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This is the text extract for Schedule Update - effective 1 January 2014, browse documents here.


Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 January 2014


Contents

Summary of PHARMAC decisions effective 1 January 2014 ........................... 3 Removal of Special Authority from Seretide .................................................. 5 Nicotine replacement therapy – not OP ......................................................... 5 Carbimazole – new listing under section 29 .................................................. 5 Courier bags for returned blood glucose meters ........................................... 5 Captopril tablets ........................................................................................... 6 Diltiazem stock issue and removal of stat dispensing .................................... 6 New listing of eltrombopag .......................................................................... 6 Oxycodone brand switch fee ......................................................................... 6 Erlotinib (Tarceva) – amendment to Special Authority criteria ...................... 7 Ketoconazole (Nizoral) .................................................................................. 7 Acipimox (Olbetam) capsules – new listing of section 29 product................. 7 Blood Ketone Diagnostic Meter ..................................................................... 7 Amoxycillin capsules tender transition update .............................................. 7 Benzbromarone patient information ............................................................. 8 Imatinib sole supply ...................................................................................... 8 Christmas Break ............................................................................................ 8 Tender News .................................................................................................. 9 Looking Forward ........................................................................................... 9 Sole Subsidised Supply Products cumulative to January 2014 ..................... 10 New Listings ................................................................................................ 21 Changes to Restrictions, Chemical Names and Presentations ...................... 23 Changes to Subsidy and Manufacturer’s Price............................................. 25 Changes to Section I ................................................................................... 26 Delisted Items ............................................................................................. 27 Items to be Delisted .................................................................................... 29 Index ........................................................................................................... 30

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Summary of PHARMAC decisions

EFFECTIVE 1 JANUARY 2014 New listings (pages 21-22) • Pancreatic enzyme (Creon 25000) cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease • Eltrombopag (Revolade) tab 25 mg and 50 mg • Cilazapril with hydrochlorothiazide (Apo-Cilazapril/Hydrochlorothiazide) tab 5 mg with hydrochlorothiazide 12.5 mg • Diltiazem hydrochloride (Cardizem CD) cap long-acting 120 mg • Acipimox (Olbetam s29) cap 250 mg – S29 • Carbimazole (AFT) tab 5 mg – S29 • Ceftriaxone (Ceftriaxone-AFT) inj 500 mg and 1 g vial • Amoxycillin (Apo-Amoxi) cap 250 mg • Pharmacy Services (BSF Oxydone BNM) brand switch fee Changes to restrictions, chemical names and presentation (pages 23-24) • Blood ketone diagnostic test meter (Freestyle Optium) – amendment to restriction • Ceftriaxone inj 500 mg and 1 g vial – amendment of chemical name • Ketoconazole (Nizoral) tab 200 mg – addition of S29 • Oxycodone hydrochloride (Oxydone BNM) tab controlled-release 10 mg, 20 mg, 40 mg and 80 mg – addition of brand switch fee • Erlotinib (Tarceva) tab 100 mg and 150 mg - amendment of chemical name and Special Authority • Fluticasone with salmeterol – removal of Special Authority • Bimatoprost (Lumigan) eye drops 0.03%, 3 ml OP – removal of restriction • Latanoprost (Hysite) eye drops 50 mcg per ml, 2.5 ml, 2.5 ml OP – removal of restriction • Travaoprost (Travatan) eye drops 0.004%, 2.5 ml OP – removal of restriction Increase in subsidy (pages 25-26) • Sodium citro-tartrate (Ural) grans eff 4 g sachets • Phenoxymethylpenicillin (penicillin V) (Cilicaine VK) cap potassium salt 250 mg and 500 mg • Aspirin (Ethics Aspirin) tab dispersible 300 mg • Lorazepam (Ativan) tab 1 mg and 2.5 mg • Azathioprine (Imuran) inj 50 mg Decreased subsidy (pages 25-26) • Aspirin (Ethics Aspirin EC) tab 100 mg • Bosentan (pms-Bosentan) tab 62.5 mg and 125 mg

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Summary of PHARMAC decisions – effective 1 January 2014 (continued) • Ethinyloestradiol with levonorgestrel (Ava 20 ED) tab 20 mcg with levonorgestrel 100 mcg and 7 inert tab • Ethinyloestradiol with levonorgestrel (Ava 30 ED) tab 30 mcg with levonorgestrel 150 mcg and 7 inert tab • Ibuprofen (Fenpaed) oral liq 20 mg per ml • Paroxetine hydrochloride (Loxamine) tab 20 mg, 30 tab pack only • Ondansetron (Dr Reddy’s Ondansetron) tab 4 mg and 8 mg • Alprazolam (Arrow-Alprazolam) tab 500 mcg • Erlotinib (Tarceva) tab 100 mg and 150 mg

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Pharmaceutical Schedule - Update News

5

Removal of Special Authority from Seretide

The Special Authority will be removed from fluticasone with salmeterol (Seretide and Seretide Accuhaler) from 1 January 2014. Please note that the daily dose maximum still applies to the dispensings of Seretide Accuhaler.

Nicotine replacement therapy – not OP

PHARMAC has become aware that some pharmacists may be dispensing Nicotine Replacement Therapy (NRT) pharmaceuticals (nicotine gum, lozenges and patches) as original packs (OP). Please note that NRT is not designated OP. The actual quantity of pharmaceutical prescribed (on prescription or Quit Card) should be dispensed and claimed.

Carbimazole – new listing under section 29

AFT has advised of a potential supply shortage of Neo-Mercazole (carbimazole) 5 mg tablets. To avoid an out-of-stock, an unapproved AFT brand will be temporarily listed from 1 January 2014. This product must be prescribed and supplied in accordance with section 29 of the Medicines Act 1981. Please note that wastage on the AFT brand may be claimed in accordance with rule 3.3.2. The Neo-Mercazole brand is expected to be back in stock in late January 2014.

Courier bags for returned blood glucose meters

We have been providing pharmacies with courier bags to return previously funded blood glucose meters no longer required by patients and arranging responsible disposal of them. If you still have meters to return, you can request a further courier bag by phoning us on 0800 660 050. We will continue to provide this service until 1 February 2014. To assist the return, please ensure that you return any meters to PHARMAC by 1 February 2014 and that only meters are put into the bags. Please do not include cases and other accessories.


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Pharmaceutical Schedule - Update News

Captopril tablets

PHARMAC has been informed that there will be a likely discontinuation of captopril tablets 12.5 mg, 25 mg, and 50 mg (m-Captopril) during 2014. In anticipation of that, we are recommending that prescribers transition their patients to another funded ACE inhibitor at the next practicable opportunity. Captopril oral liquid 5 mg per ml will remain available and fully subsidised for children under 12 years of age. PHARMAC has put together some transition advice for prescribers indicating other ACE inhibitors that may be suitable to transition their patients to. This is available on the PHARMAC website www.pharmac.govt.nz. At this stage, we recommend that pharmacists indicate to patients, when they pick up their captopril prescription, that they will likely be moving to a different ACE inhibitor early in 2014. Approximately 1,300 patients are currently taking captopril, with 1,000 having been on the treatment long term, out of a total of 290,000 patients who are currently on ACE inhibitor therapy.

Diltiazem stock issue and removal of stat dispensing

Apotex has advised of a potential supply shortage of Apo-Diltiazem 120 mg long-acting capsules. Cardizem CD 120 mg long-acting capsules will be listed fully funded from 1 January 2014 to assist in maintaining stock until Apo-Diltiazem is available again. Stat dispensing will be removed temporarily from diltiazem 120 mg long-acting capsules from 1 January 2014 until further notice.

New listing of eltrombopag

From 1 January 2014, eltrombopag (Revolade) 25 mg and 50 mg tablets will be listed fully funded subject to Special Authority criteria for idiopathic thrombocytopenic purpura pre and post splenectomy. The wastage rule (Rule 3.3.2) will apply to the dispensings of eltrombopag.

Oxycodone brand switch fee

The Oxydone BNM brand of oxycodone controlled-release tablets 10 mg, 20 mg, 40 mg and 80 mg commences sole supply from 1 January 2014. A brand switch fee will apply to dispensings of Oxydone BNM controlled-release tablets from 1 January 2014 to 31 January 2014.


Pharmaceutical Schedule - Update News

7

Erlotinib (Tarceva) – amendment to Special Authority criteria

From 1 January 2014, the Special Authority criteria for erlotinib will be widened to include first-line treatment for patients with locally advanced, or metastatic, unresectable, nonsquamous NSCLC expressing activating mutations in EGFR tyrosine kinase. A price and subsidy reduction will also occur from 1 January 2014.

Ketoconazole (Nizoral)

Janssen-Cialg (New Zealand) Ltd has discontinued the supply of Nizoral (ketoconazole) 200 mg tablets from 1 December 2013 due to ongoing safety concerns regarding liver injury. Medsafe approval has now lapsed for Nizoral tablets, so Nizoral tablets must now be prescribed and supplied in accordance with section 29 of the Medicines Act 1981. The section 29 symbol will be added to Nizoral tablets from 1 January 2014. Further information on the discontinuation can be found on the Medsafe website. Please note that no decision has been made yet to delist this product.

Acipimox (Olbetam) capsules – new listing of section 29 product

Olbetam s29 (acipimox) 250 mg capsules will be temporarily listed on the Pharmaceutical Schedule from 1 January 2014 to cover a potential supply issue with the registered Olbetam product. Olbetam s29 must be prescribed and supplied in accordance with section 29 of the Medicines Act 1981.

Blood Ketone Diagnostic Meter

From 1 January 2014 the restriction on blood ketone diagnostic meters will be amended to include patients on insulin pumps.

Amoxycillin capsules tender transition update

The Apo-Amoxi brand of amoxycillin 250 mg capsules will be listed 1 January 2014, with a subsidy reduction on 1 March 2014 for the Alphamox brand and sole supply for Apo-Amoxi brand from 1 June 2014. The dates for tender transition of the 500 mg capsules have not yet been confirmed.


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Pharmaceutical Schedule - Update News

Benzbromarone patient information

The Patient Information Leaflets Committee at Christchurch Hospital has developed patient information for benzbromarone, which the New Zealand Rheumatology Association has made available on its website at http://www.rheumatology.org.nz/downloads/ BENZBROMARONE-patient-V3.pdf Prescriber information for benzbromarone is also available on the NZRA website at http:// www.rheumatology.org.nz/downloads/Benzbromarone-prescriber-information-NZRA-V2.pdf Benzbromarone (Benzbromaron AL 100) 100 mg tablets are funded, subject to Special Authority criteria, as a last-line treatment for gout. It is not registered with Medsafe in New Zealand so must be prescribed and supplied in accordance with section 25 and section 29, respectively, of the Medicines Act 1981.

Imatinib sole supply

PHARMAC has approved a proposal to award sole supply to Imatinib-AFT capsules for all indications other than Gastro Intestinal Stromal Tumours (GIST). PHARMAC will be communicating directly over the next few months with affected patients and their Specialists, GPs and pharmacists. Further information can be found on our website at http://www.pharmac.health.nz/news#notification

Christmas Break

The PHARMAC office will be closed from 4:30 pm Tuesday 24 December 2013 and will reopen Monday 6 January 2014. The 0800 phone service will be limited during this time.


Tender News

Sole Subsidised Supply changes – effective 1 February 2014

Chemical Name Methotrexate Methotrexate Methotrexate Methotrexate Methotrexate Methotrexate Mycophenolate mofetil Mycophenolate mofetil Presentation; Pack size Inj 7.5 mg prefilled syringe; 1 syringe Inj 10 mg prefilled syringe; 1 syringe Inj 15 mg prefilled syringe; 1 syringe Inj 20 mg prefilled syringe; 1 syringe Inj 25 mg prefilled syringe; 1 syringe Inj 30 mg prefilled syringe; 1 syringe Cap 250 mg; 100 cap Tab 500 mg; 50 tab Sole Subsidised Supply brand (and supplier) Methotrexate Sandoz (Sandoz) Methotrexate Sandoz (Sandoz) Methotrexate Sandoz (Sandoz) Methotrexate Sandoz (Sandoz) Methotrexate Sandoz (Sandoz) Methotrexate Sandoz (Sandoz) Cellcept (Roche) Cellcept (Roche)

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 February 2014 • Ferrous sulphate (Ferrograd) tab long-acting 325 mg (105 mg elemental) – subsidy increase • Atomoxetine (Strattera) cap 10 mg , 18 mg, 25 mg, 40 mg, 60 mg, 80 mg and 100 mg – Special Authority amendment • Baclofen (Lioresal Intrathecal) inj 0.05 mg per ml, 1 ml ampoule and inj 2 mg per ml, 5 ml ampoule – new listing • Mycophenolate mofetil (BSF Cellcept) – BSF applies

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Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

Abacavir sulphate Acarbose Acetazolamide Acetylcysteine Aciclovir 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 dispersible 200 mg, 400 mg & 800 mg 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 100 mg 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%

Brand Name Expiry Date*

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

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

10

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated unless otherwise stated. Please note that Sole Subsidised Supply may have been awarded for a wider scope than just those presentation(s) listed in the above table.


Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

Bezafibrate Bicalutamide Blood glucose diagnostic test meter Blood glucose diagnostic test strip Boceprevir Brimonidine tartrate Bupropion hydrochloride Cabergoline Calamine Calcitonin Calcium carbonate Calcium folinate Candesartan Carbomer Cefaclor monohydrate Cefalexin monohydrate

Presentation

Tab 200 mg Tab long-acting 400 mg Tab 50 mg Meter with 50 lancets, a lancing device and 10 diagnostic test strips Blood glucose test strips Cap 200 mg Eye drops 0.2% Tab modified-release 150 mg 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 Cap 250 mg Grans for oral liq 125 mg per 5 ml Cap 500 mg Grans for oral liq 125 mg per 5 ml & 250 mg per 5 ml 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 0.5 mg, 2.5 mg & 5 mg Tab 250 mg, 500 mg & 750 mg Tab 20 mg Tab 500 mg Tab 250 mg

Brand Name Expiry Date*

Bezalip Bezalip Retard Bicalaccord CareSens N CareSens N POP CareSens II CareSens CareSens N Victrelis Arrow-Brimonidine Zyban Dostinex PSM Miacalcic Arrow-Calcium Calsource DBL Leucovorin Calcium Candestar Poly-Gel Ranbaxy-Cefaclor Cephalexin ABM Cefalexin Sandoz AFT Multichem Cetirizine - AFT Zetop Chlorsig Chlorafast healthE healthE Orion Apo-Ciclopirox Zapril Cipflox Arrow-Citalopram Apo-Clarithromycin Apo-Clarithromycin 2015 2014 2015

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

Cefazolin sodium Cefuroxime sodium Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate

Ciclopirox olamine Cilazapril Ciprofloxacin Citalopram hydrobromide Clarithromycin

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated unless otherwise stated. Please note that Sole Subsidised Supply may have been awarded for a wider scope than just those presentation(s) listed in the above table.

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Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

Clindamycin Clomiphene citrate Clomipramine hydrochloride Clonidine hydrochloride

Presentation

Cap hydrochloride 150 mg Inj phosphate 150 mg per ml, 4 ml Tab 50 mg Tab 10 mg & 25 mg Tab 25 mcg Tab 150 mcg Inj 150 mcg per ml, 1 ml Vaginal crm 1% with applicators Vaginal crm 2% with applicators Crm 1% Tab 15 mg, 30 mg & 60 mg Tab 500 mcg Crm 10% Tab 50 mg Oral liq 100 mg per ml Tab 50 mg & 100 mg 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*

Clindamycin ABM Dalacin C Serophene Apo-Clomipramine Clonidine BNM Catapres Clomazol Clomazol PSM Colgout Itch-Soothe Nausicalm Neoral Siterone Ginet 84 Desmopressin-PH&T Douglas Maxidex Maxitrol Maxitrol 2016 2016 2015 2015

Clotrimazole

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

Codeine phosphate Colchicine Crotamiton Cyclizine hydrochloride Cyclosporin Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone

Dexamethasone with neomycin Eye oint 0.1% with neomycin sulphate and polymyxin b sulphate 0.35% and polymyxin B sulphate 6,000 u per g Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin B sulphate 6,000 u per ml Dexamphetamine sulphate Dextrose Dextrose with electrolytes Diclofenac sodium Tab 5 mg Inj 50%, 10 ml Soln with electrolytes; 1,000 ml OP 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 Tab long-acting 60 mg Cap long-acting 180 mg & 240 mg Tab 30 mg & 60 mg Tab long-acting 150 mg Cap 50 mg Cap 120 mg

PSM Biomed Pedialyte-Bubblegum Apo-Diclo Diclax SR Voltaren Voltaren Ophtha Voltaren DHC Continus Apo-Diltiazem CD Dilzem Pytazen SR Laxofast 50 Laxofast 120

2015 2014 2016 2015 2014

Dihydrocodeine tartrate Diltiazem hydrochloride Dipyridamole Docusate sodium

2016 2015 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 January 2014

Generic Name

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

Presentation

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 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 Oint 2% Tab 600 mg Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg Suppos 3.6 g

Brand Name Expiry Date*

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 Boucher and Muir Zarzio Zarzio Rex Medical AFT Staphlex Flucloxin Ozole Flucon Efudix Flixonase Hayfever & Allergy Urex Forte Diurin 40 Foban Lipazil Pfizer Apo-Gliclazide Minidiab PSM 2014 2015 2015

31/12/15

2015 2014 2014 2014 2015 2015 2014 2015 2015 2014

Exemestane Felodopine Fentanyl Filgrastim Finasteride Flucloxacillin sodium

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

Fluconazole Fluorometholone Fluorouracil sodium Fluticasone propionate Furosemide Fusidic acid Gemfibrozil Gentamicin sulphate Gliclazide Glipizide Glycerol

*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 January 2014

Generic Name

Glyceryl trinitrate

Presentation

Aerosol spray 400 mcg per dose TDDS 5 mg & 10 mg Tab 600 mcg Tab 500 mcg, 1.5 mg & 5 mg Oral liq 2 mg per ml Inj 5 mg per ml, 1 ml Inj 100 mg vial 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 Patch 1.5 mg Inj 20 mg, 1 ml Tab 10 mg Tab 200 mg Tab long-acting 800 mg Crm 5% Tab 2.5 mg Nebuliser soln, 250 mcg per ml, 1 ml Nebuliser soln, 250 mcg per ml, 2 ml Inj 50 mg per ml, 2 ml Tab 100 mg Tab 20 mg Tab long-acting 40 mg Cap 10 mg & 20 mg Powder for oral soln Cap 100 mg Shampoo 2% Oral liq 10 mg per ml; 240 ml OP Tab 100 mg Cap 15 mg & 30 mg

Brand Name Expiry Date*

Glytrin Nitroderm TTS Lycinate Serenace 2014

Haloperidol

2016

Hydrocortisone

Solu-Cortef Douglas Pharmacy Health ABM Colifoam Locoid Lipocream Locoid Crelo Locoid Locoid DP Lotn HC ABM Hydroxocobalamin Plaquenil Scopoderm TTS Buscopan Gastrosoothe Arrowcare Brufen SR Aldara Dapa-Tabs Univent Ferrum H PSM Ismo 20 Corangin Oratane Konsyl-D Itrazole Sebizole 3TC Zetlam Solox

2016 2015 2014 2015 2015

Hydrocortisone acetate Hydrocortisone butyrate

Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hyoscine hydrobromide Hyoscine N-butylbromide Ibuprofen Imiquimod Indapamide Ipratropium bromide Iron polymaltose Isoniazid Isosorbide mononitrate Isotretinoin Ispaghula (psyllium) husk Itraconazole Ketoconazole Lamivudine Lansoprazole

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

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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 January 2014

Generic Name

Latanoprost Letrozole Levonorgestrel Lidocaine [lignocaine] hydrochloride Lisinopril Lithium carbonate Lodoxamide trometamol Losartan Losartan with hydrochlorothiazide Macrogol Macrogol 400 and propylene glycol Mask for spacer device Mebendazole Mebeverine hydrochloride Medroxyprogesterone acetate Megestrol acetate Methotrexate Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Mesalazine Metformin hydrochloride Methadone hydrochloride

Presentation

Eye drops 50 mcg per ml Tab 2.5 mg Tab 1.5 mg Inj 2% ampoule, 5 ml & 20 ml 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 Powder 13.125 g, sachets Eye drops 0.4% and propylene glycol 0.3%, 0.4 ml Size 2 Tab 100 mg Tab 135 mg Tab 2.5 mg, 5 mg, 10 mg & 100 mg Inj 150 mg per ml, 1 ml syringe Tab 160 mg Inj 25 mg per ml, 2 ml & 20 ml 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 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

Brand Name Expiry Date*

Hysite Letraccord Postinor-1 Lidocaine-Claris Xylocaine Viscous Arrow-Lisinopril Lithicarb FC Douglas Lomide Lostaar Arrow-Losartan & Hydroclorothiazide Lax-Sachets Systane Unit Dose EZ-fit Paediatric Mask De-Worm Colofac Provera Depo-Provera Apo-Megestrol Hospira Medrol Depo-Medrol Depo-Medrol with Lidocaine Pentasa Asacol Apotex Biodone Biodone Forte Biodone Extra Forte Solu-Medrol Pfizer Metamide 2015 2015 2016 2015 2014 2015 2015 2014 2014 2014 2014 2014 2016 2015 2014 2014 2016 2015 2016 2015 2015 2015 2015 2014 2015 2015

Methylprednisolone sodium succinate Metoclopramide hydrochloride

2015 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.

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Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

Metoprolol succinate Metoprolol tartrate

Presentation

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 Tab 50 mg Oral gel 20 mg per g Crm 2% Tab 30 mg & 45 mg Inj 5 mg vial 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 Tab long-acting 10 mg, 30 mg, 60 mg & 100 mg 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*

Metoprolol-AFT CR Lopresor Lopresor Slow-Lopresor Puri-nethol Decozol Multichem Avanza Arrow Apo-Moclobemide m-Mometasone RA-Morph Arrow-Morphine LA DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Hospira Naltraccord Naphcon Forte Apo-Nadolol Noflam 250 Noflam 500 AstraZeneca Nevirapine Alphapharm Habitrol Habitrol Habitrol Apo-Nicotinic Acid Noriday 28 Primolut N Arrow-Norfloxacin 2014 2015 2014 2014 2015 2015

Mercaptopurine Miconazole Miconazole nitrate Mirtazapine Mitomycin C Moclobemide Mometasone furoate Morphine hydrochloride Morphine sulphate

2016 2015 2014 2015 2016 2015 2015 2015 2016 2014

Morphine tartrate Naltrexone hydrochloride Naphazoline hydrochloride Nadolol Naproxen Neostigmine Nevirapine Nicotine

Inj 80 mg per ml, 1.5 ml & 5 ml Tab 50 mg 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

2016 2016 2014 2015 2015 2014 2015 2014

Nicotinic acid Norethisterone Norfloxacin

16

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated unless otherwise stated. Please note that Sole Subsidised Supply may have been awarded for a wider scope than just those presentation(s) listed in the above table.


Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

Nortriptyline hydrochloride Nystatin Octreotide (somatostatin analogue) Oil in water emulsion Omeprazole

Presentation

Tab 10 mg & 25 mg Oral liq 100,000 u per ml 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 Tab controlled-release 10 mg, 20 mg, 40 mg & 80 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

Brand Name Expiry Date*

Norpress Nilstat Octreotide Max Rx 2016 2014 2014

healthE Fatty Cream Omezol Relief Midwest Dr Reddy’s Omeprazole Ox-Pam Apo-Oxybutynin Oxydone BNM 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

2015 2014

Oxazepam Oxybutynin Oxycodone hydrochloride

2014 2016 2015

Oxytocin Pamidronate disodium Pantoprazole Paracetamol

2015 2014 2014 2015 2014

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

2014 2015 2017 2017

*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 January 2014

Generic Name

Pergolide Permethrin Pethidine hydrochloride

Presentation

Tab 0.25 mg & 1 mg Crm 5% Lotn 5% Tab 50 mg & 100 mg Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

Permax Lyderm A-Scabies PSM DBL Pethidine Hydrochloride DBL Pethidine Hydrochloride PSM Apo-Pindolol Pizaccord Sandomigran Coloxyl Span-K Cholvastin Cilicaine Allersoothe Allersoothe Mestinon PyridoxADE Apo-Pyridoxine Arrow-Quinapril Accuretic 10 Accuretic 20 Peptisoothe Arrow-Ranitidine Mycobutin Norvir Rizamelt ArrowRoxithromycin Asthalin Duolin 2014 2016 2015 2014 2015 2015 2015 2014 2014 2015 2014

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

Tab 15 mg & 30 mg Tab 5 mg, 10 mg & 15 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 Cap 150 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 50 mg & 100 mg Tab 25 mg, 50 mg & 100 mg

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

Ranitidine hydrochloride Rifabutin Ritonavir Rizatriptan Roxithromycin Salbutamol Salbutamol with ipratropium bromide Sertraline Sildenafil

Arrow-Sertraline Silagra

2016 2014

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 January 2014

Generic Name

Simvastatin

Presentation

Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Inj 23.4%, 20 ml ampoule Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml Eye drops 1 mg per ml, 10 ml OP 800 ml 230 ml (single patient) Tab 25 mg & 100 mg Tab 500 mg Tab EC 500 mg Tab 50 mg & 100 mg Inj 12 mg per ml, 0.5 ml cartridge Tab 20 mg Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium, 500 ml & 1,000 ml Tab 10 mg Cap 5 mg, 20 mg, 100 mg & 250 mg Tab 1 mg, 2 mg & 5 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Cap 40 mg Tab 25 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 Crm 0.5 mg per g 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

Brand Name Expiry Date*

Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Biomed Micolette Hylo-Fresh Volumatic Space Chamber Plus Spirotone Salazopyrin Salazopyrin EN Arrow-Sumatriptan Genox Pinetarsol 2014

Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Sodium hyaluronate Spacer device Spironolactone Sulphasalazine Sumatriptan Tamoxifen citrate Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Temozolomide Terazosin Terbinafine Testosterone cypionate Testosterone undecanoate Tetrabenazine Tetracosactrin Timolol maleate Tobramycin

2016 2016 2016 2015 2016 2016 2016 2014 2014

Normison Temaccord Arrow Dr Reddy’s Terbinafine Depo-Testosterone Andriol Testocaps Motetis Synacthen Synacthen Depot Arrow-Timolol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol ReTrieve Kenacort-A Kenacort-A40 Aristocort Aristocort Oracort

2014 2016 2016 2014 2014 2015 2016 2014 2014 2014

Tolcapone Tramadol hydrochloride Tretinoin Triamcinolone acetonide

2014 2014 2016 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.

19


Sole Subsidised Supply Products – cumulative to January 2014

Generic Name

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

Presentation

Eye drops 0.5% & 1% Cap 250 mg Inj 500 mg Tab 40 mg & 80 mg Tab, strong, BPC Tab (BCP cap strength) Cap 100 mg & oral liq 10 mg per ml Tab 300 mg with lamivudine 150 mg Oint BP Caps 137.4 mg (50 mg elemental)

Brand Name Expiry Date*

Mydriacyl Ursosan Mylan Isoptin Bplex Mvite Retrovir Alphapharm Multichem Zincaps 2014 2014 2014 2014 2016 2016 2016 2014 2014 2014

20

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated unless otherwise stated. Please note that Sole Subsidised Supply may have been awarded for a wider scope than just those presentation(s) listed in the above table.


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 January 2014

37 PANCREATIC ENZYME Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease ............................................................ 94.38 100 ✔ Creon 25000

45

ELTROMBOPAG – Special Authority see SA1412 – Retail pharmacy – Wastage claimable Tab 25 mg ......................................................................... 1,771.00 28 ✔ Revolade Tab 50 mg ......................................................................... 3,542.00 28 ✔ Revolade ➽ SA1412 Special Authority for Subsidy Initial application - (idiopathic thrombocytopenic purpura – post-splenectomy) only from a haematologist. Approvals valid for 6 weeks for applications meeting the following criteria: All of the following: 1. Patient has had a splenectomy; and 2. Two immunosuppressive therapies have been trialled and failed after therapy of 3 months each (or 1 month for rituximab); and 3. Either: 3.1. Patient has a platelet count of ≤20,000 platelets per microlitre and has evidence of active bleeding; or 3.2. Patient has a platelet count of ≤10,000 platelets per microlitre. Initial application - (idiopathic thrombocytopenic purpura – preparation for splenectomy) only from a haematologist. Approvals valid for 6 weeks where the patient requires eltrombopag treatment as preparation for splenectomy. Renewal– (idiopathic thrombocytopenic purpura – post-splenectomy) from a haematologist. Approvals valid for 12 months where the patient has obtained a response (see Note) from treatment during the initial approval or subsequent renewal periods and further treatment is required. Note: Response to treatment is defined as a platelet count of >30,000 platelets per microlitre.

53

CILAZAPRIL WITH HYDROCHLOROTHIAZIDE ❋ Tab 5 mg with hydrochlorothiazide 12.5 mg............................. 10.72 DILTIAZEM HYDROCHLORIDE Cap long-acting 120 mg ............................................................ 1.91 ACIPIMOX ❋ Cap 250 mg ............................................................................ 18.75 CARBIMAZOLE Tab 5 mg ................................................................................ 10.80

100

✔ Apo-Cilazapril/ Hydrochlorothiazide ✔ Cardizem CD ✔ Olbetam s29 S29

57 60 86 90

30 30 100

✔ AFT S29

CEFTRIAXONE – Subsidy by endorsement a) Up to 5 inj available on a PSO b) Subsidised only if prescribed for a dialysis or cystic fibrosis patient, or the treatment of gonorrhoea, or the treatment of pelvic inflammatory disease, or the treatment of suspected meningitis in patients who have a known allergy to penicillin, and the prescription or PSO is endorsed accordingly. Inj 500 mg vial .......................................................................... 1.50 1 ✔ Ceftriaxone-AFT Inj 1 g vial ................................................................................. 5.22 5 ✔ Ceftriaxone-AFT

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

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

21


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings – effective 1 January 2014 (continued)

92 AMOXYCILLIN Cap 250 mg ............................................................................ 16.18 a) Up to 30 cap available on a PSO b) Up to 10 x the maximum PSO quantity for RFPP – see rule 5.2.6 PHARMACY SERVICES - May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for BSF Oxydone BNM is 2451794. 500 ✔ Apo-Amoxi

187

1 fee

✔ BSF Oxydone BNM

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

22

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


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions, Chemical Names and Presentations

Effective 1 January 2014

29 BLOOD KETONE DIAGNOSTIC TEST METER – Up to 1 meter available on a PSO Meter funded for the purposes of blood ketone diagnostics only. Patient has had one or more episodes of ketoacidosis and is at risk of future episodes or patient is on an insulin pump. Only one meter per patient will be subsidised every 5 years. Meter ...................................................................................... 40.00 1 ✔ Freestyle Optium CEFTRIAXONE SODIUM – Subsidy by endorsement (amendment to chemical name and presentation description) a) Up to 5 inj available on a PSO b) Subsidised only if prescribed for a dialysis or cystic fibrosis patient, or the treatment of gonorrhoea, or the treatment of pelvic inflammatory disease, or the treatment of suspected meningitis in patients who have a known allergy to penicillin, and the prescription or PSO is endorsed accordingly. Inj 500 mg vial .......................................................................... 2.70 1 ✔ Veracol 1.50 ✔ Ceftriaxone-AFT Inj 1 g vial ............................................................................... 10.49 5 ✔ Aspen Ceftriaxone 5.22 ✔ Ceftriaxone-AFT KETOCONAZOLE (addition of Section 29) Tab 200 mg – Retail pharmacy-Specialist ................................ 38.12 30 ✔ Nizoral S29 Prescriptions must be written by, or on the recommendation of, an infectious disease physician, clinical microbiologist, dermatologist, endocrinologist or oncologist OXYCODONE HYDROCHLORIDE a) Only on a controlled drug form b) See prescribing guideline below c) No patient co-payment payable d) Safety medicine; prescriber may determine dispensing frequency Tab controlled-release 10 mg – Brand switch fee payable (Pharmacode 2451794) ............ 6.75 Tab controlled-release 20 mg – Brand switch fee payable (Pharmacode 2451794) .......... 11.50 Tab controlled-release 40 mg – Brand switch fee payable (Pharmacode 2451794) .......... 18.50 Tab controlled-release 80 mg – Brand switch fee payable (Pharmacode 2451794) .......... 34.00

90

97

127

20 20 20 20

✔ Oxydone BNM ✔ Oxydone BNM ✔ Oxydone BNM ✔ Oxydone BNM

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions – effective 1 January 2014 (continued)

159 ERLOTINIB HYDROCHLORIDE – Retail pharmacy - Specialist – Special Authority SA14111044 Tab 100 mg ....................................................................... 1,133.00 30 ✔ Tarceva Tab 150 mg ....................................................................... 1,700.00 30 ✔ Tarceva ➽ SA14111044 Special Authority for Subsidy Initial application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 Patient has advanced, unresectable, Non Small Cell Lung Cancer (NSCLC); and 2 Patient has documented disease progression following treatment with first line platinum based chemotherapy; and 3 Erlotinib is to be given for a maximum of 3 months. Either 1 All of the following: 1.1 Patient has locally advanced or metastatic, unresectable, non-squamous Non Small Cell Lung Cancer (NSCLC); and 1.2 There is documentation confirming that the disease expresses activating mutations of EGFR tyrosine kinase; and 1.3 Either 1.3.1 Patient is treatment naïve; or 1.3.2 Both: 1.3.2.1 Patient has documented disease progression following treatment with first line platinum based chemotherapy; and 1.3.2.2 Patient has not received prior treatment with gefitinib; and 1.4 Erlotinib is to be given for a maximum of 3 months, or 2 The patient received funded erlotinib prior to 31 December 2013 and radiological assessment (preferably including CT scan) indicates NSCLC has not progressed. Renewal application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 6 months where radiological assessment (preferably including CT scan) indicates NSCLC has not progressed. 183 FLUTICASONE WITH SALMETEROL – Special Authority see SA1179 – Retail pharmacy Aerosol inhaler 50 mcg with salmeterol 25 mcg ....................... 37.48 120 dose OP Aerosol inhaler 125 mcg with salmeterol 25 mcg .................... 49.69 120 dose OP Powder for inhalation 100 mcg with salmeterol 50 mcg – No more than 2 dose per day ............................................ 37.48 60 dose OP Powder for inhalation 250 mcg with salmeterol 50 mcg – No more than 2 dose per day ............................................ 49.69 60 dose OP BIMATOPROST – Retail pharmacy-Specialist (removal of restriction) ❋ Eye drops 0.03% ..................................................................... 18.50 LATANOPROST – Retail pharmacy-Specialist (removal of restriction) ❋ Eye drops 50 mcg per ml, 2.5 ml ............................................... 1.99 TRAVOPROST – Retail pharmacy-Specialist (removal of restriction) ❋ Eye drops 0.004% ................................................................... 19.50 3 ml OP ✔ Seretide ✔ Seretide ✔ Seretide Accuhaler ✔ Seretide Accuhaler ✔ Lumigan

190 190 190

2.5 ml OP ✔ Hysite 2.5 ml OP ✔ Travatan

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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 January 2014

46 63 ASPIRIN ( subsidy) ❋ Tab 100 mg ............................................................................ 10.50 BOSENTAN – Special Authority see SA0967 – Retail pharmacy ( subsidy) Tab 62.5 mg ...................................................................... 1,500.00 Tab 125 mg ....................................................................... 1,500.00 ETHINYLOESTRADIOL WITH LEVONORGESTREL ( subsidy) ❋ Tab 20 mcg with levonorgestrel 100 mcg and 7 inert tab – Up to 84 tab available on a PSO .......................................... 2.65 ❋ Tab 30 mcg with levonorgestrel 150 mcg and 7 inert tab – Up to 84 tab available on a PSO .......................................... 2.30 SODIUM CITRO-TARTRATE ( subsidy) ❋ Grans eff 4 g sachets ................................................................ 3.93 PHENOXYMETHYLPENICILLIN (PENICILLIN V) ( subsidy) Cap potassium salt 250 mg – Up to 30 cap available on a PSO ....................................... 11.99 Cap potassium salt 500 mg ..................................................... 14.45 a) Up to 20 cap available on a PSO b) Up to 2 x the maximum PSO quantity for RFPP – see rule 5.2.6 NYSTATIN ( price) Tab 500,000 u ........................................................................ 14.16 (17.09) Cap 500,000 u ........................................................................ 12.81 (15.47) IBUPROFEN ( subsidy) ❋ ‡ Oral liq 20 mg per ml .............................................................. 1.89 ASPIRIN ( subsidy) ❋ Tab dispersible 300 mg – Up to 30 tab available on a PSO .............................................. 2.55 PAROXETINE HYDROCHLORIDE ( subsidy) ❋ Tab 20 mg ................................................................................ 1.44 (2.38) Note: Loxamine tab 20 mg, 90 tab packsize, remains fully subsidised. ONDANSETRON ( subsidy) ❋ Tab 4 mg ( price) .................................................................... 3.31 ❋ Tab 8 mg ................................................................................. 1.24 (1.70) 990 60 60 ✔ Ethics Aspirin EC ✔ pms-Bosentan ✔ pms-Bosentan

77

84 84 28

✔ Ava 20 ED ✔ Ava 30 ED ✔ Ural

81 93

50 50

✔ Cilicaine VK ✔ Cilicaine VK

97

50 Nilstat 50 Nilstat 200 ml ✔ Fenpaed

114 124

100 30

✔ Ethics Aspirin

129

Loxamine

136

30 10

✔ Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price – effective 1 January 2014 (continued)

141 ALPRAZOLAM – Safety medicine; prescriber may determine dispensing frequency ( subsidy) Tab 500 mcg............................................................................. 3.25 50 (4.10) Arrow-Alprazolam ‡ Safety cap for extemporaneously compounded oral liquid preparations. LORAZEPAM – Safety medicine; prescriber may determine dispensing frequency ( subsidy) Tab 1 mg ................................................................................ 19.82 250 ✔ Ativan ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 2.5 mg ............................................................................. 13.49 100 ✔ Ativan ‡ Safety cap for extemporaneously compounded oral liquid preparations. ERLOTINIB – Retail pharmacy-Specialist – Special Authority SA1411 ( subsidy) Tab 100 mg ....................................................................... 1,133.00 30 Tab 150 mg ....................................................................... 1,700.00 30 AZATHIOPRINE – Retail pharmacy-Specialist ( subsidy) ❋ Inj 50 mg .............................................................................. 126.00 1

142

159

✔ Tarceva ✔ Tarceva

165

✔ Imuran

Changes to Section I

Effective 1 January 2014

225 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] Inj 45 mcg in 0.5 ml syringe ................................................... 90.00 10 ✔ Influvac

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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 January 2014

41 ASCORBIC ACID a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg .............................................................................. 7.00 VITAMIN B COMPLEX ❋ Tab, strong, BPC ....................................................................... 4.30 VITAMINS ❋ Tab (BPC cap strength) ............................................................. 7.60 CHLORTALIDONE [CHLORTHALIDONE] ❋ Tab 25 mg ................................................................................ 4.80 MAGNESIUM SULPHATE ❋ Paste ........................................................................................ 2.98 (4.90)

500 500 1,000 30 80 g

✔ Vitala-C ✔ B-PlexADE ✔ MultiADE ✔ Igroton S29

41 41 59 75

PSM

84

OESTROGENS – See prescribing guideline ❋ Conjugated, equine tab 300 mcg ............................................... 3.01 28 (11.48) Premarin ❋ Conjugated, equine tab 625 mcg ............................................... 4.12 28 (11.48) Premarin Note: The old Pharmacodes are being delisted; Pharmacodes 2427478 and 2427486 will remain fully funded. AMOXYCILLIN Drops 125 mg per 1.25 ml ........................................................ 4.00 30 ml OP ✔ Ospamox Paediatric Drops

92 95

LINCOMYCIN – Retail pharmacy-Specialist Prescriptions must be written by, or on the recommendation of, an infectious disease physician or a clinical microbiologist Inj 300 mg per ml, 2 ml ........................................................... 80.00 5 ✔ Lincocin GABAPENTIN – Special Authority see SA1071– Retail pharmacy ▲ Cap 400 mg ............................................................................ 14.75 100 ✔ Nupentin Note: This is the blister pack presentation only. The Nupentin capsules in the bottle will remain fully funded. OXYCODONE HYDROCHLORIDE a) Only on a controlled drug form b) See prescribing guideline c) No patient co-payment payable d) Safety medicine; prescriber may determine dispensing frequency Tab controlled-release 10 mg .................................................... 6.75 (11.14) Tab controlled-release 20 mg .................................................. 11.50 (18.93) Tab controlled-release 40 mg .................................................. 18.50 (33.29) Tab controlled-release 80 mg .................................................. 34.00 (58.03)

131

127

20 OxyContin 20 OxyContin 20 OxyContin 20 OxyContin

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items – effective 1 January 2014 (continued)

225 Influenza vaccine – Hospital pharmacy [Xpharm] Inj ........................................................................................... 90.00 10 ✔ Fluvax

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

28

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 February 2014

187 PHARMACY SERVICES ❋ Brand switch fee........................................................................ 4.33 1 fee ✔ BSF Oxydone BNM

Effective 1 April 2014

129 PAROXETINE HYDROCHLORIDE ❋ Tab 20 mg ................................................................................ 1.44 (2.38) Note: Loxamine tab 20 mg, 90 tab packsize, remains fully subsidised. ONDANSETRON ❋ Tab 4 mg .................................................................................. 3.31 ❋ Tab 8 mg .................................................................................. 1.24 (1.70) 137 30 Loxamine

136

30 10

✔ Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron

ALPRAZOLAM – Safety medicine; prescriber may determine dispensing frequency ( subsidy) Tab 250 mcg............................................................................. 2.50 50 ✔ Arrow-Alprazolam ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 500 mcg............................................................................. 3.25 50 (4.10) Arrow-Alprazolam ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 1 mg............................................................................... 5.00 50 ✔ Arrow-Alprazolam ‡ Safety cap for extemporaneously compounded oral liquid preparations.

Effective 1 July 2014

37 PANCREATIC ENZYME Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease ............................................................ 94.38

100

✔ Creon Forte

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


Index

Pharmaceuticals and brands A Acipimox ........................................................... 21 Alprazolam ................................................... 26, 29 Amoxycillin .................................................. 22, 27 Apo-Amoxi......................................................... 22 Apo-Cilazapril/Hydrochlorothiazide ..................... 21 Arrow-Alprazolam ........................................ 26, 29 Ascorbic acid ..................................................... 27 Aspen Ceftriaxone .............................................. 23 Aspirin ............................................................... 25 Ativan ................................................................ 26 Ava 20 ED.......................................................... 25 Ava 30 ED.......................................................... 25 Azathioprine ....................................................... 26 B Bimatoprost ....................................................... 24 Blood ketone diagnostic test meter ..................... 23 Bosentan ........................................................... 25 B-PlexADE ......................................................... 27 BSF Oxydone BNM ....................................... 22, 29 C Carbimazole ....................................................... 21 Cardizem CD ...................................................... 21 Ceftriaxone................................................... 21, 23 Ceftriaxone-AFT ........................................... 21, 23 Chlortalidone [chlorthalidone] ............................. 27 Cilazapril with hydrochlorothiazide ...................... 21 Cilicaine VK........................................................ 25 Creon 25000...................................................... 21 Creon Forte ........................................................ 29 D Diltiazem hydrochloride ...................................... 21 Dr Reddy’s Ondansetron .............................. 25, 29 E Eltrombopag ...................................................... 21 Erlotinib ....................................................... 24, 26 Ethics Aspirin ..................................................... 25 Ethics Aspirin EC................................................ 25 Ethinyloestradiol with levonorgestrel ................... 25 F Fenpaed ............................................................. 25 Fluticasone with salmeterol ................................ 24 Fluvax ................................................................ 28 Freestyle Optium ................................................ 23 G Gabapentin ........................................................ 27 H Hysite ................................................................ 24 I Ibuprofen ........................................................... 25 Igroton ............................................................... 27 Imuran ............................................................... 26 Influenza vaccine.......................................... 26, 28 Influvac .............................................................. 26 K Ketoconazole ..................................................... 23 L Latanoprost........................................................ 24 Lincocin ............................................................. 27 Lincomycin ........................................................ 27 Lorazepam ......................................................... 26 Loxamine ..................................................... 25, 29 Lumigan ............................................................ 24 M Magnesium sulphate .......................................... 27 MultiADE............................................................ 27 N Nilstat ................................................................ 25 Nizoral ............................................................... 23 Nupentin ............................................................ 27 Nystatin ............................................................. 25 O Oestrogens ........................................................ 27 Olbetam s29 ...................................................... 21 Ondansetron ................................................ 25, 29 Ospamox Paediatric Drops ................................. 27 Oxycodone hydrochloride ............................. 23, 27 OxyContin .......................................................... 27 Oxydone BNM .................................................... 23 P Pancreatic enzyme ....................................... 21, 29 Paroxetine hydrochloride .............................. 25, 29 Pharmacy services....................................... 22, 29 Phenoxymethylpenicillin (penicillin v) .................. 25 pms-Bosentan ................................................... 25 Premarin ............................................................ 27 R Revolade............................................................ 21 S Seretide ............................................................. 24 Seretide Accuhaler ............................................. 24 Sodium citro-tartrate .......................................... 25 T Tarceva........................................................ 24, 26 Travatan............................................................. 24 Travoprost ......................................................... 24 U Ural.................................................................... 25 V Veracol .............................................................. 23 Vitala-C .............................................................. 27 Vitamin B complex ............................................. 27 Vitamins ............................................................ 27

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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 January 2014

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 January 2014 Contents Summary of PHARMAC decisions effective 1 January 2014 … 3 Removal of Special Authority from Seretide ….. 5 Nicotine replacement therapy – not OP … 5 Carbimazole…

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