osteoporosis .............................. 20 Alendronate sodium ........................................... 43 Alendronate sodium with cholecalciferol ....... 16, 43 Alpha-Bromocriptine .......................................... 37 Alpha-Keri Lotion ......................................... 29, 38 Aminoacid formula with minerals without phenylalanine .................................................. 19 Aminoacid formula without phenylalanine ........... 16 Amoxycillin clavulanate ................................ 14, 39 Amsacrine ......................................................... 32 Amsidine ........................................................... 32 Amsidyl ............................................................. 32 Anastrozole-dp ............................................. 19, 24 Andriol Testocaps .............................................. 17 Apo-Bromocriptine ............................................. 17 Apo-Clopidogrel ........................................... 31, 48 APO-go .............................................................. 33 Apo-Moclobemide.................................. 30, 41, 46 Apomorphine hydrochloride ............................... 33 Aprepitant .................................................... 16, 43 Aquasun 30+ .................................................... 27 Aquasun Oil Free Faces SPF30+ ........................ 27 Aquasun Sensitive SPF 30+ .............................. 38 Aredia ................................................................ 52 Arrow-Azithromycin ........................................... 23 Arrow-Clopidogrel ........................................ 17, 48 Arrow-Etidronate .......................................... 14, 40 Arrow-Lamotrigine ....................................... 38, 40 Arrow-Metformin................................................ 18 Atenolol ............................................................. 50 Atropine sulphate ......................................... 28, 44 Avanza......................................................... 14, 41 Azathioprine ....................................................... 33 Azithromycin ...................................................... 23 Azol ............................................................. 31, 48 B Baraclude .................................................... 24, 50 B-D Micro-Fine................................................... 31 Baclofen ................................................ 29, 44, 47 Betadine............................................................. 50 Betadine Skin Prep ....................................... 31, 50 Betahistine dihydrochloride........................... 31, 47 Betaloc CR ............................................. 22, 31, 49 Betamethasone valerate ............................... 29, 44 Beta Scalp ................................................... 29, 44 Blood glucose diagnostic test meter ....... 15, 44, 47 Blood glucose diagnostic test strip ... 15, 28, 34, 44 Bromocriptine mesylate................................ 17, 37 Budesonide .................................................. 31, 48 Butacort Aqueous ........................................ 31, 48 C Calamine...................................................... 28, 36 Cancidas............................................................ 48 Carbohydrate supplement................................... 33 Carboplatin .................................................. 30, 44 Carboplatin Ebewe ....................................... 30, 44 CareSens ..................................................... 15, 44 CareSens II .................................................. 15, 44 CareSens POP ............................................. 15, 44 Caspofungin....................................................... 48 Catapres ...................................................... 28, 44 Catapres-TTS-1 ........................................... 28, 44 Catapres-TTS-2 ........................................... 28, 44 Catapres-TTS-3 ........................................... 28, 44 Chlorhexidine ............................................... 39, 48 Chlorhexidine with cetrimide ............................... 39 Cilazapril ............................................................ 33 Clarithromycin.............................................. 15, 19 Clexane .............................................................. 50 Clobetasol propionate................................... 29, 44 Clonazepam ....................................................... 48 Clonidine...................................................... 28, 44 Clonidine hydrochloride .......................... 28, 30, 44 Clopidogrel ............................................ 17, 31, 48 Clopine .............................................................. 50 Clopixol........................................................ 17, 50 Clozapine ........................................................... 50 Codeine phosphate ............................................ 27 Colifoam ...................................................... 28, 46 Cosopt ......................................................... 30, 45 Curam ......................................................... 14, 39 Cyclosporin A .................................................... 24 Cyproterone acetate with ethinyloestradiol .......... 14 D Dasatinib............................................................ 50 Desflurane ......................................................... 50 Dextrochlorpheniramine maleate ................... 15, 38 Diclohexal .......................................................... 16 Diltiazem hydrochloride ...................................... 39 Dilzem ............................................................... 39 DM Ject ....................................................... 17, 49 DP-Anastrozole ............................................ 19, 24 D-Zol ........................................................... 31, 48 Danazol........................................................ 31, 48 Dermol......................................................... 29, 44 Diabetic enteral feed 1kcal/ml ............................. 35 Diazepam......................................... 37, 39, 45, 48 Diclax SR ........................................................... 16 Diclocil .............................................................. 34

Index

Pharmaceuticals and brands Diclofenac sodium ............................................. 16 Dicloxacillin........................................................ 34 Dixarit .......................................................... 30, 44 Dorzolamide hydrochloride with timolol maleate.......................................... 30, 45 E Elemental formula .............................................. 16 Emend Tri-Pack ........................................... 16, 43 Eligard ......................................................... 29, 46 Enoxaparin sodium............................................. 50 Entecavir ...................................................... 24, 50 Epirubicin........................................................... 51 Epirubicin Ebewe................................................ 51 Ethinyloestradiol with gestodene ......................... 34 Ethinyloestradiol with levonorgestrel ................... 34 Etidronate disodium ..................................... 14, 40 F Fentanyl citrate................................................... 51 Fleet Glycerin Suppositories ............................... 34 Flixotide ............................................................. 45 Flixotide Accuhaler ............................................. 45 Fluarix ................................................................ 19 Flucloxacillin sodium .................................... 29, 45 Flucon.......................................................... 31, 36 Fluorometholone .......................................... 31, 36 Flutamide ..................................................... 31, 48 Flutamin ....................................................... 31, 48 Fluticasone ........................................................ 45 Fluvax ................................................................ 19 Foremount Child’s Silicone Mask ........................ 21 Fortimel ............................................................. 31 Fortini ................................................................ 33 Fortini Multifibre ................................................. 33 Fosamax ............................................................ 43 Fosamax Plus .............................................. 16, 43 G Gabapentin ........................................................ 51 GenRx Moclobemide .................................... 15, 41 Gentamicin sulphate ..................................... 29, 45 Ginet 84 ............................................................. 14 Glucose ............................................................. 40 Glucose with sodium, potassium, magnesium, chloride, acetate and gluconate ....................... 40 Gluten free pasta ................................................ 37 Glycerol ............................................................. 34 Glyceryl trinitrate ................................................ 45 Glycine .............................................................. 40 Goserelin acetate ............................................... 23 H Habitrol .............................................................. 22 Healon Clear ...................................................... 52 Healon GV.......................................................... 52 healthE......................................................... 48, 51 Heparinised saline .................................. 16, 37, 45 Heparin sodium...................................... 15, 28, 45 Hydrocortisone ...................................... 29, 33, 46 Hydrocortisone acetate ................................ 28, 46 Hydroxyethyl starch 130/0.4 .............................. 48 Hydroxyethyl starch 200/0.5 .............................. 46 Hysite ................................................................ 16 Hytrin................................................................. 33 I Idarubicin hydrochloride ............................... 27, 40 Indomethacin ..................................................... 33 Influenza vaccine................................................ 18 Inhibace ............................................................. 33 Insulin pen needles................................. 17, 31, 48 Insulin syringes, disposable with attached needle ......................................... 17, 49 Invirase .............................................................. 51 Isentress ...................................................... 16, 47 Isoflurane ........................................................... 51 Isotane 10.................................................... 27, 36 Isotane 20.................................................... 27, 36 Isotretinoin ....................................... 17, 27, 36, 49 K Kenacomb ......................................................... 34 Kenacort-A......................................................... 34 Ketone blood beta-ketone electrodes .................. 22 Ketovite ............................................................. 18 Ketovite Liquid ................................................... 18 Klacid ................................................................ 19 Klamycin...................................................... 15, 19 Konakion ..................................................... 37, 47 Konakion MM..................................................... 19 L Labetalol ............................................................ 34 Lamotrigine...................................... 37, 38, 40, 49 Lansoprazole ............................................... 27, 40 Latanoprost........................................................ 16 Leuprorelin............................................. 29, 46, 51 Levodopa with carbidopa ....................... 21, 30, 46 Lignocaine ......................................................... 49 Lioresal Intrathecal ............................................. 47 Lithium carbonate .............................................. 27 L-ornithine l-aspartate (lola) ............................... 52 Lucrin Depot PDS............................................... 51 M m-Hydrocortisone .............................................. 33 m-Mometasone............................................ 14, 41 Mannitol............................................................. 40 Mask for spacer device ...................................... 21 Mesalazine ................................................... 27, 40 Metabolic Mineral Mixture................................... 19

Index

Pharmaceuticals and brands Metformin hydrochloride ........................ 14, 18, 41 Methylprednisolone sodium succinate .......... 29, 46 Metoprolol succinate .............................. 22, 31, 49 Minulet 28.......................................................... 34 Mirtazapine .................................................. 14, 41 Moclobemide ................................... 15, 30, 41, 46 Mogine ........................................................ 37, 49 Mometasone furoate .................................... 14, 41 Morphine hydrochloride................................ 30, 46 Morphine sulphate........................................ 30, 46 Multivitamins ..................................................... 18 N Naproxen ..................................................... 29, 46 Neoral ................................................................ 24 Nevirapine .......................................................... 51 Nicotine ............................................................. 22 Nicotinell ............................................................ 22 Nitrados ............................................................. 27 Nitrazepam......................................................... 27 Nitronal .............................................................. 45 Noflam 250 .................................................. 29, 46 Noflam 500 .................................................. 29, 46 Nupentin ............................................................ 51 O Oil in water emulsion .......................................... 51 Ondansetron hydrochloride................................. 49 Optium 10 second test ....................................... 34 Optium Blood Ketone Test Strips ........................ 22 Optium Xceed .................................................... 47 Oral feed 1kcal/ml .............................................. 31 Oratane ........................................................ 17, 49 Orgran ............................................................... 37 Oxaliplatin Ebewe ......................................... 14, 41 Ox-Pam ............................................................. 27 Oxaliplatin .................................................... 14, 41 Oxazepam .......................................................... 27 Oxytocin ...................................................... 29, 47 Oxytocin with ergometrine maleate ..................... 47 P Pacifen ........................................................ 29, 44 Pacific Atenolol .................................................. 50 Paclitaxel ..................................................... 37, 49 Paclitaxel Ebewe ................................................ 49 Paclitaxel Ebewe ................................................ 37 Paediatric oral feed 1.5kcal/ml............................ 33 Paediatric oral feed 1kcal/ml............................... 33 Paediatric oral feed with fibre 1.5kcal/ml............. 33 Paediatric Seravit ............................................... 18 Pamidronate disodium ....................................... 52 Pamisol ............................................................. 52 Pancuronium bromide ........................................ 47 Paraffin .............................................................. 51 Parnate S29 ....................................................... 24 Pediasure........................................................... 33 Pegfilgrastim ...................................................... 52 Pegatron Combination Therapy ........................... 36 Pegylated interferon alpha-2b with ribavirin ......... 36 Pentasa ....................................................... 27, 40 Pentastarch........................................................ 46 Pepti Junior Gold................................................ 16 Peptisorb ........................................................... 38 Phenobarbitone sodium...................................... 15 Phytomenadione .................................... 19, 37, 47 Pilocarpine ................................................... 37, 38 Pilocarpine oral liquid ......................................... 26 Pilopt ........................................................... 37, 38 Pioglitazone ....................................................... 28 PKU Anamix Infant ............................................. 16 PKU Lophlex LQ ................................................. 16 Plavix ................................................................. 31 Polaramine................................................... 15, 38 Polycose............................................................ 33 Potassium chloride ...................................... 28, 47 Potassium chloride with glucose ........................ 41 Potassium chloride with glucose and sodium chloride ........................................ 42 Potassium chloride with sodium chloride ............ 42 Povidone iodine ........................................... 31, 50 Pro-Pam .......................................... 37, 39, 45, 48 Protein supplement ............................................ 32 Protifar............................................................... 32 Protifar 90.......................................................... 32 Q Q 300 .......................................................... 30, 47 Quinine sulphate .......................................... 30, 47 R Raltegravir potassium................................... 16, 47 RA-Morph .................................................... 30, 46 Requip ............................................................... 35 Requip Follow-on Pack....................................... 35 Requip Starter Pack............................................ 35 Resource Diabetic TF RTH.................................. 35 Rheumacin ........................................................ 33 Risperidone.................................................. 16, 47 Risperon ...................................................... 16, 47 Rivotril ............................................................... 48 Ropinirole hydrochloride..................................... 35 S Saquinavir .......................................................... 51 SC Profi-Fine................................................ 17, 48 Semi-elemental enteral feed 1kcal/ml.................. 38 Sevoflurane ........................................................ 52 Sevredol ...................................................... 30, 46 Sinemet ....................................................... 30, 46

Index

Pharmaceuticals and brands Sinemet CR............................................ 21, 30, 46 Sodium chloride ................................................. 42 Sodium chloride with glucose............................. 42 Sodium cromoglycate ........................................ 30 Sodium hyaluronate ........................................... 52 Solox ........................................................... 27, 40 Solu-Medrol ................................................. 29, 46 Space Chamber ................................................. 21 Spacer device .................................................... 21 Span-K ........................................................ 28, 47 Sprycel .............................................................. 50 StarQuin 200 6% ................................................ 46 Sunscreens, proprietary ............................... 27, 38 Suprane ............................................................. 50 Syntocinon................................................... 29, 47 Syntometrine................................................ 29, 47 T Tamoxifen citrate................................................ 52 Tamoxifen Sandoz.............................................. 52 Teniposide ......................................................... 38 Terazosin hydrochloride ..................................... 33 Testosterone undecanoate.................................. 17 Thioprine ........................................................... 33 Timolol maleate.................................................. 47 Timoptol XE ....................................................... 47 Trandate ............................................................ 34 Tranylcypromine sulphate .................................. 24 Triamcinolone acetonide .................................... 34 Triamcinolone acetonide with gramicidin, neomycin and nystatin .................................... 34 Trimipramine maleate ......................................... 37 Triphasil 28 ........................................................ 34 Tripress ............................................................. 37 V Vaxigrip ............................................................. 19 Vergo 16 ...................................................... 31, 47 Vinorelbine ......................................................... 31 Viramune ........................................................... 51 Viramune Suspension ........................................ 51 Vitadol C ............................................................ 28 Vitamin A with vitamins D and C ......................... 28 Voltaren SR ........................................................ 16 Volumatic .......................................................... 21 Voluven.............................................................. 48 Vumon ............................................................... 38 W Water ........................................................... 42, 43 Water with sodium, potassium, calcium and chloride .................................................... 43 Water with sodium, potassium, magnesium, chloride, acetate and gluconate ....................... 43 Wool fat with mineral oil ............................... 29, 38 X Xylocaine Jelly ................................................... 49 Z Zavedos ....................................................... 27, 40 Zinc ................................................................... 27 Zofran ................................................................ 49 Zoladex .............................................................. 23 Zuclopenthixol hydrochloride ........................ 17, 50

Pharmaceutical Management Agency Level 9, 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 ISSN 1172-9376 (Print) ISSN 1179-3686 (Online)

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 November 2009

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 November 2009 Cumulative for September, October and November 2009 Section H cumulative for August, September, October and November 2009 Contents Summary of PHARMAC decisions effective 1 November 2009 ….. 3…

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