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


Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 April 2014

Cumulative for January, February, March and April 2014


Contents

Summary of PHARMAC decisions effective 1 April 2014 ............................... 3 Disipal – discontinuation ............................................................................... 4 Imatinib mesilate – brand change ................................................................. 4 Diltiazem supply issue and Schedule changes ............................................... 5 Dispensing Named Patient Pharmaceutical Assessment (NPPA) pharmaceuticals ............................................................................................ 5 Insulin pump consumables prescriptions....................................................... 5 Methotrexate tablet brand change................................................................ 5 Zopiclone 30 tablet pack size delisting .......................................................... 6 Azathioprine tablet brand change ................................................................. 6 Olbetam – remove s29 .................................................................................. 6 News in brief ................................................................................................. 6 Tender News .................................................................................................. 7 Looking Forward ........................................................................................... 7 Sole Subsidised Supply Products cumulative to April 2014 ........................... 8 New Listings ................................................................................................ 19 Changes to Restrictions, Chemical Names and Presentations ...................... 23 Changes to Subsidy and Manufacturer’s Price............................................. 30 Changes to Section I ................................................................................... 33 Delisted Items ............................................................................................. 34 Items to be Delisted .................................................................................... 38 Index ........................................................................................................... 42

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Summary of PHARMAC decisions

EFFECTIVE 1 APRIL 2014 New listings (pages 19-22) • Diltiazem hydrochloride (Cardizem CD) cap long-acting 180 mg and 240 mg • Imipramine hydrochloride (Tofranil) tab 10 mg • Maprotiline hydrochloride (Ludiomil) tab 25 mg • Methotrexate (Trexate) tab 2.5 mg and 10 mg – PCT – Retail pharmacy – Specialist • Imatinib mesilate (Imatinib-AFT) cap 100 mg – no patient co-payment payable • Azathioprine (Azamun) tab 50 mg – Retail pharmacy – Specialist • Oral feed (powder) (Ensure) powder (chocolate) 850 g OP – Special Authority – Hospital pharmacy [HP3] Changes to restrictions, chemical names and presentation (pages 23-29) • Diltiazem hydrochloride cap long-acting 180 mg and 240 mg – removal of Stat • Diltiazem hydrochloride tab 30 mg and 60 mg – removal of Stat • Acipimox (Olbetam) cap 250 mg – removal of s29 • Oxycodone hydrochloride – removal of Prescribing Guidelines Decreased subsidy (pages 30-33) • Dexamethasone phosphate (Hospira) inj 4 mg per ml, 1 ml ampoule and 2 ml ampoule • Fluoxetine hydrochloride (Fluox) cap 20 mg • Betahistine dihydrochloride (Vergo 16) tab 16 mg • Prochlorperazine (Antinaus) tab 5 mg

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4 Pharmaceutical Schedule - Update News

Disipal – discontinuation

Disipal (orphenadrine hydrochloride) 50 mg tablets will be delisted from 1 November 2014 due to supplier discontinuation. The supplier has advised that stock available in the country has an expiry date of October 2014. The following funded pharmaceuticals could be considered as suitable alternatives – benztropine mesylate 2 mg tablets (Benztrop) and procyclidine hydrochloride 5 mg tablets (Kemadrin).

Imatinib mesilate – brand change

From 1 April 2014, a new brand of imatinib mesilate 100 mg capsules, Imatinib-AFT, will be listed in the Pharmaceutical Schedule fully subsidised without restriction. Imatinib-AFT is not registered for the treatment of Gastrointestinal Stromal Tumour (GIST). Previously, the Glivec brand was funded subject to Special Authority criteria for patients with Chronic Myeloid Leukaemia (CML) or Gastrointestinal Stromal Tumour (GIST) and their Glivec was sent directly to them by PHARMAC. After 1 April 2014, the Glivec brand will be funded, subject to Special Authority criteria, for patients with Gastrointestinal Stromal Tumour (GIST) only and their Glivec will continue to be sent directly to them by PHARMAC. All other patients will need to change to the Imatinib-AFT brand to continue to receive fully funded imatinib and will need to pick up their imatinib (Imatinib-AFT brand) directly from a community pharmacy. All CML patients with a current Special Authority approval had 2 months’ supply of Glivec delivered to them on 26 March 2014. PHARMAC has contacted the community pharmacies that have been nominated by CML patients or that have NPPA patients with further details about the change. Only the Imatinib-AFT brand can be dispensed and claimed from a community pharmacy. There will be no patient co-payment for imatinib dispensed from community pharmacy for at least the duration of 2014. Pharmacies will receive a Brand Switch Fee between 1 July 2014 and 1 October 2014 for dispensing Imatinib-AFT 100 mg capsules.


Pharmaceutical Schedule - Update News

5

Diltiazem supply issue and Schedule changes

Apotex has advised PHARMAC of supply issues with all presentations of its diltiazem hydrochloride long-acting capsules. From 1 April 2014, the following changes will be made to the Pharmaceutical Schedule to address this issue: • Cardizem CD long-acting capsules 180 mg and 240 mg will be listed fully subsidised. • Stat dispensing will be removed temporarily from all presentations of diltiazem hydrochloride, tablets and long-acting capsules. • Sole Subsidised Supply will be suspended on the Apo-Diltiazem CD brand of diltiazem hydrochloride 180 mg and 240 mg long-acting capsules.

Dispensing Named Patient Pharmaceutical Assessment (NPPA) pharmaceuticals

When a pharmaceutical has been approved for funding via NPPA, a pharmacy is nominated to dispense the pharmaceutical. The pharmacy is notified that it has been nominated via a letter from the Ministry of Health (this letter also confirms the duration of the approval, the maximum dosage and the funding approved, excluding GST, for the duration). If a patient changes pharmacy, the new pharmacy should advise PHARMAC (0800 66 00 50 option 3 or email nppa@pharmac.govt.nz) of the change before dispensing the medicine. PHARMAC will then be able to confirm the details of the approval.

Insulin pump consumables prescriptions

A reminder that the default dispensing period for all insulin pump consumable products (infusion sets, cartridges) is monthly. These products should only be dispensed stat (3 months at one time) when Access Exemption (Section F, Part II) applies.

Methotrexate tablet brand change

The Trexate brand of methotrexate 2.5 mg and 10 mg tablets will be subsidised from 1 April 2014. There will be a subsidy reduction for the Methoblastin brand from 1 June 2014. From 1 September 2014 the Trexate brand will commence Sole Supply. A Brand Switch Fee will apply and patient information leaflets to support the change will be available to download from www.pharmaconline.co.nz.


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Pharmaceutical Schedule - Update News

Zopiclone 30 tablet pack size delisting

The 30 tablet pack size of Apo-Zopiclone 7.5 mg tablets will be delisted and Sole Subsidised Supply will be reinstated for the 500 tablet pack size from 1 May 2014. The 30 tablet pack size was listed temporarily from 1 November 2012.

Azathioprine tablet brand change

The Azamun brand of azathioprine 50 mg tablets will be subsidised from 1 April 2014. There will be a subsidy reduction for the Imuprine and Imuran brands from 1 June 2014 and Sole Supply of the Azamun brand will commence on 1 September 2014.

Olbetam – remove s29

Olbetam s29 (acipimox 250 mg capsules) was temporarily listed from 1 January 2014 to cover a potential supply issue. This product is now approved and is no longer required to be prescribed and supplied in accordance with section 29 of the Medicines Act 1981. “s29” and the s29 symbol will be removed from the listing from 1 April 2014.

News in brief

• A 100 tab pack size Tofranil (imipramine hydrochloride) tab 10 mg will be listed temporarily from 1 April 2014. • A 30 tab pack size of Ludiomil (maprotiline hydrochloride) tab 25 mg will be listed temporarily from 1 April 2014. • Apo-Bromocriptine (bromocriptine) cap 5 mg will be delisted from 1 October 2014 due to supplier discontinuation. • Pergolide (Permax) tab 0.25 mg and 1 mg will be delisted from 1 September 2014 due to supplier discontinuation. • Ensure Plus oral feed 1.5 kcal/ml (strawberry) liquid, 237 ml pack size will be delisted from 1 October 2014 due to supplier discontinuation. • An 850 g pack size for Ensure oral feed powder (chocolate) will be listed from 1 April 2014. The 900 g pack size will be delisted from 1 October 2014.


Tender News

Sole Subsidised Supply changes – effective 1 May 2014

Chemical Name Compound electrolytes Ferrous sulphate Lactulose Lamivudine Oxytocin Phenoxymethylpenicillin (Penicillin V) Urea Zopiclone Presentation; Pack size Powder for oral soln; 10 sachets Oral liq 30 mg (6 mg elemental) per 1 ml; 500 ml Oral liq 10 g per 15 ml; 500 ml Tab 150 mg; 60 tab Inj 5 iu per ml, 1 ml ampoule; 5 inj Inj 10 iu per ml, 1 ml ampoule; 5 inj Grans for oral liq 125 mg per 5 ml; 100 ml Grans for oral liq 250 mg per 5 ml; 100 ml Crm 10%; 100 g OP Tab 7.5 mg; 500 tab Sole Subsidised Supply brand (and supplier) Enerlyte (Multichem) Ferodan (Mylan) Laevolac (Douglas) Lamivudine Alphapharm (Mylan) Oxytocin BNM (Boucher) AFT (AFT) healthE Urea Cream (Jaychem) Apo-Zopiclone (Apotex)

Looking Forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for future implementation 1 May 2014 • Amoxycillin (Apo-Amoxi) cap 500 mg – new listing • Olanzapine (Zyprexa Relprevv) inj 210 mg, 300 mg and 405 mg – amendment to Special Authority • Paliperidone (Invega Sustenna) inj 25 mg, 50 mg, 75 mg, 100 mg and 150 mg syringe – Special Authority – new listing • Risperidone (Risperdal Consta) inj 25 mg, 37.5 mg and 50 mg vial – amendment to Special Authority and price decrease • Tacrolimus (Tacrolimus Sandoz) cap 0.5 mg, 1 mg and 5 mg – new listing

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Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

Abacavir sulphate Acarbose Acetazolamide Acetylcysteine Aciclovir Allopurinol Alprazolam 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 Tab 250 mcg, 500 mcg & 1 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 100 mg Tab dispersible 300 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

Brand Name Expiry Date*

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

Aqueous cream Ascorbic acid Aspirin Atenolol Atorvastatin Atropine sulphate Azithromycin Baclofen Bendrofluazide Benzathine benzylpenicillin

8

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


Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

Benzylpenicillin sodium (Penicillin G) Betaxolol hydrochloride 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

Inj 600 mg Eye drops 0.5% Eye drops 0.25% 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

Brand Name Expiry Date*

Sandoz Betoptic Betoptic S 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 2014 2014 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

Cefazolin sodium Cefuroxime sodium Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate

Ciclopirox olamine Cilazapril Ciprofloxacin

*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 April 2014

Generic Name

Citalopram hydrobromide Clarithromycin Clindamycin Clomiphene citrate Clomipramine hydrochloride Clonidine hydrochloride

Presentation

Tab 20 mg Tab 500 mg Tab 250 mg 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 Tab 75 mg 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% Eye oint 0.1% with neomycin 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 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

Brand Name Expiry Date*

Arrow-Citalopram Apo-Clarithromycin Apo-Clarithromycin Clindamycin ABM Dalacin C Serophene Apo-Clomipramine Clonidine BNM Catapres Arrow - Clopid Clomazol Clomazol PSM Colgout Itch-Soothe Nausicalm Neoral Siterone Ginet 84 Desmopressin-PH&T Douglas Maxidex Maxitrol Maxitrol 2014 2014 2016 2016 2015 2015

Clopidogrel Clotrimazole

2016 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 and polymyxin b sulphate

Dexamphetamine sulphate Dextrose Dextrose with electrolytes Diclofenac sodium

PSM Biomed Pedialyte-Bubblegum Apo-Diclo Diclax SR Voltaren Voltaren Ophtha Voltaren DHC Continus

2015 2014 2016 2015 2014

Dihydrocodeine tartrate

2016

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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 April 2014

Generic Name

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

Presentation

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 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

Brand Name Expiry Date*

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

31/12/15

2015 2014 2014 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

Fluconazole Fluorometholone Fluorouracil sodium Fluticasone propionate Furosemide Fusidic acid Gemfibrozil

*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 April 2014

Generic Name

Gentamicin sulphate Gliclazide Glipizide Glycerol Glyceryl trinitrate

Presentation

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 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 Oral liq 20 mg per ml 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 Cap 10 mg & 20 mg Powder for oral soln Cap 100 mg

Brand Name Expiry Date*

Pfizer Apo-Gliclazide Minidiab PSM Glytrin Nitroderm TTS Lycinate Serenace 2015 2014 2015 2015 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 Fenpaed Arrowcare Brufen SR Aldara Dapa-Tabs Univent Ferrum H PSM Ismo 20 Oratane Konsyl-D Itrazole

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

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

Imiquimod Indapamide Ipratropium bromide Iron polymaltose Isoniazid Isosorbide mononitrate Isotretinoin Ispaghula (psyllium) husk Itraconazole

12

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


Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

Ketoconazole Lamivudine Lansoprazole Latanoprost Letrozole Levonorgestrel Lidocaine [lignocaine] hydrochloride Lisinopril Lithium carbonate Lodoxamide trometamol Loratadine 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

Presentation

Shampoo 2% Oral liq 10 mg per ml; 240 ml OP Tab 100 mg Cap 15 mg & 30 mg 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 10 mg 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

Brand Name Expiry Date*

Sebizole 3TC Zetlam Solox Hysite Letraccord Postinor-1 Lidocaine-Claris Xylocaine Viscous Arrow-Lisinopril Lithicarb FC Douglas Lomide Lorafix 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 2014 2016 2014 2015 2015 2015 2016 2015 2014 2015 2015 2014 2014 2016 2014 2014 2014 2016 2015 2014 2014 2016 2015 2016 2015 2015 2015 2015 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 April 2014

Generic Name

Methadone hydrochloride

Presentation

Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Inj prefilled syringe 7.5 mg, 10 mg, 15 mg, 20 mg, 25 mg & 30 mg 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 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 Cap long-acting 10 mg, 30 mg, 60 mg and 100 mg 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*

Biodone Biodone Forte Biodone Extra Forte Methotrexate Sandoz Solu-Medrol Pfizer Metamide Metoprolol-AFT CR Lopresor Lopresor Slow-Lopresor Puri-nethol Decozol Multichem Avanza Arrow Apo-Moclobemide m-Mometasone RA-Morph m-Eslon Arrow-Morphine LA DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Hospira Cellcept Naltraccord Naphcon Forte Apo-Nadolol 2014 2015

Methotrexate Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol succinate Metoprolol tartrate

2016 2015 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

Morphine tartrate Mycophenolate mofetil Naltrexone hydrochloride Naphazoline hydrochloride Nadolol

Inj 80 mg per ml, 1.5 ml & 5 ml Cap 250 mg Tab 500 mg Tab 50 mg Eye drops 0.1% Tab 40 mg & 80 mg

2016 2016 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 April 2014

Generic Name

Naproxen Neostigmine Nevirapine Nicotine

Presentation

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 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 4 mg & 8 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

Brand Name Expiry Date*

Noflam 250 Noflam 500 AstraZeneca Nevirapine Alphapharm Habitrol Habitrol Habitrol Apo-Nicotinic Acid Noriday 28 Primolut N Arrow-Norfloxacin Norpress Nilstat Octreotide Max Rx 2014 2015 2014 2014 2016 2014 2014 2015 2014 2015 2014

Nicotinic acid Norethisterone Norfloxacin Nortriptyline hydrochloride Nystatin Octreotide (somatostatin analogue) Oil in water emulsion Omeprazole

healthE Fatty Cream Omezol Relief Midwest Dr Reddy’s Omeprazole Onrex Ox-Pam Apo-Oxybutynin Oxydone BNM OxyNorm Oxycodone Orion Syntometrine Pamidronate BNM Pantocid IV Paracare Parafast Ethics Paracetamol Paracare Double Strength

2015 2014

Ondansetron Oxazepam Oxybutynin Oxycodone hydrochloride

2016 2014 2016 2015

Oxytocin Pamidronate disodium Pantoprazole Paracetamol

2015 2014 2014 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.

15


Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

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

Presentation

Tab paracetamol 500 mg with codeine phosphate 8 mg Tab 20 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% Tab 50 mg & 100 mg Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

Paracetamol + Codeine (Relieve) Loxamine Breath-Alert Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack 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 2014 2014 2015 2014 2014 2016 2015 2017 2017

Pergolide Permethrin Pethidine hydrochloride

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

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

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

16

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


Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

Quinapril with hydrochlorothiazide

Presentation

Tab 10 mg with hydrochlorothiazide 12.5 mg Tab 20 mg with hydrochlorothiazide 12.5 mg Oral liq 150 mg per 10 ml Tab 150 mg & 300 mg Cap 150 mg Tab 100 mg Tab orodispersible 10 mg Tab 150 mg & 300 mg Oral liq 400 mcg per ml 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 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 Tab 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 Cap 400 mcg 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

Brand Name Expiry Date*

Accuretic 10 Accuretic 20 Peptisoothe Arrow-Ranitidine Mycobutin Norvir Rizamelt ArrowRoxithromycin Ventolin Asthalin Duolin 2014 2016 2015 2014 2015 2016 2015 2015 2015

Ranitidine hydrochloride Rifabutin Ritonavir Rizatriptan Roxithromycin Salbutamol

Salbutamol with ipratropium bromide Sertraline Sildenafil Simvastatin

Arrow-Sertraline Silagra Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Biomed Micolette Hylo-Fresh Volumatic Space Chamber Plus Spiractin Spirotone Salazopyrin Salazopyrin EN Arrow-Sumatriptan Genox Tamsulosin-Rex Pinetarsol

2016 2014 2014

Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Sodium hyaluronate Spacer device Spironolactone Sulphasalazine Sumatriptan Tamoxifen citrate Tamsulosin hydrochloride Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Temozolomide

2016 2016 2016 2015 2016 2016 2016 2014 2016 2014

Normison Temaccord

2014 2016

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

17


Sole Subsidised Supply Products – cumulative to April 2014

Generic Name

Terazosin Terbinafine Testosterone cypionate Testosterone undecanoate Tetrabenazine Tetracosactrin Timolol maleate

Presentation

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%, gel forming; 2.5 ml OP & eye drops 0.5%, gel forming; 2.5 ml OP 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 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*

Arrow Dr Reddy’s Terbinafine Depo-Testosterone Andriol Testocaps Motetis Synacthen Synacthen Depot Timoptol XE Arrow-Timolol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol ReTrieve Kenacort-A Kenacort-A40 Aristocort Aristocort Oracort Mydriacyl Ursosan Mylan Isoptin Bplex Mvite Retrovir Alphapharm Multichem Zincaps 2016 2014 2014 2015 2016 2014 2016 2014 2014

Tobramycin

Tolcapone Tramadol hydrochloride Tretinoin Triamcinolone acetonide

2014 2014 2016 2014

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

2014 2014 2014 2014 2016 2016 2016 2014 2014 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.


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 April 2014

57 DILTIAZEM HYDROCHLORIDE Cap long-acting 180 mg ............................................................ 7.56 Cap long-acting 240 mg .......................................................... 10.22 30 30 ✔ Cardizem CD ✔ Cardizem CD

128 128 154

IMIPRAMINE HYDROCHLORIDE – Safety medicine; prescriber may determine dispensing frequency Tab 10 mg .............................................................................. 10.96 100 ✔ Tofranil MAPROTILINE HYDROCHLORIDE – Safety medicine; prescriber may determine dispensing frequency Tab 25 mg ................................................................................ 7.52 30 ✔ Ludiomil METHOTREXATE ❋ Tab 2.5 mg – PCT – Retail pharmacy-Specialist......................... 3.82 ❋ Tab 10 mg – PCT – Retail pharmacy-Specialist........................ 26.25 IMATINIB MESILATE ❋ Cap 100 mg – no patient co-payment payable ....................... 298.90 30 50 60

✔ Trexate ✔ Trexate

160

✔ Imatinib-AFT

Note: Imatinib-AFT is not a registered for the treatment of Gastro Intestinal Stromal Tumours (GIST). The Glivec brand of imatinib mesilate (supplied by Novartis) remains fully subsidised under Special Authority for patients with unresectable and/or metastatic malignant GIST, see SA0643. 165 212 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg – For azathioprine oral liquid formulation refer, ..................... 13.22

100

✔ Azamun

ORAL FEED (POWDER) – Special Authority see SA1228 – Hospital pharmacy [HP3] Powder (chocolate) ................................................................. 13.00 850 g OP

✔ Ensure

Effective 1 March 2014

27 PANTOPRAZOLE ❋ Tab EC 20 mg ........................................................................... 2.68 ❋ Tab EC 40 mg ........................................................................... 3.54 PRAZOSIN ❋ Tab 1 mg .................................................................................. 5.53 ❋ Tab 2 mg .................................................................................. 7.00 ❋ Tab 5 mg ................................................................................ 11.70 100 100 100 100 100 ✔ Pantoprazole Actavis 20 ✔ Pantoprazole Actavis 40 ✔ Apo-Prazosin ✔ Apo-Prazosin ✔ Apo-Prazosin

52 74

SUNSCREENS, PROPRIETARY – Subsidy by endorsement Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Lotn, ......................................................................................... 3.30 100 g OP ✔ Marine Blue Lotion SPF 50+ 5.10 200 g OP ✔ Marine Blue Lotion SPF 50+

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

19


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings – effective 1 March 2014 (continued)

95 114 151 205 PYRIMETHAMINE – Special Authority see SA1328 – Retail pharmacy – wastage claimable – see rule 3.3.2 Tab 25 mg .............................................................................. 36.95 50 ✔ Daraprim S29 KETOPROFEN ❋ Cap long-acting 200 mg .......................................................... 12.07 CYCLOPHOSPHAMIDE – wastage claimable – see rule 3.3.2 Tab 50 mg – PCT – Retail pharmacy-Specialist........................ 79.00 28 50 ✔ Oruvail SR

✔ Endoxan S29

DIABETIC ORAL FEED 1KCAL/ML – Special Authority see SA1095 – Hospital pharmacy [HP3] Liquid (vanilla)........................................................................... 1.78 237 ml OP (2.10) Sustagen Diabetic AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA1108 – Hospital pharmacy [HP3] Liquid (forest berries), 250 ml carton .................................... 540.00 18 OP ✔ Easiphen Liquid

217

Effective 1 February 2014

61 70 ISOSORBIDE MONONITRATE ❋ Tab long-acting 40 mg .............................................................. 7.50 DIMETHICONE ❋ Crm 5% pump bottle .................................................................. 4.73 DEXAMETHASONE PHOSPHATE Dexamethasone phosphate injection will not be funded for oral use. ❋ Inj 4 mg per ml, 1 ml ampoule – Up to 5 inj available on a PSO ........................................... 25.80 ❋ Inj 4 mg per ml, 2 ml ampoule – Up to 5 inj available on a PSO ........................................... 17.98 BACLOFEN Inj 0.05 mg per ml, 1 ml ampoule - Subsidy by endorsement ... 11.55 30 ✔ Ismo 40 Retard

500 ml OP ✔ healthE Dimethicone 5%

82

10 5

✔ Dexamethasonehameln ✔ Dexamethasonehameln ✔ Lioresal Intrathecal

121

1

Subsidised only for use in a programmable pump in patients where oral antispastic agents have been ineffective or have caused intolerable side effects and the prescription is endorsed accordingly. Inj 2 mg per ml, 5 ml ampoule - Subsidy by endorsement ...... 209.29 1 ✔ Lioresal Intrathecal Subsidised only for use in a programmable pump in patients where oral antispastic agents have been ineffective or have caused intolerable side effects and the prescription is endorsed accordingly.

129

FLUOXETINE HYDROCHLORIDE ❋ Tab dispersible 20 mg, scored – Subsidy by endorsement ......... 2.50

30

✔ Arrow-Fluoxetine

Subsidised by endorsement 1) When prescribed for a patient who cannot swallow whole tablets or capsules and the prescription is endorsed accordingly; or 2) When prescribed in a daily dose that is not a multiple of 20 mg in which case the prescription is deemed to be endorsed. Note: Tablets should be combined with capsules to facilitate incremental 10 mg doses. ❋ Cap 20 mg ................................................................................ 1.74 90 ✔ Arrow-Fluoxetine

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

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

20


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings – effective 1 February 2014 (continued)

192 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 4.33 The Pharmacode for the BSF Cellcept is 2452189. 208 ORAL ELEMENTAL FEED 0.8 KCAL/ML – Special Authority see SA1377 – Hospital pharmacy [HP3] Liquid (grapefruit), 250 ml carton .......................................... 171.00 18 OP ✔ Elemental 028 Extra Liquid (pineapple & orange), 250 ml carton............................ 171.00 18 OP ✔ Elemental 028 Extra Liquid (summer fruit), 250 ml carton ..................................... 171.00 18 OP ✔ Elemental 028 Extra 1 fee ✔ BSF Cellcept

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

30 30 100

✔ AFT S29

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

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

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)

90 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 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

92

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions, Chemical Names and Presentations

Effective 1 April 2014

57 DILTIAZEM HYDROCHLORIDE (removal of stat) Tab 30 mg ................................................................................ 4.60 Tab 60 mg – For diltiazem hydrochloride oral liquid formulation refer,....... 8.50 Cap long-acting 180 mg ............................................................ 7.56 47.67 Cap long-acting 240 mg .......................................................... 10.22 63.58 ACIPIMOX (removal of section 29) ❋ Cap 250 mg ............................................................................ 18.75 OXYCODONE HYDROCHLORIDE (remove Prescribing Guideline) 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 Prescribing Guideline Prescribers should note that oxycodone is significantly more expensive than long-acting morphine sulphate and clinical advice suggests that it is reasonable to consider this as a second-line agent to be used after morphine. 100 100 30 500 30 500 30 ✔ Dilzem ✔ Dilzem ✔ Cardizem CD ✔ Apo-Diltiazem CD ✔ Cardizem CD ✔ Apo-Diltiazem CD ✔ Olbetam s29 S29

60 127

Effective 1 March 2014

27 PANTOPRAZOLE (amendment to presentation description) ❋ Tab EC 20 mg ........................................................................... 2.68 1.23 ❋ Tab EC 40 mg ........................................................................... 3.54 1.54 30 100 28 100 28 ✔ Pantoprazole Actavis 20 ✔ Dr Reddy’s Pantoprazole ✔ Pantoprazole Actavis 40 ✔ Dr Reddy’s Pantoprazole

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP – Up to 50 test available on a PSO (amendment to restriction) The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed for a patient on with insulin or a sulphonylurea but are on a different prescription and endorsed accordingly. Pharmacists may annotate the prescription as endorsed where there exists a record of prior dispensing of insulin or sulphonylurea; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4) Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5) Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. Blood glucose test strips – Note differing brand requirements ... 10.56 50 test OP ✔ CareSens ✔ CareSens N

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 March 2014 (continued)

31 BLOOD GLUCOSE TEST STRIPS (VISUALLY IMPAIRED) (amendment to restriction) The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed for a patient on with insulin or a sulphonylurea but are on a different prescription and endorsed accordingly. Pharmacists may annotate the prescription as endorsed where there exists a record of prior dispensing of insulin or sulphonylurea; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed;or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly; or 4) Prescribed for a patient on home TPN at risk of hypoglycaemia or hyperglycaemia and endorsed accordingly; or 5) Prescribed for a patient with a genetic or an acquired disorder of glucose homeostasis excluding type 1 or type 2 diabetes and metabolic syndrome and endorsed accordingly. SensoCard blood glucose test strips are subsidised only if prescribed for a patient who is severely visually impaired and is using a SensoCard Plus Talking Blood Glucose Monitor. Blood glucose test strips ......................................................... 26.20 31 50 test OP ✔ SensoCard

INSULIN SYRINGES AND NEEDLES (amendment to restriction) Subsidy is available for disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly. Pharmacists may annotate the prescription as endorsed where there exists a record of prior dispensing of insulin. ELTROMBOPAG – Special Authority see SA14181412 – Retail pharmacy Wastage claimable – see rule 3.3.2 Tab 25 mg ......................................................................... 1,771.00 Tab 50 mg ......................................................................... 3,542.00

45

28 28

✔ Revolade ✔ Revolade

➽ SA14181412 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 Any of the following: 3.1. Patient has a platelet count of 20,000 to 30,000 platelets per microlitre and has evidence of significant mucocutaneous bleeding; or 3.2. Patient has a platelet count of ≤20,000 platelets per microlitre and has evidence of active bleeding; or 3.3. 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.

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 Restrictions – effective 1 March 2014 (continued)

73 COAL TAR (amendment to presentation description) Soln BP – Only in combination ................................................. 12.55 200 ml ✔ Midwest

Up to 10 % only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain, with or without other dermatological galenicals. 151 LOMUSTINE – PCT only – Retail pharmacy-Specialist Cap 10 mg ............................................................................ 132.59 Cap 40 mg ............................................................................ 399.15 FLUDARABINE PHOSPHATE – PCT only-Specialist Tab 10 mg – PCT – Retail pharmacy-Specialist ................... 433.50 ANAGRELIDE HYDROCHLORIDE – PCT only – Retail pharmacy-Specialist Cap 0.5 mg .......................................................................... CBS MESNA – PCT only-Specialist Tab 400 mg – PCT – Retail pharmacy-Specialist ................. 227.50 Tab 600 mg – PCT – Retail pharmacy-Specialist ................. 339.50 IDARUBICIN HYDROCHLORIDE – PCT only-Specialist Cap 5 mg – PCT – Retail pharmacy-Specialist ..................... 115.00 Cap 10 mg – PCT – Retail pharmacy-Specialist ................... 144.50 20 20 20 100 50 50 1 1

✔ CeeNU ✔ CeeNU ✔ Fludara Oral

153 154 157

✔ Agrylin ✔ Teva

✔ Uromitexan ✔ Uromitexan

157

✔ Zavedos ✔ Zavedos

158 185

PROCARBAZINE HYDROCHLORIDE – PCT only – Retail pharmacy-Specialist Cap 50 mg ............................................................................ 225.00 50

✔ Natulan

MONTELUKAST – Special Authority see SA14211409 – Retail pharmacy Prescribing Guideline: Clinical evidence indicates that the effectiveness of montelukast is strongest when montelukast is used in short treatment courses. Tab 4 mg ................................................................................ 18.48 28 ✔ Singulair Tab 5 mg ................................................................................ 18.48 28 ✔ Singulair Tab 10 mg .............................................................................. 18.48 28 ✔ Singulair ➽ SA14211409 Special Authority for Subsidy Initial application — (Pre-school wheeze) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 To be used for the treatment of intermittent severe wheezing (possibly viral) in children under 5 years; and 2 The patient has had at least three episodes in the previous 12 months of acute wheeze severe enough to seek medical attention. Renewal — (Pre-school wheeze) from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Initial application — (exercise-induced asthma) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has been trialled with maximal asthma therapy, including inhaled corticosteroids and long-acting beta-adrenoceptor agonists; and 2 Patient continues to receive optimal inhaled corticosteroid therapy; and 3 Patient continues to experience frequent episodes of exercise-induced bronchoconstriction. continued...

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

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

25


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions – effective 1 March 2014 (continued)

continued... Initial application — (aspirin desensitisation) only from a clinical immunologist or allergist. Approvals valid for 1 year without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient is undergoing aspirin desensitisation therapy under the supervision of a clinical immunologist or allergist; and 2 Patient has moderate to severe aspirin-exacerbated respiratory disease or Samter’s triad; and 3 Nasal polyposis, confirmed radiologically or surgically; and 4 Documented aspirin or NSAID allergy confirmed by aspirin challenge or a clinical history of severe reaction to aspirin or NSAID where challenge would be considered dangerous.

Effective 1 February 2014

42 FERROUS SULPHATE (amendment to presentation description) ❋‡ Oral liq 30 mg (6 mg elemental) per 1 ml (6 mg elemental per 1 ml) ................................................... 10.28

500 ml

✔ Ferodan

82

DEXAMETHASONE SODIUM PHOSPHATE (amendment to chemical name and presentation description) Dexamethasone sodium phosphate injection will not be funded for oral use. ❋ Inj 4 mg per ml, 1 ml ampoule – Up to 5 inj available on a PSO ........................................... 25.80 10 ✔ Dexamethasonehameln 21.50 5 ✔ Hospira ❋ Inj 4 mg per ml, 2 ml ampoule – Up to 5 inj available on a PSO ........................................... 17.98 5 ✔ Dexamethasonehameln 31.00 ✔ Hospira ROPINIROLE HYDROCHLORIDE (reinstate certified exemption and remove s29) ▲ Tab 0.25 mg ............................................................................. 2.36 100 6.20 84 ▲ Tab 1 mg .................................................................................. 5.32 100 15.95 84 ▲ Tab 2 mg .................................................................................. 7.72 100 24.95 84 ▲ Tab 5 mg ................................................................................ 14.48 100 38.00 84 OXYCODONE HYDROCHLORIDE (removal of Brand switch fee) 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 – 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

123

✔ Apo-Ropinirole ✔ Ropin ✔ Apo-Ropinirole ✔ Ropin ✔ Apo-Ropinirole ✔ Ropin ✔ Apo-Ropinirole ✔ Ropin

S29 S29 S29 S29

127

20 20 20 20

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

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

Changes to Restrictions – effective 1 February 2014 (continued)

145 ATOMOXETINE – Special Authority see SA14160951 – Retail pharmacy Cap 10 mg ............................................................................ 107.03 Cap 18 mg ............................................................................ 107.03 Cap 25 mg ............................................................................ 107.03 Cap 40 mg ............................................................................ 107.03 Cap 60 mg ............................................................................ 107.03 Cap 80 mg ............................................................................ 139.11 Cap 100 mg .......................................................................... 139.11 28 28 28 28 28 28 28 ✔ Strattera ✔ Strattera ✔ Strattera ✔ Strattera ✔ Strattera ✔ Strattera ✔ Strattera

➽ SA14160951 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has ADHD (Attention Deficit and Hyperactivity Disorder) diagnosed according to DSM-IV or ICD 10 criteria; and 2 Once-daily dosing; and 3 Any of the following: 3.1 Treatment with a subsidised formulation of a stimulant has resulted in the development or worsening of serious adverse reactions or where the combination of subsidised stimulant treatment with another agent would pose an unacceptable medical risk; or 3.2 Treatment with a subsidised formulation of a stimulant has resulted in worsening of co-morbid substance abuse or there is a significant risk of diversion with subsidised stimulant therapy; or 3.3 An effective dose of a subsidised formulation of a stimulant has been trialled and has been discontinued because of inadequate clinical response; or 3.4 Treatment with a subsidised formulation of a stimulant is considered inappropriate because the patient has a history of psychoses or has a first-degree relative with schizophrenia; and 4 The patient will not be receiving treatment with atomoxetine in combination with a subsidised formulation of a stimulant, except for the purposes of transitioning from subsidised stimulant therapy to atomoxetine. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Note: A “subsidised formulation of a stimulant” refers to currently subsidised methylphenidate hydrochloride tablet formulations (immediate-release, sustained-release and extended-release) or dexamphetamine sulphate tablets. 166 MYCOPHENOLATE MOFETIL – Special Authority see SA1041 – Retail pharmacy Dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically. Tab 500 mg – Brand switch fee payable (Pharmacode 24512189).................................................... 25.00 50 ✔ Cellcept Cap 250 mg – Brand switch fee payable (Pharmacode 2452189)...................................................... 25.00 100 ✔ Cellcept MAGNESIUM HYDROXIDE 8% MIXTURE Magnesium hydroxide paste 29% Methyl hydroxybenzoate Water MAGNESIUM HYDROXIDE (amendment to presentation description) Paste 29% .............................................................................. 22.61 275 g 1.5 g to 1,000 ml 770 ml 500 g ✔ PSM

197

198

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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions – 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

90

97

Prescriptions must be written by, or on the recommendation of, an infectious disease physician, clinical microbiologist, dermatologist, endocrinologist or oncologist 127 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

20 20 20 20

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

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


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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

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


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 April 2014

82 DEXAMETHASONE PHOSPHATE ( subsidy) Dexamethasone phosphate injection will not be funded for oral use. ❋ Inj 4 mg per ml, 1 ml ampoule – Up to 5 inj available on a PSO ........................................... 12.90 (21.50) ❋ Inj 4 mg per ml, 2 ml ampoule – Up to 5 inj available on a PSO ........................................... 17.98 (31.00) FLUOXETINE HYDROCHLORIDE ( subsidy) ❋ Cap 20 mg ................................................................................ 1.62 (2.70) BETAHISTINE DIHYDROCHLORIDE ( subsidy) ❋ Tab 16 mg ................................................................................ 4.95 PROCHLORPERAZINE ( subsidy) ❋ Tab 5 mg – Up to 30 tab available on a PSO .............................. 9.75

5 Hospira 5 Hospira 84 Fluox 84 500 ✔ Vergo 16

129 135 136

✔ Antinaus

Effective 1 March 2014

53 73 CILAZAPRIL WITH HYDROCHLOROTHIAZIDE ( subsidy) ❋ Tab 5 mg with hydrochlorothiazide 12.5 mg............................... 3.00 COAL TAR ( subsidy) Soln – Only in combination ...................................................... 12.55 28 200 ml ✔ Inhibace Plus ✔ Midwest

Up to 10% only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain, with or without other dermatological galenicals. 74 SUNSCREENS, PROPRIETARY – Subsidy by endorsement ( subsidy) Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Crm........................................................................................... 3.30 100 g OP (5.89) Hamilton Sunscreen Lotn .......................................................................................... 4.13 125 ml OP (6.94) Aquasun 30+ CEFTRIAXONE – Subsidy by endorsement ( subsidy) 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 (2.70) Veracol Inj 1 g vial ................................................................................. 5.22 5 (10.49) Aspen Ceftriaxone

90

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


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price – effective 1 March 2014 (continued)

123 ROPINIROLE HYDROCHLORIDE ( subsidy) ▲ Tab 0.25 mg ............................................................................. 1.98 (6.20) ▲ Tab 1 mg .................................................................................. 4.47 (15.95) ▲ Tab 2 mg .................................................................................. 6.48 (24.95) ▲ Tab 5 mg ................................................................................ 12.16 (38.00) ASPIRIN ( price) ❋ Tab EC 300 mg ......................................................................... 2.00 (8.50) 84 Ropin 84 Ropin 84 Ropin 84 Ropin 100 Aspec 300

124 131

GABAPENTIN – Special Authority see SA1071 – Retail pharmacy ( subsidy) ▲ Cap 300 mg – For gabapentin oral liquid formulation, refer page 194 ..................................................................... 11.00 100 ▲ Cap 400 mg ............................................................................ 13.75 100 INTERFERON BETA-1-ALPHA – Special Authority see SA1062 ( subsidy) Inj 6 million iu prefilled syringe ............................................ 1,229.91 Inj 6 million iu per 0.5 ml pen injector ................................. 1,229.91 Inj 6 million iu per vial ......................................................... 1,229.91 4 4 4

✔ Nupentin ✔ Nupentin ✔ Avonex ✔ Avonex Pen ✔ Avonex

144

Effective 1 February 2014

42 FERROUS SULPHATE ❋ Tab long-acting 325 mg (105 mg elemental) ( subsidy and  price) .......................................................... 2.06 ❋‡ Oral liq 30 mg (6 mg elemental) per 1 ml ( subsidy) .......................................................................... 10.28 COMPOUND ELECTROLYTES ( subsidy) Powder for oral soln – Up to 10 sach available on a PSO............ 0.90 UREA ( subsidy) ❋ Crm 10% .................................................................................. 1.65 (3.07) OXYTOCIN – Up to 5 inj available on a PSO ( subsidy) Inj 5 iu per ml, 1 ml ampoule ..................................................... 4.75 Inj 10 iu per ml, 1 ml ampoule ................................................... 5.98 PHENOXYMETHYLPENICILLIN (PENICILLIN V) ( subsidy) Grans for oral liq 125 mg per 5 ml ............................................. 1.64 a) Up to 200 ml available on a PSO b) Wastage claimable – see rule 3.3.2 Grans for oral liq 250 mg per 5 ml ............................................. 1.74 a) Up to 300 ml available on a PSO b) Up to 2 x the maximum PSO quantity for RFPP – see rule 5.2.6 c) Wastage claimable – see rule 3.3.2 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

30 500 ml 5 100 g OP

✔ Ferrograd ✔ Ferodan ✔ Electral

50 70

Nutraplus 5 5 100 ml 100 ml

79

✔ Syntocinon ✔ Syntocinon ✔ AFT

93

✔ AFT

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

31


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price – effective 1 February 2014 (continued)

108 LAMIVUDINE – Special Authority see SA1364 – Retail pharmacy ( subsidy) Tab 150 mg ............................................................................ 52.50 (153.60) PAROXETINE HYDROCHLORIDE ( price) ❋ Tab 20 mg ................................................................................ 1.44 60 3TC 30 ✔ Loxamine

129

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 .............................................. 2.55 990 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

✔ Ethics Aspirin

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

32

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


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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 (continued)

129 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) 141 30 Loxamine

136

30 10

✔ Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron

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

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

33


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 April 2014

129 136 PAROXETINE HYDROCHLORIDE ❋ Tab 20 mg ................................................................................ 1.44 ONDANSETRON ❋ Tab 4 mg .................................................................................. 3.31 ❋ Tab 8 mg .................................................................................. 1.24 (1.70) 30 30 ✔ Loxamine ✔ Dr Reddy’s Ondansetron

Dr Reddy’s Ondansetron ❋ Tab disp 4 mg ........................................................................... 0.68 4 ✔ Dr Reddy’s Ondansetron Note – Dr Reddy’s Ondansetron tab dispersible 4 mg in the 10 pack size remains subsidised. ALPRAZOLAM – Safety medicine; prescriber may determine dispensing frequency Tab 250 mcg............................................................................. 2.50 50 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 500 mcg............................................................................. 3.25 50 (4.10) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 1 mg .................................................................................. 5.00 50 ‡ Safety cap for extemporaneously compounded oral liquid preparations. CYCLOPHOSPHAMIDE Tab 50 mg – PCT – Retail pharmacy-Specialist........................ 25.71 BUDESONIDE Powder for inhalation, 200 mcg per dose ................................. 15.20 Powder for inhalation, 400 mcg per dose ................................. 25.60 SALBUTAMOL ‡ Oral liq 400 mcg per ml ............................................................. 1.99 50

141

✔ Arrow-Alprazolam Arrow-Alprazolam ✔ Arrow-Alprazolam

151 182

✔ Cycloblastin

200 dose OP ✔ Budenocort 200 dose OP ✔ Budenocort 150 ml ✔ Salapin

184

Effective 1 March 2014

46 CLOPIDOGREL ❋ Tab 75 mg – For clopidogrel oral liquid formulation, refer page 199 ....................................................................... 5.87 (16.25) CAPTOPRIL ❋ Tab 12.5 mg ............................................................................. 2.00 ❋ Tab 25 mg ................................................................................ 2.40 ❋ Tab 50 mg ................................................................................ 3.50 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

90 Apo-Clopidogrel 100 100 100 84 Norinyl-1/28 ✔ m-Captopril ✔ m-Captopril ✔ m-Captopril

52 78

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

34

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 March 2014 (continued)

80 93 138 165 181 TAMSULOSIN HYDROCHLORIDE – Special Authority see SA1032 – Retail pharmacy ❋ Cap 400 mcg ............................................................................ 4.05 30 (5.98) PENICILLIN G BENZATHINE [BENZATHINE BENZYLPENICILLIN] Inj 1.2 mega u per 2 ml – Up to 5 inj available on a PSO......... 315.00 ONDANSETRON ❋ Tab disp 4 mg ......................................................................... 17.18 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg – For azathioprine oral liquid formulation, refer page 199 ..................................................................... 18.45 LORATADINE ❋ Tab 10 mg ................................................................................ 1.30 (2.09) PARAFFIN LIQUID WITH SOFT WHITE PARAFFIN ❋ Eye oint with soft white paraffin ................................................. 3.63 10 10

Tamsulosin-Rex ✔ Bicillin LA ✔ Zofran Zydis

100 100

✔ Imuran

Loraclear Hayfever Relief 3.5 g OP

191 207

✔ 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 OP ✔ Pediasure 1.27 237 ml OP ✔ Pediasure

Effective 1 February 2014

24 41 87 DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE ❋ Tab 2.5 mg with atropine sulphate 25 mcg ................................ 3.90 CALCITRIOL ❋‡ Oral liq 1 mcg per ml ............................................................. 39.40 LEUPRORELIN Inj 3.75 mg ........................................................................... 221.60 Inj 11.25 mg ......................................................................... 591.68 100 10 ml OP 1 1 ✔ Diastop ✔ Rocaltrol solution ✔ Lucrin Depot ✔ Lucrin Depot

111

INTERFERON ALFA-2A – PCT – Retail pharmacy-Specialist a) See prescribing guideline b) Prescriptions must be written by, or on the recommendation of, an internal medicine physician or ophthalmologist Inj 6 m iu prefilled syringe ........................................................ 62.64 1 ✔ Roferon-A Inj 9 m iu prefilled syringe ........................................................ 93.96 1 ✔ Roferon-A QUETIAPINE – Safety medicine; prescriber may determine dispensing frequency Tab 100 mg ............................................................................ 14.00 60 Note – Dr Reddy’s Quetiapine tab 100 mg in the 90 pack size remains subsidised. ✔ Dr Reddy’s Quetiapine

138

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

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

35


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted items – effective 1 February 2014 (continued)

156 DOCETAXEL – PCT only – Specialist Inj 20 mg ................................................................................ 48.75 Inj 80 mg .............................................................................. 195.00 1 1 ✔ Docetaxel Ebewe ✔ Docetaxel Ebewe ✔ Myaccord Ceptolate Ceptolate ✔ Myaccord ✔ Chloromycetin

166

MYCOPHENOLATE MOFETIL – Special Authority see SA1041 – Retail pharmacy Tab 500 mg ............................................................................ 25.00 50 (60.00) Cap 250 mg ............................................................................ 12.50 50 (30.00) 25.00 100 CHLORAMPHENICOL Ear drops 0.5%.......................................................................... 2.20 Note – Chloramphenicol eye drops 0.5% are subsidised for use in the ear. PHARMACY SERVICES ❋ Brand switch fee........................................................................ 4.33 5 ml OP

188

192 214

1 fee

✔ BSF Oxydone BNM

ORAL FEED 2 KCAL/ML – Special Authority see SA1195 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube, or who have severe epidermolysis bullosa. The prescription must be endorsed accordingly. Liquid (vanilla) – Higher subsidy of $2.25 per 237 ml with Endorsement ................................................................. 1.14 237 ml OP (2.25) Two Cal HN Note – Two Cal HN 200 ml OP packsize remains subsidised.

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.

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

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

36


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items – effective 1 January 2014 (continued)

92 95 AMOXYCILLIN Drops 125 mg per 1.25 ml ........................................................ 4.00 30 ml OP ✔ Ospamox Paediatric Drops

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) INFLUENZA VACCINE – HOSPITAL PHARMACY [XPHARM] Inj ........................................................................................... 90.00

131

127

20 OxyContin 20 OxyContin 20 OxyContin 20 OxyContin 10 ✔ Fluvax

225

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

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

37


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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 May 2014

38 LACTULOSE – Only on a prescription ❋ Oral liq 10 g per 15 ml ............................................................... 7.68 1,000 ml ✔ Laevolac

Note – Laevolac oral liq 10 g per 15 ml in the 500 ml pack size remains listed. 50 COMPOUND ELECTROLYTES Powder for oral soln – Up to 10 sach available on a PSO............ 0.90 UREA ❋ Crm 10% ................................................................................... 1.65 (3.07) OXYTOCIN – Up to 5 inj available on a PSO Inj 5 iu per ml, 1 ml ampoule ..................................................... 4.75 Inj 10 iu per ml, 1 ml ampoule ................................................... 5.98 LAMIVUDINE – Special Authority see SA1364 – Retail pharmacy Tab 150 mg ............................................................................ 52.50 (153.60) ZOPICLONE Tab 7.5 mg ............................................................................... 1.90 Note – Apo-Zopiclone in the 500 tab pack size remains listed. 192 PHARMACY SERVICES ❋ Brand switch fee........................................................................ 4.33 1 fee ✔ BSF Cellcept 5

✔ Electral

70

100 g OP Nutraplus 5 5 60 3TC 30

79

✔ Syntocinon ✔ Syntocinon

108

145

✔ Apo-Zopiclone

Effective 1 June 2014

54 92 CILAZAPRIL WITH HYDROCHLOROTHIAZIDE ❋ Tab 5 mg with hydrochlorothiazide 12.5 mg............................... 3.00 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 28 500 ✔ Inhibace Plus ✔ Alphamox

92

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 (2.70) Veracol Inj 1 g vial ................................................................................. 5.22 5 (10.49) Aspen Ceftriaxone

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

38

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 June 2014 (continued)

123 ROPINIROLE HYDROCHLORIDE ▲ Tab 0.25 mg ............................................................................. 1.98 (6.20) ▲ Tab 1 mg .................................................................................. 4.47 (15.95) ▲ Tab 2 mg .................................................................................. 6.48 (24.95) ▲ Tab 5 mg ................................................................................ 12.16 (38.00) 84 Ropin 84 Ropin 84 Ropin 84 Ropin

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 DEXAMETHASONE PHOSPHATE Dexamethasone phosphate injection will not be funded for oral use. ❋ Inj 4 mg per ml, 1 ml ampoule – Up to 5 inj available on a PSO ........................................... 12.90 (21.50) ❋ Inj 4 mg per ml, 2 ml ampoule – Up to 5 inj available on a PSO ........................................... 17.98 (31.00) FLUOXETINE HYDROCHLORIDE ❋ Tab dispersible 20 mg, scored – Subsidy by endorsement .................................................... 2.50

100

✔ Creon Forte

82

5 Hospira 5 Hospira

129

30

✔ Fluox

Subsidised by endorsement 1) When prescribed for a patient who cannot swallow whole tablets or capsules and the prescription is endorsed accordingly; or 2) When prescribed in a daily dose that is not a multiple of 20 mg in which case the prescription is deemed to be endorsed. Note: Tablets should be combined with capsules to facilitate incremental 10 mg doses. ❋ Cap 20 mg ................................................................................ 1.62 (2.70) 84 Fluox

Effective 1 August 2014

25 MESALAZINE Suppos 1 g ............................................................................. 50.96 Note – The 30 suppos packsize remains subsidised. 28 ✔ Pentasa

42

FERROUS SULPHATE ❋ Tab long-acting 325 mg (105 mg elemental).............................. 5.06 150 (15.58) Ferrograd Note – Ferrograd tab long-acting 325 mg (105 mg elemental) 30 tab packsize remains subsidised. SPIRONOLACTONE ❋ Tab 25 mg ................................................................................ 3.65 100

59

✔ Spirotone

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

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

39


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be delisted – effective 1 August 2014 (continued)

61 66 ISOSORBIDE MONONITRATE ❋ Tab long-acting 40 mg .............................................................. 7.50 CICLOPIROX OLAMINE a) Only on a prescription b) Not in combination Soln 1% .................................................................................... 4.36 (11.54) 30 ✔ Corangin

20 ml OP Batrafen

138 208

OLANZAPINE – Safety medicine; prescriber may determine dispensing frequency Tab 2.5 mg ............................................................................... 2.00 28

✔ Olanzine

ORAL ELEMENTAL FEED 0.8KCAL/ML – Special Authority see SA1377 – Hospital pharmacy [HP3] Liquid (grapefruit) ...................................................................... 9.50 250 ml OP ✔ Elemental 028 Extra Liquid (pineapple & orange) ....................................................... 9.50 250 ml OP ✔ Elemental 028 Extra Liquid (summer fruit) ................................................................. 9.50 250 ml OP ✔ Elemental 028 Extra

Effective 1 September 2014

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 199 ....................................................................... 0.57 30 500 30 500 30 ✔ Acetec ✔ Acetec ✔ Acetec ✔ Acetec ✔ Acetec

74

SUNSCREENS, PROPRIETARY – Subsidy by endorsement Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Lotn .......................................................................................... 2.55 100 ml OP ✔ Marine Blue Lotion SPF 30+ 5.10 200 ml OP ✔ Marine Blue Lotion SPF 30+ Note – Marine Blue Lotion SPF 50+ will be listed from 1 March 2014.

114 122

KETOPROFEN ❋ Cap long-acting 100 mg .......................................................... 21.56 ❋ Cap long-acting 200 mg .......................................................... 43.12 PERGOLIDE ▲ Tab 0.25 mg ........................................................................... 48.00 ▲ Tab 1 mg .............................................................................. 170.00

100 100 100 100

✔ Oruvail SR ✔ Oruvail SR

✔ Permax ✔ Permax

217

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA1108 – Hospital pharmacy [HP3] Liquid (forest berries) .............................................................. 30.00 250 ml OP ✔ Easiphen Liquid Note – Easiphen Liquid (forest berries), 250 ml carton in an 18 OP packsize remains subsidised.

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

40

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


Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Effective 1 October 2014

122 208 BROMOCRIPTINE MESYLATE ❋ Cap 5 mg ................................................................................ 60.43 100 ✔ Apo-Bromocriptine

RENAL ORAL FEED 2KCAL/ML – Special Authority see SA1101 – Hospital pharmacy [HP3] Liquid (apricot) .......................................................................... 2.88 125 ml OP ✔ Renilon 7.5 Liquid (caramel) ........................................................................ 2.88 125 ml OP ✔ Renilon 7.5 Note – Renilon 7.5 liquid (apricot) and (caramel), 125 ml in 4 OP pack size remain listed.

212 213

ORAL FEED (POWDER) – Special Authority see SA1228 – Hospital pharmacy [HP3] Powder (chocolate) ................................................................. 13.00 900 g OP

✔ Ensure

ORAL FEED 1.5KCAL/ML – Special Authority see SA1228 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube, or who have severe epidermolysis bullosa. The prescription must be endorsed accordingly. Liquid (strawberry) – Higher subsidy of up to $1.33 per 237 ml with Endorsement ...................................................... 0.85 237 ml OP (1.33) Ensure Plus

Effective 1 November 2014

123 ORPHENADRINE HYDROCHLORIDE Tab 50 mg .............................................................................. 35.15 250 ✔ Disipal

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

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

41


Index

Pharmaceuticals and brands Symbols 3TC ............................................................. 32, 38 A Acetec ............................................................... 40 Acipimox ..................................................... 21, 23 Agrylin ............................................................... 25 Alphamox .......................................................... 38 Alprazolam ................................................... 33, 34 Aminoacid formula without phenylalanine ..... 20, 40 Amoxycillin ............................................ 22, 37, 38 Anagrelide hydrochloride .................................... 25 Antinaus ............................................................ 30 Apo-Amoxi......................................................... 22 Apo-Bromocriptine ............................................. 41 Apo-Cilazapril/Hydrochlorothiazide ..................... 21 Apo-Clopidogrel ................................................. 34 Apo-Diltiazem CD ............................................... 23 Apo-Prazosin ..................................................... 19 Apo-Ropinirole ................................................... 26 Apo-Zopiclone.................................................... 38 Aquasun 30+ .................................................... 30 Arrow-Alprazolam ........................................ 33, 34 Arrow-Fluoxetine ................................................ 20 Ascorbic acid ..................................................... 36 Aspec 300 ......................................................... 31 Aspen Ceftriaxone .................................. 28, 30, 38 Aspirin ......................................................... 31, 32 Ativan ................................................................ 33 Atomoxetine ....................................................... 27 Ava 20 ED.......................................................... 32 Ava 30 ED.......................................................... 32 Avonex .............................................................. 31 Avonex Pen ........................................................ 31 Azamun ............................................................. 19 Azathioprine ........................................... 19, 33, 35 B Baclofen ............................................................ 20 Batrafen ............................................................. 40 Benzathine benzylpenicillin ................................. 35 Betahistine dihydrochloride................................. 30 Bicillin LA........................................................... 35 Bimatoprost ....................................................... 29 Blood glucose diagnostic test strip ..................... 23 Blood glucose test strips (visually impaired) ....... 24 Blood ketone diagnostic test meter ..................... 28 Bosentan ........................................................... 32 B-PlexADE ......................................................... 36 Bromocriptine mesylate...................................... 41 BSF Cellcept ................................................ 21, 38 BSF Oxydone BNM ....................................... 22, 36 Budenocort ........................................................ 34 Budesonide ........................................................ 34 C Calcitriol ............................................................ 35 Captopril ............................................................ 34 Carbimazole ....................................................... 21 Cardizem CD .......................................... 19, 21, 23 CareSens ........................................................... 23 CareSens N ........................................................ 23 CeeNU ............................................................... 25 Ceftriaxone....................................... 22, 28, 30, 38 Ceftriaxone-AFT ........................................... 22, 28 Cellcept ............................................................. 27 Ceptolate ........................................................... 36 Chloramphenicol ................................................ 36 Chloromycetin.................................................... 36 Chlortalidone [chlorthalidone] ............................. 36 Ciclopirox olamine.............................................. 40 Cilazapril with hydrochlorothiazide .......... 21, 30, 38 Cilicaine VK........................................................ 32 Clopidogrel ........................................................ 34 Coal tar ........................................................ 25, 30 Compound electrolytes................................. 31, 38 Corangin ............................................................ 40 Creon 25000...................................................... 21 Creon Forte ........................................................ 39 Cycloblastin ....................................................... 34 Cyclophosphamide ...................................... 20, 34 D Daraprim s29 ..................................................... 20 Dexamethasone-hameln ............................... 20, 26 Dexamethasone phosphate............... 20, 26, 30, 39 Diabetic oral feed 1kcal/ml ................................. 20 Diastop .............................................................. 35 Diltiazem hydrochloride .......................... 19, 21, 23 Dilzem ............................................................... 23 Dimethicone....................................................... 20 Diphenoxylate hydrochloride with atropine sulphate .................................... 35 Disipal ............................................................... 41 Docetaxel ........................................................... 36 Docetaxel Ebewe ................................................ 36 Dr Reddy’s Ondansetron .............................. 33, 34 Dr Reddy’s Pantoprazole .................................... 23 Dr Reddy’s Quetiapine ........................................ 35 E Easiphen Liquid............................................ 20, 40 Electral ........................................................ 31, 38 Elemental 028 Extra ..................................... 21, 40 Eltrombopag ................................................ 21, 24 Enalapril maleate ................................................ 40 Endoxan s29 ...................................................... 20

42


Index

Pharmaceuticals and brands Ensure ......................................................... 19, 41 Ensure Plus........................................................ 41 Erlotinib ....................................................... 29, 33 Ethics Aspirin ..................................................... 32 Ethics Aspirin EC................................................ 32 Ethinyloestradiol with levonorgestrel ................... 32 F Fenpaed ............................................................. 32 Ferodan ....................................................... 26, 31 Ferrograd ..................................................... 31, 39 Ferrous sulphate .................................... 26, 31, 39 Fludarabine phosphate ....................................... 25 Fludara Oral ....................................................... 25 Fluox............................................................ 30, 39 Fluoxetine hydrochloride ......................... 20, 30, 39 Fluticasone with salmeterol ................................ 29 Fluvax ................................................................ 37 Freestyle Optium ................................................ 28 G Gabapentin .................................................. 31, 37 H Hamilton Sunscreen ........................................... 30 healthE Dimethicone 5% ..................................... 20 Hysite ................................................................ 29 I Ibuprofen ........................................................... 32 Idarubicin hydrochloride ..................................... 25 Igroton ............................................................... 36 Imatinib-AFT ...................................................... 19 Imatinib mesilate ................................................ 19 Imipramine hydrochloride ................................... 19 Imuran ......................................................... 33, 35 Influenza vaccine.......................................... 33, 37 Influvac .............................................................. 33 Inhibace Plus ............................................... 30, 38 Insulin syringes and needles............................... 24 Interferon alfa-2a................................................ 35 Interferon beta-1-alpha ....................................... 31 Ismo 40 Retard .................................................. 20 Isosorbide mononitrate................................. 20, 40 K Ketoconazole ..................................................... 28 Ketoprofen ................................................... 20, 40 L Lacri-Lube ......................................................... 35 Lactulose ........................................................... 38 Laevolac ............................................................ 38 Lamivudine .................................................. 32, 38 Latanoprost........................................................ 29 Leuprorelin......................................................... 35 Lincocin ............................................................. 37 Lincomycin ........................................................ 37 Lioresal Intrathecal ............................................. 20 Lomustine.......................................................... 25 Loraclear Hayfever Relief.................................... 35 Loratadine.......................................................... 35 Lorazepam ......................................................... 33 Loxamine ............................................... 32, 33, 34 Lucrin Depot ...................................................... 35 Ludiomil............................................................. 19 Lumigan ............................................................ 29 M Magnesium hydroxide ........................................ 27 Magnesium hydroxide 8% mixture ...................... 27 Magnesium sulphate .......................................... 36 Maprotiline hydrochloride ................................... 19 Marine Blue Lotion SPF 30+ .............................. 40 Marine Blue Lotion SPF 50+ .............................. 19 m-Captopril ........................................................ 34 Mesalazine ......................................................... 39 Mesna ............................................................... 25 Methotrexate ...................................................... 19 Montelukast ....................................................... 25 MultiADE............................................................ 36 Myaccord .......................................................... 36 Mycophenolate mofetil ................................. 27, 36 N Natulan .............................................................. 25 Nilstat ................................................................ 32 Nizoral ............................................................... 28 Norethisterone with mestranol ............................ 34 Norinyl-1/28 ...................................................... 34 Nupentin ...................................................... 31, 37 Nutraplus ..................................................... 31, 38 Nystatin ............................................................. 32 O Oestrogens ........................................................ 36 Olanzapine ......................................................... 40 Olanzine ............................................................. 40 Olbetam ............................................................. 23 Olbetam s29 ...................................................... 21 Ondansetron .......................................... 33, 34, 35 Oral elemental feed 0.8 kcal/ml..................... 21, 40 Oral feed 1.5kcal/ml ........................................... 41 Oral feed 2 kcal/ml ............................................. 36 Oral feed (powder) ....................................... 19, 41 Orphenadrine hydrochloride................................ 41 Oruvail SR.................................................... 20, 40 Ospamox Paediatric Drops ................................. 37 Oxycodone hydrochloride ................. 23, 26, 28, 37 OxyContin .......................................................... 37 Oxydone BNM .............................................. 26, 28

43


Index

Pharmaceuticals and brands Oxytocin ...................................................... 31, 38 P Paediatric oral feed 1kcal/ml............................... 35 Pancreatic enzyme ....................................... 21, 39 Pantoprazole ................................................ 19, 23 Pantoprazole Actavis 20 ............................... 19, 23 Pantoprazole Actavis 40 ............................... 19, 23 Paraffin liquid with soft white paraffin ................. 35 Paroxetine hydrochloride ........................ 32, 33, 34 Pediasure........................................................... 35 Penicillin G benzathine........................................ 35 Pentasa ............................................................. 39 Pergolide ........................................................... 40 Permax .............................................................. 40 Pharmacy services........................... 21, 22, 36, 38 Phenoxymethylpenicillin (penicillin v) ............ 31, 32 pms-Bosentan ................................................... 32 Prazosin............................................................. 19 Premarin ............................................................ 36 Procarbazine hydrochloride ................................ 25 Prochlorperazine ................................................ 30 Pyrimethamine ................................................... 20 Q Quetiapine.......................................................... 35 R Renal oral feed 2kcal/ml ..................................... 41 Renilon 7.5 ........................................................ 41 Revolade...................................................... 21, 24 Rocaltrol solution ............................................... 35 Roferon-A .......................................................... 35 Ropin ..................................................... 26, 31, 39 Ropinirole hydrochloride......................... 26, 31, 39 S Salapin .............................................................. 34 Salbutamol......................................................... 34 SensoCard ......................................................... 24 Seretide ............................................................. 29 Seretide Accuhaler ............................................. 29 Singulair ............................................................ 25 Sodium citro-tartrate .......................................... 32 Spironolactone ................................................... 39 Spirotone ........................................................... 39 Strattera ............................................................. 27 Sunscreens, proprietary ......................... 19, 30, 40 Sustagen Diabetic .............................................. 20 Syntocinon................................................... 31, 38 T Tamsulosin hydrochloride .................................. 35 Tamsulosin-Rex ................................................. 35 Tarceva........................................................ 29, 33 Teva .................................................................. 25 Tofranil .............................................................. 19 Travatan............................................................. 29 Travoprost ......................................................... 29 Trexate............................................................... 19 Two Cal HN........................................................ 36 U Ural.................................................................... 32 Urea............................................................. 31, 38 Uromitexan ........................................................ 25 V Veracol .................................................. 28, 30, 38 Vergo 16 ............................................................ 30 Vitala-C .............................................................. 36 Vitamin B complex ............................................. 36 Vitamins ............................................................ 36 Z Zavedos ............................................................. 25 Zofran Zydis ....................................................... 35 Zopiclone ........................................................... 38

44


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 April 2014

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 April 2014 Cumulative for January, February, March and April 2014 Contents Summary of PHARMAC decisions effective 1 April 2014 …. 3 Disipal – discontinuation …. 4 Imatinib mesilate – brand…

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