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


Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 September 2013


Contents

Summary of PHARMAC decisions effective 1 September 2013 ...................... 3 New brand of enalapril maleate tablets ........................................................ 5 Change to the definition of Specialist ........................................................... 5 New listing of mesalazine granules ............................................................... 6 Widening of access to imiglucerase............................................................... 6 New listing of desmopressin tablets .............................................................. 6 Wastage rule amended ................................................................................. 6 New listing of boceprevir capsules ................................................................ 7 Special Authority removed from Arrow-Venlafaxine XR ................................. 7 Oxycodone controlled-release tablet brand-switch........................................ 7 Adalimumab Special Authority application form ........................................... 7 Tofranil out-of-stock ...................................................................................... 7 Lacri-Lube brand name change ..................................................................... 8 Pediasure packaging change ......................................................................... 8 News in brief ................................................................................................. 8 Tender News .................................................................................................. 9 Looking Forward ......................................................................................... 10 Sole Subsidised Supply products cumulative to September 2013................ 11 New Listings ................................................................................................ 20 Changes to Restrictions, Chemical Names and Presentations ...................... 22 Changes to Subsidy and Manufacturer’s Price............................................. 26 Changes to General Rules............................................................................ 28 Delisted Items ............................................................................................. 29 Items to be Delisted .................................................................................... 30 Index ........................................................................................................... 31

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Summary of PHARMAC decisions

EFFECTIVE 1 SEPTEMBER 2013 New listings (pages 20-21) • Mesalazine (Pentasa) modified release granules 1 g sachet – 1 OP • Tetracosactrin (Synacthen) inj 250 mcg per ml, 1 ml ampoule • Desmopressin (Minirin) tab 100 mcg and 200 mcg – Special Authority – Retail pharmacy • Boceprevir (Victrelis) cap 200 mg – Special Authority – Retail pharmacy – note this will be listed under a new TG heading Hepatitis C Treatment • Risedronate sodium (Risedronate Sandoz) tab 35 mg • Thiotepa (Tepadina) inj 15 mg – PCT only – Specialist – S29 • Imipramine hydrochloride (Tofranil S29) – S29 • Paraffin liquid with soft white paraffin (Refresh Night Time) eye oint • Pharmacy Services (BSF Acetec) brand switch fee • Paediatric oral feed 1 kcal/ml (Pediasure) liquid (chocolate, strawberry and vanilla), 200 ml OP. Note – the packaging has changed to Recloseable Plastic Bottle (RPB) with new Pharmacodes. • Paediatric oral feed 1 kcal/ml (Pediasure) liquid (vanilla), 250 ml OP Changes to restrictions, chemical names and presentation (pages 22-25) • Enalapril maleate – Brand switch fee payable and removal of the stat symbol • Tetracosacrin (Synacthen) inj 250 mcg amendment of presentation to inj 250 mcg per ml, 1 ml ampoule • Interferon alpha-2a amended to interferon alfa-2a • Interferon alpha-2b amended to interferon alfa-2b • Pegylated interferon alpha-2a amended to pegylated interferon alfa-2a and amendment to Special Authority • Venlafaxine (Arrow-Venlafaxine XR) tab 37.5 mg, 75 mg, 150 mg and 225 mg – removal of Special Authority • Risperidone (Risperdal Quicklet) tab orally-disintegrating tablets amended to tab orodispersible • Cytarabine inj – amendment to presentation description • Paediatric enteral feed with fibre 0.75 kcal/ml changed to paediatric enteral feed with fibre 0.76 kcal/ml • Imiglucerase inj 40 iu per ml, 200 iu vial and 400 iu vial amendment to access criteria – note the criteria are not printed in the Schedule. Decreased subsidy (pages 26-27) • Vitamin B complex (Bplex and B-PlexADE) tab, strong, BPC • Ascorbic acid (Vitala-C, Cvite) tab 100 mg • Vitamins (MultiADE, Mvite) tab (BPC cap strength)

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Summary of PHARMAC decisions – effective 1 September 2013 (continued) • Potassium iodate (NeuroKare) tab 256 mcg (150 mcg elemental iodine) • Dextrose with electrolytes (Pedialyte-Bubblegum) soln with electrolytes • Pegylated interferon alfa-2a (Pegasys) inj 180 mcg prefilled syringe (Pegasys RBV Combination Pack) inj 180 mcg prefilled syringe x 4 with ribavirin tab 200 mg x 112 and inj 180 mcg prefilled syringe x 4 with ribavirin tab 200 mg x 168 – Special Authority – Retail pharmacy • Lidocaine [lignocaine] hydrochloride (Xylocaine) inj 1 %, 5 ml ampoule and 20 ml ampoule. • Venlafaxine (Arrow-Venlafaxine XR) tab 37.5 mg, 75 mg, 150 mg, 225 mg • Cytarabine (Pfizer) inj 20 mg per ml, 5 ml, inj 100 mg per ml, 10 ml vial, inj 100 mg per ml, 20 ml vial – PCT – Retail pharmacy - Specialist • Cytarabine (Baxter) inj 1 mg for ECP and inj 100 mg intrathecal syringe for ECP – PCT only – Specialist • Mycophenolate mofetil (Cellcept) tab 500 mg and Cap 250 mg – Special Authority – Retail pharmacy Increased subsidy (pages 26-27) • Pindolol (Apo-Pindolol) tab 5 mg, 10 mg and 15 mg • Gemfibrozil (Lipazil) tab 600 mg • Lamivudine (3TC) oral liq 10 mg per ml, 240 ml OP

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Pharmaceutical Schedule - Update News

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New brand of enalapril maleate tablets

Due to a pharmacy level recall of m-Enalapril tablets the Acetec brand of enalapril maleate tablets were listed fully subsidised in the Pharmaceutical Schedule from 12 August 2013. This is a pharmacy level recall led by Multichem. For queries regarding the recall, please contact Multichem directly on 0508 50 77 55. All-at-once dispensing (stat) will be temporarily removed from all strengths of enalapril maleate tablets from 1 September 2013. An additional fee for service will be paid to pharmacy using the Brand Switch Fee mechanism. This will apply

from 1 September 2013 to all packs and presentations.

Change to the definition of Specialist

From 1 September 2013 the defined list of approved vocational scopes will be removed from the definition of Specialist. All vocational scopes approved by the Medical Council will now be classed as Specialists. This will see the following four new vocational scopes of practice included that were not previously listed for Specialist subsidy: • General Practice • Pain Medicine • Rural Hospital Medicine • Urgent Care (formerly known as Accident and Medical Practice).


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Pharmaceutical Schedule - Update News

New listing of mesalazine granules

Mesalazine (Pentasa) modified release granules, 1 g sachets, 120 g OP will be listed from 1 September 2013.

Widening of access to imiglucerase

The Special Authority criteria for imiglucerase will be widened from 1 September 2013. In summary: • The Special Authority criteria will be widened to included funded access to imiglucerase for some patients with type 3 Gaucher disease; • The maximum funded dose of imiglucerase will be increased from 15 iu/kg per month to 30 iu/kg per month for children with type 1 or type 3 Gaucher disease meeting certain criteria.

New listing of desmopressin tablets

The Minirin brand of desmopressin tablets, 100 mcg and 200 mcg will be listed fully funded subject to Special Authority criteria for patients with primary nocturnal enuresis or cranial diabetes insipidis from 1 September 2013.

Wastage rule amended

From 1 September 2013 the wastage rule will be amended to include any other pharmaceutical that PHARMAC determines, from time to time and notes in the Pharmaceutical Schedule. This rule will allow 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 current 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 dispense and claim for the remaining product.


Pharmaceutical Schedule - Update News

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New listing of boceprevir capsules

Boceprevir (Victrelis) 200 mg capsules will be listed fully funded from 1 September 2013 subject to Special Authority criteria for patients with chronic hepatitis C, genotype 1. The wastage rule will be applied to boceprevir to allow pharmacy to dispense in frequencies less than monthly, i.e. weekly dispensings, without the risk that the remainder of the pack would not be collected.

Special Authority removed from Arrow-Venlafaxine XR

The Special Authority that currently applies to the Arrow-Venlafaxine XR brand of venlafaxine tablets listed in Section B of the Pharmaceutical Schedule will be removed from 1 September 2013. The price and subsidy for Arrow-Venlafaxine XR will also be reduced from 1 September 2013. There wil be no change to the listing of the efexor XR brand of venlafaxine capsules, which will remain subject to the same Special Authority that currently applies to it.

Oxycodone controlled-release tablet brand-switch

The brand change for oxycodone controlled-release tablets does not include the 5 mg tablets. The Oxycontin brand of oxycodone controlled-release 5 mg tablets will remain listed and fully funded.

Adalimumab Special Authority application form

The Ministry of Health has informed PHARMAC that the Special Authority application form for adalimumab SA1371 is now available for on-line processing for all criteria.

Tofranil out-of-stock

Imipramine hydrochloride (Tofranil) 10 mg and 25 mg tablets, supplied by AFT, are temporarily out-of-stock. AFT has sourced imipramine hydrochloride (Tofranil S29) 10 mg tablets which will be supplied under Section 29 of the Medicines Act 1981 and will be listed fully funded from 1 September 2013. The S29 stock is expected to be available in the week beginning 19 August 2013. AFT will supply stock directly to the pharmacy for free for dispensing prior to 1 September 2013.


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Pharmaceutical Schedule - Update News

Lacri-Lube brand name change

Refresh Night Time is the new brand name for Lacri-Lube. Refresh Night Time will be listed from 1 September 2013 and Lacri-Lube will be delisted 1 March 2014. A new Pharmacode will apply for Refresh Night Time.

Pediasure packaging change

Pediasure packaging will change from cans to re-closable plastic bottles. The new packaging, with new Pharmacodes, will be listed from 1 September 2013. The old packaging will be delisted from 1 March 2014.

News in brief

• The Imuran brand of azathioprine 50 mg tablets will be delisted 1 March 2014. Stock of Mylan’s brand of azathioprine 50 mg tablets (Imuprine) is now available. • Norinyl-1/28 oral contraceptive (norethisterone with mestranol) will be delisted 1 March 2014. • The Bicillin LA brand of penicillin G benzathine inj 1.2 mega units per 2 ml will be delisted 1 March 2014. Bicillin LA (benzathine benzylpenicillin) is back in stock.


Tender News

Sole Subsidised Supply changes – effective 1 October 2013

Chemical Name Aciclovir Aciclovir Aciclovir Ciclopirox olamine Cilazapril Cilazapril Cilazapril Clindamycin Clomiphene citrate Clonidine hydrochloride Dihydrocodeine tartrate Fusidic acid Ipratropium bromide Ipratropium bromide Ispaghula (psyllium) husk Levonorgestrel Lidocaine [lignocaine] hydrochloride Lidocaine [lignocaine] hydrochloride Medroxyprogesterone acetate Medroxyprogesterone acetate Medroxyprogesterone acetate Medroxyprogesterone acetate Medroxyprogesterone acetate Methotrexate Methotrexate Morphine sulphate Morphine sulphate Morphine sulphate Morphine sulphate Morphine tartrate Morphine tartrate Presentation; Pack size Tab dispersible 200 mg; 25 tab Tab dispersible 400 mg; 56 tab Tab dispersible 800 mg; 35 tab Nail-soln 8%; 7 ml OP Tab 0.5 mg; 90 tab Tab 2.5 mg; 90 tab Tab 5 mg; 90 tab Inj phosphate 150 mg per ml, 4 ml; 10 inj Tab 50 mg; 10 tab Tab 25 mcg; 112 tab Tab long-acting 60 mg; 60 tab Oint 2%; 15 g OP Nebuliser soln, 250 mcg per ml, 1 ml; 20 neb Nebuliser soln, 250 mcg per ml, 2 ml; 20 neb Powder for oral soln; 500 g OP Tab 1.5 mg; 1 tab Inj 2% ampoule, 5 ml; 25 inj Inj 2% ampoule, 20 ml; 1 inj Inj 150 mg per ml, 1 ml syringe; 1 inj Tab 2.5 mg; 30 tab Tab 5 mg; 100 tab Tab 10 mg; 30 tab Tab 100 mg; 100 tab Inj 25 mg per ml, 2 ml; 5 inj Inj 25 mg per ml, 20 ml; 1 inj Tab long-acting 10 mg; 10 tab Tab long-acting 30 mg; 10 tab Tab long-acting 60 mg; 10 tab Tab long-acting 100 mg; 10 tab Inj 80 mg per ml, 1.5 ml; 5 inj Inj 80 mg per ml, 5 ml; 5 inj Sole Subsidised Supply brand (and supplier) Lovir (Douglas) Lovir (Douglas) Lovir (Douglas) Apo-Ciclopirox (Apotex) Zapril (Mylan) Zapril (Mylan) Zapril (Mylan) Dalacin C (Pfizer) Serophene (Merck) Clonidine BNM (Boucher and Muir) DHC Continus (MundiPharm) Foban (AFT) Univent (Rex Medical) Univent (Rex Medical) Konsyl-D (Mylan) Postinor-1 (Bayer) Lidocaine-Claris (Multichem) Lidocaine-Claris (Multichem) Depo-Provera (Pfizer) Provera (Pfizer) Provera (Pfizer) Provera (Pfizer) Provera (Pfizer) Hospira (Hospira) Hospira (Hospira) Arrow-Morphine LA (Arrow) Arrow-Morphine LA (Arrow) Arrow-Morphine LA (Arrow) Arrow-Morphine LA (Arrow) Hospira (Hospira) Hospira (Hospira)

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Sole Subsidised Supply changes – effective 1 October 2013 (continued)

Naltrexone hydrochloride Rifabutin Sertraline Sertraline Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Spironolactone Spironolactone Sumatriptan Sumatriptan Sumatriptan Temozolomide Temozolomide Temozolomide Temozolomide Tetrabenazine Terazosin Terazosin Terazosin Tretinoin Tab 50 mg; 30 tab Cap 150 mg; 30 cap Tab 50 mg; 90 tab Tab 100 mg; 90 tab Inj 23.4%, 20 ml; 5 inj Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml; 50 enema Tab 25 mg; 100 tab Tab 100 mg; 100 tab Inj 12 mg per ml, 0.5 ml cartridge; 2 OP Tab 50 mg; 100 tab Tab 100 mg; 100 tab Cap 5 mg; 5 cap Cap 20 mg; 5 cap Cap 100 mg; 5 cap Cap 250 mg; 5 cap Tab 25 mg; 112 tab Tab 1 mg; 28 tab Tab 2 mg; 28 tab Tab 5 mg; 28 tab Crm 0.5 mg per g; 50 g OP Naltraccord (Arrow) Mycobutin (Pfizer) Arrow-Sertraline (Arrow) Arrow-Sertraline (Arrow) Biomed (Biomed) Micolette (AFT) Spirotone (Mylan) Spirotone (Mylan) Arrow-Sumatriptan (Arrow) Arrow-Sumatriptan (Arrow) Arrow-Sumatriptan (Arrow) Temaccord (Douglas) Temaccord (Douglas) Temaccord (Douglas) Temaccord (Douglas) Motetis (Douglas) Arrow (Arrow) Arrow (Arrow) Arrow (Arrow) ReTrieve (Valeant)

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 October 2013 • Riluzole (Rilutek) 50 mg tablets – Special Authority – Retail pharmacy

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Sole Subsidised Supply Products – cumulative to September 2013

Generic Name

Abacavir sulphate Acarbose Acetazolamide Acetylcysteine Allopurinol Amantadine hydrochloride Aminophylline Amiodarone hydrochloride Amisulpride 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 100 mg & 300 mg Cap 100 mg Inj 25 mg per ml, 10 ml Inj 50 mg per ml, 3 ml ampoule Oral liq 100 mg per ml Tab 100 mg, 200 mg & 400 mg Tab 10 mg Tab 25 mg & 50 mg Tab 2.5 mg Tab 5 mg & 10 mg Inj 250 mg, 500 mg & 1 g 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 50 mg & 100 mg Tab 10 mg, 20 mg, 40 mg & 80 mg Inj 600 mcg, 1 ml Tab 500 mg Tab 10 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 200 mg Tab long-acting 400 mg Tab 50 mg

Brand Name Expiry Date*

Ziagen Ziagen Accarb Diamox Martindale Acetylcysteine Apo-Allopurinol Symmetrel DBL Aminophylline Cordarone-X Solian Arrow-Amitriptyline Amitrip Apo-Amlodipine Apo-Amlodipine Ibiamox Augmentin Augmentin Curam Duo AFT Mylan Atenolol Zarator AstraZeneca Apo-Azithromycin Pacifen ArrowBendrofluazide Bicillin LA Sandoz Betoptic Betoptic S Bezalip Bezalip Retard Bicalaccord 2014 2014 2015 2015 2015 2015 2016 2014 2015 2014 2014 2015 2014 2014 2015 2014 2015 2014 2014 2014 2016 2016 2014 2014 2014 2015

Aqueous cream Atenolol Atorvastatin Atropine sulphate Azithromycin Baclofen Bendrofluazide Benzathine benzylpenicillin Benzylpenicillin sodium (Penicillin G) Betaxolol hydrochloride Bezafibrate Bicalutamide

*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.

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Sole Subsidised Supply Products – cumulative to September 2013

Generic Name

Blood glucose diagnostic test meter Blood glucose diagnostic test strip Boceprevir Brimonidine tartrate Cabergoline Calamine Calcitonin Calcium carbonate Calcium folinate Candesartan Carbomer Cefazolin sodium Cefuroxime sodium Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate

Presentation

Meter with 50 lancets, a lancing device and 10 diagnostic test strips Blood glucose test strips Cap 200 mg 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 Ophthalmic gel 0.3%, 0.5 g Inj 500 mg & 1 g Inj 750 mg 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 250 mg, 500 mg & 750 mg Tab 20 mg Tab 500 mg Tab 250 mg Tab 10 mg & 25 mg Tab 150 mcg Inj 150 mcg per ml, 1 ml Crm 1% Tab 15 mg, 30 mg & 60 mg Crm 10% Tab 50 mg Oral liq 100 mg per ml Tab 50 mg & 100 mg

Brand Name Expiry Date*

CareSens N CareSens N POP CareSens II CareSens CareSens N Victrelis Arrow-Brimonidine Dostinex PSM Miacalcic Arrow-Calcium Calsource DBL Leucovorin Calcium Candestar Poly-Gel AFT Multichem Cetirizine - AFT Zetop Chlorsig Chlorafast healthE healthE Orion Apo-Ciclopirox Cipflox Arrow-Citalopram Apo-Clarithromycin Apo-Clarithromycin Apo-Clomipramine Catapres Clomazol PSM Itch-Soothe Nausicalm Neoral Siterone 2015

2015 2016 2014 2015 2015 2014 2014 2014 2015 2016 2014 2014 2014 2015 2015 2014 2015 2014 2014 2014 2015 2015 2014 2016 2015 2015 2015 2015

Ciclopirox olamine Ciprofloxacin Citalopram hydrobromide Clarithromycin Clomipramine hydrochloride Clonidine hydrochloride Clotrimazole Codeine phosphate Crotamiton Cyclizine hydrochloride Cyclosporin Cyproterone acetate

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*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 September 2013

Generic Name

Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone

Presentation

Tab 2 mg with ethinyloestradiol 35 mcg and 7 inert tabs Nasal spray 10 mcg per dose Tab 1 mg & 4 mg Eye oint 0.1%

Brand Name Expiry Date*

Ginet 84 Desmopressin-PH&T Douglas Maxidex Maxitrol Maxitrol 2014 2014 2015 2014 2014

Dexamethasone with neomycin Eye oint 0.1% with neomycin sulphate and polymyxin b sulphate 0.35% and polymyxin B sulphate 6,000 u per g Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin B sulphate 6,000 u per ml Dexamphetamine sulphate Dextrose Diclofenac sodium Tab 5 mg Inj 50%, 10 ml Tab EC 25 mg & 50 mg 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 Cap long-acting 120 mg, 180 mg & 240 mg Tab 30 mg & 60 mg Tab long-acting 150 mg Cap 50 mg Cap 120 mg Tab 10 mg Tab 2 mg & 4 mg Tab 100 mg Oint BP Inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg & 150 mg Tab 200 mg Inj 500 mcg per ml, 1 ml Tab 200 mg Tab 10 mcg Tab 20 mcg with levonorgestrel 100 mcg & 7 inert tab Tab 30 mcg with levonorgestrel 150 mcg & 7 inert tab Tab 25 mg Tab long-acting 5 mg & 10 mg Tab long-acting 2.5 mg

PSM Biomed Apo-Diclo Diclax SR Voltaren Voltaren Ophtha Voltaren Apo-Diltiazem CD Dilzem Pytazen SR Laxofast 50 Laxofast 120 Prokinex Apo-Doxazosin Doxine AFT Clexane Entapone DBL Ergometrine Arrow-Etidronate NZ Medical and Scientific Ava 20 ED Ava 30 ED Aromasin Plendil ER Plendil ER

2015 2014 2015 2014

Diltiazem hydrochloride

2015

Dipyridamole Docusate sodium Domperidone Doxazosin mesylate Doxycycline hydrochloride Emulsifying ointment Enoxaparin sodium Entacapone Ergometrine maleate Etidronate disodium Ethinyloestradiol Ethinyloestradiol with levonorgestrel

2014 2014 2015 2014 2014 2014 2015 2015 2014 2015 2015 2014

Exemestane Felodopine

2014 2015

*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.

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Sole Subsidised Supply Products – cumulative to September 2013

Generic Name

Fentanyl Filgrastim Finasteride Flucloxacillin sodium

Presentation

Inj 50 mcg per ml, 2 ml & 10 ml Inj 300 mcg per 0.5 ml Inj 480 mcg 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% Crm 5% Metered aqueous nasal spray, 50 mcg per dose Tab 500 mg Tab 40 mg Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg Suppos 3.6 g Aerosol spray 400 mcg per dose TDDS 5 mg & 10 mg Tab 600 mcg Tab 5 mg & 20 mg Crm 1% Powder Rectal foam 10%, CFC-Free (14 applications) Lipocream 0.1% Milky emul 0.1% Oint 0.1% Scalp lotn 0.1% Lotn 1% with wool fat hydrous 3% and mineral oil Inj 1 mg per ml, 1 ml Tab 200 mg Inj 20 mg, 1 ml Tab 10 mg Tab 200 mg Tab long-acting 800 mg Crm 5%

Brand Name Expiry Date*

Boucher and Muir Zarzio Zarzio Rex Medical AFT Staphlex Flucloxin Ozole Flucon Efudix Flixonase Hayfever & Allergy Urex Forte Diurin 40 Pfizer Apo-Gliclazide Minidiab PSM Glytrin Nitroderm TTS Lycinate Douglas Pharmacy Health ABM Colifoam Locoid Lipocream Locoid Crelo Locoid Locoid DP Lotn HC ABM Hydroxocobalamin Plaquenil Buscopan Gastrosoothe Arrowcare Brufen SR Aldara 2015

31/12/15

2014 2015 2014 2014 2015 2015 2015 2015 2015 2014 2015 2015 2014

Fluconazole Fluorometholone Fluorouracil sodium Fluticasone propionate Furosemide Gentamicin sulphate Gliclazide Glipizide Glycerol Glyceryl trinitrate

Hydrocortisone

2015 2014 2015 2015

Hydrocortisone acetate Hydrocortisone butyrate

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

2014 2015 2015 2014 2014 2014

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*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 September 2013

Generic Name

Iron polymaltose Isoniazid Isosorbide mononitrate Isotretinoin Ketoconazole Lamivudine Lansoprazole Latanoprost Letrozole Levonorgestrel Lignocaine hydrochloride Lisinopril Lithium carbonate Lodoxamide trometamol Losartan Losartan with hydrochlorothiazide Macrogol 400 and propylene glycol Mask for spacer device Mebendazole Mebeverine hydrochloride Megestrol acetate Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Mesalazine Metformin hydrochloride Methadone hydrochloride

Presentation

Inj 50 mg per ml, 2 ml Tab 100 mg Tab 20 mg Tab long-acting 40 mg Cap 10 mg & 20 mg Shampoo 2% Tab 100 mg Cap 15 mg & 30 mg Eye drops 50 mcg per ml Tab 2.5 mg Subdermal implant (2 x 75 mg rods) Viscous soln 2% Tab 5 mg, 10 mg & 20 mg Tab 250 mg & 400 mg Cap 250 mg Eye drops 0.1% Tab 12.5 mg, 25 mg, 50 mg & 100 mg Tab 50 mg with hydrochlorothiazide 12.5 mg Eye drops 0.4% and propylene glycol 0.3%, 0.4 ml 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 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

Brand Name Expiry Date*

Ferrum H PSM Ismo 20 Corangin Oratane Sebizole Zetlam Solox Hysite Letraccord Jadelle Xylocaine Viscous Arrow-Lisinopril Lithicarb FC Douglas Lomide Lostaar Arrow-Losartan & Hydroclorothiazide Systane Unit Dose EZ-fit Paediatric Mask De-Worm Colofac Apo-Megestrol Medrol Depo-Medrol Depo-Medrol with Lidocaine Pentasa Asacol Apotex Biodone Biodone Forte Biodone Extra Forte 2014 2015 2014 2015 2014 2014 2015 2015 2015 31/12/13 2014 2015 2015 2014 2014 2014 2014 2016 2015 2014 2014 2015 2015 2015 2015 2015 2014 2015 2015

*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.

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Sole Subsidised Supply Products – cumulative to September 2013

Generic Name

Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol succinate Metoprolol tartrate

Presentation

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 Oral gel 20 mg per g Crm 2% Tab 30 mg & 45 mg Tab 150 mg & 300 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 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

Brand Name Expiry Date*

Solu-Medrol Pfizer Metamide Metoprolol-AFT CR Lopresor Lopresor Slow-Lopresor Decozol Multichem Avanza Apo-Moclobemide m-Mometasone RA-Morph DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Naphcon Forte Apo-Nadolol Noflam 250 Noflam 500 AstraZeneca Nevirapine Alphapharm Habitrol Habitrol Habitrol Apo-Nicotinic Acid Noriday 28 Primolut N Arrow-Norfloxacin Norpress Nilstat 2014 2015 2014 2014 2016 2014 2015 2014 2015 2015

Miconazole Miconazole nitrate Mirtazapine Moclobemide Mometasone furoate Morphine hydrochloride Morphine sulphate

2015 2014 2015 2015 2015 2015 2014

Naphazoline hydrochloride Nadolol Naproxen Neostigmine Nevirapine Nicotine

Eye drops 0.1% Tab 40 mg & 80 mg Tab 250 mg Tab 500 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 350 mcg Tab 5 mg Tab 400 mg Tab 10 mg & 25 mg Oral liq 100,000 u per ml

2014 2015 2015 2014 2015 2014

Nicotinic acid Norethisterone Norfloxacin Nortriptyline hydrochloride Nystatin

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*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 September 2013

Generic Name

Octreotide (somatostatin analogue) Oil in water emulsion Omeprazole

Presentation

Inj 50 mcg per ml, 1 ml Inj 100 mcg per ml, 1 ml Inj 500 mcg per ml, 1 ml Crm Cap 10 mg, 20 mg & 40 mg Powder Inj 40 mg Tab 10 mg & 15 mg Oral liq 5 mg per ml Tab 5 mg Inj 50 mg per ml, 1 ml Inj 10 mg per ml, 1 ml & 2 ml Inj 5 iu with ergometrine maleate 500 mcg per ml, 1 ml Inj 3 mg per ml, 10 ml; 6 mg per ml, 10 ml & 9 mg per ml, 10 ml Inj 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 Low range & normal range Inj 135 mcg prefilled syringe & inj 180 mcg prefilled syringe Inj 135 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 112 Inj 135 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 168 Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 112 Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 168 Tab 0.25 mg & 1 mg Crm 5% Lotn 5%

Brand Name Expiry Date*

Octreotide Max Rx 2014

healthE Fatty Cream Omezol Relief Midwest Dr Reddy’s Omeprazole Ox-Pam Apo-Oxybutynin OxyNorm Oxycodone Orion Syntometrine Pamidronate BNM Pantocid IV Paracare Parafast Ethics Paracetamol Paracare Double Strength Paracetamol + Codeine (Relieve) Breath-Alert Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Permax Lyderm A-Scabies

2015 2014

Oxazepam Oxybutynin Oxycodone hydrochloride Oxytocin Pamidronate disodium Pantoprazole Paracetamol

2014 2016 2015 2015 2014 2014 2015 2014

Paracetamol with codeine Peak flow meter Pegylated interferon alfa-2a Pegylated interferon alfa-2a

2014 2015 2017 2017

Pergolide Permethrin

2014 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 September 2013

Generic Name

Pethidine hydrochloride

Presentation

Tab 50 mg & 100 mg Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

PSM DBL Pethidine Hydrochloride DBL Pethidine Hydrochloride PSM Pizaccord Sandomigran Coloxyl Span-K Cholvastin Cilicaine Allersoothe Allersoothe Mestinon PyridoxADE Apo-Pyridoxine Arrow-Quinapril Accuretic 10 Accuretic 20 Peptisoothe Arrow-Ranitidine Norvir Rizamelt ArrowRoxithromycin Asthalin Duolin 2014 2015 2014 2015 2015 2015 2015 2014

Phenobarbitone Pioglitazone Pizotifen Poloxamer Potassium chloride Pravastatin Procaine penicillin Promethazine hydrochloride Pyridostigmine bromide Pyridoxine hydrochloride Quinapril Quinapril with hydrochlorothiazide

Tab 15 mg & 30 mg Tab 15 mg, 30 mg & 45 mg Tab 500 mcg Oral drops 10% Tab long-acting 600 mg Tab 20 mg & 40 mg Inj 1.5 mega u Oral liq 5 mg per 5 ml Tab 10 mg & 25 mg Tab 60 mg Tab 25 mg Tab 50 mg Tab 5 mg, 10 mg & 20 mg 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 Tab 100 mg Tab orodispersible 10 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 25 mg, 50 mg & 100 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Eye drops 1 mg per ml, 10 ml OP 800 ml 230 ml (single patient)

2015 2015 2015 2014 2015 2014 2014 2015 2014 2014 2015 2015

Ranitidine hydrochloride Ritonavir Rizatriptan Roxithromycin Salbutamol Salbutamol with ipratropium bromide Sildenafil Simvastatin

Silagra Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Hylo-Fresh Volumatic Space Chamber Plus

2014 2014

Sodium hyaluronate Spacer device

2016 2015

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 September 2013

Generic Name

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

Presentation

Tab 20 mg Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium, 500 ml & 1,000 ml Tab 10 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Cap 40 mg Inj 250 mcg per ml, 1 ml ampoule 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 Eye drops 0.5% & 1% Cap 250 mg Inj 500 mg Tab 40 mg & 80 mg Tab 300 mg with lamivudine 150 mg Oint BP Caps 137.4 mg (50 mg elemental)

Brand Name Expiry Date*

Genox Pinetarsol 2014 2014

Normison Dr Reddy’s Terbinafine Depo-Testosterone Andriol Testocaps Synacthen Synacthen Depot Arrow-Timolol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol Kenacort-A Kenacort-A40 Aristocort Aristocort Oracort Mydriacyl Ursosan Mylan Isoptin Alphapharm Multichem Zincaps

2014 2014 2014 2015 2014 2014 2014

Tolcapone Tramadol hydrochloride Triamcinolone acetonide

2014 2014 2014

Tropicamide Ursodeoxycholic acid Vancomycin hydrochloride Verapamil hydrochloride Zidovudine [AZT] with lamivudine Zinc and castor oil Zinc sulphate

2014 2014 2014 2014 2014 2014 2014

September changes are in bold type

*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


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 September 2013

25 82 87 MESALAZINE Modified release granules, 1 g ............................................... 141.72 TETRACOSACTRIN ❋ Inj 250 mcg per ml, 1 ml ampoule ........................................... 17.71 DESMOPRESSIN Tab 100 mcg – Special Authority see SA1401 – Retail pharmacy................................................................ 36.40 Tab 200 mcg – Special Authority see SA1401 – Retail pharmacy................................................................ 93.60 120 g OP 1 ✔ Pentasa ✔ Synacthen

30 30

✔ Minirin ✔ Minirin

➽ SA1401 Special Authority for Subsidy Initial application (Nocturnal enuresis) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: 1. The patient has primary nocturnal enuresis; and 2. The nasal forms of desmopressin are contraindicated; and 3. An enuresis alarm is contraindicated. Initial application (Diabetes insipidus) from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: 1. The patient has cranial diabetes insipidus; and 2. The nasal forms of desmopressin are contraindicated Renewal from any relevant practitioner. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. 98 BOCEPREVIR – Special Authority see SA1365 – Retail pharmacy – Wastage rule applies Cap 200 mg ....................................................................... 5,015.00 336 ✔ Victrelis ➽ SA1365 Special Authority for Subsidy Initial application — (chronic hepatitis C – genotype 1, first-line) from gastroenterologist, infectious disease physician or general physician Approvals valid for 18 months for applications meeting the following criteria: All of the following: 1 Patient has chronic hepatitis C, genotype 1; and 2 Patient has not received prior pegylated interferon treatment; and 3 Patient has IL-28B genotype CT or TT; and 4 Patient is to be treated in combination with pegylated interferon and ribavirin; and 5 Patient is hepatitis C protease inhibitor treatment-naive; and 6 Maximum of 44 weeks therapy. Initial application — (chronic hepatitis C – genotype 1, second-line) from gastroenterologist, infectious disease physician or general physician. Approvals valid for 18 months for applications meeting the following criteria: All of the following: 1 Patient has chronic hepatitis C, genotype 1; and 2 Patient has received pegylated interferon treatment; and 3 Any of the following: 3.1. Patient was a responder relapser; or 3.2. Patient was a partial responder; or 3.3. Patient received pegylated interferon prior to 2004; and 4 Patient is to be treated in combination with pegylated interferon and ribavirin; and 5 Maximum of 44 weeks therapy. Note: Due to risk of severe sepsis boceprevir should not be initiated if either Platelet count <100 x109 /l or Albumin <35 g/l. Note: the wastage rule applies to boceprevir to allow dispensing to occur more frequently than monthly. 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

20


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 September 2013 (continued)

113 123 RISEDRONATE SODIUM Tab 35 mg ............................................................................... 4.00 4 ✔ Risedronate Sandoz

IMIPRAMINE HYDROCHLORIDE – Safety medicine; prescriber may determine dispensing frequency – Wastage rule applies Tab 10 mg ................................................................................ 6.58 60 ✔ Tofranil S29 S29 THIOTEPA – PCT only – Specialist Inj 15 mg ............................................................................. CBS PARAFFIN LIQUID WITH SOFT WHITE PARAFFIN ❋ Eye oint with soft white paraffin ................................................. 3.63 PHARMACY SERVICES – May only be claimed once per patient Brand switch fee ....................................................................... 4.33 The Pharmacode for BSF Acetec is 2445441

148

1 3.5 g OP 1 fee

✔ Tepadina S29 ✔ Refresh Night Time ✔ BSF Acetec

186 187

202

PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA1379 – Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (strawberry) .................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (vanilla) .......................................................................... 1.07 200 ml OP ✔ Pediasure Note – the packaging has changed to Recloseable Plastic Bottle (RPB) with new Pharmacodes. PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA1379 – Hospital pharmacy [HP3] Liquid (vanilla) .......................................................................... 1.34 250 ml OP ✔ Pediasure

202

Effective 12 August 2013

52 ENALAPRIL MALEATE ❋ Tab 5 mg ................................................................................. 0.36 5.94 ❋ Tab 10 mg ............................................................................... 0.44 7.33 ❋ Tab 20 mg – For enalapril maleate oral liquid formulation refer, page 189 ............................................................................... 0.57 30 500 30 500 30 ✔ Acetec ✔ Acetec ✔ Acetec ✔ Acetec ✔ Acetec

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

Changes to Restrictions, Chemical Names and Presentations

Effective 1 September 2013

52 ENALAPRIL MALEATE – Brand switch fee payable (Pharmacode 2445441) - see page 187 for details Tab 5 mg .................................................................................. 0.36 30 ✔ Acetec 1.07 90 ✔ m-Enalapril 5.94 500 ✔ Acetec Tab 10 mg ................................................................................ 0.44 30 ✔ Acetec 1.32 90 ✔ m-Enalapril 7.33 500 ✔ Acetec Tab 20 mg – For enalapril maleate oral liquid formulation refer, page 189 ............................................................................... 0.57 30 ✔ Acetec 1.72 90 ✔ m-Enalapril Note: the removal of the stat symbol will be temporary due to a stock recall TETRACOSACTRIN (amendment to presentation) ❋ Inj 250 mcg per ml, 1 ml ampoule .......................................... 17.71 177.18 1 10 ✔ Synacthen ✔ Synacthen

82 106

Guidelines for the use of interferon in the treatment of hepatitis C: Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or an infectious disease physician. All subjects undergoing treatment require careful monitoring for side effects. Patients should be otherwise fit. Hepatocellular carcinoma should be excluded by ultrasound examination and alpha-fetoprotein level. Criteria for Treatment 1) Diagnosis • Anti-HCV positive on at least two occasions with a positive PCR for HCV-RNA and preferably confirmed by a supplementary RIBA test; or • PCR-RNA positive for HCV on at least 2 occasions if antibody negative; or • Anti-HCV positive on at least two occasions with a positive supplementary RIBA test with a negative PCR for HCV RNA but with a liver biopsy consistent with 2(b) following. Exclusion Criteria 1) Autoimmune liver disease. (Interferon may exacerbate autoimmune liver disease as well as other autoimmune diseases such as thyroid disease). 2) Pregnancy. 3) Neutropenia (<2.0 × 109) and/or thrombocytopenia. 4) Continuing alcohol abuse and/or continuing intravenous drug users. Dosage The current recommended dosage is 3 million units of interferon alfa-2a alpha-2a or interferon alpha-2b alfa-2b administered subcutaneously 3 times a week for 52 weeks (twelve months) Exit Criteria The patient’s response to interferon treatment should be reviewed at either three or four months. Interferon treatment should be discontinued in patients who do not show a substantial reduction (50%) in their mean pretreatment ALlevel at this stage. INTERFERON ALFA-2A ALPHA-2A – PCT – Retail pharmacy-Specialist (amendment to chemical name) a) See prescribing guideline b) Prescriptions must be written by, or on the recommendation of, an internal medicine physician or ophthalmologist 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

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

107

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

22


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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2013 (continued)

107 INTERFERON ALFA-2B ALPHA-2B – PCT – Retail pharmacy-Specialist (amendment to chemical name) a) See prescribing guideline b) Prescriptions must be written by, or on the recommendation of, an internal medicine physician or ophthalmologist 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 PEGYLATED INTERFERON ALFA-2A ALPHA-2A – Special Authority see SA14001365 – Retail pharmacy See prescribing guideline Inj 135 mcg prefilled syringe ............................................... 1,448.00 4 Inj 180 mcg prefilled syringe .................................................. 900.00 4 Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 112 ......................................................... 1,159.84 1 OP Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 168 ........................................................ 1,290.00 1 OP

107

✔ Pegasys ✔ Pegasys ✔ Pegasys RBV Combination Pack ✔ Pegasys RBV Combination Pack

➽ SA14001365 Special Authority for Subsidy Initial application — (chronic hepatitis C - genotype 1, 4, 5 or 6 infection or co-infection with HIV or genotype 2 or 3 post liver transplant) from any specialist. Approvals valid for 18 months for applications meeting the following criteria: Both: 1. Any of the following: 1.1 Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or 1.2 Patient has chronic hepatitis C and is co-infected with HIV; or 1.3 Patient has chronic hepatitis C genotype 2 or 3 and has received a liver transplant; and 2. Maximum of 48 weeks therapy. Notes: Consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure. Consider reducing treatment to 24 weeks if serum HCV RNA level at Week 4 is undetectable by sensitive PCR assay (less than 50IU/ml) AND Baseline serum HCV RNA is less than 400,000IU/ml. Renewal application — (Chronic hepatitis C – genotype 1 infection) from gastroenterologist, infectious disease physician or general physician. Approvals valid for 18 months for patients meeting the following criteria: All of the following: 1 Patient has chronic hepatitis C, genotype 1; and 2 Patient has had previous treatment with pegylated interferon and ribavirin; and 3 Either: 3.1 Patient has responder relapsed; or 3.2 Patient was a partial responder; and 4 Patient is to be treated in combination with boceprevir; and 5 Maximum of 48 weeks therapy. Initial application (Chronic Hepatitis C – genotype 1 infection treatment more than 4 years prior) from a gastroenterologist, infectious disease physician or general physician. Approvals valid for 18 months for patients meeting the following criteria: All of the following 1. Patient has chronic hepatitis C, genotype 1; and continued... 2. Patient has had previous treatment with pegylated interferon and ribavirin; and

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

Changes to Restrictions - effective 1 September 2013 (continued)

continued... 3. Any of the following: 3.1. Patient has responder relapsed; or 3.2. Patient was a partial responder; or 3.3. Patient received interferon treatment prior to 2004; and 4. Patient is to be treated in combination with boceprevir; and 5. Maximum of 48 weeks therapy. Initial application — (chronic hepatitis C - genotype 2 or 3 infection without co-infection with HIV) from any specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1. Patient has chronic hepatitis C, genotype 2 or 3 infection; and 2. Maximum of 6 months therapy. Initial application — (Hepatitis B) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 18 months for applications meeting the following criteria: All of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 Patient is Hepatitis B treatment-naive; and 3 ALT > 2 times Upper Limit of Normal; and 4 HBV DNA < 10 log10 IU/ml; and 5 Either: 5.1 HBeAg positive; or 5.2 serum HBV DNA ≥ 2,000 units/ml and significant fibrosis (≥ Metavir Stage F2 or moderate fibrosis); and 6 Compensated liver disease; and 7 No continuing alcohol abuse or intravenous drug use; and 8 Not co-infected with HCV, HIV or HDV; and 9 Neither ALT nor AST > 10 times upper limit of normal; and 10 No history of hypersensitivity or contraindications to pegylated interferon; and 11 Maximum of 48 weeks therapy. Notes: Approved dose is 180 mcg once weekly. The recommended dose of Pegylated Interferon-alpha 2a Interferon alfa-2a is 180 mcg once weekly. In patients with renal insufficiency (calculated creatinine clearance less than 50ml/min), Pegylated Interferonalpha 2a Interferon alfa-2a dose should be reduced to 135 mcg once weekly. In patients with neutropaenia and thrombocytopaenia, dose should be reduced in accordance with the datasheet guidelines. Pegylated Interferon-alpha 2a Interferon alfa-2a is not approved for use in children. 125 VENLAFAXINE – Special Authority see SA1061 – Retail pharmacy Tab 37.5 mg ............................................................................ 5.06 Tab 75 mg ................................................................................ 6.44 Tab 150 mg .............................................................................. 8.86 Tab 225 mg ............................................................................ 14.34 Cap 37.5 mg – Special Authority see SA1061 – Retail pharmacy ................................................................ 8.71 Cap 75 mg – Special Authority see SA1061 – Retail pharmacy .............................................................. 17.42 Cap 150 mg – Special Authority see SA1061 – Retail pharmacy .............................................................. 21.35 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

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

24

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


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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2013 (continued)

136 RISPERIDONE – Special Authority see SA0927 – Retail pharmacy Safety medicine; prescriber may determine dispensing frequency Tab orodispersible Orally-disintegrating tablets 0.5 mg ........... 21.42 Tab orodispersible Orally-disintegrating tablets 1 mg ............. 42.84 Tab orodispersible Orally-disintegrating tablets 2 mg ............. 85.71 CYTARABINE Inj 100 mg 20 mg per ml, 5 ml vial – PCT – Retail pharmacy-Specialist ..................................... 55.00 80.00 Inj 1 g 100 mg per ml, 10 ml vial – PCT – Retail pharmacy-Specialist .................................................. 8.83 42.65 Inj 2 g 100 mg per ml, 20 ml vial – PCT – Retail pharmacy-Specialist ................................................ 17.65 34.47

28 28 28

✔ Risperdal Quicklet ✔ Risperdal Quicklet ✔ Risperdal Quicklet

148

5 1 1

✔ Pfizer ✔ Mayne ✔ Pfizer ✔ Mayne ✔ Pfizer ✔ Mayne

204

PAEDIATRIC ENTERAL FEED WITH FIBRE 0.76 0.75 KCAL/ML – Special Authority see SA1196 – Hospital pharmacy [HP3] Liquid ........................................................................................ 4.00 500 ml OP ✔ Nutrini Low Energy Multi Fibre

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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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 September 2013

42 42 VITAMIN B COMPLEX ( subsidy) ❋ Tab, strong, BPC ....................................................................... 4.30 ASCORBIC ACID ( subsidy) a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg .............................................................................. 7.00 VITAMINS ( subsidy) ❋ Tab (BPC cap strength) ............................................................. 7.60 POTASSIUM IODATE ( subsidy) ❋ Tab 256 mcg (150 mcg elemental iodine) ................................. 6.53 DEXTROSE WITH ELECTROLYTES ( subsidy) Soln with electrolytes ................................................................ 6.55 PINDOLOL ( subsidy) ❋ Tab 5 mg ................................................................................. 9.72 ❋ Tab 10 mg ............................................................................ 15.62 ❋ Tab 15 mg ............................................................................. 23.46 GEMFIBROZIL ( subsidy) ❋ Tab 600 mg ............................................................................ 17.60 500 ✔ B-PlexADE ✔ Bplex

42 43 51

500

✔ Vitala-C ✔ Cvite ✔ MultiADE ✔ Mvite ✔ NeuroKare

1,000

90

1,000 ml OP ✔ Pedialyte – Bubblegum 100 100 100 60 ✔ Apo-Pindolol ✔ Apo-Pindolol ✔ Apo-Pindolol ✔ Lipazil

56 59 105 107

LAMIVUDINE – Special Authority see SA1364 – Retail pharmacy ( subsidy) Oral liq 10 mg per ml ............................................................. 102.50 240 ml OP ✔ 3TC PEGYLATED INTERFERON ALFA-2A – Special Authority see SA1400 – Retail pharmacy ( subsidy) See prescribing guideline Inj 180 mcg prefilled syringe .................................................. 900.00 4 ✔ Pegasys Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 112 ............................................................................ 1,159.84 1 OP ✔ Pegasys RBV Combination Pack Inj 180 mcg prefilled syringe × 4 with ribavirin tab 200 mg × 168 ........................................................................... 1,290.00 1 OP ✔ Pegasys RBV Combination Pack LIDOCAINE [LIGNOCAINE] HYDROCHLORIDE ( subsidy) Inj 1%, 5 ml ampoule – Up to 25 inj available on a PSO ............ 17.50 (35.00) Inj 1%, 20 ml ampoule – Up to 5 inj available on a PSO ............ 12.00 (20.00) 50 Xylocaine 5 Xylocaine

119

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

26

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


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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 September 2013 (continued)

125 VENLAFAXINE ( subsidy) Tab 37.5 mg ............................................................................ 5.06 Tab 75 mg ................................................................................ 6.44 Tab 150 mg ............................................................................. 8.86 Tab 225 mg ............................................................................ 14.34 CYTARABINE ( subsidy) Inj 20 mg per ml, 5 ml vial – PCT – Retail pharmacy-Specialist ................................................ 55.00 Inj 100 mg per ml, 10 ml vial – PCT – Retail pharmacy-Specialist .................................................. 8.83 Inj 100 mg per ml, 20 ml vial – PCT – Retail pharmacy-Specialist ................................................ 17.65 Inj 1 mg for ECP – PCT only – Specialist ................................... 0.11 Inj 100 mg intrathecal syringe for ECP – PCT only – Specialist.......................................................................... 11.00 28 28 28 28 ✔ Arrow-Venlafaxine XR ✔ Arrow-Venlafaxine XR ✔ Arrow-Venlafaxine XR ✔ Arrow-Venlafaxine XR

148

5 1 1 10 mg

✔ Pfizer ✔ Pfizer ✔ Pfizer ✔ Baxter

100 mg OP ✔ Baxter

161

MYCOPHENOLATE MOFETIL – Special Authority see SA1041 – Retail pharmacy ( subsidy) Dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically. Tab 500 mg ........................................................................... 25.00 50 ✔ Cellcept Cap 250 mg ........................................................................... 25.00 100 ✔ Cellcept

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

27


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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules

Effective 1 September 2013

15 “Specialist”, in relation to a Prescription, means a doctor who holds a current annual practising certificate and who satisfies the criteria set out in paragraphs (a) or (b) or (c) or (d) below: a) i) the doctor is vocationally registered in accordance with the criteria set out by the Medical Council of New Zealand and the HPCA Act 2003 and who has written the prescription in the course of practising in that area of medicine; and or ii) the doctor’s vocational scope of practice is one of those listed below: — anaesthetics, cardiothoracic surgery, dermatology, diagnostic radiology, emergency medicine, general surgery, internal medicine, neurosurgery, obstetrics and gynaecology, occupational medicine, ophthalmology, oral and maxillofacial surgery, otolaryngology head and neck surgery, orthopaedic surgery, paediatric surgery, paediatrics, pathology, plastic and reconstructive surgery, psychological medicine or psychiatry, public health medicine, radiation oncology, rehabilitation medicine, urology and venereology; or b) the doctor is recognised by the Ministry of Health as a specialist for the purposes of this Schedule and receives remuneration from a DHB at a level which that DHB considers appropriate for specialists and who has written that prescription in the course of practising in that area of medicine; or c) the doctor is recognised by the Ministry of Health as a specialist in relation to a particular area of medicine for the purpose of writing Prescriptions and who has written the Prescription in the course of practising in that area of medicine; or d) the doctor writes the prescription on DHB stationery and is appropriately authorised by the relevant DHB to do so. 3.3 Original Packs, Certain Antibiotics and Unapproved Medicines 3.3.1 Notwithstanding clauses 3.1 and 3.3 of the Schedule, if a Practitioner prescribes or orders a Community Pharmaceutical that is identified as an Original Pack (OP) on the Pharmaceutical Schedule and is packed in a container from which it is not practicable to dispense lesser amounts, every reference in those clauses to an amount or quantity eligible for Subsidy, is deemed to be a reference: a) where an amount by weight or volume of the Community Pharmaceutical is specified in the Prescription, to the smallest container of the Community Pharmaceutical, or the smallest number of containers of the Community Pharmaceutical, sufficient to provide that amount; and b) in every other case, to the amount contained in the smallest container of the Community Pharmaceutical that is manufactured in, or imported into, New Zealand. 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, but excluding any medicine listed as Cost, Brand, Source of Supply,or c) any other pharmaceutical that PHARMAC determines, from time to time and notes in the Pharmaceutical Schedule. 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 between the amount dispensed and the amount prescribed by the Practitioner is less than 10% (eg; if a prescription is for 105 mls then a 100ml 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.

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

18

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

28


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 September 2013

31 32 107 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 PEGYLATED INTERFERON ALFA-2A – Special Authority see SA1365 – Retail pharmacy See prescribing guideline Inj 135 mcg prefilled syringe .................................................. 362.00 1 ✔ Pegasys Inj 180 mcg prefilled syringe ................................................. 450.00 1 ✔ Pegasys FAT SUPPLEMENT – Special Authority see SA1374 – Hospital pharmacy [HP3] Oil ........................................................................................... 28.73 250 ml OP ✔ Liquigen ENTERAL FEED 1KCAL/ML – Special Authority see SA1228 – Hospital pharmacy [HP3] Liquid ........................................................................................ 2.65 500 ml OP ✔ Nutrison Standard RTH ENTERAL FEED WITH FIBRE 1 KCAL/ML – Special Authority see SA1228 – Hospital pharmacy [HP3] Liquid ........................................................................................ 2.65 500 ml OP ✔ Nutrison Multi Fibre

199 207

207

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

29


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 December 2013

187 PHARMACY SERVICES – May only be claimed once per patient Brand switch fee ....................................................................... 4.33 The Pharmacode for BSF Acetec is 2445441 1 fee ✔ BSF Acetec

Effective 1 March 2014

77 NORETHISTERONE WITH MESTRANOL ❋ Tab 1 mg with mestranol 50 mcg and 7 inert tab........................ 6.62 (13.80) a) Higher subsidy of $13.80 per 84 tab with Special Authority see SA0500 b) Up to 84 tab available on a PSO PENICILLIN G BENZATHINE [BENZATHINE BENZYLPENICILLIN] Inj 1.2 mega u per 2 ml – Up to 5 inj available on a PSO......... 315.00 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg – For azathioprine oral liquid formulation refer, page 189 ............................................................................. 18.45 PARAFFIN LIQUID WITH SOFT WHITE PARAFFIN ❋ Eye oint with soft white paraffin ................................................. 3.63 84 Norinyl-1/28

90 161 186 202

10

✔ Bicillin LA

100 3.5 g OP

✔ Imuran ✔ Lacri-Lube

PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA1379 – Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (strawberry) ................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (vanilla) .......................................................................... 1.07 200 ml O ✔ Pediasure 1.27 237 ml OP ✔ Pediasure Note – Replacement Pediasure packs were listed 1 September 2013.

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

30

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


Index

Pharmaceuticals and brands Symbols 3TC ................................................................... 26 A Acetec ......................................................... 21, 22 Apo-Pindolol ...................................................... 26 Arrow-Venlafaxine XR................................... 24, 27 Ascorbic acid ..................................................... 26 Azathioprine ....................................................... 30 B Bicillin LA........................................................... 30 Boceprevir ......................................................... 20 Bplex ................................................................. 26 B-PlexADE ......................................................... 26 BSF Acetec .................................................. 21, 30 C Cellcept ............................................................. 27 Cvite .................................................................. 26 Cytarabine ................................................... 25, 27 D Desmopressin .................................................... 20 Dextrose with electrolytes................................... 26 E Efexor XR ........................................................... 24 Enalapril maleate .......................................... 21, 22 Enteral feed 1kcal/ml .......................................... 29 Enteral feed with fibre 1 kcal/ml .......................... 29 F Fat supplement .................................................. 29 G Gemfibrozil ........................................................ 26 I Imuran ............................................................... 30 Insulin pen needles............................................. 29 Insulin syringes, disposable with attached needle ............................................... 29 Interferon alfa-2a................................................ 22 Interferon alfa-2b ............................................... 23 Interferon alpha-2a ............................................. 22 Interferon alpha-2b ............................................. 23 Imipramine hydrochloride ................................... 21 Intron-A ............................................................. 23 L Lacri-Lube ......................................................... 30 Lamivudine ........................................................ 26 Lidocaine [lignocaine] hydrochloride .................. 26 Lipazil ................................................................ 26 Liquigen ............................................................. 29 M m-Enalapril ........................................................ 22 Mesalazine ......................................................... 20 Minirin ............................................................... 20 MultiADE............................................................ 26 Mvite ................................................................. 26 Mycophenolate mofetil ....................................... 27 N NeuroKare.......................................................... 26 Norethisterone with mestranol ............................ 30 Norinyl-1/28 ...................................................... 30 Nutrini Low Energy Multi Fibre ............................ 25 Nutrison Multi Fibre ............................................ 29 Nutrison Standard RTH....................................... 29 P Paediatric enteral feed with fibre 0.75 Kcal/ml..... 25 Paediatric enteral feed with fibre 0.76 kcal/ml ..... 25 Paediatric oral feed 1kcal/ml......................... 21, 30 Paraffin liquid with soft white paraffin ........... 21, 30 Pedialyte – Bubblegum ....................................... 26 Pediasure..................................................... 21, 30 Pegasys............................................................. 23 Pegasys................................................. 23, 26, 29 Pegasys RBV Combination Pack .................. 23, 26 Pegylated interferon alfa-2a .................... 23, 26, 29 Pegylated interferon alpha-2a ............................. 23 Penicillin g benzathine [benzathine benzylpenicillin] ............................ 30 Pentasa ............................................................. 20 Pharmacy services....................................... 21, 30 Pindolol ............................................................. 26 Potassium iodate ............................................... 26 R Refresh Night Time ............................................ 21 Risedronate Sandoz ........................................... 21 Risedronate sodium ........................................... 21 Risperdal Quicklet .............................................. 25 Risperidone........................................................ 25 Roferon-A .......................................................... 22 S Synacthen.................................................... 20, 22 T Tepadina ............................................................ 21 Tetracosactrin .............................................. 20, 22 Thiotepa............................................................. 21 Tofranil S29 ....................................................... 21 V Venlafaxine .................................................. 24, 27 Victrelis.............................................................. 20 Vitala-C .............................................................. 26 Vitamin B complex ............................................. 26 Vitamins ............................................................ 26 X Xylocaine ........................................................... 26

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Pharmaceutical Management Agency Level 9, 40 Mercer Street, PO Box 10-254, Wellington 6143, New Zealand Phone: 64 4 460 4990 - Fax: 64 4 460 4995 - www.pharmac.govt.nz Freephone Information line (9am-5pm weekdays) 0800 66 00 50 ISSN 1172-9376 (Print) ISSN 1179-3686 (Online)

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

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

Metadata

Title

Schedule Update - effective 1 September 2013

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 September 2013 Contents Summary of PHARMAC decisions effective 1 September 2013 …. 3 New brand of enalapril maleate tablets ….. 5 Change to the definition of Specialist ….. 5 New…

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