This is the text extract for Sole supply of metoprolol; Closing Date: Closed; Contact: Stephen Woodruffe, browse documents here.

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30 September 2011

Sole Supply of Metoprolol Succinate and Metoprolol Tartrate

PHARMAC is seeking feedback on the following sole supply proposals for metoprolol succinate (tablets) and metoprolol tartrate (tablets and injection) arising from our Request for Proposals for these products issued in June 2011. In summary, these proposals would result in the following brands having sole supply and hospital supply status (the only funded brand in the Community, and the available brand in DHB hospitals) from 1 August 2012 (metoprolol tartrate) and 1 September 2012 (metoprolol succinate) until 30 June 2015:  AFT’s brand of metoprolol succinate tablets (Metoprolol-AFT CR) – this would result in a brand switch for patients using the Betaloc CR or Myloc CR brands of metoprolol succinate and who wish to remain on a funded product while making in excess of $5 million per annum available for the funding of other medicines. Novartis’ brands of metoprolol tartrate tablets (Lopresor and Slow-Lopresor) – this would result in no change as these are the currently available brands. Novartis’ brand of metoprolol tartrate injection (Lopresor) – the Lopresor brand of metoprolol tartrate injection would replace the Betaloc brand, in addition Lopresor would be fully funded (Betaloc currently has a part-charge).

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Feedback sought PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Friday, 14 October 2011 to: Stephen Woodruffe Therapeutic Group Manager PHARMAC PO Box 10 254 Wellington 6143 Email: stephen.woodruffe@pharmac.govt.nz Fax: 04 460 4995

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

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Details of the proposal Listings and Sole Supply Status We propose that the following brands of metoprolol succinate tablets, metoprolol tartrate tablets and metoprolol tartrate injection be awarded Sole Supply Status and Hospital Supply Status, meaning they would be the only brands subsidised on the Pharmaceutical Schedule, and the only brands available in DHB hospitals subject to a discretionary variance limit of 1%.

Chemical Metoprolol succinate long-acting tablets 23.75 mg, 47.5 mg, 95 mg and 190 mg Metoprolol tartrate tablets 50 mg and 100 mg Metoprolol tartrate long-acting tablets 200 mg Metoprolol tartrate injection 1 mg per ml, 5 ml Sole Supply Brand Metoprolol-AFT CR Lopresor Slow-Lopresor Lopresor Brands to be delisted Betaloc CR Myloc CR None None Betaloc

Sole Supply Status and Hospital Supply Status would be effective from 1 August 2012 for metoprolol tartrate and 1 September 2012 for metoprolol succinate, and would end 30 June 2015: The implementation timeline would be as follows:  1 January 2012 – Listing and full funding of Lopresor (metoprolol tartrate 1 mg per ml, 5 ml) injection in Section B and Part II of Section H of the Pharmaceutical Schedule. 1 May 2012 – Price reductions for Metoprolol-AFT CR, Lopresor (tablets) and SlowLopresor. – Reference pricing of Betaloc injection to Lopresor injection.    1 June 2012 – Reference pricing of Betaloc CR / Myloc CR to Metoprolol-AFT CR. 1 August 2012 – Delisting of Betaloc (injection) from the Pharmaceutical Schedule. 1 September 2012 – Delisting of Betaloc CR / Myloc CR from the Pharmaceutical Schedule.

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The proposed pricing of metoprolol succinate is between 45% and 56% lower than the current pricing depending upon the strength. Therefore, this proposal would reduce expenditure in excess of $5 million per annum. These savings would be used for the funding of other medicines. In addition the price reduction for metoprolol tartrate injection would result in it being fully funded – currently there is a part-charge. The timing of the proposed changes to the prices and subsidies (ex-manufacturer, excluding GST) for metoprolol succinate and metoprolol tartrate in the Pharmaceutical Schedule are shown below:

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Metoprolol Succinate

Strength Brand Pack Size Subsidy and Price (Price in brackets if different to subsidy) Current* 1 May 2012* 1 June to 31 1 September August 2012* 2012* $2.18 $0.96 $0.96 $0.96 $2.18 $2.74 $2.74 $4.71 $4.71 $8.51 $8.51 $2.18 $1.41 $2.74 $2.42 $4.71 $4.66 $8.51 $0.96 ($2.18) $1.41 $1.41 ($2.74) $2.42 $2.42 ($4.71) $4.66 $4.66 ($8.51) Delisted $1.41 Delisted $2.42 Delisted $4.66 Delisted

23.75 mg long-acting tablet

47.5 mg long-acting tablet

95 mg long-acting tablet

190 mg long-acting tablet

MetoprololAFT CR Betaloc CR & Myloc CR MetoprololAFT CR Betaloc CR & Myloc CR MetoprololAFT CR Betaloc CR & Myloc CR MetoprololAFT CR Betaloc CR & Myloc CR

30 30 30 30 30 30 30 30

*Subsidies and prices ex-manufacturer, excluding GST

Metoprolol Tartrate

Strength Brand Pack Size Subsidy and Price (Price in brackets if different to subsidy) Current* 1 May 2012 to 1 August 31 July 2012* 2012* $16.50 $16.00 $16.00 $21.80 $18.40 Listed 1 January 2012 at $24.00 $24.08 ($34.00) $21.00 $18.00 $24.00 $24.00 ($34.00) $21.00 $18.00 $24.00 Delisted

50 mg tablet 100 mg tablet 200 mg longacting tablet 1 mg per ml, 5 ml injection

Lopresor Lopresor Slow-Lopresor Lopresor Betaloc

100 60 28 5 5

*Subsidies and prices ex-manufacturer, excluding GST

We note that:  Metoprolol-AFT CR has been available fully funded since June 2009.  A larger pack size of metoprolol succinate is also available, we would therefore appreciate feedback as to whether a 30 or a 90 tablet pack is more appropriate. Background In June 2011, PHARMAC invited proposals (through a “Request for Proposals”) from suppliers for the Sole Supply of metoprolol succinate and/or metoprolol tartrate in the Community and DHB hospitals. The proposals to award Sole Supply of metroprolol succinate and metoprolol tartrate, as well as to fully fund metoprolol tartrate injection are a result of this process.

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