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


Pharmaceutical Management Agency

Section H for Hospital Pharmaceuticals

The Hospital Medicines List (HML)

Update Update Effective 1 July 2013

New Zealand Section H for To be read in conjunction with Hospital Pharmaceuticals Pharmaceutical Schedule

Effective 1 July 2013

Cumulative for May, June and July 2013


Contents

HML Launch .................................................................................................. 3 Printing and distribution ............................................................................... 3 In this HML update........................................................................................ 3 Section H changes to Part II .......................................................................... 4 A summary of decision made since notification of the therapeutic groups and included in the HML book ..................................... 13 Index ........................................................................................................... 16

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Section H of the Pharmaceutical Schedule - Update News

3

HML Launch

Additions and amendments to the HML will be in a separate publication to community Schedule amendments until further notice. Included in this HML Update are the changes made to the HML since the HML book was sent to print. Changes included in this HML Update should be read in addition to the July 2013 HML Schedule.

Printing and distribution

An electronic copy of the HML is available on our website at www.pharmac.health.nz/ medicines/hospital-pharmaceuticals. This is a searchable (bookmarked) PDF. We are working to have an interactive HML search facility as soon as possible after 1 July 2013. The interactive HML will be updated monthly, so will combine the HML PDF and HML Update information. We will let you know via our newsletters when this is available. Additional copies of the HML (hard copy) can be obtained by contacting us. Our HML contact details are on the back cover of this publication.

In this HML Update

This HML Update shows changes made to the Hospital Medicines List that were not finalised prior to the printing of the HML hard copy. Some of these have resulted from requests and corrections from DHBs. We thank you for engaging with us. Additions and amendments are listed in this HML Update by therapeutic group order. An HML page number is referenced against all changes in left hand column. This page references directly to where the listing occurs, or would occur, in the hard copy HML book. At the end of this Update is a summary of changes made since notification of the therapeutic groups, known as the A-Z list on the Pharmac website. The changes in this summary have been incorporated into the July 2013 HML book. These changes have been notified and are available on the PHARMAC website. All changes are effective from 1 July 2013.


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 July 2013

ALIMENTARY TRACT AND METABOLISM

15 18 MESALAZINE (correcting formulation) Tab EC 400 mg ....................................................................... 49.50 INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE ( price) Inj insulin lispro 25% with insulin lispro protamine 75%, 100 u per ml, 3 ml cartridge................................................. 42.66 Inj insulin lispro 50% with insulin lispro protamine 50%, 100 u per ml, 3 ml cartridge................................................. 42.66 URSODEOXYCHOLIC ACID (amendment to restriction)  250 mg – 1% DV May-12 to 2014................................ 71.50 Cap Restricted Alagille syndrome or progressive familial intrahepatic cholestasis Either: 1. Patient has been diagnosed with Alagille syndrome; or 2. Patient has progressive familial intrahepatic cholestasis Chronic severe drug induced cholestatic liver injury All of the following: 1. Patient has chronic severe drug induced cholestatic liver injury; and 2. Cholestatic liver injury not due to Total Parenteral Nutrition (TPN) use in adults; and 3. Treatment with ursodeoxycholic acid may prevent hospital admission or reduce duration of stay Cirrhosis Both: 1. Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative by liver biopsy; and 2. Patient not requiring a liver transplant (bilirubin > 100umol/l; decompensated cirrhosis Pregnancy/Cirrhosis Either: 1. Patient diagnosed with cholestasis of pregnancy; or 2. Both: 2.1. Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and 2.2. Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis). Note: Liver biopsy is not usually required for diagnosis but is helpful to stage the disease. Haematological transplant Both: 1. Patient at risk of veno-occlusive disease or has hepatic impairment and is undergoing conditioning treatment prior to allogenic stem cell or bone marrow transplantation; and 2. Treatment for up to 13 weeks. Total parenteral nutrition induced cholestasis Both: 1. Paediatric patient has developed abnormal liver function as indicated on testing which is likely to be induced by TPN; and 2. Liver function has not improved with modifying the TPN composition 100 Asacol

5 5 100

Humalog Mix 25 Humalog Mix 50 Ursosan

19

4

 Restriction

(Brand) indicates a brand example only. It is not a contracted product.


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

20 24 ISPAGHULA (PSYLLIUM) HUSK ( price and addition of HSS) Powder for oral soln – 1% DV Sep-13 to 2016 .......................... 5.51 ASCORBIC ACID Tab 100 mg ........................................................................... 13.80 (Vitala-C tab 100 mg to be delisted 1 September 2013) MULTIVITAMINS Tab (BPC cap strength) (MultiADE tab (BPC cap strength) to be delisted 1 September 2013) 500 g 500 Konsyl-D Cvite

25

(Mvite)

BLOOD AND BLOOD FORMING ORGANS

31 TICAGRELOR  90 mg .......................................................................... 90.00 Tab 56 Brilinta

Restricted Restricted to treatment of acute coronary syndromes specifically for patients who have recently been diagnosed with an ST-elevation or a non-ST-elevation acute coronary syndrome, and in whom fibrinolytic therapy has not been given in the last 24 hours and is not planned.

CARDIOVASCULAR SYSTEM

42

METOLAZONE (amendment to restriction)  5 mg Tab Restricted Either: 1. For the treatment of Patients with has refractory heart failure who are and is intolerant or have has not responded to loop diuretics and/or loop-thiazide combination therapy; or 2. Patient has severe refractory nephrotic oedema unresponsive to high dose loop diuretics and concentrated albumin infusions

DERMATOLOGICALS

48 FUSIDATE SODIUM [FUSIDIC ACID] ( price and addition of HSS) Oint 2% – 1% DV Sep-13 to 2016 ............................................. 3.45 15 g Foban

INFECTIONS

69 MOXIFLOXACIN (additional restriction)  400 mg......................................................................... 52.00 Tab 5 Avelox  2 mg per ml, 250 ml bag ................................................. 70.00 Inj 1 Avelox IV 400 Restricted Mycoplasma genitalium All of the following: 1. Has nucleic acid amplification test (NAAT) confirmed Mycoplasma genitalium; and 2. has tried and failed to clear infection using azithromycin; and 3. treatment is only for 7 days.

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

5


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

70 FOSFOMYCIN  Powder for oral sol, 3 g sachet Restricted Infectious disease physician or clinical microbiologist PIVMECILLINAM  200 mg Tab Restricted Infectious disease physician or clinical microbiologist NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS PROTEASE INHIBITORS STRAND TRANSFER INHIBITORS Restricted Confirmed HIV/AIDS Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 × total lymphocyte count; or 2.3.2.3 Viral load counts > 100000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 500 cells/mm3 Prevention of maternal transmission Either: 1 Prevention of maternal foetal transmission; or 2 Treatment of the newborn for up to eight weeks. Post-exposure prophylaxis following non-occupational exposure to HIV Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either Any of the following: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. 2.3 Patient has had non-consensual intercourse and the clinician considers that the risk assessment indicates prophylaxis is required Percutaneous exposure Patient has percutaneous exposure to blood known to be HIV positive

71

77 78 79 80

6

 Restriction

(Brand) indicates a brand example only. It is not a contracted product.


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

82

ENTECAVIR  0.5 mg........................................................................ 400.00 Tab 30 Baraclude Restricted Gastroenterologist or infectious disease physician All of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 Patient is Hepatitis B nucleoside analogue treatment-naive; and 3 Entecavir dose 0.5 mg/day; and 4 Either: 4.1 ALT greater than upper limit of normal; or 4.2 Bridging fibrosis or cirrhosis (Metavir stage 3 or greater or moderate fibrosis) on liver histology; and 5 Either: 5.1 HBeAg positive; or 5.2 Patient has ≥ 2,000 IU HBV DNA units per ml and fibrosis (Metavir stage 2 or greater) on liver histology; and 6 No continuing alcohol abuse or intravenous drug use; and 7 Not co-infected with HCV, HIV or HDV; and 8 Neither ALT nor AST greater than 10 times upper limit of normal; and 9 No history of hypersensitivity to entecavir; and 10 No previous documented lamivudine resistance (either clinical or genotypic). LAMIVUDINE (amendment to restriction)  liq 5 mg per ml Oral  100 mg – 1% DV Dec-12 to 2014................................. 32.50 Tab

82

28

Zetlam

Restricted Gastroenterologist, infectious disease specialist, paediatrician or general physician Initiation Re-assessment required after 12 months 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and 1.1.2 HBeAg positive or HBV DNA positive defined as > 100,000 copies per ml by quantitative PCR at a reference laboratory; and 1.1.3 ALT greater than twice upper limit of normal or bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent) on liver histology or clinical/radiological evidence of cirrhosis; or 21 HBV DNA positive cirrhosis prior to liver transplantation; or 32 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; or 43 Hepatitis B virus naïve patient who has received a liver transplant from an anti-HBc (Hepatitis B core antibody) positive donor; or 4 Hepatitis B surface antigen (HbsAg) positive patient who is receiving chemotherapy for a malignancy, or high dose steroids (at least 20mg/day for at least 7 days) or who has received such treatment within the previous two months; or 5 Hepatitis B surface antigen positive patient who is receiving anti tumour necrosis factor treatment; or 6 Hepatitis B core antibody (anti-HBc) positive patient who is receiving rituximab plus high dose steroids (e.g. R-CHOP). 2 All of the following: 2.1 No continuing alcohol abuse or intravenous drug use; and 2.2 Not coinfected with HCV or HDV; and 2.3 Neither ALT nor AST greater than 10 times upper limit of normal; and 2.4 No history of hypersensitivity to lamivudine; and 2.5 No previous lamivudine therapy with genotypically proven lamivudine resistance. Continuation – patients who have maintained continuous treatment and response to lamivudine Re-assessment required after 2 years

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

continued...

7


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

continued... All of the following: 1 Have maintained continuous treatment with lamivudine; and 2 Most recent test result shows continuing biochemical response (normal ALT); and 3 HBV DNA <100,00 copies per ml by quantitative PCR at a reference laboratory; or Continuation – when given in combination with adefovir dipivoxil for patients with cirrhosis and resistance to lamivudine Re-assessment required after 2 years All of the following: 1 Lamivudine to be used in combination with adefovir dipivoxil; and 2 Patient is cirrhotic; and Documented resistance to lamivudine, defined as: 3 Patient has raised serum ALT (> 1 × ULN); and 4 Patient has HBV DNA greater than 100,000 copies per mL, or viral load = 10 fold over nadir; and 5 Detection of M204I or M204V mutation; or Continuation – when given in combination with adefovir dipivoxil for patients with resistance to adefovir dipivoxil Re-assessment required after 2 years All of the following: 1 Lamivudine to be used in combination with adefovir dipivoxil; and Documented resistance to adefovir, defined as: 2 Patient has raised serum ALT (> 1 × ULN); and 3 Patient has HBV DNA greater than 100,000 copies per mL, or viral load = 10 fold over nadir; and 4 Detection of N236T or A181T/V mutation. 83

TENOFOVIR DISOPROXIL FUMARATE (amendment to restriction)  300 mg....................................................................... 531.00 Tab 30 Viread Restricted Confirmed hepatitis B Either: 1 All of the following: 1.1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 1.2 Patient has had previous lamivudine, adefovir or entecavir therapy; and 1.3 HBV DNA greater than 20,000 IU/mL or increased ≥ 10 fold over nadir; and 1.4 Any of the following: 1.4.1 Lamivudine resistance - detection of M204I/V mutation; or 1.4.2 Adefovir resistance - detection of A181T/V or N236T mutation; or 1.4.3 Entecavir resistance - detection of relevant mutations including I169T, L180M T184S/A/I/L/G/C M,S202C/G/I,M204V or M250I/V mutation; or 2 Patient is either listed or has undergone liver transplantation for HBV; or 3 Patient has decompensated cirrhosis with a Mayo score >20. Pregnant or Breastfeeding, Active hepatitis B Limited to four twelve months’ treatment Both: 1 Patient is HBsAg positive and pregnant; and 2 Either: 2.1 HBV DNA > 20,000 IU/mL and ALT > ULN; or 2.2 HBV DNA > 100 million IU/mL and ALT normal Pregnant, prevention of vertical transmission Limited to six months’ treatment Both: 1 Patient is HBsAg positive and pregnant; and

continued...

8

 Restriction

(Brand) indicates a brand example only. It is not a contracted product.


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

continued... 2 HBV DNA > 100 20 million IU/mL and ALT normal. Confirmed HIV/AIDS Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 × total lymphocyte count; or 2.3.2.3 Viral load counts > 100000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 500 cells/mm3 Prevention of maternal transmission Either: 1 Prevention of maternal foetal transmission; or 2 Treatment of the newborn for up to eight weeks. Post-exposure prophylaxis following non-occupational exposure to HIV Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. 2.3 Patient has been subjected to non-consensual intercourse and the clinician considers that the risk assessment indicates prophylaxis is required. Percutaneous exposure Patient has percutaneous exposure to blood known to be HIV positive 84

VALACICLOVIR (additional restriction)  500 mg....................................................................... 102.72 Tab Restricted Immunocompromised patients Limited to 7 days treatment Both: 1 Patients is immunocompromised; and 2 Patient has herpes zoster.

30

Valtrex

NERVOUS SYSTEM

106

VENLAFAXINE ( price)  37.5 mg.......................................................................... 7.84 Tab  75 mg........................................................................... 13.94 Tab  150 mg......................................................................... 17.08 Tab  225 mg......................................................................... 27.14 Tab  37.5 mg ......................................................................... 8.71 Cap  75 mg .......................................................................... 17.42 Cap  150 mg ........................................................................ 21.35 Cap

28 28 28 28 28 28 28

Arrow-Venlafaxine XR Arrow-Venlafaxine XR Arrow-Venlafaxine XR Arrow-Venlafaxine XR Efexor XR Efexor XR Efexor XR

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

9


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

108

GABAPENTIN (additional restriction)  100 mg .......................................................................... 7.16 Cap  300 mg ........................................................................ 11.50 Cap  Cap 400 mg ........................................................................ 14.75  Tab 600 mg Restricted For preoperative and/or postoperative use for up to a total of 8 days’ use or For the pain management of burns patients with monthly review.

100 100 100

Nupentin Nupentin Nupentin

111

SUMATRIPTAN ( price and addition of HSS) Tab 50 mg – 1% DV Sep-13 to 2016 ...................................... 29.80 Tab 100 mg – 1% DV Sep-13 to 2016 .................................... 54.80 Inj 12 mg per ml, 0.5 ml cartridge – 1% DV Sep-13 to 2016 .... 13.80 ONDANSETRON ( price and addition of HSS) Inj 2 mg per ml, 2 ml ampoule – 1% DV Sep-13 to 2016 ........... 1.82 Inj 2 mg per ml, 4 ml ampoule – 1% DV Sep-13 to 2016 ........... 2.18 MELATONIN (addition of suggested brand)  Tab modified-release 2 mg

100 100 2 5 5

Arrow-Sumatriptan Arrow-Sumatriptan Arrow-Sumatriptan Ondanaccord Ondanaccord (Circadin)

112

118

ONCOLOGY AGENTS AND IMMUNOSUPPRESSANTS

123

DOXORUBICIN HYDROCHLORIDE (addition of presentation and note)  50 mg vial Inj  2 mg per ml, 25 ml vial – 1% DV Mar-13 to 2015 ........... 17.00 Inj 1 Note: DV limit applies to all 50 mg presentations of doxorubicin hydrochloride

Arrow-Doxorubicin

SENSORY ORGANS

166 166 CARBOMER (delay to brand listing) Ophthalmic gel 0.3%, single dose .............................................. 8.25 MACROGOL 400 AND PROPYLENE GLYCOL (delay to brand listing) Eye drops 0.4% with propylene glycol 0.3% preservative free, single dose ............................................................................ 4.30 30 Poly Gel

24

Systane Unit Dose

SPECIAL FOODS

168 FOOD/FLUID THICKENERS (amendment to note) NOTE: While pre-thickened drinks have not been included in Section H, DHB hospitals may continue to use such products, provided that use was established prior to 1 July 2013. PHARMAC intends to make a further decision in relation to prethickened drinks in the future, and will notify of any change to this situation. NOTE: While pre-thickened drinks and supplements have not been included in Section H, DHB hospitals may continue to use such products for patients with dysphagia, provided that: • use was established prior to 1 July 2013; and • the product has not been specifically considered and excluded by PHARMAC; and • use of the product conforms to any applicable indication restrictions for similar products that are listed in Section H (for example, use of thickened high protein products should be in line with the restriction for high protein oral feed in Section H). PHARMAC intends to make a further decision in relation to pre-thickened drinks and supplements in the future, and will notify of any change to this situation.

10

 Restriction

(Brand) indicates a brand example only. It is not a contracted product.


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

168 CAROB BEAN GUM WITH MAIZE STARCH AND MALTODEXTRIN (change to suggested brand name) Powder (Karicare Aptamil Feed Thickener) (Feed Thickener Karicare Aptamil) HIGH CALORIE PRODUCTS (amendment to restriction) Restricted Either: Any of the following: 1 Patient is fluid volume or rate restricted; or 2 Patient requires low electrolyte; or 23 Both: 23.1 Any of the following: 23.1.1 Cystic fibrosis; or 23.1.2 Any condition causing malabsorption; or 23.1.3 Faltering growth in an infant/child; or 23.1.4 Increased nutritional requirements; and 23.2 Patient has substantially increased metabolic requirements.

173

173

 Liquid 6.3 g protein, 14.2 g carbohydrate

and 4.9 g fat per 100 ml, 1,000 ml bag

HIGH PROTEIN ENTERAL FEED 1.25 KCAL/ML (amendment to restriction) (Nutrison Protein Plus) (Nutrison Protein Plus Multi Fibre)

 Liquid 6.3 g protein, 14.1 g carbohydrate, 4.9 g fat

and 1.5 g fibre per 100 ml, 1,000 ml bag

Restricted Both: 1 The patient has a high protein requirement; and 2 Any of the following: 2.1 Patient has liver disease; or 2.2 Patient is obese (BMI > 30) and is undergoing surgery; or 2.3 Patient is fluid restricted; or 2.4 Patient does not have increased energy requirements. 2.4 Patient’s needs cannot be more appropriately met using a high calorie product. 174

EXTENSIVELY HYDROLYSED FORMULA (change to suggested brand name)  Powder 14 g protein, 53.4 g carbohydrate and 27.3 g fat per 100 g, 450 g can

(Gold Pepti Junior Karicare Aptamil) (Karicare Aptamil Gold Pepti Junior)

175

PRETERM FORMULA  Powder 1.9 g protein, 7.5 g carbohydrate and 3.9 g fat per 14 g, can ................................................... 15.25 400 g Restricted For infants born before 33 weeks’ gestation or weighing less than 1.5 kg at birth.

S-26 Gold Premgro

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

11


Price (ex man. Excl. GST) $ Per

Brand or Generic Manufacturer

Changes to Section H - effective 1 July 2013 (continued)

176 Paediatric Products Infant Formulas PAEDIATRIC ORAL FEED 1 KCAL/ML  Liquid 2.6 g protein, 10.3 g carbohydrate, 5.4 g fat and 0.6 g fibre per 100 ml, 100 ml bottle Restricted Both: 1. Either of the following: 1.1 The patient is fluid restricted; or 1.2 The patient has increased nutritional requirements due to faltering growth; and 2. Patient is under 18 months old and weighs less than 8kg. HIGH ARGININE ORAL FEED 1.4 KCAL/ML  Liquid 7.6 g protein, 18.9 g carbohydrate, 3.9 g fat and 1.4 g fibre per 100 ml, carton .......................................... 4.00

(Infatrini)

178

237 ml

Impact Advanced Recovery (Vanilla) (Impact Advanced Recovery (Chocolate))

Note: these listings are new Pharmacodes for existing products.

VARIOUS

189 IOHEXOL Inj 350 mg per ml, 500 ml bottle ............................................ 780.00 10 (Omnipaque inj 350 mg per ml, 500 ml bottle to be delisted 1 September 2013) PLERFUTREN Inj 1.1 mg per ml, 2 ml vial Omnipaque

191

12

 Restriction

(Brand) indicates a brand example only. It is not a contracted product.


13

A summary of decisions made since notification of the therapeutic groups and included in the HML book

Part I of Section H (Rules) • Amendment of Rule 5.2 to clarify appropriate records of clinician consultation Alimentary Tract and Metabolism group • L-ornithine l-aspartate (LOLA) – addition of prescribing restriction and moved to Bile and Liver therapy subheading • Hyoscine butylbromide and mebeverine hydrochloride – correction of subheading to Antispasmodics and Other Agents Altering Gut Motility • Calcium carbonate – removal of 420 mg tablet • Bismuth – correction of chemical to bismuth trioxide Blood and Blood Forming group • Bivalirudin – amendment of prescribing restriction to better reflect current use of the product • Rivaroxaban – amendment of prescribing restriction to better align with community restriction • Sodium chloride – addition of inj 0.9% 3 ml, 5 ml and 10 ml syringes with restriction. Cardiovascular group • Captopril – amendment of prescribing restriction applying to oral liquid to allow management of rebound transient hypertension following cardiac surgery • Metolozone – amendment of prescribing restriction to better reflect current practice • Perindopril – removal of prescribing restriction. Fully funded brand now listed in community schedule. • Gemfibrozil – correction of subheading to Fibrates • Bendroflumethazide [bendrofluazide], chlortalidone [chlorthalidone], chlorothiazide, indapamide and metolazone – correction of therapeutic subheading to Thiazide and related diuretics Dermatology group • Mafenide acetate – new listing of powder 50 g sachet with restriction for burns patients • Malathion with permethrin and piperonyl butoxide – new temporary listing to cover out-of- stock Hormone Preparations group • Liothyronine – new listing of 20 mcg tablets with restriction for thyroid cancer patients receiving radioiodine therapy • Oxandrolone – new listing of 2.5 mg tablets under new heading and a new subheading Anabolic Agents with restriction for burns patients • Argipressin – amendment of chemical name to Argipressin [vasopressin]


14

Infections group • Flucytosine – new prescribing restriction restricting to infectious disease physician or clinical microbiologist • Interferon gamma – correction of prescribing restriction to patients with chronic granulomatous disease. • Isoniazid and isoniazid with rifampicin – amendment of prescribing restriction to include paediatrician • Oseltamivir – new listing of tablet and powder for suspension under new influenza subheading with restriction to hospitalized patients for influenza treatment or prophylaxis • Tetracycline – new listing of 500 mg capsule. • Tenofovir disoproxil fumarate – amendment of restriction to include HIV indication • Ivermectin – amendment of prescribing restriction to include dermatologist • Moxifloxacin – amendment of prescribing restriction to include respiratory physician and to include a penetrating eye injury indication Musculoskeletal System group • Zoledronic acid – amendment of restriction to include an osteogenesis imperfecta indication. Nervous System group • Nicotine – new listing for solution for inhalation, 15 mg cartridge with example brand Nicorette Inhalator with restriction • Benzocaine – new listing of topical gel 20%

• Lidocaine [lignocaine] hydrochloride with adrenaline and tetracaine hydrochloride – amendment of presentation description • Lidocaine [lignocaine] hydrochloride with adrenaline – new listing of 1.8 ml and 2.2 ml dental cartridges • Clonazepam – move 500 mcg and 2 mg tablet from Control of Epilepsy subheading(Antiepilepsy Drugs heading) to Anxiolytics subheading (Anxiolytics heading) • Clonidine – move from Prophylaxis of Migraine (Antimigraine Preparations heading) subheading to Centrally-Acting Agents subheading (Cardiovascular group) • Modafanil – amend restriction applying to 100 mg tablets to restrict to neurologist or respiratory specialist • Risperidone – amend restriction that applies to 25 mg, 37.5 mg and 50 mg injection vials to include other psychotic disorder, to align with community schedule Special Authority • Melatonin – new listing of 2 mg and 3 mg capsules, 1 mg, 2 mg and 3 mg tablets and 2 mg modified release tablets with restriction Oncology Agents and Immunosuppressants group • Irinotecan hydrochloride – correction of subheading to Other Cytotoxic Agents Respiratory group • Tiotropium bromide – amendment of restriction to include requirement for FEV1, • Dornase alfa – amendment of restriction to include significant mucus production indication


15

Sensory group • Pilocarpine – new listing of 4% eye drops • Sodium hyaluronate with chondroitin sulphate – correction of presentation description for 0.55 ml syringe Special foods group • Deletion of products not supplied in New Zealand • Amendment of a number of presentations to better reflect their nutritional composition • Amendment of brand names (noncontracted products) Various group • Ethanol – new listing of 96% liquid


Index

Pharmaceuticals and brands A Arrow-Doxorubicin ............................................. 10 Arrow-Sumatriptan ............................................. 10 Arrow-Venlafaxine XR........................................... 9 Asacol ................................................................. 4 Ascorbic acid ....................................................... 5 Avelox.................................................................. 5 Avelox IV 400....................................................... 5 B Baraclude ............................................................ 7 Brilinta ................................................................. 5 C Carbomer........................................................... 10 Carob bean gum with maize starch and maltodextrin ............................................. 11 Circadin ............................................................. 10 Cvite .................................................................... 5 D Doxorubicin hydrochloride .................................. 10 E Efexor XR ............................................................. 9 Entecavir .............................................................. 7 Extensively hydrolysed formula........................... 11 F Feed Thickener Karicare Aptamil ......................... 11 Foban .................................................................. 5 Food/Fluid Thickeners ........................................ 10 Fosfomycin .......................................................... 6 Fusidate sodium [fusidic acid] .............................. 5 G Gabapentin ........................................................ 10 Gold Pepti Junior Karicare Aptamil ...................... 11 H High arginine oral feed 1.4 Kcal/ml ..................... 12 High calorie products ......................................... 11 High protein enteral feed 1.25 Kcal/ml ................ 11 Humalog Mix 25................................................... 4 Humalog Mix 50................................................... 4 I Impact Advanced Recovery (Chocolate) ............. 12 Impact Advanced Recovery (Vanilla) .................. 12 Infatrini .............................................................. 12 Insulin lispro with insulin lispro protamine ............. 4 Iohexol ............................................................... 12 Ispaghula (psyllium) husk..................................... 5 K Karicare Aptamil Feed Thickener ......................... 11 Karicare Aptamil Gold Pepti Junior ...................... 11 Konsyl-D.............................................................. 5 L Lamivudine .......................................................... 7 M Macrogol 400 and propylene glycol .................... 10 Melatonin ........................................................... 10 Mesalazine ........................................................... 4 Metolazone .......................................................... 5 Moxifloxacin......................................................... 5 Multivitamins ....................................................... 5 Mvite ................................................................... 5 N Non-nucleoside reverse transcriptase inhibitors .... 6 Nucleoside reverse transcriptase inhibitors ........... 6 Nupentin ............................................................ 10 Nutrison Protein Plus.......................................... 11 Nutrison Protein Plus Multi Fibre ......................... 11 O Omnipaque ........................................................ 12 Ondanaccord ..................................................... 10 Ondansetron ...................................................... 10 P Paediatric oral feed 1 kcal/ml.............................. 12 Pivmecillinam....................................................... 6 Plerfutren ........................................................... 12 Poly Gel ............................................................. 10 Preterm Formula ................................................ 11 Protease inhibitors ............................................... 6 S S-26 Gold Premgro .............................................. 11 Strand transfer inhibitors ...................................... 6 Sumatriptan ....................................................... 10 Systane Unit Dose .............................................. 10 T Tenofovir disoproxil fumarate ............................... 8 Ticagrelor ............................................................ 5 U Ursodeoxycholic acid ........................................... 4 Ursosan ............................................................... 4 V Valaciclovir .......................................................... 9 Valtrex ................................................................. 9 Venlafaxine .......................................................... 9 Viread .................................................................. 8 Z Zetlam ................................................................. 7

16


Hospital Medicines List queries: Freephone Information line 0800 66 00 50 (option 2) Fax: 64 4 974 7819 Email: HML@pharmac.govt.nz Pharmaceutical Management Agency www.pharmac.health.nz/medicines/hospital-pharmaceuticals 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

Pharmaceutical Management Agency Level 9, 40 Mercer Street, PO Box 10-254, Wellington 6143, New Zealand Phone: 64 4 460 4990 - Fax: ISSN 1172-9376 (Print) 64 4 460 4995 - www.pharmac.govt.nz Freephone Information line ISSN 1179-3686 (Online)(9am-5pm weekdays) 0800 66 00 50 ISSN 1172-3694 (Print) - in compiling this Update, While care has been takenISSN 1179-3708 (Online) 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 While care has been taken in compiling this Update, Pharmaceutical Management on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will Agency takes no responsibility for any errors or omissions and shall not be liable to any be corrected if necessary by an erratum or otherwise in the next edition of the Update. person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Update.

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

Metadata

Title

HML Update - effective 1 July 2013

Abstract

Pharmaceutical Management Agency Section H for Hospital Pharmaceuticals The Hospital Medicines List (HML) Update Update Effective 1 July 2013 New Zealand Section H for To be read in conjunction with Hospital Pharmaceuticals Pharmaceutical Schedule Effective 1 July 2013 Cumulative for…

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