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This is the text extract for Schedule Update - effective 1 April 2013, browse documents here.


Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 April 2013

Cumulative for January, February, March and April 2013 Section H for April 2013


Contents

Summary of PHARMAC decisions effective 1 April 2013 ............................... 3 Wastage Rule extended to Section 29 medicines .......................................... 6 New listings of various unapproved medicines.............................................. 6 Itraconazole .................................................................................................. 7 Change to ciprofloxacin restriction................................................................ 7 Glyceryl trinitrate ointment – new listing ...................................................... 7 Oral feeds change to endorsement criteria ................................................... 7 Apo-Selegiline – new listing of s29 presentation ........................................... 7 Changes to microgram units and chemical names in April Pharmaceutical Schedule ...................................................................... 8 News in brief ................................................................................................. 8 Tender News .................................................................................................. 9 Looking Forward ........................................................................................... 9 Sole Subsidised Supply products cumulative to April 2013 ......................... 10 New Listings ................................................................................................ 21 Changes to Restrictions ............................................................................... 32 Changes to Subsidy and Manufacturer’s Price............................................. 40 Changes to General Rules............................................................................ 45 Changes to Brand Name ............................................................................. 47 Changes to PSO........................................................................................... 47 Changes to Section I ................................................................................... 48 Delisted Items ............................................................................................. 50 Items to be Delisted .................................................................................... 55 Section H changes to Part II ........................................................................ 58 Index ........................................................................................................... 60

2


Summary of PHARMAC decisions

EFFECTIVE 1 APRIL 2013 New listings (pages 21-25) • Glyceryl trinitrate (Rectogestic) oint 0.2%, 30 g OP – Special Authority – Retail pharmacy • Diazoxide (Proglicem) cap 25 mg and 100 mg – Special Authority – Retail pharmacy – S29 • Bismuth trioxide (De-Nol) tab 120 mg – S29 • Propranolol (Roxane) oral liq 4 mg per ml – Special Authority – Retail pharmacy – S29 • Metolazone (Metolazone) tab 5 mg – Special Authority – Retail pharmacy • Hydralazine hydrochloride (Hydralazine) tab 25 mg – Special Authority – Retail pharmacy • Albendazole (Eskazole) tab 400 mg – Special Authority – Retail pharmacy – S29 • Praziquantel (Biltricide) tab 600 mg • Paromomycin (Humatin) cap 250 mg – Special Authority – Retail pharmacy – S29 • Tetracycline (Tertacyclin Wolff) cap 500 mg – Special Authority – Retail pharmacy – S29 • Pyrimethamine (Daraprim) tab 25 mg – Special Authority – Retail pharmacy – S29 • Sulfadiazine sodium (Wockhardt) tab 500 mg – Special Authority – Retail pharmacy – S29 • Itraconazole (Sporanox) oral liq 10 mg per ml, 150 ml OP – Special Authority – Retail pharmacy • Para-amino salicylic acid (Paser) grans for oral liq 4 g sachet – Retail pharmacySpecialist – S29 – No patient co-payment payable • Protionamide (Peteha) tab 250 mg – Retail pharmacy-Specialist – S29 – No patient co-payment payable • Cycloserine (King) cap 250 mg – Retail pharmacy-Specialist – S29 – No patient co-payment payable • Clofazimine (Lamprene) cap 50 mg – Retail pharmacy-Specialist – S29 – No patient co-payment payable • Primaquine phosphate (Primacin) tab 7.5 mg – Special Authority – Retail pharmacy – S29 • Efavirenz (Stocrin) oral liq 30 mg per ml, 180 ml OP – Special Authority – Retail pharmacy – S29 • Stavudine [D4T] (Zerit) powder for oral soln 1 mg per ml, 200 ml OP – Special Authority – Retail pharmacy – S29

3


Summary of PHARMAC decisions – effective 1 April 2013 (continued) • Benzbromarone (Benzbromaron) tab 100 mg – Special Authority – Retail pharmacy – S29 • Selegiline hydrochloride (Apo-Selegiline S29) tab 5 mg – S29 • Stiripentol (Diacomit) cap 250 mg and powder for oral liq 250 mg sachet – Special Authority – Retail pharmacy – S29 • Docetaxel (Docetaxel Sandoz) inj 20 mg & 80 mg – PCT only – Specialist • Pegaspargase (Oncaspar) inj 3,750 IU per 5 ml – PCT only – Specialist – Special Authority – S29 • Olopatadine (Patanol) eye drops 0.1%, 5 ml OP • Pharmacy Services (BSF Nevirapine Alphapharm) - Brand switch fee • High fat low carbohydrate formula (Ketocal 3:1) powder (unflavoured), 300 g OP Changes to restrictions (pages 32-34) • Felodipine (Plendil ER) tab long-acting 5 mg and 10 mg – removal of brand switch fee payable • Ciprofloxacin (Cipflox) tab 250 mg, 500 mg and 750 mg – change to restriction • Clindamycin (Clindamycin ABM) cap hydrochloride 150 mg and (Dalacin C) inj phosphate 150 mg per ml, 4 ml – Specialist type added to Retail pharmacy Specialist • Fusidic acid (Fucidin) tab 250 mg – Specialist type added to Retail pharmacy Specialist • Lincomycin (Lincocin) inj 300 mg per ml, 2 ml – Specialist type added to Retail pharmacy Specialist • Itraconazole (Itrazole) cap 100 mg - Subsidy by endorsement • Ketoconazole (Nizoral) tab 200 mg – Specialist type added to Retail pharmacy Specialist • Dapsone (Dapsone) tab 25 mg and 100 mg – Specialist type added to Retail pharmacy - Specialist • Ethambutol hydrochloride (Myambutol) tab 100 g and 400 mg – Addition of Retail pharmacy-Specialist • Isoniazid (PSM) tab 100 mg, (Rifinah) tab 100 mg with rifampicin 150 mg and tab 150 mg with rifampicin 300 mg – Specialist type added to Retail pharmacy - Specialist • Pyrazinamide (AFT-Pyrazinamide) tab 500 mg – Specialist type added to Retail pharmacy - Specialist • Rifabutin (Mycobutin) cap 150 mg – Specialist type added to Retail pharmacy Specialist

4


Summary of PHARMAC decisions – effective 1 April 2013 (continued) • Rifampicin (Rifadin) tab 600 mg, cap 150 mg, cap 300 mg, oral liq 100 mg per 5 ml – Subsidy by endorsement • Nevirapine (Nevirapine Alphapharm) addition of brand switch fee payable • Interferon alpha-2a (Roferon-A) inj 3 m iu, 6 m iu and 9 m iu prefilled syringe – Specialist type added to Retail pharmacy - Specialist • Interferon alpha-2b (Intron-A) inj 18 m iu, 1.2 multidose pen, inj 30 m iu, 1.2 multidose pen, inj 60 m iu, 1.2 multidose pen - Specialist type added to Retail pharmacy - Specialist • Oral feed 1.5 kcal/ml, oral feed with fibre 1.5 kcal/ml and oral feed 2kcal/ml – change to additional subsidy by endorsement • KetoCal brand name changed to KetoCal 4:1 Decreased subsidy (page 40) • Quinapril (Accupril) tab 5 mg, 10 mg and 20 mg • Oxybutynin (Apo-Oxybutynin) tab 5 mg • Baclofen (Pacifen) tab 10 mg • Nortriptyline hydrochloride (Norpress) tab 10 mg and 25 mg Increased subsidy (page 40) • Oxybutynin (Apo-Oxybutynin) oral liq 5 mg per 5 ml

5


6 Pharmaceutical Schedule - Update News

Wastage Rule extended to Section 29 medicines

From 1 April 2013, Rule 3.3.2 that currently applies to specified oral liquid antibiotics will now also apply to all funded medicines supplied under section 29 of the Medicines Act 1981. These are indicated by the S29 symbol in the Pharmaceutical Schedule. This rule allows pharmacists to claim the remainder of partly-dispensed packs if the remaining stock is not able to be dispensed. If a patient has repeats, the wastage should only be claimed once the prescription is completed. If a patient returns with a new prescription and the pharmacist has not discarded the stock, the pharmacy should unclaim the wastage and continue to use stock. The wastage rule is different from the Original Pack rule where the entirety of the pack must be claimed at each dispensing. We note that it is considered fraud to claim wastage and then use the remaining product.

New listings of various unapproved medicines

Various unapproved medicines including 10 medicines supplied by Link Pharmaceuticals Ltd under section 29 of the Medicines Act will be listed fully subsidised from 1 April 2013. For each medicine, there is an identified clinical need that we consider cannot currently be met by available registered medicines. Funding for most of these medicines was previously provided via PHARMAC’s NPPA scheme or through DHB hospitals. PHARMAC’s funding of an unapproved medicine is not an endorsement of the medicine’s quality, safety or efficacy. Any medical practitioner prescribing an unapproved medicine must comply with relevant legislation and regulations (including the Health and Disability Commissioner’s Code of Consumer Rights), whether it is subsidised or not.


Pharmaceutical Schedule - Update News

7

Itraconazole

Itraconazole (Sporanox) oral liquid 10 mg per ml will be listed fully subsidised from 1 April 2013 subject to Special Authority criteria for patients with congenital immune deficiency. Itraconazole capsules (Itrazole) will be subsidised by endorsement for tinea unguium where terbinafine or topical cream cannot be tolerated or has not been successful. This endorsement can be overridden (waived) by an infectious disease specialist, clinical microbiologist or dermatologist.

Change to ciprofloxacin restriction

The Retail Pharmacy Specialist restriction that applies to 750 mg ciprofloxacin tablets will be removed from 1 April 2013. It will be replaced with subsidy by endorsement on all strengths of ciprofloxacin for patients with specified infections. The endorsement can be waived if the prescription or PSO is written by, or recommended by, an infectious disease specialist or a clinical microbiologist.

Glyceryl trinitrate ointment – new listing

Glyceryl trinitrate (Rectogesic) ointment 0.2% will be listed fully subsidised from 1 April 2013 subject to Special Authority criteria for patients with chronic anal fissure.

Oral feeds change to endorsement criteria

From 1 April 2013, patients who have severe epidermolysis bullosa will be eligible to additional subsidy by endorsement of liquid oral feeds (standard supplements).

Apo-Selegiline – new listing of s29 presentation

To address a potential out-of-stock for Apo-Selegiline, a section 29 presentation will be listed temporarily from 1 April 2013.


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Pharmaceutical Schedule - Update News

Changes to microgram units and chemical names in April Pharmaceutical Schedule

You may notice some minor changes to the April 2013 Pharmaceutical Schedule. The weight unit "mcg" will replace "µg" and there will be changes to some chemical names and presentation descriptions. These include furosemide that will change to furosemide [frusemide] and bendrofluazide that will change to bendroflumethazide [bendrofluazide]. Please note that the square brackets indicate that the name inside the brackets will also appear in the index.

News in brief

• Igroton (chlorthalidone) 25 mg tablets will be delisted on 1 October 2013 due to stock of the Hygroton brand now being available. • A Brand Switch Fee will apply to dispensings of Nevirapine Alphapharm, nevirapine 200 mg tab, from 1 April 2013 to 1 July 2013. • Mercilon 21 (20 µg ethinyloestradiol with 150 µg desogestrel) and Marvelon 21 (30 µg ethinyloestradiol with 150 µg desogestrel) tablets will be delisted from 1 October due to supplier discontinuation. Mercilon 28 and Marvelon 28 will remain available.


Tender News

Sole Subsidised Supply changes – effective 1 May 2013

Chemical Name Azithromycin Diltiazem hydrochloride Diltiazem hydrochloride Diltiazem hydrochloride Miconazole Moclobemide Moclobemide Nadalol Nadalol Pamidronate disodium Pamidronate disodium Pamidronate disodium Sildenafil Sildenafil Sildenafil Presentation; Pack size Tab 500 mg; 2 tab Cap long-acting 120 mg; 500 cap Cap long-acting 180 mg; 500 cap Cap long-acting 240 mg; 500 cap Oral gel 20 mg per g; 40 g OP Tab 150 mg; 500 tab Tab 300 mg; 100 tab Tab 40 mg; 100 tab Tab 80 mg; 100 tab Inj 3 mg per ml, 10 ml; 1 vial Inj 6 mg per ml, 10 ml; 1 vial Inj 9 mg per ml, 10 ml; 1 vial Tab 25 mg; 4 tab Tab 50 mg; 4 tab Tab 100 mg; 4 tab Sole Subsidised Supply brand (and supplier) Apo-Azithromycin (Apotex) Apo-Diltiazem CD (Apotex) Apo-Diltiazem CD (Apotex) Apo-Diltiazem CD (Apotex) Decozol (AFT) Apo-Moclobemide (Apotex) Apo-Moclobemide (Apotex) Apo-Nadolol (Apotex) Apo-Nadolol (Apotex) Pamidronate BNM (Boucher & Muir ) Pamidronate BNM (Boucher & Muir ) Pamidronate BNM (Boucher & Muir ) Silagra (Arrow) Silagra (Arrow) Silagra (Arrow)

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 future implementation 1 May 2013 • Perindopril (Apo-Perindopril) tabs 2 mg and 5 mg – new listing • Removal of higher subsidy by endorsement on Coversyl brand of perindopril

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Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Abacavir sulphate Acarbose Acetazolamide Acetylcysteine Aciclovir Allopurinol Amantadine hydrochloride Aminophylline Amitriptyline Amlodipine Amoxycillin Amoxycillin clavulanate

Presentation

Oral liq 20 mg per ml Tab 300 mg Tab 50 mg and 100 mg Tab 250 mg Inj 200 mg per ml, 10 ml Tab dispersible 200 mg, 400 mg & 800 mg Tab 100 mg & 300 mg Cap 100 mg Inj 25 mg per ml, 10 ml Tab 10 mg Tab 25 mg & 50 mg Tab 2.5 mg Tab 5 mg & 10 mg Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg 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 Tab 500 mg with potassium clavulanate 125 mg Crm Tab 100 mg Tab 100 mg Tab dispersible 300 mg Tab 50 mg & 100 mg Tab 10 mg, 20 mg, 40 mg & 80 mg Inj 600 µg, 1 ml Tab 50 mg Inj 50 mg Tab 2.5 mg & 5 mg Inj 1.2 mega u per 2.3 ml Inj 600 mg Eye drops 0.5% Eye drops 0.25% Tab long-acting 400 mg

Brand Name Expiry Date*

Ziagen Ziagen Accarb Diamox Martindale Acetylcysteine Lovir Apo-Allopurinol Symmetrel DBL Aminophylline Arrow-Amitriptyline Amitrip Apo-Amlodipine Apo-Amlodipine Ibiamox Alphamox Augmentin Augmentin Curam Duo AFT Vitala-C Ethics Aspirin EC Ethics Aspirin Mylan Atenolol Zarator AstraZeneca Imuprine Imuran ArrowBendrofluazide Bicillin LA Sandoz Betoptic Betoptic S Bezalip Retard 2014 2014 2013 2013 2015 2015 2015 2013 2014 2015 2014 2014 2015 2014 2015 2014 2015 2013 2014 2014 2014 2014 2014 2014 2013 2015

Aqueous cream Ascorbic acid Aspirin Atenolol Atorvastatin Atropine sulphate Azathioprine Bendrofluazide Benzathine benzylpenicillin Benzylpenicillin sodium (Penicillin G) Betaxolol hydrochloride Bezafibrate

10

*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 April 2013

Generic Name

Bicalutamide Bisacodyl Bisoprolol fumarate Blood glucose diagnostic test meter Blood glucose diagnostic test strip Brimonidine tartrate Cabergoline Calamine Calcitonin Calcium carbonate Calcium folinate Candesartan Captopril Cefaclor monohydrate Cefazolin sodium Ceftriaxone sodium Cefuroxime sodium Cetomacrogol Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate

Presentation

Tab 50 mg Tab 5 mg Tab 2.5 mg, 5 mg & 10 mg Meter with 50 lancets, a lancing device and 10 diagnostic test strips Blood glucose test strips Eye drops 0.2% Tab 0.5 mg Lotn, BP Inj 100 iu per ml, 1 ml Tab 1.25 g (500 mg elemental) Tab eff 1.75 g (1 g elemental) Tab 15 mg Tab 4 mg, 8 mg, 16 mg & 32 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 & 1 g Inj 500 mg Inj 1 g Inj 750 mg Crm BP Oral liq 1 mg per ml Tab 10 mg Eye oint 1% Eye drops 0.5% Mouthwash 0.2% Handrub 1% with ethanol 70% Soln 4% Nail-soln 8% Tab 0.5 mg, 2.5 mg & 5 mg Tab 5 mg with hydrochlorothiazide 12.5 mg Tab 250 mg, 500 mg & 750 mg Tab 20 mg Tab 500 mg Tab 250 mg

Brand Name Expiry Date*

Bicalaccord Lax-Tab Bosvate CareSens N CareSens N POP CareSens II CareSens CareSens N Arrow-Brimonidine Dostinex PSM Miacalcic Arrow-Calcium Calsource DBL Leucovorin Calcium Candestar m-Captopril Capoten Ranbaxy-Cefaclor AFT Veracol Aspen Ceftriaxone Multichem PSM Cetirizine - AFT Zetop Chlorsig Chlorafast healthE healthE Orion Apo-Ciclopirox Zapril Inhibace Plus Cipflox Arrow-Citalopram Apo-Clarithromycin Apo-Clarithromycin 2014 2013 2013 2015

2015 2014 2015 2015 2014 2014 2014 2015 2013 2013 2014 2013 2014 2013 2014 2015 2015 2014 2015 2013 2013 2014 2014 2014

Ciclopirox olamine Cilazapril Cilazapril with hydrochlorothiazide Ciprofloxacin Citalopram hydrobromide Clarithromycin

*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.

11


Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Clindamycin Clomipramine hydrochloride Clonidine hydrochloride Clopidogrel Clotrimazole

Presentation

Cap hydrochloride 150 mg Tab 10 mg & 25 mg Tab 150 µg Inj 150 µg per ml, 1 ml 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 Tab 50 mg Oral liq 100 mg per ml Tab 50 mg & 100 mg Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs Nasal spray 10 µg per dose Tab 1 mg & 4 mg Eye oint 0.1% Eye drops 0.1% Inj 4 mg per ml, 1 ml & 2 ml

Brand Name Expiry Date*

Clindamycin ABM Apo-Clomipramine Catapres Apo-Clopidogrel Clomazol Clomazol Clomazol Midwest Colgout Electral Itch-Soothe Nausicalm Cycloblastin Neoral Siterone Ginet 84 Desmopressin-PH&T Douglas Maxidex Maxidex Hospira Maxitrol Maxitrol 2013 2015 2015 2013 2014 2013 2013 2013 2013 2015 2015 2013 2015 2015 2014 2014 2015 2014 2013 2013 2014

Coal tar Colchicine Compound electrolytes Crotamiton Cyclizine hydrochloride Cyclophosphamide Cyclosporin Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone

Dexamethasone sodium phosphate

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 Dexamphetamine sulphate Dextrose Dextrose with electrolytes Tab 5 mg Inj 50%, 10 ml Soln with electrolytes

PSM Biomed Pedialyte – Fruit Pedialyte – Bubblegum Pedialyte – Plain Diclax SR Voltaren Voltaren Ophtha Voltaren DHC Continus

2015 2014 2013

Diclofenac sodium

Tab long-acting 75 mg & 100 mg Inj 25 mg per ml, 3 ml Eye drops 1 mg per ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab long-acting 60 mg

2015 2014

Dihydrocodeine tartrate

2013

12

*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 April 2013

Generic Name

Diltiazem hydrochloride Dipyridamole Docusate sodium Docusate sodium with sennosides Doxazosin mesylate Doxycycline hydrochloride Emulsifying ointment Enalapril Enoxaparin sodium Entacapone Ergometrine maleate Escitalopram Etidronate disodium Ethinyloestradiol Ethinyloestradiol with levonorgestrel

Presentation

Tab 30 mg & 60 mg Tab long-acting 150 mg Cap 50 mg Cap 120 mg Tab 50 mg with total sennosides 8 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 Inj 500 µg per ml, 1 ml Tab 10 mg & 20 mg Tab 200 mg Tab 10 µg Tab 20 µg with levonorgestrel 100 µg & 7 inert tab Tab 30 µg with levonorgestrel 150 µg & 7 inert tab Tab 25 mg Tab long-acting 5 mg & 10 mg Tab long-acting 2.5 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) Inj 300 µg per 0.5 ml Inj 480 µg per 0.5 ml Tab 5 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap 250 mg & 500 mg Inj 250 mg, 500 mg & 1 g Cap 50 mg, 150 mg & 200 mg Eye drops 0.1%

Brand Name Expiry Date*

Dilzem Pytazen SR Laxofast 50 Laxofast 120 Laxsol Apo-Doxazosin Doxine AFT m-Enalapril Clexane Entapone DBL Ergometrine Loxalate Arrow-Etidronate NZ Medical and Scientific Ava 20 ED Ava 30 ED Aromasin Plendil ER Plendil ER Mylan Fentanyl Patch Boucher and Muir Ferodan Zarzio Zarzio Rex Medical AFT Staphlex Flucloxin Ozole Flucon 2014 2015 2013 2015 2014 2014 2013 2014 2014 2014 2015 2015 2015 2014 2013 2015 2015 2014

Exemestane Felodopine Fentanyl

Fentanyl citrate Ferrous sulphate Filgrastim Finasteride Flucloxacillin sodium

2015 2013

31/12/15

2014 2015 2014 2014 2015

Fluconazole Fluorometholone

*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.

13


Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Fluorouracil sodium Fluoxetine hydrochloride Flutamide Fluticafone propionate Furosemide

Presentation

Crm 5% Cap 20 mg Tab dispersible 20 mg, scored Tab 250 mg Metered aqueous nasal spray, 50 µg per dose Tab 500 mg Tab 40 mg Inj 10 mg per ml, 2 ml Crm 2% Oint 2% Tab 600 mg Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg Suppos 3.6 g Liquid Aerosol spray 400 µg per dose 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 Tab 5 mg & 20 mg Crm 1% Powder Inj 50 mg per ml, 1 ml Rectal foam 10%, CFC-Free (14 applications) Lipocream 0.1% Milky emul 0.1% Oint 0.1% Scalp lotn 0.1% 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

Brand Name Expiry Date*

Efudix Fluox Fluox Flutamin Flixonase Hayfever & Allergy Urex Forte Diurin 40 Frusemide-Claris Foban Foban Lipazil Pfizer Apo-Gliclazide Minidiab PSM healthE Glytrin Nitroderm TTS Lycinate Serenace Serenace Serenace Douglas Pharmacy Health ABM Solu-Cortef Colifoam Locoid Lipocream Locoid Crelo Locoid Locoid Micreme H DP Lotn HC ABM Hydroxocobalamin Plaquenil Buscopan Gastrosoothe 2015 2013 2013 2015 2015 2013 2013 2013 2015 2014 2015 2015 2013 2014

Fusidic acid Gemfibrozil Gentamicin sulphate Gliclazide Glipizide Glycerol Glyceryl trinitrate

Haloperidol

2013

Hydrocortisone

2015 2014 2013 2015 2015

Hydrocortisone acetate Hydrocortisone butyrate

Hydrocortisone with miconazole Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hyoscine N-butylbromide

2013 2014 2015 2015 2014

14

*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 April 2013

Generic Name

Ibuprofen

Presentation

Tab 200 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 100 mg 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 Tab 100 mg Oral liq 10 mg per ml Tab 150 mg Cap 15 mg & 30 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 Tab 5 mg, 10 mg & 20 mg Tab 250 mg & 400 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 Tab 12.5 mg, 25 mg, 50 mg & 100 mg

Brand Name Expiry Date*

Arrowcare Brufen SR Fenpaed Aldara Dapa-Tabs Univent Univent Ferrum H PSM Ismo 20 Corangin Oratane Itrazole Sebizole Laevolac Zetlam 3TC 3TC Solox Hysite Letraccord Jadelle Xylocaine Viscous Xylocaine EMLA EMLA Arrow-Lisinopril Lithicarb FC Douglas Lomide Diamide Relief Lorapaed Loraclear Hayfever Relief Ativan Lostaar 2015 2015 2014 2014 2013 2013 2014 2015 2014 2015 2013 2014 2013 2014 2013 2015 2015 2015 31/12/13 2014 2013 2013 2014 2013 2014 2013 2013

Imiquimod Indapamide Ipratropium bromide

Iron polymaltose Isoniazid Isosorbide mononitrate Isotretinoin Itraconazole Ketoconazole Lactulose Lamivudine

Lansoprazole Latanoprost Letrozole Levonorgestrel Lignocaine hydrochloride Lignocaine with prilocaine

Lisinopril Lithium carbonate Lodoxamide trometamol Loperamide hydrochloride Loratadine

Lorazepam Losartan

2013 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.

15


Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Losartan with hydrochlorothiazide Macrogol 3350 Malathion Mask for spacer device Mebendazole Mebeverine hydrochloride Megestrol acetate Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Mercaptopurine Mesalazine Metformin hydrochloride Methadone hydrochloride

Presentation

Tab 50 mg with hydrochlorothiazide 12.5 mg Powder 13.125 g, sachets Liq 0.5% Shampoo 1% Size 2 Tab 100 mg Tab 135 mg Tab 160 mg Tab 4 mg & 100 mg Inj 40 mg per ml Inj 40 mg per ml with lignocaine 1 ml Tab 50 mg Enema 1 g per 100 ml Suppos 500 mg Tab immediate-release 500 mg & 850 mg Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Tab 5 mg Inj 25 mg per ml, 2 ml & 20 ml Inj 40 mg per ml, 1 ml; 62.5 mg per ml, 2 ml; 500 mg & 1 g Inj 5 mg per ml, 2 ml Tab 10 mg Tab long-acting 23.75 mg, 47.5 mg, 95 mg & 190 mg Inj 1 mg per ml, 5 ml Tab 50 mg & 100 mg Tab long-acting 200 mg Crm 2% Tab 30 mg & 45 mg Crm 0.1% Oint 0.1% Oral liq 1 mg per ml, 2 mg per ml, 5 mg per ml & 10 mg per ml

Brand Name Expiry Date*

Arrow-Losartan & Hydroclorothiazide Lax-Sachets A-Lices A-Lices EZ-fit Paediatric Mask De-Worm Colofac Apo-Megestrol Medrol Depo-Medrol Depo-Medrol with Lidocaine Purinethol Pentasa Asacol Apotex Biodone Biodone Forte Biodone Extra Forte Methatabs Hospira Solu-Medrol Pfizer Metamide Metoprolol-AFT CR Lopresor Lopresor Slow-Lopresor Multichem Avanza m-Mometasone RA-Morph 2014 2014 2013 2015 2014 2014 2015 2015 2015 2015 2013 2015 2014 2015 2015 2013 2013 2015 2014 2015 2015

Methotrexate Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol succinate Metoprolol tartrate

Miconazole nitrate Mirtazapine Mometasone furoate Morphine hydrochloride

2014 2015 2015 2015

16

*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 April 2013

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

Brand Name Expiry Date*

DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Arrow-Morphine LA m-Elson Hospira Konsyl-D Naphcon Forte Noflam 250 Noflam 500 Naltraccord AstraZeneca Nevirapine Alphapharm Habitrol Habitrol Habitrol Apo-Nicotinic Acid Arrow-Norfloxacin Noriday 28 Primolut N Nilstat Nilstat Nilstat Octreotide Max Rx 2014 2014 2015 2014 2014 2013 2014 2013 2013 2014 2015 2013 2014 2015 2014 2014

2013

Morphine tartrate Mucilaginous laxatives Naphazoline hydrochloride Naproxen Naltrexone hydrochloride Neostigmine Nevirapine Nicotine

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 Tab 200 mg 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 350 µg Tab 5 mg Oral liq 100,000 u per ml Cap 500,000 u Tab 500,000 u Inj 50 µg per ml, 1 ml Inj 100 µg per ml, 1 ml Inj 500 µg per ml, 1 ml Crm Cap 10 mg, 20 mg & 40 mg Powder Inj 40 mg Tab disp 8 mg Tab 4 mg & 8 mg

Nicotinic acid Norfloxacin Norethisterone Nystatin

Octreotide (somatostatin analogue) Oil in water emulsion Omeprazole

healthE Fatty Cream Omezol Relief Midwest Dr Reddy’s Omeprazole Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron Ox-Pam

2015 2014

Ondansetron

2013

Oxazepam

Tab 10 mg & 15 mg

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.

17


Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Oxycodone hydrochloride Oxytocin Pantoprazole

Presentation

Inj 10 mg per ml, 1 ml & 2 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml Inj 40 mg Tab 20 mg & 40 mg Suppos 500 mg Tab 500 mg Oral liq 120 mg per 5 ml 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 Tab 0.25 mg & 1 mg Crm 5% Lotn 5% Tab 50 mg & 100 mg Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

Oxycodone Orion Syntometrine Pantocid IV Dr Reddy’s Pantoprazole Paracare Parafast Ethics Paracetamol Paracare Double Strength Paracetamol + Codeine (Relieve) Lacri-Lube Loxamine Breath-Alert Permax Lyderm A-Scabies PSM DBL Pethidine Hydrochloride DBL Pethidine Hydrochloride PSM Cilicaine VK AFT AFT Pizaccord Sandomigran Coloxyl Span-K Dr Reddy’s Pramipexole Cholvastin Cilicaine Allersoothe Mestinon PyridoxADE Apo-Pyridoxine 2015 2015 2014 2015 2013 2014 2014 2015 2014 2014 2015 2015 2014 2013 2015 2014

Paracetamol

Paracetamol with codeine Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak flow meter Pergolide Permethrin Pethidine hydrochloride

2014 2013 2013 2015 2014 2014 2015 2014

Phenobarbitone Phenoxymethylpenicillin (Pencillin V)

Tab 15 mg & 30 mg 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 15 mg, 30 mg & 45 mg Tab 500 µg Oral drops 10% Tab long-acting 600 mg Tab 0.125 mg & 0.25 mg Tab 20 mg & 40 mg Inj 1.5 mega u Tab 10 mg & 25 mg Tab 60 mg Tab 25 mg Tab 50 mg

2015 2013

Pioglitazone Pizotifen Poloxamer Potassium chloride Pramipexole hydrochloride Pravastatin Procaine penicillin Promethazine hydrochloride Pyridostigmine bromide Pyridoxine hydrochloride

18

*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 April 2013

Generic Name

Quinapril with hydrochlorothiazide

Presentation

Tab 10 mg with hydrochlorothiazide 12.5 mg Tab 20 mg with hydrochlorothiazide 12.5 mg Oral liq 150 mg per 10 ml Tab 150 mg & 300 mg Cap 150 mg Tab 100 mg Tab orodispersible 10 mg Tab 0.25 mg, 1 mg, 2 mg & 5 mg Tab 150 mg & 300 mg Nebuliser soln, 1 mg per ml & 2 mg per ml, 2.5 ml Nebuliser soln, 2.5 mg with ipratropium bromide 0.5 mg per vial, 2.5 ml 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% 800 ml 230 ml (single patient) Tab 25 mg & 100 mg Inj 12 mg per ml, 0.5 ml Tab 50 mg & 100 mg Tab 20 mg Cap 400 µg Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium, 500 ml & 1,000 ml Tab 10 mg Cap 5 mg, 20 mg, 100 mg & 250 mg Tab 1 mg, 2 mg & 5 mg

Brand Name Expiry Date*

Accuretic 10 Accuretic 20 Peptisoothe Arrow-Ranitidine Mycobutin Norvir Rizamelt Ropin ArrowRoxithromycin Asthalin Duolin 2014 2013 2015 2014 2013 2015 2015 2015 2015

Ranitidine hydrochloride Rifabutin Ritonavir Rizatriptan Ropinirole hydrochloride Roxithromycin Salbutamol Salbutamol with ipratropium bromide Sertraline Simvastatin

Arrow-Sertraline Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Biomed Micolette Ural Rexacrom Volumatic Space Chamber Plus Spirotone Arrow-Sumatriptan Arrow-Sumatriptan Genox Tamsulosin-Rex Pinetarsol

2013 2014

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

2013 2013 2013 2013 2015

Spironolactone Sumatriptan Tamoxifen citrate Tamsulosin hydrochloride Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Temozolomide Terazosin hydrochloride

2013 2013 2014 2013 2014

Normison Temaccord Arrow

2014 2013 2013

*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.

19


Sole Subsidised Supply Products – cumulative to April 2013

Generic Name

Terbinafine Testosterone cypionate Testosterone undecanoate Tetrabenazine Tetracosactrin Timolol maleate Tobramycin

Presentation

Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Cap 40 mg Tab 25 mg Inj 250 µg Inj 1 mg per ml, 1 ml Eye drops 0.25% & 0.5% Eye drops 0.3% Eye oint 0.3% Inj 40 mg per ml, 2 ml Tab 100 mg Cap 50 mg Inj 10 mg per ml, 1 ml Inj 40 mg per ml, 1 ml Crm 0.02% Oint 0.02% 0.1% in Dental Paste USP Tab 500 mg Eye drops 0.5% & 1% Eye drops 0.25% Cap 250 mg Inj 500 mg Tab 40 mg & 80 mg Tab, strong, BPC Tab (BPC cap strength) Cap 100 mg Oral liq 10 mg per ml Tab 300 mg with lamivudine 150 mg Oint BP Caps 137.4 mg (50 mg elemental)

Brand Name Expiry Date*

Dr Reddy’s Terbinafine Depo-Testosterone Andriol Testocaps Motetis Synacthen Synacthen Depot Arrow-Timolol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol Kenacort-A Kenacort-A40 Aristocort Aristocort Oracort Cyklokapron Mydriacyl Enuclene Ursosan Mylan Isoptin B-PlexADE MultiADE Retrovir Retrovir Alphapharm Multichem Zincaps 2014 2014 2015 2013 2014 2014 2014

Tolcapone Tramadol hydrochloride Triamcinolone acetonide

2014 2014 2014

Tranexamic acid Tropicamide Tyloxapol Ursodeoxycholic acid Vancomycin hydrochloride Verapamil hydrochloride Vitamin B complex Vitamins Zidovudine [AZT] Zidovudine [AZT] with lamivudine Zinc and castor oil Zinc sulphate April changes in bold

2013 2014 2014 2014 2014 2014 2013 2013 2013 2014 2014 2014

20

*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.


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 April 2013

27 GLYCERYL TRINITRATE – Special Authority see SA1329 – Retail pharmacy ❋ Oint 0.2% ................................................................................ 22.00 30 g OP ✔ Rectogesic

➽ SA1329 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has chronic anal fissure that has persisted for longer than three weeks. 28 DIAZOXIDE – Special Authority see SA1320 – Retail pharmacy Cap 25 mg – For diazoxide oral liquid formulation refer, page 179 ................................................................. 110.00 Cap 100 mg .......................................................................... 280.00

100 100

✔ Proglicem S29 ✔ Proglicem S29

➽ SA1320 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 12 months where used for the treatment of confirmed hypoglycaemia caused by hyperinsulinism. Renewal from any relevant practitioner. Approvals valid without further renewal where the treatment remains appropriate and the patient is benefiting from treatment. 28 BISMUTH TRIOXIDE Tab 120 mg ............................................................................ 32.50 PROPRANOLOL – Special Authority see SA1327– Retail pharmacy ❋ Oral liq 4 mg per ml .............................................................. CBS

112

✔ De-Nol S29

54

500 ml

✔ Roxane S29

➽ SA1327 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 For the treatment of a child under 12 years with an haemangioma causing functional impairment (not for cosmetic reasons only); or 2 For the treatment of a child under 12 years with cardiac arrthymias or congenital cardiac abnormalities. Renewal from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 For the treatment of a child under 12 years with an haemangioma causing functional impairment (not for cosmetic reasons only); or 2 For the treatment of a child under 12 years with cardiac arrthymias or congenital cardiac abnormalities. 56 METOLAZONE – Special Authority see SA1323 – Retail pharmacy Tab 5 mg ............................................................................. CBS 1 ✔ Metolazone

➽ SA1323 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 For the treatment of heart failure in patients who are intolerant or have not responded to ACE inhibitors and/or angiotensin receptor blockers; or, 2 For the treatment of heart failure, in patients in whom treatment with ACE inhibitors and/or angiotensin receptor blockers is not tolerated due to renal impairment.

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

21


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 April 2013 (continued)

57 HYDRALAZINE HYDROCHLORIDE – Special Authority see SA1321 – Retail pharmacy Tab 25 mg ........................................................................... CBS 1 ✔ Hydralazine

➽ SA1321 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 For the treatment of refractory hypertension; or 2 For the treatment of heart failure in combination with a nitrate, in patients who are intolerant or have not responded to ACE inhibitors and/or angiotensin receptor blockers. 84 ALBENDAZOLE – Special Authority see SA1318 – Retail pharmacy Tab 400 mg .......................................................................... 849.65

60

✔ Eskazole S29

➽ SA1318 Special Authority for Subsidy Initial application from infectious disease specialist or clinical microbiologist. Approvals valid for 6 months where the patient has hydatids. Renewal from infectious disease specialist or clinical microbiologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefitting from the treatment. 84 87 PRAZIQUANTEL Tab 600 mg ............................................................................ 50.40 PAROMOMYCIN – Special Authority see SA1324 – Retail pharmacy Cap 250 mg .......................................................................... 126.00 8 ✔ Biltricide

16

✔ Humatin S29

➽ SA1324 Special Authority for Subsidy Initial application only from an infectious disease specialist or clinical microbiologist. Applications valid for 1 month where the patient has confirmed cryptosporidium infection. Renewal only from an infectious disease specialist or clinical microbiologist. Applications valid for 1 month where the patient has confirmed cryptosporidium infection. 87 TETRACYCLINE – Special Authority see SA1332 – Retail pharmacy Cap 500 mg ............................................................................ 46.00 30 ✔ Tetracyclin Wolff

S29

➽ SA1332 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 For the eradication of helicobacter pylori following unsuccessful treatment with appropriate first-line therapy; and 2 For use only in combination with bismuth as part of a quadruple therapy regimen. 87 PYRIMETHAMINE – Special Authority see SA1328 – Retail pharmacy Tab 25 mg .............................................................................. 26.14

30

✔ Daraprim S29

➽ SA1328 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; or 2 For pregnant patients for the term of the pregnancy; or 3 For infants with congenital toxoplasmosis until 12 months of age. 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

22


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 April 2013 (continued)

87 SULFADIAZINE SODIUM – Special Authority see SA1331 – Retail pharmacy Tab 500 mg .......................................................................... 221.00 56 ✔ Wockhardt S29

➽ SA1331 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; or 2 For pregnant patients for the term of the pregnancy; or 3 For infants with congenital toxoplasmosis until 12 months of age. 89 ITRACONAZOLE Oral liq 10 mg per ml – Special Authority see SA1322 – Retail pharmacy.............................................................. 141.80

150 ml OP ✔ Sporanox

➽ SA1322 Special Authority for Subsidy Initial application from an infectious disease specialist, clinical microbiologist or clinical immunologist, or from any relevant practitioner on the recommendation of an infectious disease specialist, clinical microbiologist or clinical immunologist. Approvals valid for 6 months where the patient has a congenital immune deficiency. Renewal from any relevant practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefitting from the treatment. 90 PARA-AMINO SALICYLIC ACID - Retail pharmacy-Specialist. a) No patient co-payment payable b) Specialist must be an infectious disease specialist, clinical microbiologist or respiratory specialist. Grans for oral liq 4 g sachet ................................................... 280.00 30 ✔ Paser S29 PROTIONAMIDE – Retail pharmacy-Specialist. a) No patient co-payment payable b) Specialist must be an infectious disease specialist, clinical microbiologist or respiratory specialist. Tab 250 mg .......................................................................... 305.00 100 ✔ Peteha S29 CYCLOSERINE - Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious disease specialist, clinical microbiologist or respiratory specialist Cap 250 mg ....................................................................... 1,140.63 100 ✔ King S29 CLOFAZIMINE - Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious disease specialist, clinical microbiologist or dermatologist. Cap 50 mg ............................................................................ 197.50 100 ✔ Lamprene S29 PRIMAQUINE PHOSPHATE – Special Authority see SA1326 – Retail pharmacy Tab 7.5 mg ........................................................................... 117.00 56

90

90

90

90

✔ Primacin S29

➽ SA1326 Special Authority for Subsidy Initial application from an infectious disease specialist or clinical microbiologist. Approvals valid for 1 month for applications meeting the following criteria: 1 The patient has vivax or ovale malaria; and 2 Primaquine is to be given for a maximum of 21 days.

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

23


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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 April 2013 (continued)

97 EFAVIRENZ – Special Authority see SA1025 – Retail pharmacy Oral liq 30 mg per ml ............................................................. 145.79 STAVUDINE [D4T] – Special Authority see SA1025 – Retail pharmacy Powder for oral soln 1 mg per ml ........................................... 100.76 BENZBROMARONE – Special Authority see SA1319 – Retail pharmacy Tab 100 mg ............................................................................ 45.00 180 ml OP ✔ Stocrin S29

98

200 ml OP ✔ Zerit S29

118

100

✔ Benzbromaron S29

➽ SA1319 Special Authority for Subsidy Initial application from any relevant practitioner. Applications valid for 6 months for applications meeting the following criteria: Both: 1 Any of: 1.1 The patient has a serum urate level greater than 0.36 mmol/l despite treatment with allopurinol at doses of at least 600 mg/day and appropriate doses of probenecid; or 1.2 The patient has experienced intolerable side effects from allopurinol such that treatment discontinuation is required and serum urate remains greater than 0.36 mmol/l despite appropriate doses of probenecid; or 1.3 Both: 1.3.1 The patient has renal impairment and serum urate remains greater than 0.36 mmol/l despite optimal treatment with allopurinol (see Note); and 1.3.2 The patient has a rate of creatinine clearance greater than or equal to 20 ml/min; or 1.4 All of the following: 1.4.1 The patient is taking azathioprine and requires urate-lowering therapy; and 1.4.2 Allopurinol is contraindicated; and 1.4.3 Appropriate doses of probenecid are ineffective or probenecid cannot be used due to reduced renal function; and 2 The patient is receiving monthly liver function tests. Renewal from any relevant practitioner. Applications valid for 2 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 There is no evidence of liver toxicity and patient is continuing to receive regular (at least every three months) liver function tests. Notes: Benzbromarone has been associated with potentially fatal hepatotoxicity. Optimal treatment with allopurinol in patients with renal impairment is defined as treatment to the creatinine clearance-adjusted dose of allopurinol then, if serum urate remains greater than 0.36 mmol/l, a gradual increase of the dose of allopurinol to 600 mg or the maximum tolerated dose. 119 SELEGILINE HYDROCHLORIDE ❋ Tab 5 mg ............................................................................... 16.06 STIRIPENTOL – Special Authority see SA1330 – Retail pharmacy Cap 250 mg .......................................................................... 509.29 Powder for oral liq 250 mg sachet ......................................... 509.29 100 ✔ Apo-Selegiline S29

S29

127

60 60

✔ Diacomit S29 ✔ Diacomit S29

➽ SA1330 Special Authority for Subsidy Initial application only from a paediatric neurologist or Practitioner on the recommendation of a paediatric neurologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Patient has confirmed diagnosis of Dravet syndrome; and 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

24


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

continued... 2 Seizures have been inadequately controlled by appropriate courses of sodium valproate, clobazam and at least two of the following: topiramate, levetiracetam, ketogenic diet. Renewal from any relevant practitioner. Approvals valid without further renewal where the patient continues to benefit from treatment as measured by reduced seizure frequency from baseline. 151 DOCETAXEL – PCT only – Specialist Inj 20 mg ................................................................................ 48.75 Inj 80 mg .............................................................................. 195.00 PEGASPARGASE – PCT only – Specialist – Special Authority see SA1325 Inj 3,750 IU per 5 ml........................................................... 3,005.00 1 1 ✔ Docetaxel Sandoz ✔ Docetaxel Sandoz

New Listings - effective 1 April 2013 (continued)

152

1

✔ Oncaspar S29

➽ SA1325 Special Authority for Subsidy Initial application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following: 1 The patient has newly diagnosed acute lymphoblastic leukaemia; and 2 Pegaspargase to be used with a contemporary intensive multi-agent chemotherapy treatment protocol; and 3 Treatment is with curative intent. Renewal only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following: 1 The patient has relapsed acute lymphoblastic leukaemia; and 2 Pegaspargase to be used with a contemporary intensive multi-agent chemotherapy treatment protocol; and 3 Treatment is with curative intent. 176 177 OLOPATADINE Eye drops 0.1% ....................................................................... 17.00 PHARMACY SERVICES - May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Nevirapine Alphapharm is 2433265 (BSF Nevirapine Alphapharm Brand switch fee to be delisted 1 July 2013) 205 HIGH FAT LOW CARBOHYDRATE FORMULA – Special Authority see SA1197 – Retail pharmacy Powder (unflavoured) ............................................................. 35.50 300 g OP ✔ KetoCal 3:1 5 ml OP 1 fee ✔ Patanol ✔ BSF Nevirapine Alphapharm

Effective 1 March 2013

58 SILDENAFIL – Special Authority see SA1293 – Retail pharmacy Tab 25 mg ................................................................................ 1.85 Tab 50 mg ................................................................................ 1.85 GENTAMICIN SULPHATE Inj 10 mg per ml, 2 ml – Subsidy by endorsement ................. 175.10 4 4 25 ✔ Silagra ✔ Silagra ✔ APP Pharmaceuticals

S29

88

Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly.

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

25


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 March 2013 (continued)

119 PRAMIPEXOLE HYDROCHLORIDE s Tab 1 mg .................................................................................. 7.20 OXYCODONE HYDROCHLORIDE a) Only on a controlled drug form b) See prescribing guideline below c) No patient co-payment payable d) Safety medicine; prescriber may determine dispensing frequency Inj 50 mg per ml, 1 ml ............................................................. 60.00 FLUTAMIDE – Retail pharmacy-Specialist Tab 250 mg ............................................................................ 16.50 PHARMACY SERVICES - May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Zetlam is 2433257 (BSF Zetlam Brand switch fee to be delisted 1 June 2013) ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Alphapharm is 2433494 (BSF Alphapharm Brand switch fee to be delisted 1 June 2013) ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Entapone is 2433249 (BSF Entapone Brand switch fee to be delisted 1 June 2013) ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Accarb is 2433486 (BSF Accarb Brand switch fee to be delisted 1 June 2013) 30 ✔ Dr Reddy’s Pramipexole

123

5 30 1 fee 1 fee 1 fee 1 fee

✔ OxyNorm ✔ Flutamin S29 S29 ✔ BSF Zetlam ✔ BSF Alphapharm ✔ BSF Entapone ✔ BSF Accarb

158 177

Effective 1 February 2013

51 QUINAPRIL ❋ Tab 5 mg ................................................................................. 3.44 ❋ Tab 10 mg ............................................................................... 4.64 ❋ Tab 20 mg ................................................................................ 6.34 ATENOLOL ❋ Oral liq 25 mg per 5 ml ............................................................ 21.25 Restricted to children under 12 years of age. FLUCLOXACILLIN SODIUM Grans for oral liq 125 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 2.49 Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 3.25 Note – this listing is for a sugar free formulation with new pharmacodes. CAPSAICIN – Special Authority see SA1289 – Retail pharmacy Crm 0.025% .............................................................................. 9.95 90 90 90 ✔ Arrow-Quinapril 5 ✔ Arrow-Quinapril 10 ✔ Arrow-Quinapril 20

53

300 ml OP ✔ Atenolol AFT S29

86

100 ml 100 ml

✔ AFT ✔ AFT

102

45 g OP

✔ Zostrix

➽ SA1289 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has osteoarthritis that is not responsive to paracetamol and oral non-steroidal anti-inflammatories are contraindicated. 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

26


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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 February 2013 (continued)

126 VENLAFAXINE – Special Authority see SA1061 – Retail pharmacy Tab 225 mg ........................................................................... 35.12 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg – For azathioprine oral liquid formulation refer, page 179 ............................................................................. 18.45 FLUTICASONE PROPIONATE Metered aqueous nasal spray, 50 µg per dose ........................... 2.30 28 ✔ Arrow-Venlafaxine XR

160

100

✔ Imuran

171

120 dose OP ✔ Flixonase Hayfever & Allergy Note – this Flixonase Hayfever & Allergy has different packaging and a new pharmacode 191 ENTERAL/ORAL FEED 1KCAL/ML – Special Authority see SA1098 – Hospital pharmacy [HP3] Powder (unflavoured) .............................................................. 78.97 400 g OP ✔ Heparon Junior

New Listings - effective 1 January 2013

32 INSULIN PUMP – Special Authority see SA1237– Retail pharmacy a) Only on a prescription b) Maximum of 1 insulin pump per prescription c) Maximum of 1 insulin pump per patient each four year period Min basal rate 0.05 U/h; clear colour .................................. 4,400.00 Min basal rate 0.05 U/h; smoke colour................................ 4,400.00 Min basal rate 0.05 U/h; purple colour ................................ 4,400.00 Min basal rate 0.05 U/h; pink colour ................................... 4,400.00 Min basal rate 0.05 U/h; blue colour ................................... 4,400.00 35

1 1 1 1 1

✔ Paradigm 522 ✔ Paradigm 722 ✔ Paradigm 522 ✔ Paradigm 722 ✔ Paradigm 522 ✔ Paradigm 722 ✔ Paradigm 522 ✔ Paradigm 722 ✔ Paradigm 522 ✔ Paradigm 722

INSULIN PUMP RESERVOIR – Special Authority see SA1240 – Retail pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of reservoirs will be funded per year (Maximum of 13 packs per annum) Cartridge for 5 and 7 series pump; 1.8 ml x 10 ........................ 50.00 1 OP ✔ Paradigm 1.8 Reservoir Cartridge for 7 series pump; 3.0 ml x 10 .................................. 50.00 1 OP ✔ Paradigm 3.0 Reservoir Syringe and cartridge for 50X pump, 3.0 ml x 10...................... 50.00 1 OP ✔ 50X 3.0 Reservoir INSULIN PUMP INFUSION SET (TEFLON CANNULA, ANGLE INSERTION) – Special Authority see SA1240 – Retail pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) 13 mm teflon cannula; angle insertion; 45 cm line x 10 with 10 needles;........................................ 130.00 1 OP ✔ Paradigm Silhouette MMT-368 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

34

27


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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 January 2013 (continued)

continued... 13 mm teflon cannula; angle insertion; 60 cm line x 10 with 10 needles;........................................ 130.00 13 mm teflon cannula; angle insertion; 80 cm line x 10 with 10 needles;........................................ 130.00 13 mm teflon cannula; angle insertion; 120 cm line x 10 with 10 needles;...................................... 130.00 17 mm teflon cannula; angle insertion; 110 cm line x 10 with 10 needles; luer lock ........................ 130.00 17 mm teflon cannula; angle insertion; 60 cm line x 10 with 10 needles; luer lock .......................... 130.00 17 mm teflon cannula; angle insertion; 110 cm line x 10 with 10 needles;...................................... 130.00 17 mm teflon cannula; angle insertion; 60 cm line x 10 with 10 needles;........................................ 130.00 17 mm teflon cannula; angle insertion; 80 cm line x 10 with 10 needles;........................................ 130.00 34 1 OP 1 OP 1 OP 1 OP 1 OP 1 OP 1 OP 1 OP ✔ Paradigm Silhouette MMT-381 ✔ Paradigm Silhouette MMT-383 ✔ Paradigm Silhouette MMT-382 ✔ Silhouette MMT-371 ✔ Silhouette MMT-373 ✔ Paradigm Silhouette MMT-377 ✔ Paradigm Silhouette MMT-378 ✔ Paradigm Silhouette MMT-384

INSULIN PUMP INFUSION SET (TEFLON CANNULA, STRAIGHT INSERTION) – Special Authority see SA1240 – Retail pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) 9 mm teflon cannula; straight insertion; 80 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Quick-Set MMT-386 6 mm teflon cannula; straight insertion; 80 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Quick-Set MMT-387 9 mm teflon cannula; straight insertion; 110 cm tubing x 10 with 10 needles; luer lock.................... 130.00 1 OP ✔ Quick-Set MMT-390 6 mm teflon cannula; straight insertion; 110 cm tubing x 10 with 10 needles; luer lock.................... 130.00 1 OP ✔ Quick-Set MMT-391 9 mm teflon cannula; straight insertion; 60 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Quick-Set MMT-392 6 mm teflon cannula; straight insertion; 60 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Quick-Set MMT-393 9 mm teflon cannula; straight insertion; 106 cm tubing x 10 with 10 needles; ................................. 130.00 1 OP ✔ Paradigm Quick-Set MMT-396 9 mm teflon cannula; straight insertion; 60 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Quick-Set MMT-397 6 mm teflon cannula; straight insertion; continued...

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

28

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 January 2013 (continued)

continued... 110 cm tubing x 10 with 10 needles; ................................. 130.00 1 OP 1 OP ✔ Paradigm Quick-Set MMT-398 ✔ Paradigm Quick-Set MMT-399

6 mm teflon cannula; straight insertion; 60 cm tubing x 10 with 10 needles; ................................... 130.00 34

INSULIN PUMP INFUSION SET (STEEL CANNULA) – Special Authority see SA1240 – Retail pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) 6 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-863 6 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Sure-T MMT-864 6 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-865 6 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Sure-T MMT-866 8 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-873 8 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Sure-T MMT-874 8 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-875 8 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Sure-T MMT-876 10 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-883 10 mm steel needle; 29 G; manual insertion; 60 cm tubing x 10 with 10 needles; .................................. 130.00 1 OP ✔ Paradigm Sure-T MMT-884 10 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; luer lock...................... 130.00 1 OP ✔ Sure-T MMT-885 10 mm steel needle; 29 G; manual insertion; 80 cm tubing x 10 with 10 needles; ................................... 130.00 1 OP ✔ Paradigm Sure-T MMT-886 INSULIN PUMP INFUSION SET (TEFLON CANNULA, STRAIGHT INSERTION WITH INSERTION DEVICE) – Special Authority see SA1240 – Retail pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) 6 mm teflon cannula; straight insertion; insertion device; 45 cm pink tubing x 10 with 10 needles; ................ 130.00 1 OP ✔ Paradigm Mio MMT-921 continued... Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

34

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

29


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 January 2013 (continued)

continued... 6 mm teflon cannula; straight insertion; insertion device; 60 cm pink tubing x 10 with 10 needles ................. 130.00 6 mm teflon cannula; straight insertion; insertion device; 80 cm pink tubing x 10 with 10 needles; ................ 130.00 6 mm teflon cannula; straight insertion; insertion device; 45 cm blue tubing x 10 with 10 needles ................. 130.00 6 mm teflon cannula; straight insertion; insertion device; 60 cm blue tubing x 10 with 10 needles ................. 130.00 6 mm teflon cannula; straight insertion; insertion device; 80 cm blue tubing x 10 with 10 needles ................. 130.00 6 mm teflon cannula; straight insertion; insertion device; 80 cm clear tubing x 10 with 10 needles ................ 130.00 9 mm teflon cannula; straight insertion; insertion device; 80 cm clear tubing x 10 with 10 needles ................ 130.00

1 OP 1 OP 1 OP 1 OP 1 OP 1 OP 1 OP

✔ Paradigm Mio MMT-923 ✔ Paradigm Mio MMT-925 ✔ Paradigm Mio MMT-941 ✔ Paradigm Mio MMT-943 ✔ Paradigm Mio MMT-945 ✔ Paradigm Mio MMT-965 ✔ Paradigm Mio MMT-975 ✔ Calcitriol-AFT ✔ Calcitriol-AFT ✔ Bezalip

39

CALCITRIOL ❋ Cap 0.25 µg ............................................................................ 10.10 ❋ Cap 0.5 µg .............................................................................. 18.73 BEZAFIBRATE ❋ Tab 200 mg ............................................................................. 9.70 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP ..................................................................... 1.77 LEVONORGESTREL ❋ Tab 750 µg ............................................................................. 12.50 TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist Inj 250 mg per ml, 4 ml ........................................................... 86.00 PENICILLIN G BENZATHINE [BENZATHINE BENZYLPENICILLIN] Inj 1.2 mega u per 2 ml – Up to 5 inj available on a PSO......... 315.00 POSACONAZOLE – Special Authority see SA1285 – Retail pharmacy Oral liq 40 mg per ml ............................................................. 761.13

100 100 90

47 61

100 g 2 1 10

✔ Pharmacy Health ✔ Next Choice ✔ Reandron 1000 ✔ Bicillin LA

73 77 86 89

105 ml OP ✔ Noxafil

➽ SA1285 Special Authority for Subsidy Initial application only from a haematologist or infectious disease specialist. Approvals valid for 6 weeks for patients meeting the following criteria: Either: 1. Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation chemotherapy; or 2. Patient has received a stem cell transplant and has graft versus host disease and is on significant immunosuppressive therapy*. 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

30


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 January 2013 (continued)

continued... Renewal only from a haematologist or infectious disease specialist. Approvals valid for 6 weeks for patients meeting the following criteria: Either: 1. Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation therapy; or 2. Patient has received a stem cell transplant and has graft versus host disease and is on significant immunosuppression* and requires on going posaconazole treatment. * Graft versus host disease (GVHD) on significant immunosuppression is defined as acute GVHD, grade II to IV, or extensive chronic GVHD, or if they were being treated with intensive immunosuppressive therapy consisting of either high-dose corticosteroids (≥1 mg per kilogram of body weight per day for patients with acute GVHD or ≥0.8 mg per kilogram every other day for patients with chronic GVHD), antithymocyte globulin, or a combination of two or more immunosuppressive agents or types of treatment. 102 DICLOFENAC SODIUM ❋ Tab EC 25 mg .......................................................................... 4.00 ❋ Tab EC 50 mg ........................................................................ 16.00 LEVODOPA WITH CARBIDOPA (new formulation) Tab 100 mg with carbidopa 25 mg – For levodopa with carbidopa oral liquid formulation refer, page 179 .................................. 20.00 Tab long-acting 200 mg with carbidopa 50 mg ........................ 47.50 Tab 250 mg with carbidopa 25 mg ......................................... 40.00 TRAMADOL HYDROCHLORIDE Tab sustained-release 100 mg ................................................... 2.14 Tab sustained-release 150 mg ................................................... 3.21 Tab sustained-release 200 mg ................................................... 4.28 DOMPERIDONE ❋ Tab 10 mg - For domperidone oral liquid formulation refer, page 179 .................................................... 3.25 INTERFERON BETA-1-ALPHA – Special Authority see SA1062 Inj 6 million iu per 0.5 ml pen injector ................................. 1,425.10 DOXORUBICIN – PCT only – Specialist Inj 50 mg ................................................................................ 17.00 Inj 200 mg .............................................................................. 65.00 PHARMACY SERVICES - May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Plendil ER is 2430231 (BSF Plendil ER Brand switch fee to be delisted 1 April 2013) 100 500 ✔ Apo-Diclo ✔ Apo-Diclo

119

100 100 100 20 20 20

✔ Sinemet ✔ Sinemet CR ✔ Sinemet ✔ Tramal SR 100 ✔ Tramal SR 150 ✔ Tramal SR 200

121

131

100 4 1 1 1 fee

✔ Prokinex ✔ Avonex Pen ✔ Arrow-Doxorubicin ✔ Arrow-Doxorubicin ✔ BSF Plendil ER

140 152

178

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

31


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions

Effective 1 April 2013

54 FELODIPINE ❋ Tab long-acting 5 mg – Brand switch fee payable (Pharmacode 2430231) - see page 177 for details................. 3.10 ❋ Tab long-acting 10 mg – Brand switch fee payable (Pharmacode 2430231) - see page 177 for details ................ 4.60 30 30 ✔ Plendil ER ✔ Plendil ER

87

CIPROFLOXACIN – Subsidy by endorsement a) Subsidised only if: i. Patient has either (a) microbiologically confirmed and clinically significant pseudomonas infection; or (b) prostatitis; or (c) pyelonephritis; or (d) gonorrhoea; or ii. Prescription or PSO is written by, or on the recommendation of, an infectious disease specialist or a clinical microbiologist; and b) The prescription or PSO is endorsed accordingly. Tab 250 mg – Up to 5 tab available on a PSO ............................ 2.20 28 ✔ Cipflox Tab 500 mg – Up to 5 tab available on a PSO ............................ 3.00 28 ✔ Cipflox 10.71 100 ✔ Cipflox Tab 750 mg – Retail pharmacy-Specialist .................................. 5.15 28 ✔ Cipflox 5.52 30 ✔ Ciprofloxacin Rex CLINDAMYCIN Cap hydrochloride 150 mg – Maximum of 4 cap per prescription; can be waived by endorsement - Retail pharmacy – Specialist. .............................................. 9.90 16 ✔ Clindamycin ABM Specialist must be an infectious disease specialist or a clinical microbiologist Inj phosphate 150 mg per ml, 4 ml – Retail pharmacy-Specialist ................................................ 160.00 10 ✔ Dalacin C Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist or clinical microbiologist FUSIDIC ACID Tab 250 mg – Retail pharmacy-Specialist ................................ 34.50 12 ✔ Fucidin Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist or clinical microbiologist LINCOMYCIN – Retail pharmacy-Specialist Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist or clinical microbiologist Inj 300 mg per ml, 2 ml .......................................................... 80.00 5 ✔ Lincocin ITRACONAZOLE – Retail pharmacy-Specialist Cap 100 mg – Subsidy by endorsement ................................... 4.25 15 ✔ Itrazole Funded for tinea vesicolor where topical treatment has not been successful and diagnosis has been confirmed by mycology, or for tinea unguium where terbinafine has not been successful in eradication or the patient is intolerant to terbinafine and diagnosis has been confirmed by mycology and the prescription is endorsed accordingly. Can be waived by endorsement – Retail pharmacy - Specialist. Specialist must be an infectious disease specialist, clinical microbiologist or dermatologist.

87

87

88

89

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

32

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 April 2013 (continued)

89 KETOCONAZOLE Tab 200 mg – Retail pharmacy-Specialist ................................ 38.12 30 ✔ Nizoral Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist, clinical microbiologist, dermatologist, endocrinologist, or oncologist. DAPSONE – Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist, clinical microbiologist or dermatologist. Tab 25 mg .............................................................................. 95.00 100 ✔ Dapsone Tab 100 mg ......................................................................... 110.00 100 ✔ Dapsone ETHAMBUTOL HYDROCHLORIDE – Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist, clinical microbiologist or a respiratory specialist. Tab 100 mg ........................................................................... 48.01 56 ✔ Myambutol S29 Tab 400 mg ............................................................................ 49.34 90 56 ✔ Myambutol S29

90

90

ISONIAZID – Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an internal medicine specialist, clinical microbiologist, dermatologist or public health specialist. ❋ Tab 100 mg ........................................................................... 20.00 100 ✔ PSM ❋ Tab 100 mg with rifampicin 150 mg ........................................ 90.04 100 ✔ Rifinah ❋ Tab 150 mg with rifampicin 300 mg ...................................... 179.57 100 ✔ Rifinah PYRAZINAMIDE – Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist, clinical microbiologist or a respiratory specialist. ❋ Tab 500 mg – For pyrazinamide oral liquid formulation refer, page 179 .................................................................... 59.00 100 ✔ AFT-Pyrazinamide RIFABUTIN – Retail pharmacy-Specialist a) No patient co-payment payable b) Prescriptions must be written by, or on the recommendation of, an infectious diseases specialist, respiratory specialist or a gastroenterologist. ❋ Cap 150 mg – For rifabutin oral liquid formulation refer, page 179 ................................................................. 213.19 30 ✔ Mycobutin RIFAMPICIN – Retail pharmacy-Specialist Subsidy by endorsement a) No patient co-payment payable b) For confirmed recurrent Staphylococcus aureus infection in combination with other effective anti staphylococcal antimicrobial based on susceptibilities and the prescription is endorsed accordingly; can be waived by endorsement. – Retail pharmacy-Specialist. Specialist must be an internal medicine specialist, clinical microbiologist, dermatologist, paediatrician or public health specialist. ❋ Tab 600 mg .......................................................................... 114.40 30 ✔ Rifadin ❋ Cap 150 mg ........................................................................... 58.66 100 ✔ Rifadin ❋ Cap 300 mg .......................................................................... 122.36 100 ✔ Rifadin ❋ Oral liq 100 mg per 5 ml ......................................................... 12.66 60 ml ✔ Rifadin 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

90

90

91

33


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 April 2013 (continued)

97 NEVIRAPINE – Special Authority see SA1025 – Retail pharmacy – Brand switch fee payable (Pharmacode 2433249) - see page 177 for details Tab 200 mg ........................................................................... 95.94 60 ✔ Nevirapine Alphapharm INTERFERON ALPHA-2A – PCT – Retail pharmacy-Specialist a) Prescriptions must be written by, or on the recommendation of, an internal medicine specialist or ophthalmologist b) See prescribing guideline Inj 3 m iu prefilled syringe ....................................................... 31.32 1 ✔ Roferon-A Inj 6 m iu prefilled syringe ........................................................ 62.64 1 ✔ Roferon-A Inj 9 m iu prefilled syringe ....................................................... 93.96 1 ✔ Roferon-A INTERFERON ALPHA-2B – PCT – Retail pharmacy-Specialist a) Prescriptions must be written by, or on the recommendation of, an internal medicine specialist or ophthalmologist b) See prescribing guideline Inj 18 m iu, 1.2 ml multidose pen........................................... 187.92 1 ✔ Intron-A Inj 30 m iu, 1.2 ml multidose pen .......................................... 313.20 1 ✔ Intron-A Inj 60 m iu, 1.2 ml multidose pen .......................................... 626.40 1 ✔ Intron-A ORAL FEED 1.5KCAL/ML – Special Authority see SA1228 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube, or who have severe epidermolysis bullosa. The prescription must be endorsed accordingly. ORAL FEED WITH FIBRE 1.5 KCAL/ML – Special Authority see SA1228 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube, or who have severe epidermolysis bullosa. The prescription must be endorsed accordingly. ORAL FEED 2 KCAL/ML – Special Authority see SA1195 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube, or who have severe epidermolysis bullosa. The prescription must be endorsed accordingly.

100

100

198

198

199

Effective 1 March 2013

29 ACARBOSE – Brand switch fee payable (Pharmacode 2433486) - see page 177 for details ❋ Tab 50 mg ................................................................................ 9.82 90 ✔ Accarb ❋ Tab 100 mg ............................................................................ 15.83 90 ✔ Accarb BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and endorsed accordingly;or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4) Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5) Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. Blood glucose test strips – Note differing brand requirements below ............................................................ 28.75 50 test OP ✔ Accu-Chek Performa 28.75 50 test OP ✔ Freestyle Optium continued...

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

31

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

34


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 March 2013 (continued)

continued... a) Accu-Chek Performa brand: Special Authority see SA1294 – Retail pharmacy b) Freestyle Optium brand: Special Authority see SA1291 – Retail pharmacy

➽ SA1294 Special Authority for Subsidy Notes: Special Authority criteria and application details may be obtained from PHARMACs website http:/www.pharmac.govt.nz and can be sent to: PHARMAC PO Box 10 254 Facsimile: (04) 916 7571, Wellington, Email: bgstrips@pharmac.govt.nz ➽ SA1291 Special Authority for Subsidy Notes: Special Authority criteria and application details may be obtained from PHARMACs website http:/www.pharmac.govt.nz and can be sent to: PHARMAC PO Box 10 254, Facsimile: (04) 916 7571 Wellington, Email: bgstrips@pharmac.govt.nz 58 Phosphodiesterase Type 5 Inhibitors ➽ SA1086 Special Authority for Subsidy Special Authority approved by the Pulmonary Arterial Hypertension Panel Notes: Application details may be obtained from PHARMAC’s website http://www.pharmac.govt.nz or: The Coordinator, PAH Panel PHARMAC, PO Box 10-254, WELLINGTON Tel: (04) 916 7512, Fax: (04) 974 4858, Email: PAH@pharmac.govt.nz SILDENAFIL – Special Authority see SA12931086 – Retail pharmacy Tab 25 mg ............................................................................... 1.85 39.00 Tab 50 mg ................................................................................ 1.85 43.50 Tab 100 mg – For sildenafil oral liquid formulation refer, page 179 ............................................................................... 7.45 4 4 4 4 4 ✔ Silagra ✔ Viagra ✔ Silagra ✔ Viagra ✔ Silagra

➽ SA1293 Special Authority for Subsidy (Form name is sildenafil) Initial application – Raynaud’s phenomenon*. Applications from any relevant practitioner. Approvals valid without further renewal unless notified for patients meeting the following criteria: 1 Patient has Raynaud’s phenomenon; and 2 Patient has severe digital ischaemia (defined as severe pain requiring hospital admission or with a high likelihood of digital ulceration; digital ulcers; or gangrene); and 3 Patient is following lifestyle management (proper body insulation, avoidance of cold exposure, smoking cessation support, avoidance of sympathomimetic drugs); and 4 Patient has persisting severe symptoms despite treatment with calcium channel blockers and nitrates (unless contraindicated or not tolerated). Notes 1 Sildenafil is also funded for patients with Pulmonary Arterial Hypertension who are approved by the Pulmonary Arterial Hypertension Panel (an application must be made to the Panel). Application details may be obtained from: The Coordinator, PAH Panel PHARMAC, PO Box 10 254, Wellington Phone: (04) 916 7512 Facsimile: (04) 974 4858 Email: PAH@pharmac.govt.nz 2 Indications marked with an * are Unapproved Indications.

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

35


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 March 2013 (continued)

72 ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab 30 µg with levonorgestrel 150 µg and 7 inert tab................. 2.45 84 a) Brand switch fee payable (Pharmacode 2405865) - see page 177 for details b) Up to 84 tab available on a PSO ✔ Ava 30 ED

90

ETHAMBUTOL HYDROCHLORIDE – No patient co-payment payable (addition of S29 ) Tab 100 mg ............................................................................ 48.01 56 ✔ Myambutol S29 Tab 400 mg ........................................................................... 49.34 56 ✔ Myambutol S29

92

LAMIVUDINE – Special Authority see SA0832 – Retail pharmacy Tab 100 mg – Brand switch fee payable (Pharmacode 2433257) - see page 177 for details ............ 32.50

28

✔ Zetlam

98

ZIDOVUDINE [AZT] WITH LAMIVUDINE – Special Authority see SA1025– Retail pharmacy – Brand switch fee payable (Pharmacode 2433494) - see page 177 for details Note: zidovudine [AZT] with lamivudine (combination tablets) counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority. Tab 300 mg with lamivudine 150 mg ....................................... 63.50 60 ✔ Alphapharm ENTACAPONE – Brand switch fee payable (Pharmacode 2433249) - see page 177 for details s Tab 200 mg ............................................................................ 47.92 100 ✔ Entapone PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF CareSens N is 2423138 (BSF CareSens N Brand switch fee to be delisted 1 March July 2013) ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF CareSens II is 2423146 (BSF CareSens II Brand switch fee to be delisted 1 March July 2013) ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF CareSens N POP is 2423154 (BSF CareSens N POP Brand switch fee to be delisted 1 March July 2013) 1 fee 1 fee 1 fee ✔ BSF CareSens N ✔ BSF CareSens II ✔ BSF CareSens N POP

119 180

Effective 1 February 2013

52 CANDESARTAN – Special Authority see SA1223 – Retail pharmacy Brand switch fee payable (Pharmacode 2426781) - see page 177 for details Tab 4 mg .................................................................................. 4.13 Tab 8 mg .................................................................................. 6.10 Tab 16 mg .............................................................................. 10.18 Tab 32 mg ............................................................................. 17.66 90 90 90 90 ✔ Candestar ✔ Candestar ✔ Candestar ✔ Candestar

191

Paediatric Products for Children Awaiting Liver Transplant ➽ SA1098 Special Authority for Subsidy Initial application only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 3 years where the patient is a child (up to 18 years) who is awaiting liver transplant requires a liver transplant. 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 3 years for applications meeting the following criteria: continued... Both:

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

36

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

continued... 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted. 205 HIGH FAT LOW CARBOHYDRATE FORMULA WITH VITAMINS, MINERALS AND TRACE ELEMENTS AND LOW IN PROTEIN AND CARBOHYDRATE – Special Authority see SA1197 – Retail pharmacy Powder (vanilla) ...................................................................... 35.50 300 g OP ✔ KetoCal

Changes to Restrictions - effective 1 February 2013 (continued)

Changes to Restrictions - effective 1 January 2013

32 INSULIN PUMP – Special Authority see SA1237 – Retail pharmacy a) Only on a prescription b) Maximum of 1 insulin pump per prescription c) Maximum of 1 insulin pump per patient each four year period Flat panel, high contrast screen; compatible with standard luer lock infusion sets; waterproof at 12 feet for 24 hours; 0.025 u/hour basal rate; continuous glucose monitoring (CGM) enabled; Min basal rate 0.025 U/h; blue colour............................ 4,500.00 Flat panel, high contrast screen; compatible with standard luer lock infusion sets; waterproof at 12 feet for 24 hours; 0.025 u/hour basal rate; continuous glucose monitoring (CGM) enabled Min basal rate 0.025 U/h; silver colour .......................... 4,500.00 Flat panel, high contrast screen; compatible with standard luer lock infusion sets; waterproof at 12 feet for 24 hours; 0.025 u/hour basal rate; continuous glucose monitoring (CGM) enabled Min basal rate 0.025 U/h; pink colour............................ 4,500.00 Flat panel, high contrast screen; compatible with standard luer lock infusion sets; waterproof at 12 feet for 24 hours; 0.025 u/hour basal rate; continuous glucose monitoring (CGM) enabled Min basal rate 0.025 U/h; green colour ......................... 4,500.00 Flat panel, high contrast screen; compatible with standard luer lock infusion sets; waterproof at 12 feet for 24 hours; 0.025 u/hour basal rate; continuous glucose monitoring (CGM) enabled Min basal rate 0.025 U/h; black colour .......................... 4,500.00

1

✔ Animas Vibe

1

✔ Animas Vibe

1

✔ Animas Vibe

1

✔ Animas Vibe

1

✔ Animas Vibe

34

INSULIN PUMP INFUSION SET (STEEL CANNULA) – Special Authority see SA1240 – Retail Pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) 6 mm metal steel cannula; straight insertion; 60 cm grey line x 10 with 10 needles ................................. 130.00 1 OP ✔ Contact-D 8 mm metal steel cannula; straight insertion; 60 cm grey line x 10 with 10 needles.. ............................... 130.00 1 OP ✔ Contact-D 8 mm metal steel cannula; straight insertion; 110 cm grey line x 10 with 10 needles ............................... 130.00 1 OP ✔ Contact-D

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

37


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2013 (continued)

34 INSULIN PUMP INFUSION SET (TEFLON CANNULA, STRAIGHT INSERTION WITH INSERTION DEVICE) – Special Authority see SA1240 – Retail Pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) Teflon cannula straight insertion 6 mm; with auto injector; 6 mm Teflon cannula; straight insertion; Insertion device; 60 cm grey line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 6 mm; with auto injector; 6 mm Teflon cannula; straight insertion; Insertion device; 60 cm pink line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 6 mm; with auto injector; 6 mm Teflon cannula; straight insertion; Insertion device; 60 cm blue line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 9 mm; with auto injector; 9 mm Teflon cannula; straight insertion; Insertion device; 60 cm grey line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 9 mm; with auto injector; 9 mm Teflon cannula; straight insertion; Insertion device; 60 cm pink line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 9 mm; with auto injector; 9 mm Teflon cannula; straight insertion; Insertion device; 60 cm blue line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 6 mm; with auto injector; 6 mm Teflon cannula; straight insertion; Insertion device;110 cm grey line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II Teflon cannula straight insertion 9 mm; with auto injector; 9 mm Teflon cannula; straight insertion; Insertion device; 110 cm grey line x 10 with 10 needles ............................................ 140.00 1 OP ✔ Inset II INSULIN PUMP INFUSION SET (TEFLON CANNULA, ANGLE INSERTION) – Special Authority see SA1240 – Retail Pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) Teflon cannula angle insertion 13 mm; 13 mm Teflon cannula; angle insertion; 60 cm grey line x 5 with 10 needles ................................... 120.00 1 OP ✔ Comfort Short Teflon cannula angle insertion 17 mm; 17 mm Teflon cannula; angle insertion; 60 cm grey line x 5 with 10 needles ................................... 120.00 1 OP ✔ Comfort Teflon cannula angle insertion 17 mm; 17 mm Teflon cannula; angle insertion; 110 cm grey line x 5 with 10 needles ................................. 120.00 1 OP ✔ Comfort

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

34

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

38


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2013 (continued)

34 INSULIN PUMP INFUSION SET (TEFLON CANNULA, ANGLE INSERTION WITH INSERTION DEVICE) – Special Authority see SA1240 – Retail Pharmacy a) Maximum of 3 packs per prescription, b) Maximum of 1 prescription per 90 days. c) Only on a prescription Note: One additional pack of infusion sets will be funded per year (Maximum of 13 packs per annum) Teflon cannula angle insertion 13 mm with auto injector; 13 mm Teflon cannula; angle insertion; Insertion device; 60 cm grey line x 10 with 10 needles ..... 140.00 1 OP ✔ Inset 30 Teflon cannula angle insertion 13 mm with auto injector; 13 mm Teflon cannula; angle insertion; Insertion device; 60 cm pink line x 10 with 10 needles ..... 140.00 1 OP ✔ Inset 30 Teflon cannula angle insertion 13 mm with auto injector; 13 mm Teflon cannula; angle insertion; Insertion device; 60 cm blue line x 10 with 10 needles ..... 140.00 1 OP ✔ Inset 30 Teflon cannula angle insertion 13 mm with auto injector; 13 mm Teflon cannula; angle insertion; Insertion device; 110 cm grey line x 10 with 10 needles ... 140.00 1 OP ✔ Inset 30 FELODIPINE ❋ Tab long-acting 5 mg – Brand switch fee payable (Pharmacode 2430231) - see page 177 for details .................. 3.10 ❋ Tab long-acting 10 mg – Brand switch fee payable (Pharmacode 2430231) - see page 177 for details .................. 4.60

54

30 30

✔ Plendil ER ✔ Plendil ER

73

Antiandrogen Oral Contraceptives Prescribers may code prescriptions “contraceptive” (code “O”) when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: • $3.00 $5.00 prescription charge (patient co-payment) will apply. • prescription may be written for up to six months supply. Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the noncontraceptive period of supply. ie. Prescriptions may be written for up to three months supply BRIMONIDINE TARTRATE ❋ Eye Drops 0.2% – Brand switch fee payable (Pharmacode 2425823) - see page 177 for details .................... 6.45

176

5 ml OP

✔ Arrow-Brimonidine

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

39


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 April 2013

51 QUINAPRIL ( subsidy) ❋ Tab 5 mg ................................................................................. 1.15 ❋ Tab 10 mg ................................................................................ 1.55 ❋ Tab 20 mg ................................................................................ 2.11 OXYBUTYNIN ❋ Tab 5 mg ( subsidy) .............................................................. 11.20 ❋ Oral liq 5 mg per 5 ml ( subsidy)............................................ 56.45 BACLOFEN ( subsidy) ❋ Tab 10 mg – For baclofen oral liquid formulation refer, page 179 ...................................................................... 3.85 30 30 30 500 473 ml ✔ Accupril ✔ Accupril ✔ Accupril ✔ Apo-Oxybutynin ✔ Apo-Oxybutynin

75

118

100

✔ Pacifen

124

NORTRIPTYLINE HYDROCHLORIDE – Safety medicine; prescriber may determine dispensing frequency ( subsidy) Tab 10 mg ................................................................................ 4.00 100 ✔ Norpress Tab 25 mg ................................................................................ 9.00 180 ✔ Norpress

Effective 1 March 2013

30 BLOOD KETONE DIAGNOSTIC TEST METER ( subsidy) Meter funded for the purposes of blood ketone diagnostics only. Patient has had one or more episodes of ketoacidosis and is at risk of future episodes. Only one meter per patient will be subsidised every 5 years. Meter ...................................................................................... 40.00 1 ✔ Freestyle Optium KETONE BLOOD BETA-KETONE ELECTRODES – Maximum of 20 strip per prescription ( subsidy) Test strip – Not on a BSO ........................................................ 15.50 10 strip OP ✔ Freestyle Optium Ketone BLOOD GLUCOSE DIAGNOSTIC TEST STRIP ( subsidy) The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and endorsed accordingly;or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4) Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5) Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. Blood glucose test strips – Note differing brand requirements below ............................................................. 28.75 50 test OP ✔ Accu-Chek Performa 28.75 50 test OP ✔ Freestyle Optium a) Accu-Chek Performa brand: Special Authority see SA1294 – Retail pharmacy b) Freestyle Optium brand: Special Authority see SA1291 – Retail pharmacy DANTHRON WITH POLOXAMER – Only on a prescription ( subsidy) Note: Only for the prevention or treatment of constipation in the terminally ill. Oral liq 25 mg with poloxamer 200 mg per 5 ml ....................... 21.30 300 ml Oral liq 75 mg with poloxamer 1 g per 5 ml .............................. 43.60 300 ml

30

31

37

✔ Pinorax ✔ Pinorax Forte

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

40

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturers Price - effective 1 March 2013 (continued)

62 BETAMETHASONE VALERATE ( subsidy) ❋ Crm 0.1% .................................................................................. 3.50 ❋ Oint 0.1% .................................................................................. 3.50 CLOBETASOL PROPIONATE ( subsidy) ❋ Crm 0.05% ................................................................................ 3.68 ❋ Oint 0.05% ................................................................................ 3.68 BETAMETHASONE VALERATE ( subsidy) ❋ Scalp app 0.1% ........................................................................ 7.75 CLOBETASOL PROPIONATE ( subsidy) ❋ Scalp app 0.05% ....................................................................... 6.96 TRIMETHOPRIM ( subsidy) ❋ Tab 300 mg – Up to 30 tab available on a PSO .......................... 9.28 DICLOFENAC SODIUM ( subsidy) ❋ Tab EC 50 mg ........................................................................... 1.60 (2.13) BACLOFEN ( subsidy) ❋ Tab 10 mg – For baclofen oral liquid formulation refer, page 179 .............................................................................. 5.10 DOMPERIDONE ( subsidy) ❋ Tab 10 mg – For domperidone oral liquid formulation refer, page 179 ............................................................................... 3.25 (11.99) DOXORUBICIN – PCT only – Specialist ( subsidy) Inj 1 mg for ECP ........................................................................ 0.37 TAMOXIFEN CITRATE ( subsidy) ❋ Tab 10 mg .............................................................................. 17.50 PROMETHAZINE HYDROCHLORIDE ( subsidy) ❋‡ Oral liq 5 mg per 5 ml.............................................................. 2.79 (3.10) 50 g OP 50 g OP 30 g OP 30 g OP ✔ Beta Cream ✔ Beta Ointment ✔ Dermol ✔ Dermol

62

68 68 88 102

100 ml OP ✔ Beta Scalp 30 ml OP 50 50 Diclofenac Sandoz ✔ Dermol ✔ TMP

118

100

✔ Pacifen

131

100 Motilium 1 mg 100 100 ml Promethazine Winthrop Elixir ✔ Baxter ✔ Genox

151 160 166

Effective 1 February 2013

38 MICONAZOLE ( subsidy) Oral gel 20 mg per g ................................................................. 4.95 (8.70) PROTAMINE SULPHATE ( price) ❋ Inj 10 mg per ml, 5 ml ............................................................. 22.40 (101.61) BEZAFIBRATE ( subsidy) ❋ Tab 200 mg .............................................................................. 9.70 40 g OP Daktarin 10 Artex 90 ✔ Fibalip

44

47

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

41


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturers Price - effective 1 February 2013 (continued)

54 NADOLOL ( subsidy) ❋ Tab 40 mg .............................................................................. 15.57 ❋ Tab 80 mg .............................................................................. 23.74 DILTIAZEM HYDROCHLORIDE ( subsidy) ❋ Cap long-acting 120 mg ............................................................ 1.91 (4.34) ❋ Cap long-acting 180 mg ........................................................... 2.86 (6.50) ❋ Cap long-acting 240 mg ............................................................ 3.81 (8.67) ERYTHROMYCIN LACTOBIONATE ( subsidy) Inj 1 g ..................................................................................... 16.00 100 100 30 Cardizem CD 30 Cardizem CD 30 Cardizem CD 1 ✔ Erythrocin IV ✔ Apo-Nadolol ✔ Apo-Nadolol

55

85 85

AZITHROMYCIN ( subsidy) Maximum of 5 days treatment per prescription; can be waived by endorsement for the following patients: For Endorsement, patient has either: i) Received a lung transplant and requires treatment or prophylaxis for bronchiolitis obliterans syndrome *;or ii) Cystic fibrosis and has chronic infection with Pseudomonas aeruginosa or Pseudomonas related gram negative organisms * Indications marked with * are Unapproved Indications Tab 500 mg – Up to 8 tab available on a PSO ............................ 1.25 2 OP ✔ Arrow-Azithromycin PAMIDRONATE DISODIUM ( subsidy) Inj 3 mg per ml, 10 ml ............................................................ 16.00 (37.50) Inj 6 mg per ml, 10 ml ............................................................ 32.00 (75.00) Inj 9 mg per ml, 10 ml ............................................................ 48.00 (112.50) 1 Pamisol 1 Pamisol 1 Pamisol

115

125

MOCLOBEMIDE Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. ❋ Tab 150 mg ( subsidy) .......................................................... 81.83 500 ✔ Apo-Moclobemide ❋ Tab 300 mg ( subsidy) .......................................................... 29.51 100 ✔ Apo-Moclobemide DEXTROCHLORPHENIRAMINE MALEATE ( price) ❋ Tab 2 mg .................................................................................. 1.01 (5.99) 2.02 (8.40) GLYCERIN WITH SODIUM SACCHARIN – Only in combination ( subsidy) Only in combination with Ora-Plus. Suspension ............................................................................. 35.50 GLYCERIN WITH SUCROSE – Only in combination ( subsidy) Only in combination with Ora-Plus. Suspension ............................................................................. 35.50 20 Polaramine 40 Polaramine

165

183

473 ml

✔ Ora-Sweet SF

183

473 ml

✔ Ora-Sweet

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

42

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturers Price - effective 1 February 2013 (continued)

184 184 184 METHYLCELLULOSE ( subsidy) Suspension – Only in combination ........................................... 35.50 473 ml ✔ Ora-Plus

METHYLCELLULOSE WITH GLYCERIN AND SODIUM SACCHARIN – Only in combination ( subsidy) Suspension ............................................................................. 35.50 473 ml ✔ Ora-Blend SF METHYLCELLULOSE WITH GLYCERIN AND SUCROSE – Only in combination ( subsidy) Suspension ............................................................................ 35.50 473 ml ✔ Ora-Blend

Effective 1 January 2013

28 LANSOPRAZOLE ( subsidy) ❋ Cap 15 mg ................................................................................ 2.00 ❋ Cap 30 mg ................................................................................ 2.32 PREDNISOLONE SODIUM PHOSPHATE ( subsidy) ❋ Oral liq 5 mg per ml – Up to 30 ml available on a PSO .............. 10.45 Restricted to children under 12 years of age. NEVIRAPINE – Special Authority see SA1025 – Retail pharmacy ( subsidy) Tab 200 mg ............................................................................ 95.94 (319.80) LISURIDE HYDROGEN MALEATE ( subsidy) s Tab 200 µg ............................................................................ 25.00 PETHIDINE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable c) Safety medicine; prescriber may determine dispensing frequency Tab 50 mg ................................................................................ 3.95 Tab 100 mg .............................................................................. 5.80 28 28 30 ml OP ✔ Lanzol Relief ✔ Lanzol Relief ✔ Redipred

77

97

60 Viramune 30 ✔ Dopergin

119 123

10 10

✔ PSM ✔ PSM

124

AMITRIPTYLINE – Safety medicine; prescriber may determine dispensing frequency ( subsidy) Tab 10 mg ............................................................................... 1.66 50 (2.77) Amirol PHENOBARBITONE ( subsidy) For phenobarbitone oral liquid refer, page 185 ❋ Tab 15 mg .............................................................................. 28.00 ❋ Tab 30 mg .............................................................................. 29.00 PIZOTIFEN ( subsidy) ❋ Tab 500 µg ............................................................................. 23.21 CARBOPLATIN – PCT only – Specialist ( subsidy) Inj 1 mg for ECP ........................................................................ 0.13 CISPLATIN – PCT only – Specialist ( susidy) Inj 1 mg per ml, 50 ml ............................................................. 15.00 Inj 1 mg per ml, 100 ml .......................................................... 21.00

129

500 500 100 1 mg 1 1

✔ PSM ✔ PSM ✔ Sandomigran ✔ Baxter ✔ DBL Cisplatin ✔ DBL Cisplatin

131 148 148

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

43


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturers Price - effective 1 January 2013 (continued)

160 165 MEGESTROL ACETATE – Retail pharmacy-Specialist ( subsidy) Tab 160 mg ............................................................................ 51.55 (57.92) CYCLOSPORIN ( subsidy) Cap 25 mg ............................................................................. 44.63 Cap 50 mg .............................................................................. 88.91 Cap 100 mg ......................................................................... 177.81 30 Megace 50 50 50 ✔ Neoral ✔ Neoral ✔ Neoral

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

44

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules

Effective 1 April 2013

19 3.3 Original Packs, and Certain Antibiotics and Unapproved Medicines 3.3.2 If a Community Pharmaceutical is either: a) the liquid oral form of an antibiotic to which a diluent must be added by the Contractor at the time of dispensing; or b) an unapproved medicine supplied under section 29 of the Medicines Act 1981, and it is prescribed or ordered by a Practitioner in an amount that does not coincide with the amount contained in one or more standard packs of that Community Pharmaceutical, Subsidy will be paid for the amount prescribed or ordered by the Practitioner in accordance with either clause 3.1 or clause 3.3 of the Schedule, and for the balance of any pack or packs from which the Community Pharmaceutical has been dispensed. At the time of dispensing the Contractor must keep a record of the quantity discarded. To ensure wastage is reduced, the Contractor should reduce the amount dispensed to make it equal to the quantity contained in a whole pack where: a) the difference the amount dispensed and the amount prescribed by the Practitioner is less than 10% (eg; if a prescription is for 105 mls then a 100 ml pack would be dispensed); and b) in the reasonable opinion of the Contractor the difference would not affect the efficacy of the course of treatment prescribed by the Practitioner. Note: For the purposes of audit and compliance it is an act of fraud to claim wastage and then use the wastage amount for any subsequent prescription.

Effective 1 January 2013

9 Patient costs Community Pharmaceutical costs met by the Government Most of the cost of a subsidised prescription Community Pharmaceutical is met by the Government through the Pharmaceutical Budget. The Government pays a subsidy for the Community Pharmaceutical to Contractors, and a fee covering distribution and pharmacy dispensing services. The subsidy paid to Contractors does not necessarily represent the final cost to Government of subsidising a particular Community Pharmaceutical. The final cost will depend on the nature of PHARMAC’s contractual arrangements with the supplier. Fully subsidised medicines are identified with a √ in the product’s Schedule listing. SALBUTAMOL Aerosol inhaler 100 µg per dose ................................................ 3.80 ✔ Fully subsidised brand (6.00) Higher priced brand Pharmaceutical Co-Payments Some Community Pharmaceutical costs are met by the patient. Generally a patient pays a prescription charge. In addition a patient will sometimes pay a manufacturer’s surcharge, after hours service fee and any special packaging fee. PRESCRIPTION CHARGE From 1 September 2008 1 January 2013, everyone who is eligible for publicly funded health and disability services should in most circumstances pay only $3 $5 for subsidised medicines. All prescriptions from a public hospital, a midwife and a Family Planning Clinic are covered for $3 $5 co-payments. Prescriptions from the following providers are approved for $3 $5 co-payments on subsidised medicines if they meet the specified criteria: • After Hours Accident and Medical Services with a DHB or a PHO contract. • Youth Health Clinics with a DHB or a PHO contract. • Dentists who write a prescription that relates to a service being provided under a DHB contract. • Private specialists (for example, opthalmologists and orthopaedics) who write a prescription for a patient receiving a publicly funded service contracted by the DHB. • General practitioners who write a prescription during normal business hours to a person who is not enrolled in the general practice provided the person is eligible for publicly funded health and disability services and the general practice is part of a PHO. 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

45


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules - effective 1 January 2013 (continued)

continued... • Hospices that have a contract with a DHB. Patients can check whether they are eligible for publicly funded health and disability services by referring to the Eligibility Direction on the Ministry of Health’s website. To check if a medicine is fully subsidised, refer to the Pharmaceutical Schedule on PHARMAC’s website or ask your pharmacist or general practitioner. DHBs have a list of eligible providers in their respective regions. Any provider/prescriber not specifically listed by a DHB as an approved provider/prescriber should be regarded as not approved. NOTE: Information sourced from Ministry of Health Website, for more information please visit www.moh.govt.nz

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

46

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Brand Name

Effective 1 April 2013

205 HIGH FAT LOW CARBOHYDRATE FORMULA – Special Authority see SA1197 – Retail pharmacy Powder (vanilla) ...................................................................... 35.50 300 g OP ✔ KetoCal 4:1

Effective 1 January 2013

148 CISPLATIN – PCT only – Specialist Inj 1 mg per ml, 50 ml ............................................................. 15.00 Inj 1 mg per ml, 100 ml .......................................................... 21.00 1 1 ✔ Mayne DBL Cisplatin ✔ Mayne DBL Cisplatin

Changes to PSO

Effective 1 January 2013

209 PENICILLIN G BENZATHINE [BENZATHINE BENZYLPENICILLIN] ✔ Inj 1.2 mega u per 2 ml 5

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

47


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Section I

Effective 1 April 2013

217 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] Inj ........................................................................................... 90.00 ✔ Fluarix ✔ Fluvax A) is available each year for patients who meet the following criteria, as set by PHARMAC: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii) children aged four and under who have been hospitalised for respiratory illness or have a history of significant respiratory illness. iii) iv) diabetes; iv) v) chronic renal disease; v) vi) any cancer, excluding basal and squamous skin cancers if not invasive; vi) vii) the following other conditions: a) autoimmune disease, b) immune suppression, c) HIV, d) transplant recipients, e) neuromuscular and CNS diseases, f) haemoglobinopathies, or g) children on long term aspirin. h) pregnancy. c) people under 18 years of age living within the boundaries of the Canterbury District Health Board 10

The following conditions are excluded from funding: a) asthma not requiring regular preventative therapy, b) hypertension and/or dyslipidaemia without evidence of end-organ disease. B) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. C) Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor. D) Stock of the seasonal influenza vaccine is typically available from February until late July with suppliers being required to ensure supply until at least 30 June. Exact start and end dates for each season will be notified each year.

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

48

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Section I – effective 1 February 2013

216 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] A) is available 1 March until vaccine supplies are exhausted each year for patients who meet the following criteria, as set by the Ministry of Health PHARMAC: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii)diabetes; iv)chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi)the following other conditions: a) autoimmune disease, b) immune suppression, c) HIV, d) transplant recipients, e) neuromuscular and CNS diseases, f) haemoglobinopathies, g) children on long term aspirin, or h) pregnancy. c) people under 18 years of age living within the boundaries of the Canterbury District Health Board. The following conditions are excluded from funding: a) asthma not requiring regular preventative therapy, b) hypertension and/or dyslipidaemia without evidence of end-organ disease. B) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. C) Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor. D) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. D) Stock of the seasonal influenza vaccine is typically available from February until late July with suppliers being required to ensure supply until at least 30 June. Exact start and end dates for each season will be notified each year.

Effective 1 January 2013

217 DIPHTHERIA, TETANUS AND PERTUSSIS VACCINE – Hospital pharmacy [Xpharm] For children aged 11 years old and pregnant women between gestational weeks 28 and 38 during epidemics Inj 0.5 ml................................................................................... 0.00 1 ✔ Boostrix

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

49


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 April 2013

27 FAMOTIDINE – Only on a prescription ❋ Tab 20 mg ................................................................................ 8.10 ❋ Tab 40 mg .............................................................................. 11.35 250 250 ✔ Famox ✔ Famox

31

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and endorsed accordingly;or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed;or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4) Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5) Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. Blood glucose test strips × 50 and lancets × 5 ..................... 10.56 50 test OP ✔ CareSens LANSOPRAZOLE ❋ Cap 15 mg ................................................................................ 2.00 ❋ Cap 30 mg ............................................................................... 2.32 LISINOPRIL ❋ Tab 5 mg .................................................................................. 1.19 ❋ Tab 10 mg ............................................................................... 1.36 ❋ Tab 20 mg ............................................................................... 1.63 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg ............................................................................. 28.07 Cap 20 mg ............................................................................. 43.37 HYDROGEN PEROXIDE ❋ Crm 1% ..................................................................................... 8.56 NEVIRAPINE – Special Authority see SA1025 – Retail pharmacy Tab 200 mg ........................................................................... 95.94 (319.80) 28 28 30 30 30 180 180 10 g OP 60 Viramune ✔ Lanzol Relief ✔ Lanzol Relief ✔ Arrow-Lisinopril ✔ Arrow-Lisinopril ✔ Arrow-Lisinopril ✔ Oratane ✔ Oratane ✔ Crystacide

28

50

59

60 97

124

AMITRIPTYLINE – Safety medicine; prescriber may determine dispensing frequency Tab 10 mg ................................................................................ 1.66 50 (2.77) MEGESTROL ACETATE – Retail pharmacy-Specialist Tab 160 mg ............................................................................ 51.55 (57.92) PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 30

Amirol

159

Megace 1 fee ✔ BSF Plendil ER

178 202

PREMATURE BIRTH FORMULA – Special Authority see SA1221 – Hospital pharmacy [HP3] Liquid ........................................................................................ 0.75 100 ml OP ✔ S26LBW Gold RTF

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

50

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 March 2013

29 ACARBOSE ❋ Tab 50 mg ................................................................................ 9.82 ❋ Tab 100 mg ............................................................................ 15.83 90 90 ✔ Glucobay ✔ Glucobay

31

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1. Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2. Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3. Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4. Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5. Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. Blood glucose test strips ......................................................... 21.65 50 test OP ✔ FreeStyle Lite Blood glucose test strips × 50 and lancets × 5 ...................... 19.10 50 test OP ✔ On Call Advanced MACROGOL 3350 – Special Authority see SA0891 – Retail pharmacy Powder 13.125 g, sachets – Maximum of 60 sach per prescription ................................................................... 10.00 (18.14) CHLORHEXIDINE GLUCONATE Mouthwash 0.2% ...................................................................... 2.68 (3.87) CILAZAPRIL ❋ Tab 0.5 mg .............................................................................. 0.95 ENALAPRIL ❋ Tab 5 mg .................................................................................. 1.07 ❋ Tab 10 mg ................................................................................ 1.32 ❋ Tab 20 mg – For enalapril oral liquid formulation refer, page 179 ............................................................................... 1.72 LAMIVUDINE – Special Authority see SA0832– Retail pharmacy Tab 100 mg ............................................................................ 32.50 (143.00)

36

30 Movicol 200 ml OP Rivacol 30 9 90 90 28 Zeffix ✔ Zapril ✔ Arrow-Enalapril ✔ Arrow-Enalapril ✔ Arrow-Enalapril

37

50 50

92

98

ZIDOVUDINE [AZT] WITH LAMIVUDINE – Special Authority see SA1025 – Retail pharmacy Zidovudine [AZT] with lamivudine counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority. Tab 300 mg with lamivudine 150 mg ....................................... 63.50 60 (667.20) Combivir

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

51


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items – effective 1 March 2013 (continued)

103 LEFLUNOMIDE ❋ Tab 10 mg .............................................................................. 55.00 ❋ Tab 20 mg .............................................................................. 76.00 ENTACAPONE s Tab 200 mg ............................................................................ 47.92 (116.00) OXYCODONE HYDROCHLORIDE a) Only on a controlled drug form b) See prescribing guideline below c) No patient co-payment payable d) Safety medicine; prescriber may determine dispensing frequency Inj 10 mg per ml, 1 ml ............................................................... 9.93 Inj 10 mg per ml, 2 ml ............................................................. 19.87 SODIUM CROMOGLYCATE Aerosol inhaler, 5 mg per dose CFC-free .................................. 28.07 FLUOROMETHOLONE ❋ Eye drops 0.1% ......................................................................... 3.80 (4.05) PHARMACY SERVICES – may only be claimed once per patient Brand switch fee........................................................................ 4.33 30 30 100 Comtan ✔ AFT-Leflunomide ✔ AFT-Leflunomide

119

123

5 5

✔ OxyNorm ✔ OxyNorm

170 174

112 dose OP ✔ Vicrom 5 ml OP FML 1 fee ✔ BSF Ava 30 ED

177

Effective 1 February 2013

61 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP ..................................................................... 1.77 (2.78) AMOXYCILLIN CLAVULANATE Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml – Up to 200 ml available on a PSO............ 1.61 (2.20) Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml – Up to 200 ml available on a PSO.............. 2.19 (3.85) AURANOFIN Tab 3 mg ................................................................................ 68.99 FLUTICASONE PROPIONATE Metered aqueous nasal spray, 50 µg per dose ........................... 2.30 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33

100 g healthE

86

100 ml Curam 100 ml Curam 60 ✔ Ridaura

103 171

120 dose OP ✔ Flixonase Hayfever & Allergy 1 fee ✔ BSF Candestar

180

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

52

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 2013

30 METFORMIN HYDROCHLORIDE ❋ Tab immediate-release 500 mg.................................................. 6.15 500 ✔ Apotex ❋ Tab immediate-release 850 mg.................................................. 5.05 250 ✔ Apotex Note – Apotex tab immediate-release 500 mg, 1,000 mg tab pack, and 850 mg, 500 tab pack, remain subsidised. DABIGATRAN Cap 110 mg .......................................................................... 148.00 60 ✔ Pradaxa Cap 150 mg .......................................................................... 148.00 60 ✔ Pradaxa Note – these are the bottles Pharmacode 2377578 (110 mg cap) and 2377551 (150 mg cap) ATORVASTATIN ❋ Tab 10 mg ................................................................................ 0.84 (18.32) ❋ Tab 20 mg ................................................................................ 1.39 (26.70) ❋ Tab 40 mg ................................................................................ 2.44 (37.02) ❋ Tab 80 mg ................................................................................ 5.41 (110.50) 50 PHENTOLAMINE MESYLATE ❋ Inj 10 mg per ml, 1 ml ............................................................. 17.97 (31.65) FELODIPINE ❋ Tab long-acting 5 mg ................................................................ 9.30 ❋ Tab long-acting 10 mg ............................................................ 13.80 NANDROLONE DECANOATE Inj 50 mg per ml, 1 ml ............................................................. 21.16 TESTOSTERONE UNDECANOATE – Retail pharmacy- Specialist Cap 40 mg .............................................................................. 51.95 5 Regitine 90 90 1 ✔ Felo 5 ER ✔ Felo 10 ER ✔ Deca-Durabolin Orgaject S29 ✔ Arrow-Testosterone ✔ Solu-Medrol ✔ Solu-Medrol 30 30 30 30 ✔ Dr Reddy’s Atorvastatin Lipitor ✔ Dr Reddy’s Atorvastatin Lipitor ✔ Dr Reddy’s Atorvastatin Lipitor ✔ Dr Reddy’s Atorvastatin Lipitor

44

48

54

76

77 77

100

METHYLPREDNISOLONE SODIUM SUCCINATE – Retail pharmacy – Specialist Inj 40 mg per ml, 1 ml ........................................................... 151.40 25 Inj 62.5 mg per ml, 2 ml ........................................................ 412.59 25 FLUCLOXACILLIN SODIUM Cap 250 mg – Up to 30 caps available on a PSO ..................... 22.00 (32.00) Cap 500 mg ........................................................................... 74.00 (110.00) 250

86

AFT 500 AFT

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

53


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 2013 (continued)

152 DOCETAXEL – PCT only - Specialist Inj 20 mg .............................................................................. 460.00 Inj 80 mg ........................................................................... 1,650.00 LETROZOLE ❋ Tab 2.5 mg .............................................................................. 4.85 (9.00) PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 1 1 30 Letara 1 fee ✔ BSF ArrowBrimonidine ✔ Taxotere ✔ Taxotere

161

178

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

54

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 May 2013

38 MICONAZOLE Oral gel 20 mg per g ................................................................. 4.95 (8.70) DILTIAZEM HYDROCHLORIDE Cap long-acting 120 mg ............................................................ 1.91 (4.34) Cap long-acting 180 mg ........................................................... 2.86 (6.50) Cap long-acting 240 mg ............................................................ 3.81 (8.67) SILDENAFIL – Special Authority see SA1086 – Retail pharmacy Tab 25 mg .............................................................................. 39.00 Tab 50 mg .............................................................................. 43.50 Tab 100 mg – For sildenafil oral liquid formulation refer, page 179 ............................................................................. 47.00 40 g OP Daktarin 30 Cardizem CD 30 Cardizem CD 30 Cardizem CD 4 4 4 ✔ Viagra ✔ Viagra ✔ Viagra

55

58

85

AZITHROMYCIN Maximum of 5 days treatment per prescription; can be waived by endorsement for the following patients: For Endorsement, patient has either: i) Received a lung transplant and requires treatment or prophylaxis for bronchiolitis obliterans syndrome *;or ii) Cystic fibrosis and has chronic infection with Pseudomonas aeruginosa or Pseudomonas related gram negative organisms * Indications marked with * are Unapproved Indications Tab 500 mg – Up to 8 tab available on a PSO ............................ 1.25 2 OP ✔ Arrow-Azithromycin PAMIDRONATE DISODIUM Inj 3 mg per ml, 10 ml ............................................................ 16.00 (37.50) Inj 6 mg per ml, 10 ml ............................................................ 32.00 (75.00) Inj 9 mg per ml, 10 ml ............................................................ 48.00 (112.50) 1 Pamisol 1 Pamisol 1 Pamisol ✔ Neocate Advance

115

204

AMINO ACID FORMULA – Special Authority see SA1219 – Hospital pharmacy [HP3] Powder (tropical)..................................................................... 53.00 400 g OP

Effective 1 June 2013

47 102 BEZAFIBRATE ❋ Tab 200 mg .............................................................................. 9.70 DICLOFENAC SODIUM ❋ Tab EC 25 mg ........................................................................... 1.63 ❋ Tab EC 50 mg .......................................................................... 1.60 (2.13) 90 50 50 ✔ Fibalip ✔ Diclofenac Sandoz Diclofenac Sandoz

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

55


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 June 2013 (continued)

131 DOMPERIDONE ❋ Tab 10 mg – For domperidone oral liquid formulation refer, page 179 ............................................................................... 3.25 (11.99) PROMETHAZINE HYDROCHLORIDE ❋‡ Oral liq 5 mg per 5 ml ............................................................. 2.79 (3.10) PHARMACY SERVICES ❋ Brand switch fee........................................................................ 4.33 100 Motilium 100 ml Promethazine Winthrop Elixir 1 fee ✔ BSF Zetlam ✔ BSF Alphapharm ✔ BSF Entapone ✔ BSF Accarb

166

177

Effective 1 July 2013

28 51 PANTOPRAZOLE ❋ Inj 40 mg ................................................................................. 6.50 QUINAPRIL ❋ Tab 5 mg ................................................................................. 1.15 ❋ Tab 10 mg ................................................................................ 1.55 ❋ Tab 20 mg ................................................................................ 2.11 PROPRANOLOL ❋ Tab 10 mg ................................................................................ 3.55 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP ..................................................................... 1.77 1 30 30 30 100 ✔ Pantocid IV ✔ Accupril ✔ Accupril ✔ Accupril ✔ Cardinol

54 61

100 g

✔ Home Essential

63

METHYLPREDNISOLONE SODIUM SUCCINATE – Retail pharmacy-Specialist Inj 500 mg ............................................................................. 18.00 1 ✔ Solu-Medrol Note – this discontinuation applies only to Pharmacode 265349. The preservative free presentation remains listed. LEVODOPA WITH CARBIDOPA ❋ Tab 100 mg with carbidopa 25 mg – For levodopa with carbidopa oral liquid formulation refer, page 180 ................. 20.00 100 ❋ Tab long-acting 200 mg with carbidopa 50 mg ....................... 47.50 100 ❋ Tab 250 mg with carbidopa 25 mg ......................................... 40.00 100 Note – new presentations of Sinemet and Sinemet CR were listed 1 January 2013.

119

✔ Sinemet ✔ Sinemet CR ✔ Sinemet

127

GABAPENTIN Cap 100 mg .............................................................................. 7.16 100 ✔ Nupentin Cap 300 mg ............................................................................ 11.50 100 ✔ Nupentin Note – the Nupentin capsules in the blister pack are to be delisted. The Nupentin capsules in bottles will remain listed as fully funded.

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

56


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 2013 (continued)

177 PHARMACY SERVICES - May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 1 fee ✔ BSF CareSens N ✔ BSF CareSens II ✔ BSF CareSens N POP ✔ BSF Nevirapine Alphapharm ✔ Neocate

204

AMINO ACID FORMULA – Special Authority see SA1219 – Hospital pharmacy [HP3] Powder .................................................................................. 53.00 400 g OP

Effective 1 August 2013

97 191 ETRAVIRINE – Special Authority see SA1025 – Retail pharmacy Tab 100 mg .......................................................................... 770.00 120 ✔ Intelence

ENTERAL/ORAL FEED 1KCAL/ML – Special Authority see SA1098 – Hospital pharmacy [HP3] Powder ................................................................................... 78.97 400 g OP ✔ Generaid Plus

Effective 1 September 2013

31 32 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ❋ 29 g × 12.7 mm ..................................................................... 10.50 100 ✔ ABM

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE – Maximum of 100 dev per prescription ❋ Syringe 0.3 ml with 29 g × 12.7 mm needle ........................... 13.00 100 ✔ ABM ❋ Syringe 0.5 ml with 29 g × 12.7 mm needle ........................... 13.00 100 ✔ ABM ❋ Syringe 0.5 ml with 31 g × 8 mm needle ................................ 13.00 100 ✔ ABM

Effective 1 October 2013

56 71 CHLORTHALIDONE Tab 25 mg ............................................................................... 4.80 ETHINYLOESTRADIOL WITH DESOGESTREL Tab 20 µg with desogestrel 150 µg .......................................... 6.62 (16.50) a) Higher subsidy of $13.80 per 63 tab with Special Authority see SA0500 b) Up to 63 tab available on a PSO Tab 30 µg with desogestrel 150 µg ........................................... 6.62 (16.50) a) Higher subsidy of $13.80 per 63 tab with Special Authority see SA0500 b) Up to 63 tab available on a PSO 30 63 Mercilon 21 63 Marvelon 21 ✔ Igroton S29

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

57


Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 April 2013

18 19 19 24 BACLOFEN ( price and addition of HSS) Tab 10 mg - 1% DV Jun-13 to 2016.......................................... 3.85 BENZBROMARONE Tab 100 mg ............................................................................ 45.00 BISMUTH TRIOXIDE Tab 120 mg ............................................................................ 32.50 CHLORTHALIDONE (delisting) Tab 25 mg ................................................................................ 4.80 Note – Igroton tab 25 mg to be delisted from 1 June 2013 DIAZOXIDE Cap 25 mg ............................................................................ 110.00 Cap 100 mg .......................................................................... 280.00 DOCETAXEL (new listing and change to HSS) Inj 20 mg – 1% DV Sep-11 to 30 April 2013 ............................ 48.75 Inj 20 mg – 1% DV May-13 to 2014 ........................................ 48.75 Inj 80 mg – 1% DV Sep-11 to 30 April 2013 .......................... 195.00 Inj 80 mg – 1% DV May-13 to 2014 ...................................... 195.00 GLYCERYL TRINITRATE Oint 0.2% ................................................................................ 22.00 HIGH FAT LOW CARBOHYDRATE FORMULA Powder (vanilla) (amendment to brand name) .......................... 35.50 Powder (unflavoured) .............................................................. 35.50 NITAZOXANIDE Tab 500 mg ........................................................................ 1680.00 NORTRIPTYLINE HYDROCHLORIDE ( price and addition of HSS) Tab 10 mg - 1% DV Jun-13 to 2016.......................................... 4.00 Tab 25 mg - 1% DV Jun-13 to 2016.......................................... 9.00 OXYBUTYNIN (addition of HSS) Tab 5 mg - 1% DV Jun-13 to 2016 ( price)............................ 11.20 Oral liq 5 mg per 5 ml - 1% DV Jun-13 to 2016 ( price) ......... 56.45 PARA-AMINO SALICYLIC ACID Grans for oral liq 4 g sachet ................................................... 280.00 PAROMOMYCIN Cap 250 mg .......................................................................... 126.00 PEGASPARGASE Inj 3,750 IU per 5 ml........................................................... 3,005.00 Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated 100 100 112 30 Pacifen Benzbromaron De-Nol Igroton

28

100 100 1 1 1 1 30g 300 g 300 g 30 100 180 500 473 ml 30 16 1

Proglicem Proglicem Docetaxel Ebewe Docetaxel Sandoz Docetaxel Ebewe Docetaxel Sandoz Rectogesic KetoCal 4:1 KetoCal 3:1 Alinia Norpress Norpress Apo-Oxybutynin Apo-Oxybutynin Paser Humatin Oncaspar

29

37 37

50 50

52

53 53 53

58


Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II – effective 1 April 2013 (continued)

56 63 63 PROTIONAMIDE Tab 250 mg .......................................................................... 305.00 TETRACYCLINE Cap 500 mg ............................................................................ 46.00 STIRIPENTOL Cap 250 mg .......................................................................... 509.29 Powder for oral liq 250 mg sachet ......................................... 509.29 100 30 60 60 Peteha Tetracyclin Wolff Diacomit Diacomit

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

59


Index

Pharmaceuticals and brands Symbols 50X 3.0 Reservoir .............................................. 27 A Acarbose ..................................................... 34, 51 Accarb ............................................................... 34 Accu-Chek Performa .................................... 34, 40 AFT-Leflunomide ................................................ 52 Albendazole ....................................................... 22 Accupril ....................................................... 40, 56 AFT-Pyrazinamide .............................................. 33 Alinia ................................................................. 58 Alphapharm ....................................................... 36 Amino acid formula ...................................... 55, 57 Amirol .......................................................... 43, 50 Amitriptyline ................................................. 43, 50 Amoxycillin clavulanate ...................................... 52 Animas Vibe....................................................... 37 Apo-Diclo........................................................... 31 Apo-Moclobemide.............................................. 42 Apo-Nadolol ....................................................... 42 Apo-Oxybutynin ........................................... 40, 58 Apo-Selegiline S29 ............................................. 24 Apotex ............................................................... 53 Arrow-Azithromycin ..................................... 42, 55 Arrow-Brimonidine ............................................. 39 Arrow-Doxorubicin ............................................. 31 Arrow-Enalapril .................................................. 51 Arrow-Lisinopril ................................................. 50 Arrow-Quinapril 5 ............................................... 26 Arrow-Quinapril 10 ............................................. 26 Arrow-Quinapril 20 ............................................. 26 Arrow-Testosterone ........................................... 53 Arrow-Venlafaxine XR......................................... 27 Artex .................................................................. 41 Atenolol ............................................................. 26 Atenolol AFT ...................................................... 26 Atorvastatin........................................................ 53 Auranofin ........................................................... 52 Ava 30 ED.......................................................... 36 Avonex Pen ........................................................ 31 Azathioprine ....................................................... 27 Azithromycin ................................................ 42, 55 B Baclofen ................................................ 40, 41, 58 Benzbromaron ............................................. 24, 58 Benzbromarone ............................................ 24, 58 Beta Cream ........................................................ 41 Betamethasone valerate ..................................... 41 Beta Ointment .................................................... 41 Beta Scalp ......................................................... 41 Bezafibrate ............................................. 30, 41, 55 Bezalip ............................................................... 30 Bicillin LA........................................................... 30 Biltricide............................................................. 22 Bismuth trioxide ........................................... 21, 58 Blood glucose diagnostic test strip ... 34, 40, 50, 51 Blood ketone diagnostic test meter ..................... 40 Boostrix ............................................................. 49 Brimonidine tartrate ............................................ 39 BSF Accarb .................................................. 26, 56 BSF Alphapharm .......................................... 26, 56 BSF Arrow-Brimonidine ...................................... 54 BSF Ava 30 ED................................................... 52 BSF Candestar ................................................... 52 BSF CareSens II ........................................... 36, 57 BSF CareSens N ........................................... 36, 57 BSF CareSens N POP ................................... 36, 57 BSF Entapone .............................................. 26, 56 BSF Nevirapine Alphapharm ......................... 25, 57 BSF Plendil ER ............................................. 31, 50 BSF Zetlam .................................................. 26, 56 C Calamine...................................................... 52, 56 Calcitriol ............................................................ 30 Calcitriol-AFT ..................................................... 30 Calamine............................................................ 30 Candesartan....................................................... 36 Candestar .......................................................... 36 Capsaicin ........................................................... 26 Carboplatin ........................................................ 43 Cardinol ............................................................. 56 Cardizem CD ................................................ 42, 55 CareSens ........................................................... 50 Chlorhexidine gluconate ..................................... 51 Chlorthalidone .................................................... 58 Cilazapril ............................................................ 51 Cipflox ............................................................... 32 Ciprofloxacin ...................................................... 32 Ciprofloxacin Rex ............................................... 32 Cisplatin....................................................... 43, 47 Clindamycin ....................................................... 32 Clindamycin ABM............................................... 32 Clobetasol propionate......................................... 41 Clofazimine ........................................................ 23 Combivir ............................................................ 51 Comfort ............................................................. 38 Comfort Short .................................................... 38 Contact-D .......................................................... 37 Comtan .............................................................. 52 Crystacide.......................................................... 50 Curam ............................................................... 52 Cycloserine ........................................................ 23 Cyclosporin........................................................ 44 D

60


Index

Pharmaceuticals and brands Dabigatran ......................................................... 53 Daktarin ....................................................... 41, 55 Dalacin C ........................................................... 32 Danthron with poloxamer.................................... 40 Dapsone ............................................................ 33 Daraprim............................................................ 22 DBL Cisplatin ............................................... 43, 47 Deca-Durabolin Orgaject .................................... 53 De-Nol ......................................................... 21, 58 Dermol............................................................... 41 Dextrochlorpheniramine maleate ......................... 42 Diacomit ...................................................... 24, 59 Diazoxide ..................................................... 21, 58 Diclofenac Sandoz ....................................... 41, 55 Diclofenac sodium ................................. 31, 41, 55 Diltiazem hydrochloride ................................ 42, 55 Diphtheria, tetanus and pertussis vaccine ........... 49 Docetaxel ............................................... 25, 54, 58 Docetaxel Ebewe ................................................ 58 Docetaxel Sandoz......................................... 25, 58 Domperidone ......................................... 31, 41, 56 Dopergin ............................................................ 43 Doxorubicin ................................................. 31, 41 Dr Reddy’s Atorvastatin...................................... 53 Dr Reddy’s Pramipexole ..................................... 26 E Efavirenz ............................................................ 24 Enalapril ............................................................. 51 Entacapone .................................................. 36, 52 Entapone ........................................................... 36 Enteral/oral feed 1kcal/ml ............................. 27, 57 Erythrocin IV ...................................................... 42 Erythromycin lactobionate .................................. 42 Eskazole ............................................................ 22 Ethambutol hydrochloride ............................. 33, 36 Ethinyloestradiol with levonorgestrel ................... 36 Ethinyloestradiol with desogestrel ....................... 57 Etravirine............................................................ 57 F Famotidine ......................................................... 50 Famox................................................................ 50 Felo 5 ER ........................................................... 53 Felo 10 ER ......................................................... 53 Felodipine .............................................. 32, 39, 53 Fibalip .......................................................... 41, 55 Flixonase Hayfever & Allergy ........................ 27, 52 Fluarix ................................................................ 48 Flucloxacillin sodium .................................... 26, 53 Fluorometholone ................................................ 52 Flutamide ........................................................... 26 Flutamin S29...................................................... 26 Fluticasone propionate ................................. 27, 52 Fluvax ................................................................ 48 FML ................................................................... 52 FreeStyle Lite ..................................................... 51 Freestyle Optium .......................................... 34, 40 Freestyle Optium Ketone ..................................... 40 Fucidin ............................................................... 32 Fusidic acid........................................................ 32 G Gabapentin ........................................................ 56 Generaid Plus..................................................... 57 Genox ................................................................ 41 Gentamicin sulphate ........................................... 25 Glucobay ........................................................... 51 Glycerin with sodium saccharin .......................... 42 Glycerin with sucrose ......................................... 42 Glyceryl trinitrate .......................................... 21, 58 H Heparon Junior .................................................. 27 High fat low carbohydrate formula .... 25, 37, 47, 58 Home Essential .................................................. 56 Humatin ....................................................... 22, 58 Hydralazine ........................................................ 22 Hydralazine hydrochloride .................................. 22 Hydrogen peroxide ............................................. 50 I Igroton ......................................................... 57, 58 Imuran ............................................................... 27 Influenza vaccine.......................................... 48, 49 Inset 30 ............................................................. 39 Inset II................................................................ 38 Insulin pen needles............................................. 57 Insulin pump ................................................ 27, 37 Insulin pump infusion set (steel cannula) ...... 29, 37 Insulin pump infusion set (teflon cannula, angle insertion) ......................................... 27, 38 Insulin pump infusion set (teflon cannula, angle insertion with insertion device) ............... 39 Insulin pump infusion set (teflon cannula, straight insertion) ............................................ 28 Insulin pump infusion set (teflon cannula, straight insertion with insertion device) ...... 29, 38 Insulin pump reservoir ........................................ 27 Insulin syringes, disposable with attached needle ............................................................. 57 Intelence ............................................................ 57 Interferon alpha-2a ............................................. 34 Interferon alpha-2b ............................................. 34 Interferon beta-1-alpha ....................................... 31 Intron-A ............................................................. 34 Isoniazid ............................................................ 33 Isotretinoin ......................................................... 50 Itraconazole ................................................. 23, 32

61


Index

Pharmaceuticals and brands Itrazole ............................................................... 32 K KetoCal .............................................................. 37 KetoCal 3:1 .................................................. 25, 58 KetoCal 4:1 .................................................. 47, 58 Ketoconazole ..................................................... 33 Ketone blood beta-ketone electrodes .................. 40 King ................................................................... 23 L Lamivudine .................................................. 36, 51 Lamprene .......................................................... 23 Lansoprazole ............................................... 43, 50 Lanzol Relief ................................................ 43, 50 Leflunomide ....................................................... 52 Letara ................................................................ 54 Letrozole ............................................................ 54 Levodopa with carbidopa ............................. 31, 56 Levonorgestrel ................................................... 30 Lincocin ............................................................. 32 Lincomycin ........................................................ 32 Lipitor ................................................................ 53 Lisinopril ............................................................ 50 Lisuride hydrogen maleate.................................. 43 M Marvelon 21....................................................... 57 Megace........................................................ 44, 50 Megestrol acetate......................................... 44, 50 Mercilon 21 ....................................................... 57 Metformin hydrochloride .................................... 53 Methylcellulose .................................................. 43 Methylcellulose with glycerin and sodium saccharin ........................................................ 43 Methylcellulose with glycerin and sucrose .......... 43 Metolazone ........................................................ 21 Macrogol 3350 .................................................. 51 Methylprednisolone sodium succinate .......... 53, 56 Miconazole .................................................. 41, 55 Moclobemide ..................................................... 42 Motilium ...................................................... 41, 56 Movicol.............................................................. 51 Myambutol................................................... 33, 36 Mycobutin.......................................................... 33 N Nadolol .............................................................. 42 Nandrolone decanoate........................................ 53 Neocate ............................................................. 57 Neocate Advance ............................................... 55 Neoral ................................................................ 44 Nevirapine .............................................. 34, 43, 50 Nevirapine Alphapharm ...................................... 34 Next Choice ....................................................... 30 Nitazoxanide ...................................................... 58 62 Nizoral ............................................................... 33 Norpress ...................................................... 40, 58 Nortriptyline hydrochloride............................ 40, 58 Noxafil ............................................................... 30 Nupentin ............................................................ 56 O Olopatadine ........................................................ 25 On Call Advanced ............................................... 51 Oncaspar ..................................................... 25, 58 Ora-Blend .......................................................... 43 Ora-Blend SF...................................................... 43 Oral feed 1.5 kcal/ml .......................................... 34 Oral feed 2 kcal/ml ............................................. 34 Oral feed with fibre 1.5 kcal/ml ........................... 34 Ora-Plus ............................................................ 43 Ora-Sweet.......................................................... 42 Ora-Sweet SF ..................................................... 42 Oratane .............................................................. 50 Oxybutynin ................................................... 40, 58 Oxycodone hydrochloride ............................. 26, 52 OxyNorm ..................................................... 26, 52 P Pacifen .................................................. 40, 41, 58 Pamidronate disodium ................................. 42, 55 Pamisol ....................................................... 42, 55 Pantocid IV ........................................................ 56 Pantoprazole ...................................................... 56 Para-amino salicylic acid.............................. 23, 58 Paradigm 1.8 Reservoir ...................................... 27 Paradigm 3.0 Resevoir ....................................... 27 Paradigm 522 .................................................... 27 Paradigm 722 .................................................... 27 Paradigm Mio MMT-921 .................................... 29 Paradigm Mio MMT-923 .................................... 30 Paradigm Mio MMT-925 .................................... 30 Paradigm Mio MMT-941 .................................... 30 Paradigm Mio MMT-943 .................................... 30 Paradigm Mio MMT-945 .................................... 30 Paradigm Mio MMT-965 .................................... 30 Paradigm Mio MMT-975 .................................... 30 Paradigm Quick-Set MMT-386 ........................... 28 Paradigm Quick-Set MMT-387 ........................... 28 Paradigm Quick-Set MMT-396 ........................... 28 Paradigm Quick-Set MMT-397 ........................... 28 Paradigm Quick-Set MMT-398 ........................... 29 Paradigm Quick-Set MMT-399 ........................... 29 Paradigm Silhouette MMT-368 ........................... 27 Paradigm Silhouette MMT-377 ........................... 28 Paradigm Silhouette MMT-378 ........................... 28 Paradigm Silhouette MMT-381 ........................... 28 Paradigm Silhouette MMT-382 ........................... 28 Paradigm Silhouette MMT-383 ........................... 28


Index

Pharmaceuticals and brands Paradigm Silhouette MMT-384 ........................... 28 Paradigm Sure-T MMT-864 ................................ 29 Paradigm Sure-T MMT-866 ................................ 29 Paradigm Sure-T MMT-874 ................................ 29 Paradigm Sure-T MMT-876 ................................ 29 Paradigm Sure-T MMT-884 ................................ 29 Paradigm Sure-T MMT-886 ................................ 29 Paromomycin .............................................. 22, 58 Paser ........................................................... 23, 58 Patanol .............................................................. 25 Pegaspargase .............................................. 25, 58 Penicillin G benzathine [Benzathine benzylpenicillin] ...................... 30, 47 Peteha ......................................................... 23, 59 Pethidine hydrochloride ...................................... 43 Pharmacy services ........... 25, 26, 31, 36, 50, 52, 54, 56, 57 Phenobarbitone .................................................. 43 Phentolamine mesylate ...................................... 53 Pinorax .............................................................. 40 Pinorax Forte ...................................................... 40 Pizotifen ............................................................. 43 Plendil ER .................................................... 32, 39 Polaramine......................................................... 42 Posaconazole .................................................... 30 Pradaxa ............................................................. 53 Pramipexole hydrochloride ................................. 26 Praziquantel ....................................................... 22 Prednisolone sodium phosphate ......................... 43 Premature birth formula...................................... 50 Primacin ............................................................ 23 Primaquine phosphate ........................................ 23 Proglicem .................................................... 21, 58 Prokinex............................................................. 31 Promethazine Winthrop Elixir ........................ 41, 56 Promethazine hydrochloride ......................... 41, 56 Propranolol .................................................. 21, 56 Protamine sulphate ............................................ 41 Protionamide................................................ 23, 59 Pyrazinamide ..................................................... 33 Pyrimethamine ................................................... 22 Q Quick-Set MMT-390........................................... 28 Quick-Set MMT-391........................................... 28 Quick-Set MMT-392........................................... 28 Quick-Set MMT-393........................................... 28 Quinapril ................................................ 26, 40, 56 R Reandron 1000 .................................................. 30 Rectogesic................................................... 21, 58 Redipred ............................................................ 43 Regitine ............................................................. 53 Ridaura .............................................................. 52 Rifabutin ............................................................ 33 Rifadin ............................................................... 33 Rifampicin ......................................................... 33 Rifinah ............................................................... 33 Rivacol .............................................................. 51 Roferon-A .......................................................... 34 Roxane .............................................................. 21 S S26LBW Gold RTF ............................................. 50 Sandomigran ..................................................... 43 Selegiline hydrochloride ..................................... 24 Silagra ......................................................... 25, 35 Sildenafil ................................................ 25, 35, 55 Silhouette MMT-371........................................... 28 Silhouette MMT-373........................................... 28 Sinemet ....................................................... 31, 56 Sinemet CR.................................................. 31, 56 Sodium cromoglycate ........................................ 52 Solu-Medrol ................................................. 53, 56 Sporanox ........................................................... 23 Stavudine [D4T] ................................................. 24 Stiripentol .................................................... 24, 59 Stocrin ............................................................... 24 Sulfadiazine sodium ........................................... 23 Sure-T MMT-863 ............................................... 29 Sure-T MMT-865 ............................................... 29 Sure-T MMT-873 ............................................... 29 Sure-T MMT-875 ............................................... 29 Sure-T MMT-883 ............................................... 29 Sure-T MMT-885 ............................................... 29 T Tamoxifen citrate................................................ 41 Taxotere............................................................. 54 Testosterone undecanoate............................ 30, 53 Tetracycline ................................................. 22, 59 Tetracyclin Wolff .......................................... 22, 59 TMP................................................................... 41 Tramadol hydrochloride...................................... 31 Tramal SR 100................................................... 31 Tramal SR 150................................................... 31 Tramal SR 200................................................... 31 Trimethoprim ..................................................... 41 V Venlafaxine ........................................................ 27 Viagra .......................................................... 35, 55 Vicrom ............................................................... 52 Viramune ..................................................... 43, 50 W Wockhardt ......................................................... 23 Z Zapril ................................................................. 51 63


Index

Pharmaceuticals and brands Zeffix.................................................................. 51 Zerit ................................................................... 24 Zetlam ............................................................... 36 Zidovudine [AZT] with lamivudine ................. 36, 51 Zostrix................................................................ 26

64


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.

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Metadata

Title

Schedule Update - effective 1 April 2013

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 April 2013 Cumulative for January, February, March and April 2013 Section H for April 2013 Contents Summary of PHARMAC decisions effective 1 April 2013 …. 3 Wastage Rule extended to…

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