Schedule Update - effective 1 February 2012 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 February 2012

Cumulative for January and February 2012 Section H cumulative for December 2011, January and February 2012

Contents

Summary of PHARMAC decisions effective 1 February 2012 ......................... 3 Subsidy changes for some respiratory inhalation products and access restrictions to combination inhalers ............................................ 4 Pharmacy Brand Switch Payment for Bicalutamide ....................................... 5 Named Patient Pharmaceutical Assessment (NPPA) ....................................... 5 Discontinuation of Cardinol 10 mg and 40 mg tablets.................................. 5 Calcium Carbonate 600 mg tablets ............................................................... 6 Insulin Glargine removal of prescriber note................................................... 6 New Listing Rizatriptan ................................................................................. 6 Tender News .................................................................................................. 7 Looking Forward ........................................................................................... 7 Sole Subsidised Supply products cumulative to February 2012 ..................... 8 New Listings ................................................................................................ 18 Changes to Restrictions ............................................................................... 20 Changes to Subsidy and Manufacturer’s Price............................................. 26 Changes to Sole Subsidised Supply ............................................................. 29 Delisted Items ............................................................................................. 30 Items to be Delisted .................................................................................... 32 Section H changes to Part II ........................................................................ 34 Section H changes to General Rules ............................................................ 38 Index ........................................................................................................... 39

Summary of PharmaC decisions

effeCtIve 1 feBrUarY 2012 New listings (page 18) • Cefuroxime sodium (Mylan) inj 1.5 g – Retail pharmacy-Specialist – subsidy by endorsement • Pharmacy Services (BSF Bicalaccord) brand switch fee – no patient co-payment payable - may only be claimed once per patient Changes to restrictions (pages 19-21) • Insulin glargine – removal of prescriber note • Bortezomib – amended Special Authority criteria • Inhaled Corticosteroids with Long-Acting Beta-Adrenoreceptor Agonistsamended Special Authority criteria • Eformoterol fumarate – removal of endorsement for full subsidy, repeats fully subsidised where initial dispensing is prior to 1 February 2012 • Budesonide with eformoterol – removal of endorsement for full subsidy • Sodium chloride (Biomed) soln 7% - amended subsidy restriction • Sodium bicarbonate (Midwest, David Craig) – subsidised in lansoprazole suspension Decreased subsidy (page 25) • Sodium chloride (Multichem) inj 0.9 %, 10 ml • Cefaclor monohydrate (Ranbaxy Cefaclor) cap 250 mg • Ibuprofen (Ethics Ibuprofen) tab 200 mg and (Brufen) tab 400 mg and 600 mg • Eformoterol fumarate (Oxis Turbuhaler) powder for inhalation 6 µg per dose, breath activated, (Foradil) powder for inhalation, 12 µg per dose, and monodose device • Budesonide with eformoterol (Vannair) aerosol inhaler 100 µg with eformoterol fumarate 6 µg and 200 µg with eformoterol fumarate 6 µg Increased subsidy (page 25) • Benztropine mesylate (Cogentin) inj 1 mg per ml, 2 ml • Fluticasone (Flixotide Accuhaler) powder for inhalation, 50 µg per dose • Budenoside with eformoterol powder for inhalation (Symbicort Turbuhaler 100/6) 100 µg with eformoterol 6 µg, (Symbicort Turbuhaler 200/6) 200 µg with eformoterol 6 µg, (Symbicort Turbuhaler 400/12) 400 µg with eformoterol 12 µg

4 Pharmaceutical Schedule - Update News

Subsidy changes for some respiratory inhalation products and access restrictions to combination inhalers

From 1 February 2012 subsidy and restriction changes will occur to some respiratory inhalation products. These changes vary from those summarised in previous notifications. The changes are summarised below: 1) Widening of access to combination inhalers by removing the requirement for patients to be on separate ICS and LABA inhalers for at least three months prior to being eligible for funded combination inhalers via Special Authority. Please note a Special Authority approval number is still required to gain full subsidy for combination inhalers. 2) From the 1st of February 2012 there will be full funding for all patients for budesonide with eformoterol via Special Authority - all strengths of Vannair and Symbicort Turbuhaler. This applies to both new and existing patients. 3) From the 1st of February 2012 there will be a reduction in subsidy for eformoterol fumarate which will result in manufacturer's surcharges for Oxis

Turbuhaler and Foradil. To assist with the implementation of these changes, repeat dispensing for Oxis Turbuhaler and Foradil where the initial dispensing of that prescription was before 1 February 2012 will be fully funded. Subsequent prescriptions will incur a part charge. This will give clinicians and patients time to make a treatment change should patients wish to receive a fully funded product. 4) Flixotide Accuhaler (powder for inhalation), all strengths will be fully subsidised from 1 February 2012. Previous to this date, these pharmaceuticals carried a part charge. These changes have previously been notified to the market. Please refer to the full Notification located on the PHARMAC website for further details. http://www. pharmac.govt.nz/healthpros/notification

Pharmaceutical Schedule - Update News

Pharmacy Brand Switch Payment for Bicalutamide

Brand switch payments for pharmacies will be payable for dispensings of the Bicalaccord brand of bicalutamide 50mg tablets from 1 February 2012. The brand switch fee is claimable via a Pharmacode on the first dispensing of bicalutamide after 1 February 2012 for patients who have switched brands. Pharmacies should claim a fee even if the patient switched to the Sole Supply brand prior to 1 February 2012. The brand switch fee for bicalutamide will be paid only once for each patient during the claim period. The brand switch fee will not be able to be claimed for this pharmaceutical for dispensing after 30 April 2012. Further pharmacy brand switch payment information is available on the PHARMAC website at http://www.pharmac.govt.nz/ healthpros/SchedulePrinted.

Named Patient Pharmaceutical Assessment (NPPA)

From 1 March 2012, PHARMAC's Exceptional Circumstances schemes will be replaced with The prescriber note that applies to insulin glargine (Lantus and Lantus SoloStar) will be Named Patient Pharmaceutical Assessment (NPPA). The changes include removal of the criteria removed from 1 February 2012. This being restricting funding to rare conditions and changes to the application process, including follows the removal of the Special Authority for able to apply electronically. insulin glargine on 1 August 2010 to widen access to a long-acting insulin treatment at For more information, including the NPPA Policy, criteria and contact details, visit our websitefor diabetes mellitus. http://www.pharmac.govt.nz/haveyoursay/ecreview.

Discontinuation of Cardinol 10 mg and 40 mg tablets

Mylan are discontinuing the supply of the Cardinol brand of propranolol 10 mg and 40 mg tablets. Current supplies are expected to last until February 2012 for 40 mg tablets and until April 2012 for the 10 mg tablets. Alternative Beta adrenoreceptor blockers are fully funded. The long-acting 160 mg propranolol capsules (Cardinol) will continue to be supplied.

Pharmaceutical Schedule - Update News

Calcium Carbonate 600 mg tablets

As a result of a tender Agreement for the supply of calcium carbonate tablets, only the 500 mg strength tablets will continue to be funded from 1 May 2012 when the Calci-tab brand of 500 mg and 600 mg tablets are delisted.

Insulin Glargine removal of prescriber note

The prescriber note that applies to insulin glargine (Lantus and Lantus SoloStar) will be removed from 1 February 2012. This follows the removal of the Special Authority for insulin glargine on 1 August 2010 to widen access to a long-acting insulin treatment for diabetes mellitus.

New Listing Rizatriptan

As a result of the tender from 1 March 2012 there will be a new brand of Rizatriptan orodispersible tablets listed on the Pharmaceutical Schedule. Rizamelt is to be supplied by Mylan New Zealand and will be awarded sole supply from 1 August 2012.

tender News

Sole Subsidised Supply changes – effective 1 March 2012

Chemical Name Allopurinol Allopurinol Losartan Losartan Losartan Losartan Losartan with hydrochlorothiazide Paracetamol Testosterone cypionate Ciprofloxacin Ciprofloxacin Ciprofloxacin Presentation; Pack size Tab 100 mg; 1,000 tab Tab 300 mg; 500 tab Tab 12.5 mg; 90 tab Tab 25 mg; 90 tab Tab 50 mg; 90 tab Tab 100 mg; 90 tab Tab 50 mg with hydrochlorothiazide 12.5 mg; 30 tab Oral liq 120 mg per 5 ml; 500 ml Inj long-acting 100 mg per ml, 10 ml; 1 inj Tab 250 mg; 28 tab Tab 500 mg; 28 tab Tab 750 mg; 28 tab Sole Subsidised Supply brand (and supplier) Apo-Allopurinol (Apotex) Apo-Allopurinol (Apotex) Lostaar (Mylan) Lostaar (Mylan) Lostaar (Mylan) Lostaar (Mylan) Arrow-Losartan and Hydrochlorothiazide (Arrow) Ethics Paracetamol (Multichem) Depo-Testosterone (Pfizer) Cipflox (Mylan) Cipflox (Mylan) Cipflox (Mylan)

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 march 2012 • Adrenaline (Aspen Adrenaline) 1 in 10,000, 10 ml – New listing • Auranofin (Ridaura s29) tab 3 mg – New listing • Losartan (Lostaar) tab 12.5 mg, 25 mg, 50 mg and 100 mg – Brand switch fee • Losartan with hydrochlorothiazide (Arrow-Losartan & Hydrochlorothiazide) tab 50mg with hydrochlorothiazide 12.5 mg – Brand switch fee

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Abacavir sulphate Acarbose Acetazolamide Aciclovir Amantadine hydrochloride Aminophylline Amitriptyline Amlodipine Amoxycillin

Presentation

Oral liq 20 mg per ml Tab 300 mg Tab 50 mg & 100 mg Tab 250 mg Tab dispersible 200 mg, 400 mg & 800 mg Cap 100 mg Inj 25 mg per ml, 10 ml Tab 25 mg & 50 mg Tab 5 mg & 10 mg Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg Grans for oral liq 250 mg per 5 ml Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml Crm Tab 100 mg Tab 100 mg Tab dispersible 300 mg Tab 50 mg & 100 mg Inj 600 µg, 1 ml Tab 50 mg Inj 50 mg Tab 500 mg Tab 10 mg Tab 2.5 mg & 5 mg Inj 600 mg Scalp app 0.1% Eye drops 0.5% Eye drops 0.25% Tab 50 mg Tab 5 mg Crm, aqueous, BP Lotn, BP Inj 100 iu per ml, 1 ml

Brand Name Expiry Date*

Ziagen Ziagen Glucobay Diamox Lovir Symmetrel DBL Aminophylline Amitrip Apo-Amlodipine Ibiamox Alphamox Ospamox Curam Curam 2014 2012 2014 2013 2014 2014 2014 2014 2014 2013 2012 2012

Amoxycillin clavulanate

Aqueous cream Ascorbic acid Aspirin Atenolol Atropine sulphate Azathioprine Azithromycin Baclofen Bendrofluazide Benzylpenicillin sodium (Penicillin G) Betamethasone valerate Betaxolol hydrochloride Bicalutamide Bisacodyl Calamine Calcitonin

AFT Vitala-C Ethics Aspirin EC Ethics Aspirin Atenolol Tablet USP AstraZeneca Imuprine Imuran Arrow-Azithromycin Pacifen ArrowBendrofluazide Sandoz Beta Scalp Betoptic Betoptic S Bicalaccord Lax-Tab healthE API Miacalcic

2014 2013 2013 2012 2012 2013 2012 2012 2014 2014 2012 2014 2014 2013 2012 2014

*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 February 2012

Generic Name

Calcitriol Calcium carbonate Calcium folinate Captopril Cefaclor monohydrate Ceftriaxone sodium Cephalexin monohydrate Cetomacrogol Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate Ciclopiroxolamine Cilazapril Cilazapril with hydrochlorothiazide Citalopram hydrobromide Clobetasol propionate

Presentation

Cap 0.25 µg & 0.5 µg Tab eff 1.75 g (1 g elemental) Tab 15 mg Tab 12.5 mg, 25 mg & 50 mg Oral liq 5 mg per ml Grans for oral liq 125 mg per 5 ml Inj 500 mg Inj 1 g Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Crm BP Oral liq 1 mg per ml Tab 10 mg Eye drops 0.5% Eye oint 1% Soln 4% Handrub 1% with ethanol 70% Nail soln 8% Tab 0.5 mg, 2.5 mg & 5 mg Tab 5 mg with hydrochlorothiazide 12.5 mg Tab 20 mg Crm 0.05% Oint 0.05% Scalp app 0.05% TDDS 2.5 mg, 100 µg per day TDDS 5 mg, 200 µg per day TDDS 7.5 mg, 300 µg per day Inj 150 µg per ml, 1 ml Tab 25 µg Tab 150 µg Tab 75 mg Crm 1% Vaginal crm 1% with applicator Vaginal crm 2% with applicator Soln BP Tab 500 µg Powder for soln for oral use 4.4 g Crm 10% Tab 50 mg

Brand Name Expiry Date*

Airflow Calsource DBL Leucovorin Calcium m-Captorpril Capoten Ranbaxy-Cefaclor Veracol Aspen Ceftriaxone Cefalexin Sandoz Cefalexin Sandoz PSM Cetirizine - AFT Zetop Chlorafast Chlorsig Orion healthE Batrafen Zapril Inhibace Plus Arrow-Citalopram Dermol Dermol Dermol Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3 Catapres Dixarit Catapres Apo-Clopidogrel Clomazol Clomazol Clomazol Midwest Colgout Electral Itch-Soothe Nausicalm 2012 2014 2014 2013 2013 2013 2012 2013 2014 2012 2014 2012 2012 2013 2013 2014 2012

Clonidine

2012

Clonidine hydrochloride

2012

Clopidogrel Clotrimazole

2013 2014 2013 2013 2013 2013 2012 2012

Coal tar Colchicine Compound electrolytes Crotamiton Cyclizine hydrochloride

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Cyclophosphamide Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone Dexamethasone sodium phosphate

Presentation

Tab 50 mg Tab 50 mg & 100 mg Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs Nasal spray 10 µg per dose Eye oint 0.1% Eye drops 0.1% Inj 4 mg per ml, 1 ml & 2 ml

Brand Name Expiry Date*

Cycloblastin Siterone Ginet 84 Desmopressin-PH&T Maxidex Maxidex Hospira Maxitrol Maxitrol 2013 2012 2014 2014 2014 2013 2013 2014

Dexamethasone with neomycin Eye oint 0.1% with neomycin sulphate and polymyxin b sulphate 0.35% and polymyxin B sulphate 6,000 u per g Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin B sulphate 6,000 u per ml Dextrose Dextrose with electrolytes Inj 50%, 10 ml Soln with electrolytes

Biomed Pedialyte – Fruit Pedialyte – Bubblegum Pedialyte – Plain Voltaren Voltaren Ophtha Voltaren Diclofenac Sandoz DHC Continus Dilzem Cardizem CD Pytazen SR Laxofast 50 Laxofast 120 Laxsol Donepezil-Rex Apo-Doxazosin Doxine AFT Arrow-Enalapril Clexane Comtan

2014 2013

Diclofenac sodium

Inj 25 mg per ml, 3 ml Eye drops 1 mg per ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab EC 25 mg & 50 mg Tab long-acting 60 mg Tab 30 mg & 60 mg Cap long-acting 120 mg, 180 mg & 240 mg Tab long-acting 150 mg Cap 50 mg Cap 120 mg Tab 50 mg with total sennosides 8 mg Tab 5 mg & 10 mg Tab 2 mg & 4 mg Tab 100 mg Oint BP Tab 5 mg, 10 mg & 20 mg Inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg & 150 mg Tab 200 mg

2014

2012 2013 31/12/11

Dihydrocodeine tartrate Diltiazem hydrochloride

Dipyridamole Docusate sodium Docusate sodium with sennosides Donepezil hydrochloride Doxazosin mesylate Doxycycline hydrochloride Emulsifying ointment Enalapril Enoxaparin sodium (low molecular weight heparin) Entacapone

2014 2014 2013 2012 2014 2014 2014 2012 2012 2012

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Ergometrine maleate Erythromycin ethyl succinate Escitalopram Ethinyloestradiol Etidronate disodium Exemestane Felodipine Fentanyl

Presentation

Inj 500 µg per ml, 1 ml Tab 400 mg Tab 10 mg & 20 mg Tab 10 µg Tab 200 mg Tab 25 mg Tab long-acting 5 mg Tab long-acting 10 mg Transdermal patch 12.5 µg per hour, 25 µg per hour, 50 µg per hour, 75 µg per hour, 100 µg per hour Inj 50 µg per ml, 2 ml & 10 ml Oral liq 30 mg per 1 ml (6 mg elemental per 1 ml) Tab 5 mg Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Eye drops 0.1% Cap 20 mg Tab dispersible 20 mg, scored Tab 250 mg Metered aqueous nasal spray, 50 µg per dose Inj 10 mg per ml, 2 ml Tab 40 mg Crm 2% Oint 2% Cap 100 mg, 300 mg & 400 mg Tab 600 mg Inj 40 mg per ml, 2 ml Tab 80 mg Liquid TDDS 5 mg & 10 mg Tab 600 µg Inj 5 mg per ml, 1 ml Oral liq 2 mg per ml Tab 500 µg, 1.5 mg & 5 mg

Brand Name Expiry Date*

DBL Ergometrine E-Mycin Loxalate NZ Medical and Scientific Arrow-Etidronate Aromasin Felo 5 ER Felo 10 ER Mylan Fentanyl Patch Boucher and Muir Ferodan Rex Medical Flucloxin AFT AFT AFT FML Fluox Fluox Flutamin Flixonase Hayfever & Allergy Frusemide-Claris Diurin 40 Foban Foban Nupentin Lipazil Pfizer Apo-Gliclazide healthE Nitroderm TTS Lycinate Serenace Serenace Serenace 2014 2012 2013 2012 2012 2014 2012 2013

Fentanyl citrate Ferrous sulphate Finasteride Flucloxacillin sodium

2012 2013 2014 2014 2012

Fluorometholone Fluoxetine hydrochloride Flutamide Fluticasone propionate Furosemide Fusidic acid Gabapentin Gemfibrozil Gentamicin sulphate Gliclazide Glycerol Glyceryl trinitrate Haloperidol

2012 2013 2013 31/1/13 2013 2012 2013 31/7/12 2013 2012 2014 2013 2014 2013

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Hydrocortisone

Presentation

Crm 1% Powder Inj 50 mg per ml, 1 ml Tab 5 mg & 20 mg Rectal foam 10%, CFC-free (14 applications) Crm 1% with miconazole nitrate 2% Lotn 1% with wool fat hydrous 3% and mineral oil Inj 1 mg per ml, 1 ml Tab 200 mg Inj 20 mg, 1 ml Tab 10 mg Tab long-acting 800 mg Oral liq 100 mg per 5 ml Crm 5% Tab 2.5 mg Aqueous nasal spray, 0.03%, 15 ml OP Nebuliser soln, 250 µg per ml, 1 ml & 2 ml Inj 50 mg per ml, 2 ml Tab 20 mg Tab long-acting 40 mg Cap 10 mg & 20 mg Cap 100 mg Shampoo 2% Oral liq 10 g per 15 ml Oral liq 10 mg per ml Tab 150 mg Eye drops 50 µg per ml Tab 2.5 mg Subdermal implant (2 x 75 mg rods) Viscous soln 2% Inj 1%, 5 ml & 20 ml Crm 2.5% with prilocaine 2.5% (5 g tubes) Crm 2.5% with prilocaine 2.5%; 30 g OP

Brand Name Expiry Date*

Pharmacy Health ABM Solu-Cortef Douglas Colifoam Micreme H DP Lotn HC ABM Hydroxocobalamin Plaquenil Buscopan Gastrosoothe Brufen SR Fenpaed Aldara Dapa-Tabs Univent Univent Ferrum H Ismo 20 Corangin Oratane Itrazole Sebizole Laevolac 3TC 3TC Hysite Letara Jadelle Xylocaine Viscous Xylocaine EMLA EMLA 2014 2014 2012 2013 2014 2013 2013 2012 2012 31/12/13 2014 2013 2013 2014 2013 2012 2012 2013 2014 2012 2012 2014 2014 2013 2014 2013 2013

Hydrocortisone acetate Hydrocortisone with miconazole Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hyoscine N-butylbromide Ibuprofen Imiquimod Indapamide Ipratropium bromide

Iron polymaltose Isosorbide mononitrate Isotretinoin Itraconazole Ketoconazole Lactulose Lamivudine Latanoprost Letrozole Levonorgestrel Lignocaine hydrochloride Lignocaine with prilocaine

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Lisinopril Lithium carbonate Lodoxamide trometamol Loperamide hydrochloride Loratadine

Presentation

Tab 5 mg, 10 mg & 20 mg Cap 250 mg Eye drops 0.1% Cap 2 mg Oral liq 1 mg per ml Tab 10 mg Tab 1 mg & 2.5 mg Liq 0.5% Shampoo 1% Size 2 Tab 100 mg Tab 135 mg Tab 160 mg Tab 50 mg Suppos 500 mg Enema 1 g per 100 ml Tab immediate-release 500 mg & 850 mg Tab 5 mg Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Inj 25 mg per ml, 2 ml & 20 ml Tab 2.5 mg & 10 mg Tab 4 mg & 100 mg Inj 40 mg per ml, 1 ml Inj 62.5 mg per ml, 2 ml Inj 500 mg Inj 1 g Inj 5 mg per ml, 2 ml Tab 10 mg Crm 2% Tab 150 mg & 300 mg Crm 0.1% Oint 0.1% Oral liq 1 mg per ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml

Brand Name Expiry Date*

Arrow-Lisinopril Douglas Lomide Diamide Relief Lorapaed Loraclear Hayfever Relief Ativan A-Lices A-Lices EZ-fit Paediatric Mask De-Worm Colofac Apo-Megestrol Purinethol Asacol Pentasa Apotex Methatabs Biodone Biodone Forte Biodone Extra Forte Hospira Methoblastin Medrol Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Pfizer Metamide Multichem Apo-Moclobemide m-Mometasone m-Mometasone RA-Morph RA-Morph RA-Morph RA-Morph 2012 2014 2014 2013 2013

Lorazepam Malathion Mask for spacer device Mebendazole Mebeverine hydrochloride Megestrol acetate Mercaptopurine Mesalazine Metformin hydrochloride Methadone hydrochloride

2013 2013 2015 2014 2014 2012 2013 2014 2012 2012 2013 2012

Methotrexate Methylprednisolone Methylprednisolone sodium succinate

2013 2012 2012 2012

Metoclopramide hydrochloride Miconazole nitrate Moclobemide Mometasone furoate Morphine hydrochloride

2014 2014 2012 2012 2012

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Morphine sulphate

Presentation

Inj 5 mg per ml, 1 ml Inj 10 mg per ml, 1 ml Inj 15 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Tab long-acting 10 mg, 30 mg, 60 mg & 100 mg Cap long-acting 10 mg, 30 mg, 60 mg & 100 mg Tab immediate release 10 mg & 20 mg

Brand Name Expiry Date*

DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Arrow-Morphine LA m-Elson Sevredol Hospira Konsyl-D Naphcon Forte Noflam 250 Noflam 500 Naltraccord AstraZeneca Viramune Suspension Viramune Habitrol Habitrol Habitrol Apo-Nicotinic Acid Arrow-Norfloxacin Primolut N Noriday 28 Nilstat Nilstat Nilstat Omezol Relief Midwest Dr Reddy’s Omeprazole Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron Ox-Pam 2014 2014 2014 2012 2014 2013 2014 2012 2013 2013 2014 2012 2013 2014 2012 2014

2013

Morphine tartrate Mucilaginous laxatives Naphazoline hydrochloride Naproxen Natrexone hydrochloride Neostigmine Nevirapine

Inj 80 mg per ml, 1.5 ml & 5 ml Dry Eye drops 0.1% Tab 250 mg Tab 500 mg Tab 50 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Tab 200 mg

Nicotine

Gum 2 mg & 4 mg (classic, fruit, mint) Lozenge 1 mg & 2 mg Patch 7 mg, 14 mg & 21 mg Tab 50 mg & 500 mg Tab 400 mg Tab 5 mg Tab 350 µg Oral liq 100,000 u per ml Cap 500,000 u Tab 500,000 u Cap 10 mg, 20 mg & 40 mg Powder Inj 40 mg Tab disp 4 mg & 8 mg Tab 4 mg & 8 mg

2014

Nicotinic acid Norfloxacin Norethisterone Nystatin

Omeprazole

Ondansetron

2013

Oxazepam

Tab 10 mg & 15 mg

2014

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Oxytocin

Presentation

Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml Inj 40 mg Tab 20 mg & 40 mg Oral liq 250 mg per 5 ml Tab paracetamol 500 mg with codeine phosphate 8 mg Eye oint with soft white paraffin Tab 20 mg Low range & normal range Inj 135 µg prefilled syringe Inj 180 µg prefilled syringe Inj 135 µg prefilled syringe x 4 with ribavirin tab 200 mg x 112 Inj 135 µg prefilled syringe x 4 with ribavirin tab 200 mg x 168 Inj 180 µg prefilled syringe x 4 with ribavirin tab 200 mg x 112 Inj 180 µg prefilled syringe x 4 with ribavirin tab 200 mg x 168 Tab 0.25 mg & 1 mg Crm 5% Lotn 5% Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

Syntocinon Syntocinon Syntometrine Pantocid IV Dr Reddy’s Pantoprazole Paracare Double Strength Paracetamol + Codeine (Relieve) Lacri-Lube Loxamine Breath-Alert Pegasys Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Permax Lyderm A-Scabies DBL Pethidine Hydrochloride DBL Pethidine Hydrochloride Cilicaine VK AFT AFT Apo-Pindolol Pizaccord Sandomigran Coloxyl Span-K Cholvastin Redipred 2012 2012 2012 2014 2012 2014 2012 2012

Pantoprazole

2014 2013 2014 2014 2013 2013 2015 31/12/12

Paracetamol Paracetamol with codeine Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak flow meter Pegylated interferon alpha-2A

Pergolide Permethrin Pethidine hydrochloride

2014 2014 2014

Phenoxymethylpenicillin (Pencillin V)

Cap potassium salt 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 5 mg, 10 mg & 15 mg Tab 15 mg, 30 mg & 45 mg Tab 500 µg Oral drops 10% Tab long-acting 600 mg Tab 20 mg & 40 mg Oral liq 5 mg per ml

2013

Pindolol Pioglitazone Pizotifen Poloxamer Potassium chloride Pravastatin Prednisone sodium phosphate

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Pregnancy tests – hCG urine Procaine penicillin Promethazine hydrochloride Pyridostigmine bromide Pyridoxine hydrochloride Quinine sulphate Ranitidine hydrochloride Rifabutin Ropinirole hydrochloride Roxithromycin Salbutamol

Presentation

Cassette Inj 1.5 mega u Oral liq 5 mg per 5 ml Tab 60 mg Tab 25 mg Tab 50 mg Tab 300 mg Oral liq 150 mg per 10 ml Tab 150 mg & 300 mg Cap 150 mg Tab 0.25 mg, 1 mg, 2 mg & 5 mg Tab 150 mg & 300 mg Oral liq 2 mg per 5 ml Nebuliser soln, 1 mg per ml, 2.5 ml Nebuliser soln, 2 mg per ml, 2.5 ml Nebuliser soln, 2.5 mg with ipratopium bromide 0.5 mg per vial, 2.5 ml Tab 5 mg Tab 50 mg & 100 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Inj 23.4%, 20 ml Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml Grans effervescent 4 g sachets Eye drops 2% Nasal spray, 4% Inj cartridge 16 iu (5.3 mg) Inj cartridge 36 iu (12 mg) Tab 80 mg & 160 mg 800 ml 230 ml (single patient) Tab 25 mg & 100 mg Inj 12 mg per ml, 0.5 ml Tab 50 mg & 100 mg

Brand Name Expiry Date*

Innovacon hCG One Step Pregnancy Test Cilicaine Promethazine Winthrop Elixir Mestinon PyridoxADE Apo-Pyridoxine Q 300 Peptisoothe Arrow-Ranitidine Mycobutin Ropin ArrowRoxithromycin Salapin Asthalin Asthalin Duolin 2012 2014 2012 2014 2014 2012 2014 2013 2013 2012 2013 2012 2012

Salbutamol with ipratropium bromide Selegiline hydrochloride Sertraline Simvastatin

Apo-Selegiline Arrow-Sertraline Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Biomed Micolette Ural Rexacrom Rex Genotropin Genotropin Mylan Volumatic Space Chamber Plus Spirotone Arrow-Sumatriptan Arrow-Sumatriptan

2012 2013 2014

Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Sodium citro-tartrate Sodium cromoglycate Somatropin Sotalol Spacer device

2013 2013 2013 2013 2012 31/12/12 2012 2015

Spironolactone Sumatriptan

2013 2013

Sole Subsidised Supply Products – cumulative to February 2012

Generic Name

Tamoxifen citrate Tamsulosin hydrochloride Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terazosin hydrochloride Terbinafine Testosterone undecanoate Tetracosactrin Timolol maleate Tobramycin

Presentation

Tab 20 mg Cap 400 µg Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium, 500 ml & 1,000 ml Tab 10 mg Tab 1 mg, 2 mg & 5 mg Tab 250 mg Cap 40 mg Inj 250 µg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.3% Eye oint 0.3% Inj 40 mg per ml, 2 ml Tab 100 mg Cap 50 mg Crm 0.02% Oint 0.02% 0.1% in Dental Paste USP Tab 500 mg Eye drops 0.5% & 1% Cap 5 mg Eye drops 0.25% Inj 500 mg Tab 40 mg & 80 mg Tab, strong, BPC Tab (BPC cap strength) Cap 100 mg Oral liq 10 mg per ml Caps 137.4 mg (50 mg elemental) Tab 7.5 mg

Brand Name Expiry Date*

Genox Tamsulosin-Rex Pinetarsol 2014 2013 2014

Normison Arrow Dr Reddy’s Terbinafine Arrow-Testosterone Synacthen Synacthen Depot Apo-Timol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol Aristocort Aristocort Oracort Cycklokapron Mydriacyl Navoban Enuclene Mylan Isoptin B-PlexADE MultiADE Retrovir Retrovir Zincaps Apo-Zopiclone

2014 2013 2014 2012 2014 2012 2014

Tolcapone Tramadol hydrochloride Triamcinolone acetonide

2014 2014 2014

Tranexamic acid Tropicamide Tropisetron Tyloxapol Vancomycin hydrochloride Verapamil hydrochloride Vitamin B complex Vitamins Zidovudine [AZT] Zinc sulphate Zopiclone February changes in bold

2013 2014 2012 2014 2014 2014 2013 2013 2013 2014 2014

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 February 2012

79 CEFUROXIME SODIUM Inj 1.5 g – Retail pharmacy-Specialist – Subsidy by endorsement ......................................................................... 2.65 1 ✔ Mylan Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Bicalaccord is 2397137 (BSF Bicalaccord Brand switch fee to be delisted 1 May 2012) 1 fee ✔ BSF Bicalaccord

171

Effective 1 January 2012

45 54 79 ATORVASTATIN – See prescribing guideline ❋ Tab 10 mg ............................................................................... 2.90 ❋ Tab 20 mg ............................................................................... 4.36 ❋ Tab 40 mg ............................................................................... 6.51 ❋ Tab 80 mg ............................................................................... 9.67 GLYCERYL TRINITRATE ❋ Aerosol spray 400 µg per dose – Up to 250 dose available on a PSO ............................................................................... 4.45 30 30 30 30 ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin

250 dose OP ✔ Glytrin

CEFAZOLIN SODIUM – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg ............................................................................... 3.99 5 ✔ AFT Inj 1 g ...................................................................................... 3.99 5 ✔ AFT CEFUROXIME SODIUM Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ..................................................................... 6.96 5 ✔ m-Cefuroxime Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Tab 100 mg ............................................................................. 2.66 50 (8.55) ❋ Tab 200 mg ............................................................................. 3.36 50 (15.10) TEMOZOLOMIDE – Special Authority see SA1063 – Retail pharmacy Cap 5 mg ............................................................................... 16.00 5 Cap 20 mg ............................................................................. 72.00 5 Cap 100 mg ......................................................................... 350.00 5 Cap 250 mg ......................................................................... 820.00 5

98 147

Aclin Aclin ✔ Temaccord ✔ Temaccord ✔ Temaccord ✔ Temaccord

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings – Effective 21 December 2011

146 DOXORUBICIN – PCT only – Specialist Inj 200 mg ............................................................................ 150.00 1 ✔ Adriamycin

Effective 14 December 2011

143 GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA1087 Inj 1 g .................................................................................... 62.50 1 ✔ DBL Gemcitabine

▲

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 February 2012

30 INSULIN GLARGINE Note: Only for patients meeting one of the following criteria: a) Type 1 diabetes; or b) Other condition related diabetes (e.g. Cystic Fibrosis, diabetes in pregnancy, pancreatectomy patients); or c) Type 2 diabetes after there has been unacceptable hypoglycaemic events with a 3 month trial of an insulin regimen; or d) Type 2 diabetes who require insulin therapy and who require assistance from a carer or healthcare professional to administer their insulin injections. ▲ Inj 100 u per ml, 10 ml ............................................................ 63.00 1 ✔ Lantus ▲ Inj 100 u per ml, 3 ml ............................................................. 94.50 5 ✔ Lantus ▲ Inj 100 u per ml, 3 ml disposable pen ...................................... 94.50 5 ✔ Lantus SoloStar BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy – brand switch fee payable Tab 50 mg ............................................................................. 10.00 28 ✔ Bicalaccord BORTEZOMIB – PCT only – Specialist ➽ SA1127 Special Authority for Subsidy Initial application – treatment-naïve multiple myeloma/amyloidosis - only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 15 months for applications meeting the following criteria: Both: 1 Either: 1.1 The patient has treatment-naïve symptomatic multiple myeloma; or 1.2 The patient has treatment-naïve symptomatic systemic AL amyloidosis*; and 2 Maximum of 9 treatment cycles. Note: Indications marked with * are Unapproved Indications. Initial application – relapsed/refractory multiple myeloma/amyloidosis - only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 8 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 The patient has relapsed or refractory multiple myeloma; or 1.2 The patient has relapsed or refractory systemic AL amyloidosis*; and 2 The patient has received only one prior front line chemotherapy for multiple myeloma or amyloidosis; and 3 The patient has not had prior publicly funded treatment with bortezomib; and 4 Maximum of 4 further treatment cycles. Note: Indications marked with * are Unapproved Indications. Renewal – relapsed/refractory multiple myeloma/amyloidosis - only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 8 months for applications meeting the following criteria: Both: 1 The patient’s disease obtained at least a partial response from treatment with bortezomib at the completion of cycle 4; and 2 Maximum of 4 further treatment cycles (making a total maximum of 8 consecutive treatment cycles). Note: Responding relapsed/refractory multiple myeloma patients should receive no more than 2 additional cycles of treatment beyond the cycle at which a confirmed complete response was first achieved. A line of therapy is considered to comprise either: a) a known therapeutic chemotherapy regimen and supportive treatments or b) a transplant induction chemotherapy regimen, stem cell transplantation and supportive treatments. Refer to datasheet for recommended dosage and number of doses of bortezomib per treatment cycle. 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

152 145

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 February 2012 (continued)

161 INHALED CORTICOSTEROIDS WITH LONG-ACTING BETA-ADRENOCEPTOR AGONISTS ➽ SA1179 0958 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient is a child under the age of 12; and 1.2 Both: Has, for 3 months of more, been treated with: 1.2.1 An inhaled long-acting beta adrenoceptor agonist; and 1.2.2 Inhaled corticosteroids at a dose of at least 400 µg per day beclomethasone or budesonide, or 200 μg per day fluticasone; and 1.2 Has been treated with inhaled corticosteroids of at least 400 µg per day beclomethasone or budesonide, or 200 µg per day fluticasone; and 1.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product; or 2 All of the following: 2.1 Patient is over the age of 12; and 2.2 Both: Has, for 3 months or more, been treated with: 2.2.1 An inhaled long-acting beta adrenoceptor agonist; and 2.2.2 Inhaled corticosteroids at a dose of at least 800 µg per day beclomethasone or budesonide, or 500 μg per day fluticasone; and 2.2 Has been treated with inhaled corticosteroids of at least 800 µg per day beclomethasone or budesonide, or 500 µg per day fluticasone; and 2.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. 161 EFORMOTEROL FUMARATE – See prescribing guideline Additional subsidy by endorsement for Oxis Turbuhaler is available for patients where the initial dispensing was before 1 July 2011. Pharmacists may annotate prescriptions for patients who were being prescribed Oxis Turbuhaler prior to 1 July 2011 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 been endorsed accordingly. Powder for inhalation, 6 µg per dose, breath activated – Higher subsidy of $16.90 per 60 dose with Endorsement ..... 11.51 60 dose OP (16.90) Oxis Turbuhaler Powder for inhalation, 12 µg per dose, and monodose device .. 23.02 60 dose (35.80) Foradil Note: Repeats for eformoterol fumarate will be fully subsidised where the initial dispensing is before 1 February 2012. BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 0958 – Retail pharmacy Additional subsidy by endorsement for budesonide with eformoterol powder for inhalation (Symbicort Turbuhaler) is available for patients where the initial dispensing was before 1 July 2011. Pharmacists may annotate prescriptions for patients who were being prescribed budesonide with eformoterol powder for inhalation (Symbicort Turbuhaler) prior to 1 July 2011 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 been endorsed accordingly. Aerosol inhaler 100 µg with eformoterol fumarate 6 µg ........... 26.49 120 dose OP ✔ Vannair continued... ❋ Three months or six months, as applicable, dispensed all-at-once

162

▲

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 February 2012 (continued)

continued... Powder for inhalation 100 µg with eformoterol fumarate 6 µg – Higher subsidy of $55.00 per 120 dose with Endorsement ....... 55.00 120 dose OP ✔ Symbicort Turbuhaler 100/6 120 dose OP ✔ Vannair 120 dose OP ✔ Symbicort Turbuhaler 200/6 60 dose OP ✔ Symbicort Turbuhaler 400/12

Aerosol inhaler 200 µg with eformoterol fumarate 6 µg ............ 31.25 Powder for inhalation 200 µg with eformoterol fumarate 6 µg – Higher subsidy of $60.00 per 120 dose with Endorsement ... 60.00 Powder for inhalation 400 µg with eformoterol fumarate 12 µg ................................................................................. 60.00 a) Higher subsidy of $60.00 per 60 dose with Endorsement a) b) No more than 2 dose per day 164

SODIUM CHLORIDE Not funded for use as a nasal drop. Only funded for nebuliser use when in conjunction with an antibiotic intended for nebuliser use. Soln 7% .................................................................................. 23.50 90 ml OP ✔ Biomed SODIUM BICARBONATE Powder BP – Only in combination .............................................. 8.95 500 g 9.80 (29.50) Only in extemporaneously compounded omeprazole and lansoprazole suspension. ✔ Midwest David Craig

177

Effective 1 January 2012

187 Standard Supplements ➽ SA1104 Special Authority for Subsidy Initial application — (Children) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is under 18 years of age; and 2 Any of the following: 2.1 The patient has a condition causing malabsorption; or 2.2 The patient has failure to thrive; or 2.3 The patient has increased nutritional requirements; and 3 Nutrition goal has been set (eg reach a specific weight or BMI). Renewal — (Children) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is under 18 years of age; and 2 The treatment remains appropriate and the patient is benefiting from treatment; and 3 A nutrition goal has been set (eg reach a specific weight or BMI). Initial application — (Adults (This category cannot be processed electronically - fax paper copy)) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Any of the following: Patient is Malnourished 1.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 1.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2012 (continued)

continued... 1.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months; and 2 Any of the following: Patient has not responded to first-line dietary measures over a 4 week period by: 2.1 Increasing their food intake frequency (eg snacks between meals); or 2.2 Using high-energy foods (e.g. milkshakes, full fat milk, butter, cream, cheese, sugar etc); or 2.3 Using over the counter supplements (e.g. Complan); and 3 A nutrition goal has been set (e.g. to reach a specific weight or BMI).

Renewal —(Adults) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 A nutrition goal has been set (eg reach a specific weight or BMI); and 2 Any of the following: Patient is Malnourished 2.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 2.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or 2.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months. Initial application — (Adults transitioning from hospital Discretionary Community Supply) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has had up to a 30 day supply of a 1.0 or a 1.5 kcal/ml Standard Oral Supplement; and 2 A nutrition goal has been set (eg reach a specific weight or BMI); and 3 Any of the following: Patient is Malnourished 3.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 3.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or 3.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months. Initial application — (Specific medical condition) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 Is being feed via a nasogastric tube or a nasogastric tube is to be inserted for feeding; or 2 Malignancy and is considered likely to develop malnutrition as a result; or 3 Is undergoing a bone marrow transplant; or 4 Tempomandibular surgery. Renewal — (Specific medical condition) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 Is being fed via a nasogastric tube; or 2 Malignancy and is considered likely to develop malnutrition as a result; or 3 Has undergone a bone marrow transplant; or 4 Tempomandibular surgery. Initial application — (Chronic disease OR tube feeding) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified 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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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2012 (continued)

continued... 1 Is being fed via a tube or a tube is to be inserted for the purpose of feeding (not nasogastric tube - refer to specific medical condition criteria); or 2 Cystic Fibrosis; or 3 Liver disease; or 4 Chronic Renal failure; or 5 Inflammatory bowel disease; or 6 Chronic obstructive pulmonary disease with hypercapnia; or 7 Short bowel syndrome; or 8 Bowel fistula; or 9 Severe chronic neurological conditions. Renewal —(Chronic disease OR tube feeding for patients who have previously been funded under Special Authority forms SA0702 or SA0583) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Is being fed via a tube or a tube is to be inserted for the purpose of feeding (not nasogastric tube - refer to specific medical condition criteria); or 2 Cystic Fibrosis; or 3 Liver disease; or 4 Chronic Renal failure; or 5 Inflammatory bowel disease; or 6 Chronic obstructive pulmonary disease with hypercapnia; or 7 Short bowel syndrome; or 8 Bowel fistula; or 9 Severe chronic neurological conditions. 196 EXTENSIVELY HYDROLYSED FORMULA – Special Authority see SA1112 – Hospital pharmacy [HP3] Powder .................................................................................. 15.21 450 g OP ✔ Pepti Junior Gold ➽ SA1112 Special Authority for Subsidy Initial application — (Transition from Old Form (SA0603)) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 All of the following: 1.1 The infant is currently receiving funded amino acid formula under Special Authority form SA0603; and 1.2 The infant is to be trialled on, or transitioned to, an extensively hydrolysed formula; and 1.3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted; or 2 All of the following: 2.1 The patient is currently receiving funded extensively hydrolysed formula under Special Authority form SA0603; and 2.2 An assessment as to whether the infant can be transitioned to a cows milk protein or soy infant formula has been undertaken; and 2.3 The outcome of the assessment is that the infant continues to require an extensively hydrolysed infant formula; and 2.4 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted. Initial application only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2012 (continued)

continued... Any of the following: 1 Both: 1.1 Cows milk formula is inappropriate due to severe intolerance or allergy to its protein content; and 1.2 Either: 1.2.1 Soy milk formula has been trialled without resolution of symptoms; or 1.2.2 Soy milk formula is considered clinically inappropriate or contraindicated; or 2 Severe malabsorption; or 3 Short bowel syndrome; or 4 Intractable diarrhea; or 5 Biliary atresia; or 6 Cholestatic liver diseases causing malsorption; or 7 Chylous ascite; or 8 Chylothorax; or 9 Cystic fibrosis; or 10 Proven fat malabsorption; or 11 Severe intestinal motility disorders causing significant malabsorption; or 12 Intestinal failure. Renewal only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 An assessment as to whether the infant can be transitioned to a cows milk protein or soy infant formula has been undertaken; and 2 The outcome of the assessment is that the infant continues to require an extensively hydrolysed infant formula; and 3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted. Renewal —(Step Down from Amino Acid Formula) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The infant is currently receiving funded amino acid formula; and 2 The infant is to be trialled on, or transitioned to, an extensively hydrolysed formula; and 3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted.

▲

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 February 2012

39 FERROUS SULPHATE WITH FOLIC ACID ( price) ❋ Tab long-acting 325 mg (105 mg elemental) with folic acid 350 µg ........................................................... 1.80 (4.29) SODIUM CHLORIDE ( subsidy) Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 11.50 CEFACLOR MONOHYDRATE ( subsidy) Cap 250 mg ............................................................................ 24.57 30 Ferrograd-Folic 50 100 ✔ Multichem ✔ Ranbaxy Cefaclor

43 79 96 115

IBUPROFEN – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ( subsidy) ❋ Tab 200 mg ............................................................................ 12.75 1,000 ✔ Ethics Ibuprofen ❋ Tab 400 mg .............................................................................. 0.77 30 (4.56) Brufen ❋ Tab 600 mg ............................................................................. 1.15 30 (6.84) Brufen BENZTROPINE MESYLATE ( subsidy) Inj 1 mg per ml, 2 ml ............................................................... 95.00 a) Up to 5 inj available on a PS0 b) Only on a PSO FLUTICASONE ( subsidy,  price) Powder for inhalation, 50 µg per dose ....................................... 7.50 FLUTICASONE ( price) Powder for inhalation, 100 µg per dose ..................................... 7.50 Powder for inhalation, 250 µg per dose ................................... 13.60 5 ✔ Cogentin

160 160

60 dose OP ✔ Flixotide Accuhaler 60 dose OP ✔ Flixotide Accuhaler 60 dose OP ✔ Flixotide Accuhaler

161

EFORMOTEROL FUMARATE ( subsidy) Note: Repeats for eformoterol fumarate will be fully subsidised where the initial dispensing is before 1 February 2012. Powder for inhalation, 6 µg per dose, breath activated ............ 11.51 60 dose OP (16.90) Oxis Turbuhaler Powder for inhalation, 12 µg per dose, and monodose device ................................................................................. 23.02 60 dose (35.80) Foradil BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 – Retail pharmacy ( subsidy) Powder for inhalation 100 µg with eformoterol fumarate 6 µg .. 55.00 120 dose OP ✔ Symbicort Turbuhaler 100/6 Powder for inhalation 200 µg with eformoterol fumarate 6 µg .. 60.00 120 dose OP ✔ Symbicort Turbuhaler 200/6 Powder for inhalation 400 µg with eformoterol fumarate 12 µg.................................................................... 60.00 60 dose OP ✔ Symbicort Turbuhaler 400/12 BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 – Retail pharmacy( subsidy) Aerosol inhaler 100 µg with eformoterol fumarate 6 µg ............ 26.49 120 dose OP ✔ Vannair Aerosol inhaler 200 µg with eformoterol fumarate 6 µg ............ 31.25 120 dose OP ✔ Vannair

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

162

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 January 2012

40 53 53 53 54 72 FOLIC ACID ( subsidy) Oral liq 50 µg per ml ............................................................... 24.00 AMILORIDE ( subsidy) ‡ Oral liq 1 mg per ml ................................................................. 30.00 METHYLDOPA ( subsidy) ❋ Tab 125 mg ........................................................................... 14.25 ❋ Tab 250 mg ........................................................................... 15.10 ❋ Tab 500 mg ........................................................................... 23.15 SPIRONOLACTONE ( subsidy) ‡ Oral liq 5 mg per ml ................................................................. 30.00 CHLOROTHIAZIDE ( subsidy) ‡ Oral liq 50 mg per ml ............................................................... 26.00 DEXAMETHASONE ( subsidy) Oral liq 1 mg per ml – Retail pharmacy-Specialist ................... 45.00 Oral liq prescriptions: 1) Must be written by a Paediatrician or Paediatric Cardiologist; or 2) On the recommendation of a Paediatrician or Paediatric Cardiologist. TRIAMCINOLONE ACETONIDE ( subsidy) Inj 10 mg per ml, 1 ml ............................................................ 23.00 Inj 40 mg per ml, 1 ml ............................................................ 56.48 25 ml OP 25 ml OP 100 100 100 25 ml OP 25 ml OP 25 ml OP ✔ Biomed ✔ Biomed ✔ Prodopa ✔ Prodopa ✔ Prodopa ✔ Biomed ✔ Biomed ✔ Biomed

5 5

✔ Kenacort-A ✔ Kenacort-A40

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 ( subsidy) Tab 250 mg ............................................................................. 4.19 14 (7.75) Klacid (7.75) Klamycin FLUCONAZOLE ( subsidy) Cap 50 mg – Retail pharmacy-Specialist ................................... 4.77 28 (6.82) Pacific Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 (1.30) Pacific a) Maximum of 1 cap per prescription; can be waived by endorsement - Retail pharmacy - Specialist b) Patient has vaginal candida albicans and the practitioner considers that a topical imidazole (used intra vaginally) is not recommended and the prescription is endorsed accordingly; can be waived by endorsement - Retail pharmacy - Specialist. Cap 200 mg – Retail pharmacy-Specialist ............................... 13.34 28 (19.05) Pacific TRIMETHOPRIM ( subsidy) ❋ Tab 300 mg – Up to 30 tab available on a PSO .......................... 8.94 METRONIDAZOLE ( subsidy) Tab 200 mg – Up to 30 tab available on a PSO ........................ 10.45 Tab 400 mg ........................................................................... 18.15 50 100 100 ✔ TMP ✔ Trichozole ✔ Trichozole

84 85

▲

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 January 2012 (continued)

116 118 PARACETAMOL ( subsidy) ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 9.38 DOXEPIN HYDROCHLORIDE ( subsidy) Cap 10 mg ............................................................................... 6.30 Cap 25 mg ............................................................................... 6.86 Cap 50 mg ............................................................................... 8.55 NORTRIPTYLINE HYDROCHLORIDE ( subsidy) Tab 10 mg ............................................................................... 6.69 Tab 25 mg ............................................................................. 14.77 CLONAZEPAM ( subsidy) Tab 500 µg .............................................................................. 6.68 Tab 2 mg ............................................................................... 12.75 BETAHISTINE DIHYDROCHLORIDE ( subsidy) ❋ Tab 16 mg ............................................................................. 10.00 TIMOLOL MALEATE ( subsidy) ❋ Eye drops 0.25% ...................................................................... 2.08 (2.37) ❋ Eye drops 0.5% ........................................................................ 2.08 (2.29) BIMATOPROST – Retail pharmacy-Specialist ( subsidy) See prescribing guideline ▲ Eye drops 0.03% .................................................................... 18.50 HYPROMELLOSE ( price) ❋ Eye drops 0.5% ........................................................................ 2.00 (3.92) 1,000 100 100 100 100 180 100 100 84 5 ml OP Apo-Timop 5 ml OP Apo-Timop ✔ Pharmacare ✔ Anten ✔ Anten ✔ Anten ✔ Norpress ✔ Norpress ✔ Paxam ✔ Paxam ✔ Vergo 16

119

121

125 167 168 169

3 ml OP 15 ml OP

✔ Lumigan

Methopt

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Sole Subsidised Supply

Effective 1 February 2012

For the list of new Sole Subsidised Supply products effective 1 February 2012 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 8-17.

▲

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 February 2012

45 PRAVASTATIN See prescribing guideline Tab 20 mg ............................................................................... 5.44 (42.58) Tab 40 mg ............................................................................... 9.28 (65.31) FINASTERIDE – Special Authority see SA0928 – Retail pharmacy Tab 5 mg .................................................................................. 5.10 TERBINAFINE Tab 250 mg ............................................................................ 12.75 (25.50) PARACETAMOL WITH CODEINE ❋ Tab paracetamol 500 mg with codeine phosphate 8 mg ............. 2.45 DAUNORUBICIN – PCT only – Specialist Inj 5 mg per ml, 4 ml ............................................................... 99.00 BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy Tab 50 mg ............................................................................. 10.71 SPACER DEVICE a) Up to 20 dev available on a PSO b) Only on a PSO 230 ml (single patient)............................................................... 4.72

30 Pravachol 30 Pravachol 30 100 Apo-Terbinafine 100 1 30 ✔ ParaCode ✔ Mayne ✔ Bicalox ✔ Fintral

70 85

118 144 152 165

✔ Space Chamber

Effective 1 January 2012

29 39 OMEPRAZOLE ❋ Cap 10 mg ............................................................................... 0.97 ❋ Cap 20 mg ............................................................................... 1.26 ❋ Cap 40 mg ............................................................................... 1.86 CHARCOAL ❋ Tab 300 mg ............................................................................. 7.13 (9.77) 30 30 30 ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole

100 Red Seal

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 January 2012 (continued)

74 OESTRADIOL ❋ TDDS 25 µg per day ................................................................. 3.01 (10.86) a) Higher subsidy of $10.86 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription ❋ TDDS 50 µg per day ................................................................. 4.12 (13.18) a) Higher subsidy of $13.18 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription ❋ TDDS 100 µg per day ............................................................... 7.05 (16.14) a) Higher subsidy of $16.14 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription 8 Estraderm TTS 25

8 Estraderm TTS 50

8 Estraderm TTS 100

CLINDAMYCIN Inj phosphate 150 mg per ml, 4 ml – Retail pharmacySpecialist ............................................................................ 16.00 1 ✔ Dalacin C Note – Dalacin C inj phosphate 150 mg per ml, 4 ml, 10 injection pack remains listed. DARUNAVIR – Special Authority see SA1025 – Retail pharmacy Tab 300 mg ...................................................................... 1,190.00 120 ✔ Prezista

▲

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 2012

80 CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 Tab 250 mg ............................................................................. 4.19 14 (7.75) Klacid Klamycin FLUCONAZOLE Cap 50 mg – Retail pharmacy-Specialist ................................... 4.77 28 (6.82) Pacific Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 (1.30) Pacific a Maximum of 1 cap per prescription; can be waived by endorsement - Retail pharmacy - Specialist b) Patient has vaginal candida albicans and the practitioner considers that a topical imidazole (used intravaginally) is not recommended and the prescription is endorsed accordingly; can be waived by endorsement - Retail pharmacy - Specialist. Cap 200 mg – Retail pharmacy-Specialist ............................... 13.34 28 (19.05) Pacific PARACETAMOL ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 9.38 TIMOLOL MALEATE ❋ Eye drops 0.25% ...................................................................... 2.08 (2.37) ❋ Eye drops 0.5% ........................................................................ 2.08 (2.29) 1,000 5 ml OP Apo-Timop 5 ml OP Apo-Timop ✔ Pharmacare

116 167

Effective 1 May 2012

96 38 171 IBUPROFEN – Additional subsidy by Special Authority see SA 1038 – Retail pharmacy ❋ Tab 200 mg ........................................................................... 12.75 1,000 ✔ Ethics Ibuprofen CALCIUM CARBONATE ❋ Tab 1.25 g (500 mg elemental) ................................................. 6.38 ❋ Tab 1.5 g (600 mg elemental).................................................... 7.66 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Bicalaccord is 2397137 250 250 1 fee ✔ Calci-Tab 500 ✔ Calci-Tab 600 ✔ BSF Bicalaccord

Effective 1 June 2012

113 QUININE SULPHATE ❋ Tab 200 mg ............................................................................ 15.95 (17.20) 250 Q 200

Effective 1 July 2012

50 DIGOXIN ❋ Tab 62.5 µg – Up to 30 tab available on a PSO .......................... 5.56 200 ✔ Lanoxin PG ❋ Tab 250 µg – Up to 30 tab available on a PSO ........................... 6.05 100 ✔ Lanoxin Note – Lanoxin PG tab 62.5 µg, 240 tab pack, and Lanoxin tab 250 µg 240 tab pack, remain subsidised.

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 July 2012 (continued)

98 SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Tab 100 mg ............................................................................. 5.32 100 (17.10) ❋ Tab 200 mg ............................................................................. 6.72 100 (30.20)

Daclin Daclin

▲

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 February 2012

20 23 BENZTROPINE MESYLATE Inj 1 mg per ml, 2 ml ............................................................... 95.00 CEFUROXIME SODIUM Inj 1.5 g – 1% DV Apr-12 to 2014 ............................................. 2.65 Note - Zinacef inj 1.5 g to be delisted 1 April 2012. MEROPENEM ( price) Inj 500 mg ........................................................................... 105.00 Inj 1 g ................................................................................... 210.00 Note – Merrem inj 500 mg and 1 g to be delisted 1 March 2012. NORTRIPTYLINE HYDROCHLORIDE (amend pack size) Tab 25 mg .............................................................................. 14.77 QUININE SULPHATE Tab 200 mg ............................................................................ 17.20 Note – Q 200 to be delisted 1 February 2012 TOLBUTAMIDE Tab 500 mg ............................................................................ 12.00 Note – Diatol tab 500 mg to be delisted 1 February 2012 ZINC AND CASTOR OIL ( price) Ointment – 1% DV Apr-12 to 2014 ............................................ 1.63 5 1 Cogentin Mylan

10 10

Merrem Merrem

49 55

180 250

Norpress Q 200

100

Diatol

20 g

Orion

Effective 1 January 2012

17 19 AMILORIDE ( price) Oral liq 1 mg per ml ................................................................ 30.00 ATORVASTATIN Tab 10 mg ................................................................................ 2.90 Tab 20 mg ................................................................................ 4.36 Tab 40 mg ................................................................................ 6.51 Tab 80 mg ................................................................................ 9.67 20 23 BETAHISTINE DIHYDROCHLORIDE ( price) Tab 16 mg ............................................................................. 10.00 CEFACLOR MONOHYDRATE (removal of HSS) Cap 250 mg – 1% DV Mar-12 to 2013 ..................................... 24.57 25 ml 30 30 30 30 Biomed Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Vergo 16 Cefaclor Sandoz

84 100

Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 January 2012 (continued)

23 CEFAZOLIN SODIUM Inj 500 mg – 1% DV Mar-12 to 2014 ........................................ 3.99 5 Inj 1 g – 1% DV Mar-12 to 2014 ............................................... 3.99 5 Note – Hospira cefazolin sodium inj 500 mg and 1 g to be delisted 1 March 2012. CEFUROXIME SODIUM Inj 750 mg – 1% DV Mar-12 to 2014 ........................................ 6.96 Note – Zinacef inj 750 mg to be delisted 1 March 2012. CHLORHEXIDINE IN ALCOHOL Soln 2% with 70% alcohol, 500 ml (tinted red) ...................... 114.72 CHLOROTHIAZIDE ( price) Oral liq 50 mg per ml .............................................................. 26.00 CLARITHROMYCIN (HSS delayed) Tab 500mg – 1% DV Apr-12 Jan-12 to 2014 ........................... 10.95 CLONAZEPAM ( price) Tab 500 µg ............................................................................... 6.68 Tab 2 mg ................................................................................ 12.75 DEXAMETHASONE ( price) Oral liq 1 mg per ml ................................................................ 45.00 EFAVIRENZ Tab 50 mg ............................................................................ 158.33 Tab 200 mg .......................................................................... 474.99 Tab 600 mg .......................................................................... 474.99 FOLIC ACID ( price) Oral liq 50 µg per ml ............................................................... 24.00 5 AFT AFT

m-Cefuroxime

24 24 25 25

12 25 ml 14 100 100 25 ml 30 90 30 25 ml

healthE Biomed Apo-Clarithromycin Paxam Paxam Biomed Stocrin Stocrin Stocrin Biomed

28 30

34 36

GLYCERYL TRINITRATE Aerosol spray 400 µg per dose – 1% DV Mar-12 to 2014 ......... 4.45 250 dose Glytrin Note – Nitrolingual Pumpspray aerosol spray 400 µg per dose to be delisted 1 March 2012. HYPROMELLOSE ( price) Eye drops 0.5% ......................................................................... 3.92 IMIPENEM WITH CILASTATIN ( price) Inj 500 mg with cilastatin 500 mg ........................................... 18.37 MEROPENEM Inj 500 mg – 1% DV Mar-12 to 2014 ...................................... 10.50 Inj 1 g – 1% DV Mar-12 to 2014 ............................................. 21.00 Note – Merrem inj 500 mg and 1 g to be delisted 1 March 2012. METHYLDOPA ( price) Tab 125 mg ........................................................................... 14.25 Tab 250 mg ........................................................................... 15.10 Tab 500 mg ........................................................................... 23.15 15 ml 1 1 1 Methopt Primaxin Penembact Penembact

38 38 44

100 100 100

Prodopa Prodopa Prodopa

Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 January 2012 (continued)

46 METRONIDAZOLE ( price) Tab 200 mg ........................................................................... 10.45 Tab 400 mg ........................................................................... 18.15 NORTRIPTYLINE HYDROCHLORIDE ( price) Tab 10 mg ............................................................................... 6.69 Tab 25 mg ............................................................................. 14.77 SODIUM CHLORIDE ( price) Inj 0.9%, 10 ml ........................................................................ 11.50 SPIRONOLACTONE ( price) Oral liq 5 mg per ml ................................................................ 30.00 100 100 100 250 50 25 ml Trichozole Trichozole Norpress Norpress Multichem Biomed Temaccord Temaccord Temaccord Temaccord

59 60 61

TEMOZOLOMIDE Cap 5 mg – 1% DV Mar-12 to 2014 ........................................ 16.00 5 Cap 20 mg – 1% DV Mar-12 to 2014 ...................................... 72.00 5 Cap 100 mg – 1% DV Mar-12 to 2014 .................................. 350.00 5 Cap 250 mg – 1% DV Mar-12 to 2014 .................................. 820.00 5 Note – Temodal cap 5 mg, 20 mg, 100 mg and 250 mg to be delisted 1 March 2012. TRIAMCINOLONE ACETONIDE ( price) Inj 10 mg per ml, 1 ml ............................................................ 23.00 Inj 40 mg per ml, 1 ml ............................................................ 56.48 5 5

Kenacort-A Kenacort-A40

TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 5 ml ............................................................. 10.31 1 Kenacort-A Inj 40 mg per ml, 5 ml ............................................................. 23.44 1 Kenacort-A40 Note – Kenacort-A inj 10 mg per ml, 5 ml and Kenacort-A40 inj 40 mg per ml, 5 ml delisted 1 January 2012. TRIMETHOPRIM ( price) Tab 300 mg ............................................................................. 8.94 50 TMP

Effective 14 December 2011

35 GEMCITABINE HYDROCHLORIDE Inj 1 g ..................................................................................... 62.50 1 DBL Gemcitabine

Effective 21 December 2011

146 DOXORUBICIN – PCT only – Specialist Inj 200 mg ............................................................................ 150.00 1 Adriamycin

Effective 1 December 2011

17 20 AMLODIPINE Tab 2.5 mg – 1% DV Mar-12 to 2014 ...................................... 2.45 BETAMETHASONE DIPROPRIONATE WITH CALCIPOTRIOL Oint 500 µg with calcipotriol 50 µg .......................................... 26.12 Topical gel 500 µg with calcipotriol 50 µg ............................... 26.12 Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated 100 30 g 30 g Apo-Amlodipine Daivobet Daivobet

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 December 2011 (continued)

21 CALCIPOTRIOL ( price) Crm 50 µg per g ..................................................................... 16.00 45.00 Oint 50 µg per g ...................................................................... 45.00 Soln 50 µg per ml .................................................................. 16.00 CALCIUM CARBONATE Tab 1.25 g (500 mg elemental) – 1% DV Feb-12 to 2014 .......... 6.38 CEFACLOR MONOHYDRATE (Addition of HSS) Cap 250 mg – 1% DV Mar-12 to 2013 .................................... 24.57 DANTROLENE SODIUM HEMIHEPTAHYDRATE Inj 20 mg ............................................................................. 800.00 FUSIDIC ACID ( price) Eye drops 1% ........................................................................... 4.50 GLYCERIN WITH SODIUM SACCHARIN ( price) Suspension ............................................................................. 36.80 GLYCERIN WITH SUCROSE ( price) Suspension ........................................................................... 36.80 MASK FOR SPACER DEVICE Size 2 ........................................................................................ 2.99 METHYLCELLULOSE ( price) Suspension ............................................................................. 36.80 30 g 100 g 100 g 30 ml 250 100 6 5g 473 ml 473 ml 1 473 ml Daivonex Daivonex Daivonex Daivonex Arrow-Calcium Cefaclor Sandoz Dantrium IV Fucithalmic Ora-Sweet SF Ora-Sweet EZ-fit Paediatric Mask Ora-Plus Ora-Blend SF Ora-Blend Solu-Medrol Solu-Medrol Lopresor Paclitaxel Actavis Paclitaxel Actavis Paclitaxel Actavis

22 23 27 34 36 36 42 45 45 45 46

METHYLCELLULOSE WITH GLYCERIN AND SODIUM SACCHARIN ( price) Suspension ............................................................................ 36.80 473 ml METHYLCELLULOSE WITH GLYCERIN AND SUCROSE ( price) Suspension ............................................................................ 36.80 METHYLPREDNISOLONE SODIUM SUCCINATE Inj 40 mg per ml, 1 ml – 1% DV Dec-09 to 2012 ....................... 6.06 Inj 62.5 mg per ml, 2 ml – 1% DV Dec-09 to 2012 .................. 16.50 METOPROLOL TARTRATE Inj 1 mg per ml, 5 ml ............................................................... 24.00 PACLITAXEL Inj 100 mg .............................................................................. 91.67 Inj 150 mg ........................................................................... 137.50 Inj 300 mg ........................................................................... 275.00 Note – HSS still remains on Paclitaxel Ebewe PEAK FLOW METER Low Range .............................................................................. 11.44 Normal Range ......................................................................... 11.44 473 ml 1 1 5 1 1 1

46 50

1 1

Breath-Alert Breath-Alert

Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 December 2011 (continued)

55 QUININE SULPHATE Tab 200 mg ............................................................................ 17.20 Note – Q 200 tab 200 mg to be delisted 1 February 2012. 250 Q 200

REMIFENTANIL HYDROCHLORIDE (delayed HSS and delisting) Inj 1 mg vial – 1% DV Feb Jan-12 to 2014 ............................. 27.95 5 Remifentanil-AFT 50.75 Ultiva Inj 2 mg vial – 1% DV Feb Jan -12 to 2014 ............................ 41.80 5 Remifentanil-AFT 101.50 Ultiva Note – HSS for Remifentanil-AFT delayed from January 2012 until February 2012. The delisting of Ultiva inj 1 mg and 2 mg has also been delayed until 1 February 2012. SPACER DEVICE 230 ml (single patient)............................................................... 4.72 TESTOSTERONE CYPIONATE ( price) Inj long-acting 100 mg per ml, 10 ml – 1% DV Feb-12 to 2014 .................................................... 76.50 1 Space Chamber Plus

60 62

Depo-Testosterone

Section H changes to General Rules

Effective 1 December 2011

14 Discretionary Community Supply Pharmaceuticals 7.5 Subject to rules 7.6 and 7.7, DHB Hospitals must not fund for use in the community, any pharmaceuticals that are not Discretionary Community Supply Pharmaceuticals unless they have been approved under Hospital Exceptional Circumstances. 7.6 DHB Hospitals may fund from their own budgets, any Pharmaceutical that is listed in Sections A-G of the Pharmaceutical Schedule without Hospital Exceptional Circumstances (HEC) approval provided that: a) the quantity supplied does not exceed that sufficient for: i) up to 5 days treatment, or one original pack (where appropriate to provide less); or ii) more than 5 days treatment, provided that the relevant DHB Hospital has a dispensing for discharge policy and the quantity supplied is in accordance with that policy; and b) the Pharmaceutical is supplied consistent with any restrictions applying to that Pharmaceutical in Sections A-G of the Pharmaceutical Schedule. 7.7 DHB Hospitals may fund from their own budgets any Pharmaceutical without Hospital Exceptional Circumstances approval provided that the Pharmaceutical is only being supplied to the patient for them to use in the 24 hours leading up to a procedure to be performed in a DHB Hospital.

Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Index

Pharmaceuticals and brands A Aclin .................................................................. 18 Adriamycin .................................................. 19, 36 Amiloride ..................................................... 27, 34 Amlodipine......................................................... 36 Anten ................................................................. 28 Apo-Amlodipine ................................................. 36 Apo-Clarithromycin ............................................ 35 Apo-Terbinafine.................................................. 30 Apo-Timop................................................... 28, 32 Arrow-Calcium ................................................... 37 Atorvastatin.................................................. 18, 34 B Benztropine mesylate ................................... 26, 34 Betahistine dihydrochloride........................... 28, 34 Betamethasone diproprionate with calcipotriol .... 36 Bicalaccord ........................................................ 20 Bicalox............................................................... 30 Bicalutamide ................................................ 20, 30 Bimatoprost ....................................................... 28 Bortezomib ........................................................ 20 Breath-Alert........................................................ 37 Brufen................................................................ 26 BSF Bicalaccord ........................................... 18, 32 Budesonide with eformoterol ........................ 21, 26 C Calci-Tab 500 .................................................... 32 Calci-Tab 600 .................................................... 32 Calcipotriol......................................................... 37 Calcium carbonate ....................................... 32, 37 Cefaclor monohydrate ............................ 26, 34, 37 Cefaclor Sandoz ........................................... 34, 37 Cefazolin sodium ......................................... 18, 35 Cefuroxime sodium ................................ 18, 34, 35 Charcoal ............................................................ 30 Chlorhexidine in alcohol...................................... 35 Chlorothiazide .............................................. 27, 35 Clarithromycin........................................ 27, 32, 35 Clindamycin ....................................................... 31 Clonazepam ................................................. 28, 35 Cogentin ...................................................... 26, 34 D Daclin ................................................................ 33 Daivobet ............................................................ 36 Daivonex ............................................................ 37 Dalacin C ........................................................... 31 Dantrium IV ........................................................ 37 Dantrolene sodium hemiheptahydrate ................. 37 Darunavir ........................................................... 31 Daunorubicin ..................................................... 30 DBL Gemcitabine ......................................... 19, 36 Depo-Testosterone............................................. 38 Dexamethasone ........................................... 27, 35 Diatol ................................................................. 34 Digoxin .............................................................. 32 Doxepin hydrochloride........................................ 28 Doxorubicin ................................................. 19, 36 Dr Reddy’s Atorvastatin................................ 18, 34 Dr Reddy’s Omeprazole...................................... 30 E Efavirenz ............................................................ 35 Eformoterol fumarate.................................... 21, 26 Estraderm TTS 100 ............................................ 31 Estraderm TTS 25 .............................................. 31 Estraderm TTS 50 .............................................. 31 Ethics Ibuprofen ........................................... 26, 32 Extensively hydrolysed formula........................... 24 EZ-fit Paediatric Mask......................................... 37 F Ferrograd-Folic................................................... 26 Ferrous sulphate with folic acid .......................... 26 Finasteride ......................................................... 30 Fintral ................................................................ 30 Flixotide Accuhaler ............................................. 26 Fluconazole .................................................. 27, 32 Fluticasone ........................................................ 26 Folic acid ..................................................... 27, 35 Foradil ......................................................... 21, 26 Fucithalmic ........................................................ 37 Fusidic acid........................................................ 37 G Gemcitabine hydrochloride ........................... 19, 36 Glycerin with sodium saccharin .......................... 37 Glycerin with sucrose ......................................... 37 Glyceryl trinitrate .......................................... 18, 35 Glytrin .......................................................... 18, 35 H Hypromellose............................................... 28, 35 I Ibuprofen ..................................................... 26, 32 Inhaled Corticosteroids with Long-Acting Beta-Adrenoceptor Agonists ............................ 21 Imipenem with cilastatin ..................................... 35 Insulin glargine ................................................... 20 K Kenacort-A................................................... 27, 36 Kenacort-A40............................................... 27, 36 Klacid .......................................................... 27, 32 Klamycin...................................................... 27, 32 L Lanoxin .............................................................. 32 Lanoxin PG ........................................................ 32 Lantus ............................................................... 20 Lantus SoloStar ................................................. 20

Index

Pharmaceuticals and brands Lopresor ............................................................ 37 Lumigan ............................................................ 28 M Mask for spacer device ...................................... 37 m-Cefuroxime .............................................. 18, 35 Merrem .............................................................. 34 Methopt ....................................................... 28, 35 Methylcellulose .................................................. 37 Methylcellulose with glycerin and sodium saccharin............................................ 37 Methylcellulose with glycerin and sucrose .......... 37 Meropenem ................................................. 34, 35 Methyldopa .................................................. 27, 35 Methylprednisolone sodium succinate ................ 37 Metoprolol tartrate .............................................. 37 Metronidazole .............................................. 27, 36 N Norpress ................................................ 28, 34, 36 Nortriptyline hydrochloride...................... 28, 34, 36 O Oestradiol .......................................................... 31 Omeprazole........................................................ 30 Ora-Blend .......................................................... 37 Ora-Blend SF...................................................... 37 Ora-Plus ............................................................ 37 Ora-Sweet.......................................................... 37 Ora-Sweet SF ..................................................... 37 Oxis Turbuhaler ............................................ 21, 26 P Paclitaxel ........................................................... 37 Paclitaxel Actavis ............................................... 37 Paracetamol................................................. 28, 32 Paracetamol with codeine .................................. 30 ParaCode ........................................................... 30 Paxam ......................................................... 28, 35 Peak flow meter ................................................. 37 Penembact......................................................... 35 Pepti Junior Gold................................................ 24 Pharmacare ................................................. 28, 32 Pharmacy services....................................... 18, 32 Pravachol........................................................... 30 Pravastatin ......................................................... 30 Prezista.............................................................. 31 Primaxin ............................................................ 35 Prodopa ....................................................... 27, 35 Q Q 200 .................................................... 32, 34, 38 Quinine sulphate .................................... 32, 34, 38 R Ranbaxy Cefaclor ............................................... 26 Remifentanil-AFT................................................ 38 Remifentanil hydrochloride ................................. 38 S Sodium bicarbonate ........................................... 22 Sodium chloride ..................................... 22, 26, 36 Solu-Medrol ....................................................... 37 Space Chamber ................................................. 30 Space Chamber Plus .......................................... 38 Spacer device .............................................. 30, 38 Spironolactone ............................................. 27, 36 Stocrin ............................................................... 35 Sulindac....................................................... 18, 33 Symbicort Turbuhaler 100/6 ......................... 22, 26 Symbicort Turbuhaler 200/6 ......................... 22, 26 Symbicort Turbuhaler 400/12 ....................... 22, 26 T Temaccord .................................................. 18, 36 Temozolomide ............................................. 18, 36 Terbinafine ......................................................... 30 Testosterone cypionate ...................................... 38 Timolol maleate............................................ 28, 32 TMP............................................................. 27, 36 Tolbutamide ....................................................... 34 Triamcinolone acetonide .............................. 27, 36 Trichozole .................................................... 27, 36 Trimethoprim ............................................... 27, 36 U Ultiva ................................................................. 38 V Vannair .................................................. 21, 22, 26 Vergo 16 ...................................................... 28, 34 Z Zinc and castor oil .............................................. 34

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)

While care has been taken in compiling this Update, Pharmaceutical Management Agency takes no responsibility for any errors or omissions and shall not be liable to any person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Update.

If Undelivered, Return To: PO Box 10-254, Wellington 6143, New Zealand

Metadata

Title

Schedule Update - effective 1 February 2012

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 February 2012 Cumulative for January and February 2012 Section H cumulative for December 2011, January and February 2012 Contents Summary of PHARMAC decisions effective 1 February 2012 …. 3 Subsidy…

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