Online Pharmaceutical Schedule - October 2020

Funded for patients meeting any of the following criteria:

1. Up to four doses for children up to and under the age of 10 for primary immunisation; or

2. An additional four doses (as appropriate) are funded for (re-)immunisation for children up to and under the age of 10 who are patients post haematopoietic stem cell transplantation, or chemotherapy; pre or post splenectomy; pre- or post solid organ transplant, renal dialysis and other severely immunosuppressive regimens; or

3. Up to five doses for children up to and under the age of 10 receiving solid organ transplantation.

Note: A course of up-to four vaccines is funded for catch up programmes for children (up to and under the age of 10 years) to complete full primary immunisation. Please refer to the Immunisation Handbook for the appropriate schedule for catch up programmes.

1. INFLUENZA VACCINE – child aged 6 months to 35 months

   is available each year for patients aged 6 months to 35 months who meet the following criteria, as set by PHARMAC:

   1. have any of the following cardiovascular diseases

      1. ischaemic heart disease, or

      2. congestive heart failure, or

      3. rheumatic heart disease, or

      4. congenital heart disease, or

      5. cerebo-vascular disease; or

   2. have either of the following chronic respiratory diseases:

      1. asthma, if on a regular preventative therapy, or

      2. other chronic respiratory disease with impaired lung function; or

   3. have diabetes; or

   4. have chronic renal disease; or

   5. have any cancer, excluding basal and squamous skin cancers if not invasive; or

   6. have any of the following other conditions:

      1. autoimmune disease, or

      2. immune suppression or immune deficiency, or

      3. HIV, or

      4. transplant recipients, or

      5. neuromuscular and CNS diseases/disorders, or

      6. haemoglobinopathies, or

      7. on long term aspirin, or

      8. have a cochlear implant, or

      9. errors of metabolism at risk of major metabolic decompensation, or

      10. pre and post splenectomy, or

      11. down syndrome, or

   7. have been hospitalised for respiratory illness or have a history of significant respiratory illness;

   Unless meeting the criteria set out above, the following conditions are excluded from funding:

   1. asthma not requiring regular preventative therapy,

   2. hypertension and/or dyslipidaemia without evidence of end-organ disease.

2. Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine inj 30 mcg in 0.25 ml syringe (paediatric quadrivalent vaccine) to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.

1. INFLUENZA VACCINE – people 3 years and over

   is available each year for patients aged 3 years and over who meet the following criteria, as set by PHARMAC:

   1. all people 65 years of age and over; or

   2. people under 65 years of age who:

      1. have any of the following cardiovascular diseases:

         1. ischaemic heart disease, or

         2. congestive heart failure, or

         3. rheumatic heart disease, or

         4. congenital heart disease, or

         5. cerebo-vascular disease; or

      2. have either of the following chronic respiratory diseases:

         1. asthma, if on a regular preventative therapy, or

         2. other chronic respiratory disease with impaired lung function; or

      3. have diabetes; or

      4. have chronic renal disease; or

      5. have any cancer, excluding basal and squamous skin cancers if not invasive; or

      6. have any of the following other conditions:

         1. autoimmune disease, or

         2. immune suppression or immune deficiency, or

         3. HIV, or

         4. transplant recipients, or

         5. neuromuscular and CNS diseases/disorders, or

         6. haemoglobinopathies, or

         7. are children on long term aspirin, or

         8. have a cochlear implant, or

         9. errors of metabolism at risk of major metabolic decompensation, or

         10. pre and post splenectomy, or

         11. down syndrome, or

      7. are pregnant; or

   3. children aged four years or less (but over three years) who have been hospitalised for respiratory illness or have a history of significant respiratory illness;

   Unless meeting the criteria set out above, the following conditions are excluded from funding:

   1. asthma not requiring regular preventative therapy,

   2. hypertension and/or dyslipidaemia without evidence of end-organ disease.

2. Contractors will be entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria pursuant to their contract with their DHB for subsidised immunisation, and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.

3. Contractors may only claim for patient populations within the criteria that are covered by their contract, which may be a sub-set of the population described in paragraph A above.