Pharmaceutical Schedule

Community Pharmaceuticals Alimentary Tract and Metabolism Antacids and Antiflatulants Antacids and Reflux Barrier Agents Alginic acid Sodium alginate 225 mg and magnesium alginate 87.5 mg per sachet Gaviscon Infant 30 4.50 4.50 4.50 0.00000 Simethicone Oral liq aluminium hydroxide 200 mg with magnesium hydroxide 200 mg and activated simethicone 20 mg per 5 ml Mylanta P 500 1.50 4.05 1.50 0.00510 Calcium carbonate with aminoacetic acid Tab 420 mg with aminoacetic acid 180 mg Titralac 100 3.00 6.30 3.87 0.03300 1000 30.00 38.73 38.73 0.00873

Additional subsidy by endorsement is available for pregnant women. The prescription must be endorsed accordingly.

Sodium alginate Oral liq 500 mg with sodium bicarbonate 267 mg per 10 ml (aniseed) Gaviscon 500 1.50 8.08 1.50 0.01316 Oral liq 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg per 10 ml Acidex 500 1.50 4.95 1.50 0.00690 Tab 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg - peppermint flavour Gaviscon Double Strength 60 1.80 7.97 1.80 0.10283 Phosphate Binding Agents Aluminium hydroxide Tab 600 mg Alu-Tab 100 12.56 12.56 12.56 0.00000 Antidiarrhoeals Agents Which Reduce Motility Diphenoxylate hydrochloride with atropine sulphate Tab 2.5 mg with atropine sulphate 25 mcg Diastop 100 3.90 3.90 3.90 0.00000 Loperamide hydrochloride Tab 2 mg Nodia 400 11.50 11.50 11.50 0.00000 Rectal and Colonic Anti-inflammatories Budesonide Cap 3 mg Entocort CIR 100 185.00 185.00 185.00 0.00000 90 166.50 166.50 166.50 0.00000 <range>Budesonide – Cap 3 mg Controlled Release</range>

Mild to moderate ileal, ileocaecal or proximal Crohn’s disease Diabetes Cushingoid habitus Osteoporosis where there is significant risk of fracture Severe acne following treatment with conventional corticosteroid therapy

gastroenterologist general surgeon general physician 3

The treatment remains appropriate and the patient is benefiting from treatment

gastroenterologist general surgeon general physician 3 1 2

Clinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate.

Hydrocortisone acetate Rectal foam 10 %, CFC-Free (14 applications) Colifoam 21.1 21.10 21.10 21.10 0.00000 Sodium cromoglycate Cap 100 mg Nalcrom 100 89.21 89.21 89.21 0.00000 Sulphasalazine Tab 500 mg Salazopyrin 100 8.42 8.42 8.42 0.00000 Tab EC 500 mg Salazopyrin EN 100 9.44 9.44 9.44 0.00000 Olsalazine Cap 250 mg Dipentum 100 31.51 31.51 31.51 0.00000 Tab 500 mg Dipentum 100 59.86 59.86 59.86 0.00000 Mesalazine Tab long-acting 500 mg Pentasa 100 69.06 69.06 69.06 0.00000 Enema 1 g per 100 ml Pentasa 7 46.90 46.90 46.90 0.00000 Tab 400 mg Asacol 100 49.50 49.50 49.50 0.00000 Suppos 500 mg Asacol 20 25.20 25.20 25.20 0.00000 Suppos 1 g Pentasa 28 50.96 50.96 50.96 0.00000 Antihaemorrhoidals Corticosteroids Fluocortolone caproate with fluocortolone pivalate and cinchocaine Suppos 630 mcg, with fluocortolone pivalate 610 mcg, and cinchocaine hydrochloride 1 mg Ultraproct 12 2.66 2.66 2.66 0.00000 Oint 950 mcg, with fluocortolone pivalate 920 mcg, and cinchocaine hydrochloride 5 mg per g Ultraproct 30 6.35 6.35 6.35 0.00000 Soothing Agents Zinc oxide Oint zinc oxide with balsam peru Anusol 50 4.50 6.50 4.50 0.04000 Suppos zinc oxide with balsam peru Anusol 12 4.47 6.35 4.47 0.15667 Antispasmodics and Other Agents Altering Gut Motility Antispasmodics and Other Agents Altering Gut Motility Atropine sulphate Inj 600 mcg, 1 ml AstraZeneca 50 26.00 26.00 26.00 0.00000 Inj 1200 mcg, 1 ml AstraZeneca 50 32.00 32.00 32.00 0.00000 Hyoscine N-butylbromide Tab 10 mg Gastrosoothe 20 1.33 1.33 1.33 0.00000 Inj 20 mg, 1 ml Buscopan 5 7.15 7.15 7.15 0.00000 Mebeverine hydrochloride Tab 135 mg Colofac 30 3.57 8.58 3.57 0.16700 90 10.72 25.73 10.72 0.16678 Antiulcerants Antisecretory and Cytoprotective Misoprostol Tab 200 mcg Cytotec 120 52.70 52.70 52.70 0.00000 Helicobacter Pylori Eradication Omeprazole, amoxycillin and clarithromycin Omeprazole cap 20 mg x 14, amoxycillin cap 500 mg x 28 and clarithromycin tab 500 mg x 14 Losec Hp7 OAC 1 55.00 55.00 55.00 0.00000 H2 Antagonists Cimetidine Tab 200 mg Apo-Cimetidine 100 5.00 7.50 5.00 0.02500 Tab 400 mg Apo-Cimetidine 100 10.00 12.00 10.00 0.02000 Ranitidine hydrochloride Oral liq 150 mg per 10 ml Peptisoothe 300 7.95 7.95 7.95 0.00000

Oral liquid is subsidised only for patients:

with oesophageal stricture, or
in terminal care, or
who are either too young or too old to swallow conventional tablets and the prescription is endorsed accordingly.

Note: the cost of treatment with ranitidine oral liquid is more than 10 times higher than that of ranitidine tablets. Following the derestriction of access PHARMAC will be monitoring expenditure on ranitidine oral liquid more closely and may, subject to consultation and PHARMAC Board approval, restrict access again if the expenditure was to grow substantially.

Inj 25 mg per ml, 2 ml Zantac 5 8.75 8.75 8.75 0.00000 Tab 150 mg Arrow-Ranitidine 250 7.99 7.99 7.99 0.00000 Tab 300 mg Arrow-Ranitidine 250 10.94 10.94 10.94 0.00000 Famotidine Tab 20 mg Famox 250 8.10 8.10 8.10 0.00000 Tab 40 mg Famox 250 11.35 11.35 11.35 0.00000 Proton Pump Inhibitors Lansoprazole Cap 30 mg Solox 28 8.59 8.59 8.59 0.00000 Cap 15 mg Solox 28 4.30 4.30 4.30 0.00000 Pantoprazole Tab 40 mg Somac 28 3.36 26.13 3.36 0.81321 30 3.60 28.00 3.60 0.81333 Dr Reddy's Pantoprazole 28 3.36 3.36 3.36 0.00000 Tab 20 mg Somac 28 2.24 20.53 2.24 0.65321 30 2.40 22.00 2.40 0.65333 Dr Reddy's Pantoprazole 28 2.24 2.24 2.24 0.00000 Omeprazole Cap 20 mg Losec 30 24.81 24.81 24.81 0.00000 Omezol 30 5.95 5.95 5.95 0.00000 Dr Reddy's Omeprazole 28 4.27 4.27 4.27 0.00000 Inj 40 mg Losec 1 12.50 12.50 12.50 0.00000 Cap 10 mg Losec 30 17.37 17.37 17.37 0.00000 Omezol 30 5.95 5.95 5.95 0.00000 Dr Reddy's Omeprazole 28 2.99 2.99 2.99 0.00000 Cap 40 mg Losec 30 29.05 29.05 29.05 0.00000 Omezol 30 8.84 8.84 8.84 0.00000 Dr Reddy's Omeprazole 28 5.01 5.01 5.01 0.00000

For omeprazole suspension refer

Site Protective Agents Sucralfate Tab 1 g Carafate 120 35.50 48.28 35.50 0.10650 Diabetes Hyperglycaemic Agents Glucagon hydrochloride Inj 1 mg syringe kit Glucagen Hypokit 1 27.00 27.00 27.00 0.00000 Insulin - Short-acting Preparations Insulin neutral Inj human 100 u per ml Actrapid 10 25.26 25.26 25.26 0.00000 Humulin R 10 25.26 25.26 25.26 0.00000 Inj human 100 u per ml, 3 ml Actrapid Penfill 5 42.66 42.66 42.66 0.00000 Humulin R 5 42.66 42.66 42.66 0.00000 Insulin - Intermediate-acting Preparations Insulin isophane Inj human 100 u per ml, 3 ml Protaphane Penfill 5 29.86 29.86 29.86 0.00000 Humulin NPH 5 29.86 29.86 29.86 0.00000 Inj human 100 u per ml Protaphane 10 17.68 17.68 17.68 0.00000 10 17.68 17.68 17.68 0.00000 Humulin NPH 10 17.68 17.68 17.68 0.00000 Inj animal (pork) 100 u per ml Protaphane 10 25.26 25.26 25.26 0.00000 Insulin isophane with insulin neutral Inj human with neutral insulin 100 u per ml, 3 ml PenMix 30 5 42.66 42.66 42.66 0.00000 PenMix 40 5 42.66 42.66 42.66 0.00000 PenMix 50 5 42.66 42.66 42.66 0.00000 Humulin 30/70 5 42.66 42.66 42.66 0.00000 Inj human with neutral insulin 100 u per ml Mixtard 30 10 25.26 25.26 25.26 0.00000 Humulin 30/70 10 25.26 25.26 25.26 0.00000 Insulin - Long-acting Preparations Insulin glargine Inj 100 u per ml, 3 ml Lantus 5 94.50 94.50 94.50 0.00000 Inj 100 u per ml, 10 ml Lantus 1 63.00 63.00 63.00 0.00000 <range>Insulin Glargine</range>

Patient has type 1 diabetes and has received an intensive regimen (injections at least three times a day) of an intermediate acting insulin in combination with a rapid acting insulin analogue for at least three months Patient has experienced more than one unexplained severe hypoglycaemic episode in the previous 12 months (severe defined as requiring the assistance of another person) Patient has experienced unexplained symptomatic nocturnal hypoglycaemia, biochemically documented at <3.0 mmol/L, more than once a month despite optimal management Patient has documented severe, or continuing, systemic or local allergic reaction to existing insulins. Note this does not include hypoglycaemic episodes

relevant specialist 1

Patient is continuing to derive benefit due to reduced hypoglycaemic events whilst maintaining similar or better glycaemic control Patient’s allergic reaction has significantly decreased, or resolved, following the change to long-acting insulin and patient is continuing to benefit from treatment

relevant specialist general practitioner 1 Insulin - Rapid Acting Insulin Analogues Insulin lispro Inj 100 u per ml, 3 ml Humalog 5 59.52 59.52 59.52 0.00000 Inj 100 u per ml, 10 ml Humalog 10 34.92 34.92 34.92 0.00000 Insulin aspart Inj 100 u per ml, 3 ml NovoRapid Penfill 5 53.57 53.57 53.57 0.00000 Inj 100 u per ml, 10 ml NovoRapid 1 31.43 31.43 31.43 0.00000 Alpha Glucosidase Inhibitors Acarbose Tab 50 mg Glucobay 90 22.00 22.00 22.00 0.00000 Tab 100 mg Glucobay 90 31.00 31.00 31.00 0.00000 <range>Acarbose</range>

Requires but is not able to tolerate metformin therapy Requires metformin but metformin is contraindicated Has not responded to or tolerated the maximum appropriate dose of metformin

relevant specialist 2

The treatment remains appropriate and the patient is benefiting from treatment

relevant specialist 2 Oral Hypoglycaemic Agents Glibenclamide Tab 2.5 mg Gliben 100 3.78 3.78 3.78 0.00000 Tab 5 mg Gliben 100 3.31 3.31 3.31 0.00000 Gliclazide Tab 80 mg Apo-Gliclazide 500 36.46 36.46 36.46 0.00000 Glipizide Tab 5 mg Minidiab 100 3.50 3.50 3.50 0.00000 Metformin hydrochloride Tab 500 mg Arrow-Metformin 500 9.75 9.75 9.75 0.00000 Tab 850 mg Arrow-Metformin 250 8.00 8.00 8.00 0.00000 Tolbutamide Tab 500 mg Diatol 100 12.00 12.00 12.00 0.00000 Pioglitazone Tab 15 mg Actos 28 61.04 61.04 61.04 0.00000 Tab 30 mg Actos 28 93.90 93.90 93.90 0.00000 Tab 45 mg Actos 28 119.18 119.18 119.18 0.00000 <range>Pioglitazone</range>

Monotherapy To be used as monotherapy for patients who after six months of diet and lifestyle changes have inadequate glycaemic control (defined as HbA1c > 7.0% in tests carried out at least two months apart) Metformin is contraindicated or not tolerated after a minimum of a four-week trial period Sulphonylurea is contraindicated or not tolerated or the patient is obese In combination with sulphonylurea For use in combination with a sulphonylurea for patients who after diet and lifestyle changes and a six-month trial of sulphonylurea have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six-month period) Metformin is contraindicated or not tolerated after a minimum of a four-week trial period In combination with metformin For use in combination with metformin for patients who after diet and lifestyle changes and a six-month trial of the maximum tolerated dose of metformin have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six-month period) Sulphonylurea is contraindicated or not tolerated, or the patient is obese In combination with metformin after a trial of metformin and sulphonylurea For use in combination with metformin for patients who after diet and lifestyle changes and a six-month trial of a combination of metformin and sulphonylurea at maximum tolerated doses have poor glycaemic control (defined as HbA1c > 7.5% measured within the last month of the six month period) In combination with Insulin For use in combination with insulin in patients requiring more than 1.5 units per kilogram of insulin a day for at least 6 months in conjunction with metformin if tolerated

any relevant practitioner 1

Patient is continuing to derive benefit from treatment

any relevant practitioner 1

Pioglitazone is not to be used in triple oral combination (defined as a combination of metformin, sulphonylurea and pioglitazone).

Pioglitazone should not be used in patients with heart failure.

Liver function tests should be performed at baseline.

Gastrointestinal side effects are relatively common when initiating metformin therapy. Upward titration of metformin dose over several weeks and taking metformin with food will help to minimize these side effects.

Intolerance and contraindications for metformin include: serum creatinine ≥ 0.15 or creatinine clearance < 60 ml/min; significant liver impairment; severe left ventricular dysfunction; and intolerable gastrointestinal side effects that persist beyond 4 weeks duration.

Intolerance for sulphonylurea includes: nausea; diarrhoea; rash; blood disorders (thrombocytopenia, agranulocytosis, aplastic anaemia); erythema multiforme, exfoliative dermatitis, hepatitis; and syndrome of inappropriate antidiuretic hormone secretion (SIADH) with water retention and hyponatraemia.

Maximum tolerated dose of metformin defined as: A dose up to a maximum of 3 g daily.

Maximum tolerated dose of sulphonylurea defined as: A dose up to a maximum of glibenclamide 20 mg daily or glipizide 20 mg daily or gliclazide 320 mg daily.

For the purposes of these criteria “obese” is defined as body mass index (BMI) greater than 33 kg/m².

However, as ethnic differences between patients may vary BMI scores, practitioners may use discretion as to whether the patient meets this criterion.

It is considered that when applying, that the patient may have initiated “six months diet and lifestyle changes” from the date of diagnosis of type 2 diabetes.

Diabetes Management Glucose/Urine Testing Copper Tab, diagnostic Clinitest 36 5.02 30.25 5.02 0.70083 Glucose oxidase Urine diagnostic test with peroxidase Clinistix 50 4.13 6.05 4.13 0.03840 Diastix 50 4.11 6.05 4.11 0.03880 Urine diagnostic test Diabur 5000 50 4.11 7.00 4.11 0.05780 Glucose &/or Ketones/Urine Testing Glucose oxidase Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid Keto-Diastix 50 4.53 7.50 4.53 0.05940 Urine diagnostic test with peroxidase, sodium nitroprusside and aminoacetic acid Keto-Diabur 5000 50 4.53 8.00 4.53 0.06940 Sodium nitroprusside Urine diagnostic strips, buffered Ketur-Test 50 3.39 6.00 3.39 0.05220 Ketostix 50 3.40 7.15 3.40 0.07500 Glucose/Blood Testing Glucose dehydrogenase Blood/glucose test strips Optium 50 22.00 22.00 22.00 0.00000 25 11.00 11.00 11.00 0.00000 Accu-Chek Advantage 50 22.00 22.00 22.00 0.00000 Accu-Chek Performa 50 22.00 22.00 22.00 0.00000

The number of test strips available on a prescription is restricted to 50 unless:

Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or
Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or
Prescribed for a pregnant woman with diabetes and endorsed accordingly.

Glucose blood diagnostic test meter Meter Accu-Chek Advantage 1 19.00 19.00 19.00 0.00000 Optium Xceed 1 9.00 9.00 9.00 0.00000 Accu-Chek Performa 1 19.00 19.00 19.00 0.00000

A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005. Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly.

Insulin Syringes and Needles Insulin pen needles 29 g x 12.7 mm B-D Micro-Fine 30 3.93 3.93 3.93 0.00000 100 13.09 13.09 13.09 0.00000 31 g x 8 mm B-D Micro-Fine 30 3.93 3.93 3.93 0.00000 100 13.09 13.09 13.09 0.00000 31 g x 5 mm B-D Micro-Fine 100 13.09 13.09 13.09 0.00000 31 g x 6 mm NovoFine 100 26.00 26.00 26.00 0.00000

NovoFine pen needles 31 g × 6 mm are subsidised for children under 12 years of age.

Insulin syringes, disposable with attached needle Syringe 0.3 ml with 29 g x 12.7 mm needle B-D Ultra Fine 100 15.92 15.92 15.92 0.00000 10 1.59 1.99 1.59 0.04000 Syringe 0.5 ml with 29 g x 12.7 mm needle B-D Ultra Fine 10 1.59 1.99 1.59 0.04000 100 15.92 15.92 15.92 0.00000 Syringe 1 ml with 29 g x 12.7 mm needle B-D Ultra Fine 100 15.92 15.92 15.92 0.00000 10 1.59 1.99 1.59 0.04000 Syringe 0.3 ml with 31 g x 8 mm needle B-D Ultra Fine II 100 15.92 15.92 15.92 0.00000 10 1.59 1.99 1.59 0.04000 Syringe 0.5 ml with 31 g x 8 mm needle B-D Ultra Fine II 100 15.92 15.92 15.92 0.00000 10 1.59 1.99 1.59 0.04000 Syringe 1 ml with 31 g x 8 mm needle B-D Ultra Fine II 100 15.92 15.92 15.92 0.00000 10 1.59 1.99 1.59 0.04000

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.

Digestives Including Enzymes Digestives Including Enzymes Ursodeoxycholic acid Cap 300 mg Actigall 100 269.98 269.98 269.98 0.00000 <range>Ursodeoxycholic Acid – Cap 300 mg</range>

Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis)

gastroenterologist general physician 6

Liver biopsy is not usually required for diagnosis but is helpful to stage the disease.

The treatment remains appropriate and the patient is benefiting from treatment

gastroenterologist general physician 2

Actigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transplant centre. Treatment failure – doubling of serum bilirubin levels, absence of a significant decrease in ALP or ALT and AST, development of varices, ascites or encephalopathy, marked worsening of pruritus or fatigue, histological progression by two stages, or to cirrhosis, need for transplantation.

Pancreatic enzyme Tab EC 1,900 BP u lipase, 1,700 BP u amylase, 110 BP u protease Pancrex V 300 32.46 32.46 32.46 0.00000 Tab EC 5,600 BP u lipase, 5,000 BP u amylase, 330 BP u protease Pancrex V Forte 300 58.44 58.44 58.44 0.00000 Cap 8,000 BP u lipase, 9,000 BP u amylase, 430 BP u protease Pancrex V 300 67.26 67.26 67.26 0.00000 Cap 8,000 USP u lipase, 30,000 USP u amylase, 30,000 USP u protease Cotazym ECS 250 85.00 85.00 85.00 0.00000 Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease Creon Forte 100 94.38 94.38 94.38 0.00000 Cap EC 25,000 BP u lipase, 22,500 BP u amylase, 1,250 BP u protease Panzytrat 100 94.40 94.40 94.40 0.00000 Cap EC 10,000 BP u lipase, 9,000 BP u amylase and 210 BP u protease Creon 10000 100 34.93 34.93 34.93 0.00000 Laxatives Bulk-forming Agents Mucilaginous laxatives Sugar Free Mucilax 275 4.84 10.60 4.84 0.02095 Dry Mucilax 380 6.69 6.69 6.69 0.00000 Isogel 450 7.92 12.71 7.92 0.01064 Normacol 500 8.80 15.27 8.80 0.01294 Konsyl-D 325 5.72 5.72 5.72 0.00000 Dry-original flavour, regular texture only Metamucil 336 5.91 12.38 5.91 0.01926 Mucilaginous laxatives with stimulants Dry Normacol Plus 200 3.52 7.69 3.52 0.02085 500 8.80 15.27 8.80 0.01294 Granocol 250 4.40 12.00 4.40 0.03040 Faecal Softeners Docusate sodium Tab 50 mg Coloxyl 100 4.89 4.89 4.89 0.00000 Tab 120 mg Coloxyl 100 6.73 6.73 6.73 0.00000 500 24.00 24.00 24.00 0.00000 Enema conc 18% Coloxyl 100 5.40 5.40 5.40 0.00000 Poloxamer Oral drops 10% Coloxyl 30 3.93 3.93 3.93 0.00000 Docusate sodium with sennosides Tab 50 mg with total sennosides 8 mg Laxsol 200 7.98 7.98 7.98 0.00000 Osmotic Laxatives Glycerol Suppos 3.6 g PSM 20 5.00 5.00 5.00 0.00000 Suppos 2.55 g Fleet Glycerin Suppositories 12 3.12 3.12 3.12 0.00000 Sodium citrate with sodium lauryl sulphoacetate Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml Microlax 12 7.30 7.30 7.30 0.00000 Lactulose Oral liq 10 g per 15 ml Duphalac 1000 6.65 6.65 6.65 0.00000 Sodium acid phosphate Enema 16% with sodium phosphate 8% Fleet Phosphate Enema 1 2.50 2.50 2.50 0.00000 Macrogol 3350 Powder 13.125 g, sachets Movicol 30 18.14 18.14 18.14 0.00000 <range>Macrogol 3350</range>

the patient has problematic constipation requiring intervention with a per rectal preparation despite an adequate trial of other oral pharmacotherapies including lactulose where lactulose is not contraindicated

any relevant practitioner 6

the patient is compliant and is continuing to gain benefit from treatment

any relevant practitioner 12 Stimulant Laxatives Senna Tab, standardised Senokot 100 2.17 6.16 2.17 0.03990 20 0.43 1.72 0.43 0.06450 Bisacodyl Tab 5 mg Lax-Tabs 200 5.09 5.09 5.09 0.00000 Suppos 5 mg Dulcolax 6 2.35 3.00 2.35 0.10833 Suppos 10 mg Fleet 12 3.96 3.96 3.96 0.00000 Metabolic Disorder Agents Gaucher's Disease Imiglucerase Inj 40 iu per ml, 200 iu vial Cerezyme 1 1072.00 1072.00 1072.00 0.00000 <range>Imiglucerase</range>

medical practitioner 1

Subject to a budgetary cap. Applications will be considered and approved subject to funding availability.

Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:

The Co-ordinator, Gaucher’s Treatment Panel	Phone: (04) 460 4990
PHARMAC, PO Box 10 254	Facsimile: (04) 916 7571
Wellington	Email: erin.murphy@pharmac.govt.nz

Mouth and Throat Agents Used in Mouth Ulceration Benzydamine hydrochloride Soln 0.15% Difflam 200 3.60 7.14 3.60 0.01770 500 9.00 15.36 9.00 0.01272 Chlorhexidine gluconate Mouthwash 0.2% Orion 200 3.06 3.06 3.06 0.00000 Sodium carboxymethylcellulose With pectin and gelatin paste Orabase 15 4.55 7.90 4.55 0.22333 5 1.52 3.60 1.52 0.41600 Stomahesive 56 17.20 17.20 17.20 0.00000 With pectin and gelatin powder Stomahesive 28 8.48 10.95 8.48 0.08821 Triamcinolone acetonide 0.1% in Dental Paste USP Oracort 5 4.50 4.50 4.50 0.00000 Choline salicylate with cetalkonium chloride Adhesive gel 8.7% with cetalkonium chloride 0.01% Bonjela 15 2.06 5.05 2.06 0.19933 Oropharyngeal Anti-infectives Amphotericin B Lozenges 10 mg Fungilin 20 5.86 5.86 5.86 0.00000 Miconazole Oral gel 20 mg per g Daktarin 40 8.95 8.95 8.95 0.00000 Nystatin Oral liq 100,000 u per ml Nilstat 24 3.03 3.03 3.03 0.00000 Other Oral Agents Thymol glycerin Compound, BPC PSM 500 9.15 9.15 9.15 0.00000 Hydrogen peroxide Solution 10 vol PSM 100 1.28 1.28 1.28 0.00000

For folinic mouthwash, pilocarpine oral liquid or saliva substitute formula refer

Vitamins Vitamin A Vitamin A with vitamins D and C Soln 1000 u with Vitamin D 400 u and ascorbic acid 30 mg per 10 drops Vitadol C 10 4.38 5.51 4.38 0.11300 Vitamin B Group Hydroxocobalamin Inj 1 mg per ml, 1 ml Neo-B12 3 10.84 10.84 10.84 0.00000 Pyridoxine hydrochloride Tab 25 mg Healtheries 90 3.06 3.06 3.06 0.00000 Tab 50 mg Apo-Pyridoxine 500 17.63 17.63 17.63 0.00000