Schedule Update - effective 1 November 2008 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 November 2008 Cumulative for September, October and November 2008 Section H cumulative for August, September, October and November 2008

Contents

Summary of PHARMAC decisions effective 1 November 2008 ....................... 3 Levothyroxine: additional brand listed .......................................................... 7 Morphine sulphate suppositories 30 mg discontinued .................................. 7 Bicalutamide ................................................................................................. 7 Changes to various nervous system restrictions, clozapine............................ 8 Levetiractem (Keppra) Special Access Application Form ................................ 8 Vigabatrin access widened ............................................................................ 9 News in brief ................................................................................................. 9 New Insulin for patients with Diabetes ......................................................... 9 Tender News .................................................................................................. 9 Looking Forward ......................................................................................... 10 Sole Subsidised Supply products cumulative to November 2008 ................ 11 New Listings ................................................................................................ 18 Changes to Restrictions ............................................................................... 25 Changes to Subsidy and Manufacturer’s Price............................................. 36 Changes to Brand Name ............................................................................. 41 Changes to Description ............................................................................... 41 Changes to Section F: Part II ........................................................................ 41 Changes to General Rules............................................................................ 42 Changes to Sole Subsidised Supply ............................................................. 42 Delisted Items ............................................................................................. 43 Items to be Delisted .................................................................................... 45 Section H changes to Part II ........................................................................ 48 Section H changes to Part IV ....................................................................... 57 Index ........................................................................................................... 58

Summary of Pharmac decisions

effective 1 NOvemBer 2008 New listings (pages 18 to 24) • Bicalutamide (Bicalox) tab 50 mg – Special Authority – Retail pharmacy • Citalopram hydrobromide (Arrow-Citalopram) tab 20 mg - 84 tablet pack size • Insulin lispro with insulin lispro protamine inj lispro 25% with insulin lispro protamine 75% (Humalog Mix 25), 100 u per ml, 3 ml and inj lispro 50% with insulin lispro protamine 50% (Humalog Mix 50), 100 u per ml, 3 ml • Doxazosin mesylate (Apo-Doxazosin) tab 2 mg – new pack size, 500 tabs • Aqueous cream (AFT) crm • Clotrimazole (Clomazol) vaginal crm 2% with applicators • Oestradiol valerate (Progynova) tab 2 mg – new pack size, 56 tabs • Thyroxine (Goldshield) tab 50 µg and 100 µg • Amoxycillin (Ospamox) drops 100 mg per 1 ml, 30 ml OP • Amoxycillin (Ibiamox) inj 250 mg, 500 mg, 1 g – 10 injection pack size • Ciprofloxacin (Rex Medical) tab 250 mg, 500 mg and 750 mg • Citalopram hydrobromide (Arrow-Citalopram) tab 20 mg – new pack, size 84 tab • Carboplatin (Biomed) inj 1 mg for ECP – PCT only – Specialist • Carmustine (Biomed) inj 100 mg for ECP, 100 mg OP – PCT only – Specialist • Cyclophosphamide (Biomed) inj 1 mg for ECP – PCT only – Specialist • Cisplatin (Biomed) inj 1 mg for ECP – PCT only – Specialist • Ifosfamide (Biomed) inj 1 mg for ECP – PCT only – Specialist • Oxaliplatin (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Calcium folinate (Biomed) inj 1 mg for ECP – PCT only – Specialist • Cladribine (Biomed) inj 10 mg for ECP, 10 mg OP – PCT only – Specialist • Cytarabine (Biomed) inj 1 mg for ECP, and inj 100 mg intrathecal syringe for ECP, 100 mg OP – PCT only – Specialist • Fludarabine phosphate (Biomed) inj 50 mg for ECP, 50 mg OP – PCT only – Specialist • Fluorouracil sodium (Biomed) inj 1 mg for ECP – PCT only – Specialist • Gemcitabine hydrochloride (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Irinotecan (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Methotrexate (Biomed) inj 1 mg for ECP, and inj 5 mg intrathecal syringe for ECP, 5 mg OP – PCT only – Specialist

Summary of Pharmac decisions – effective 1 November 2008 (continued) • Bleomycin sulphate (Biomed) inj 1,000 iu for ECP – PCT only – Specialist • Colaspase (L-asparaginase) (Biomed) inj 10,000 iu for ECP, 10,000 iu OP – PCT only – Specialist • Dacarbazine (Biomed) inj 200 mg for ECP, 200 mg OP – PCT only – Specialist • Dactinomycin (actinomycin D) (Biomed) inj 0.5 mg for ECP, 0.5 mg OP – PCT only – Specialist • Daunorubicin (Biomed) inj 20 mg for ECP, 20 mg OP – PCT only – Specialist • Docetaxel (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Doxorubicin (Biomed) inj 1 mg for ECP – PCT only – Specialist • Epirubicin (Biomed) inj 1 mg for ECP – PCT only – Specialist • Etoposide (Biomed) inj 1 mg for ECP – PCT only – Specialist • Etoposide phosphate (Biomed) inj 1 mg (of etoposide base) for ECP – PCT only – Specialist • Idarubicin hydrochloride (Biomed) inj 1 mg for ECP – PCT only – Specialist • Mesna (Biomed) inj 1 mg for ECP – PCT only – Specialist • Mitomycin C (Biomed) inj 1 mg for ECP – PCT only – Specialist • Mitozantrone (Biomed) inj 1 mg for ECP – PCT only – Specialist • Paclitaxel (Biomed) inj 1 mg for ECP – PCT only – Specialist • Teniposide (Biomed) inj 50 mg for ECP, 50 mg OP – PCT only – Specialist • Vinblastine sulphate (Biomed) inj 1 mg for ECP – PCT only – Specialist • Vincristine sulphate (Biomed) inj 1 mg for ECP – PCT only – Specialist • Vinorelbine (Biomed) inj 1 mg for ECP – PCT only – Specialist • Octreotide (somatostatin analogue) (Hospira) inj 50 µg per ml, 1 ml, 100 µg per ml, 1 ml and 500 µg per ml, 1 ml – Special Authority – Hospital pharmacy [HP3] • Rituximab (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Trastuzumab (Biomed) inj 1 mg for ECP – PCT only – Specialist – Special Authority • Spacer device (Space Chamber) 230 ml (single patient) – Only on a WSO, maximum of 20 dev per WSO changes to restrictions (pages 25 to 35) • Folic acid (Biomed) oral liq 50 µg per ml – removal of Retail pharmacySpecialist • Dipyridamole tab 25 mg (Persantin) and tab long-acting 150 mg (Pytazen SR) – amended Special Authority applicant type to Any Relevant Practitioner

Summary of Pharmac decisions – effective 1 November 2008 (continued) • Heparin sodium (Mayne) inj 25,000 iu per ml, 0.2 ml – removal of Retail pharmacy-Specialist • Calcium polystyrene sulphonate (Calcium Resonium) powder – removal of Retail pharmacy-Specialist • Potassium bicarbonate (Phosphate-Sandoz) tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg – removal of Retail pharmacy-Specialist and addition of Note for phosphate supplementation • Acipimox (Olbetam) cap 250 mg – removal of Retail pharmacy-Specialist • Sodium polystyrene sulphonate (Resonium-A) powder – removal of Retail pharmacy-Specialist • Pravastatin (Pravachol) tab 10 mg, 20 mg and 40 mg – amended Special Authority applicant type to Any Relevant Practitioner • Candesartan (Atacand) tab 4 mg, 8 mg, 16 mg and 32 mg – amended Special Authority applicant type to Any Relevant Practitioner • Midodrine (Gutron) tab 2.5 mg and 5 mg – amended Special Authority applicant type to any relevant practitioner • Amiloride (Biomed) oral liq 1 mg per ml – removal of Retail pharmacySpecialist • Frusemide tab 500 mg (Diurin 500) and infusion 10 mg per ml, 25 ml (Lasix) – removal of Retail pharmacy-Specialist • Chlorothiazide (Biomed) oral liq 50 mg per ml – removal of Retail pharmacySpecialist • Spironolactone (Biomed) oral liq 5 mg per ml – removal of Retail pharmacySpecialist • Leflunomide (AFT-Leflunomide and Arava) tab 10 mg, 20 mg and 100 mg – amended Special Authority applicant type to any relevant practitioner • Fentanyl (Durogesic) transdermal patch, matrix 25 µg per hour, 50 µg per hour, 75 µg per hour and 100 µg per hour – amended Special Authority applicant type to any relevant practitioner • Gabapentin (Neurontin and Nupentin) tab 600 mg and cap 100 mg, 300 mg and 400 mg – Special Authority criteria for neuropathic pain • Vigabatrin (Sabril) tab 500 mg – amended Special Authority criteria to include use as a treatment for infantile spasms • Betahistine dihydrochloride (Vergo 16) tab 16 mg – removal of Retail pharmacy-Specialist • Domperidone (Motilium) tab 10 mg – amended Special Authority applicant type to any relevant practitioner

Summary of Pharmac decisions – effective 1 November 2008 (continued) • Hyoscine (scopolamine) (Scopoderm TTS) patches, 1.5 mg – amended Special Authority applicant type to any relevant practitioner • Pergolide (Permax) tab 0.25 mg and 1 mg – removal of Retail pharmacySpecialist • Clozapine (Clopine and Clozaril) tab 25 mg, 50 mg, 100 mg and 200 mg – removal of Specialist prescription • Spacer device (Space Chamber) 230 mg (autoclavable) – addition of Subsidy by endorsement Decreased subsidy (pages 36 to 40) • Quinapril (Accupril) tab 5 mg, 10 mg and 20 mg • Prednisone (Apo-Prednisone) tab 20 mg • Zopiclone (Apo-Zopiclone) tab 7.5 mg • Fludarabine phosphate (Baxter) inj 50 mg for ECP, 50 mg OP • Methotrexate (Baxter) inj 1 mg for ECP • Promethazine hydrochloride (Allersoothe) tab 10 mg and 25 mg • Phenyl free pasta (Loprofin) animal shapes 500 g OP, penne 500 g OP and lasagna 250 g OP increased subsidy (pages 36 to 40) • Heparin sodium (Multiparin) inj 5,000 iu per ml, 5 ml • Heparin sodium (Mayne) inj 25,000 iu per ml, 0.2 ml

Pharmaceutical Schedule - Update News

Levothyroxine: additional brand listed

An additional brand of levothyroxine will be listed in the Pharmaceutical Schedule from 1 November 2008. The Goldshield levothyroxine will be available fully subsidised as from 1 November, however stock of the drug will not be available until the first or second week of November.

Morphine sulphate suppositories 30 mg discontinued

The supplier of morphine suppositories, which have been imported under Section 29 of the Medicines Act, has notified PHARMAC that it is no longer willing to continue to supply this medicine due to low usage. Therefore, morphine suppositories 30 mg will be delisted from the Pharmaceutical Schedule from 1 May 2009. The Analgesic Subcommittee of PTAC has previously been consulted on alternative treatments, given that long-term supply of this low-volume item was uncertain. The Subcommittee considered that subcutaneous opioids (eg, morphine and oxycodone injection) and morphine sulphate long-acting tablets used rectally could be used as an alternative.

Bicalutamide

From 1 November 2008 bicalutamide (Bicalox) 50 mg tablets will be funded under Special Authority criteria. The listing of bicalutamide provides further treatment options for patients with advanced prostate cancer.

Pharmaceutical Schedule - Update News

Changes to various nervous system restrictions, clozapine

From 1 November 2008 the prescriberspecific restrictions applying to pergolide (Retail Pharmacy – Specialist), betahistine dihydrochloride (Retail Pharmacy – Specialist) and clozapine (Specialist prescription) have been removed. Special Authority restrictions for domperidone, hyoscine (scopolamine) patches and fentanyl transdermal patches have been amended to replace all prescriberspecific restrictions with “relevant practitioner” from 1 November 2008. Please note that with respect to clozapine, pursuant to Section 23 of the Medicines Act the following conditions will still apply to the subsidy for clozapine: 1. The medicine may only be prescribed by: • Registered medical practitioners as defined in the Health Practitioners Competence Assurance Act (HPCA) 2003 who are certified by the Medical Council of New Zealand as competent in the practice of psychiatry, and • Medical practitioners employed as registrars in the branch of psychiatry who are under the supervision of persons of the kind referred to above. • Medical officers of special scale who o work solely in the field of psychiatry o are in the employment of a District Health Board; and o are under the supervision of persons who are registered medical practitioners as defined in the HPCA 2003 who are certified by the Medical Council of New Zealand as competent in the scope of practice of psychiatry. 2. Persons prescribing the medicine must comply with appropriate local treatment guidelines. 3. The medicine must be dispensed in accordance with appropriate local dispensing guidelines.

Levetiracetam (Keppra) Special Access Application Forms

The Keppra brand of the antiepilepsy agent levetiracetam has been available subsidised ‘cost brand source’ via the Levetiracetam Special Access (LSA) programme since 1 August 2008. Applications are made on approved LSA forms which can be accessed via PHARMAC’s website www.pharmac.govt.nz under Special Authority forms.

Vigabatrin access widened

From 1 November 2008 the Special Authority restrictions applying to the antiepilepsy treatment vigabatrin have been amended to include the first-line treatment of infantile spasms.

News in brief

• The Special Authority has been removed from leflunomide tablets from 1 November 2008. • The Retail pharmacy – Specialist – restriction has been removed from a number of Cardiovascular and Blood and Blood Forming Products. • The prescriber-specific restrictions for some Cardiovascular and Blood and Blood Forming Products have been amended with “relevant practitioner” from 1 November 2008. See pages 25 to 30 for full details

New Insulin for patients with diabetes

PHARMAC is to begin funding a new insulin for patients with diabetes. From 1 November, insulin lispro with insulin lispro protamine suspension (Humalog Mix 25 and Humalog Mix 50) will be fully funded with no restrictions. Humalog Mix 25 and Humalog Mix 50 will be listed in the “Insulin - Intermediate-acting Preparations” therapeutic subgroup of the Pharmaceutical Schedule. In addition, the subgroup name for “Insulin - Rapid-acting insulin analogues will be renamed to “Insulin - Rapid-acting preparations”.

tender News

Sole Subsidised Supply changes – effective 1 December 2008

Chemical Name Calcium Presentation; Pack size Tab eff 1 g; 30 tab Sole Subsidised Supply brand (and supplier) Calcium-Sandoz 1000 (Novartis Consumer) Calsource (Novartis Consumer) Fludara (Bayer) Fludara (Bayer) Ferrum H (Aspen) Methotrexate Ebewe (InterPharma) Methotrexate Ebewe (InterPharma) Paracare Junior (API) Paracare Double Strength (API) PSM (API)

Fludarabine phosphate Fludarabine phosphate Iron polymaltose Methotrexate Methotrexate Paracetamol Paracetamol Zinc and castor oil

Tab 10 mg; 5 inj Tab 10 mg; 15 tab Inj 50 mg per ml, 2 ml; 5 inj Inj 100 mg per ml, 10 ml; 1 inj Inj 100 mg per ml, 50 ml; 1 inj Oral liq 120 mg per 5 ml; 1000 ml Oral liq 250 mg per 5 ml; 1000 ml Ointment BP; 500 g

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes. It may assist pharmacists to manage stock levels and keep prescribers up-to-date with proposals to change the Pharmaceutical Schedule. Possible decisions for implementation 1 December 2008 • Acitretin cap 10 mg and 25 mg – removal of Specialist prescription (specialist must be a dermatologist) • Adrenaline (Aspen Adrenaline) inj 1 in 1,000, 1 ml – new listing and available on a PSO • Amisulpride (Solian) tab 100 mg, 200 mg and 400 mg, and oral liquid 100 mg per ml – new listing • Antibiotic oral liquid where diluent must be added – addition of OP and removal of wastage rule • Clonazepam (Rivotril) inj 1 mg per ml, 1 ml – price and subsidy increase • Diltiazem hydrochloride (Dilzem) immediate release tab 30 mg - price and subsidy increase • Diltiazem hydrochloride (Cardizem) long-acting tab 120 mg, 180 mg and 240 mg - price and subsidy reduction • Erythropoietin beta (Recormon) pre-filled syringe – price and subsidy reductions between 20% and 48% depending upon the strength • Fluorouracil sodium (Efudix) crm 5% - increased subsidy and decreased price (full subsidy), and removal of Retail pharmacy-Specialist restriction • Isotretinoin cap 10 mg and 20 mg – removal of Specialist prescription (specialist must be a dermatologist) and addition of Special Authority • Paracetamol (Pharmacare Paracetamol) tab 500 mg – new tender listing • Prochlorperazine (Stemetil) inj 12.5 mg per ml, 1 ml and suppos 25 mg – increased subsidy

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Aciclovir Alprazolam

Presentation

Tab dispersible 200 mg Tab dispersible 400 mg Tab 250 µg Tab 500 µg Tab 1 mg Inj 10 mg per ml, 1 ml Cap 100 mg Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 100 mg Tab dispersible 300 mg Tab 100 mg Tab 50 mg & 100 mg Inj 600 µg, 1 ml Inj 1200 µg, 1 ml Tab 500 mg Metered aqueous nasal spray 50 µg Metered aqueous nasal spray 100 µg Scalp app 0.1% Tab 5 mg Eye drops 0.2% Inj 0.5%, 4 ml Inj 0.5%, 8% glucose, 4 ml Lotion BP Crm, aqueous, BP Cap 0.25 µg & 0.5 µg Inj 50 mg Tab 12.5 mg, 25 mg & 50 mg Cap 250 mg Grans for oral liq 125 mg per 5 ml Inj 750 mg & 1.5 g Crm BP Eye drops 0.5% Eye oint 1% Soln 4% Handrub 1% with ethanol 70% Mouthwash 0.2% Tab 25 mg

Brand Name Expiry Date*

Lovir Lovir Arrow-Alprazolam Arrow-Alprazolam Arrow-Alprazolam Mayne Symmetrel Apo-Amoxi Ranbaxy Amoxicillin Ranbaxy Amoxicillin Apo-Ascorbic Acid Ethics Aspirin Ethics Aspirin EC Loten AstraZeneca AstraZeneca Arrow-Azithromycin Alanase Alanase Beta Scalp Lax-Tab AFT Marcain Isobaric Marcain Heavy ABM ABM Calcitriol-AFT Calcium Folinate Ebewe Apo-Captopril Ranbaxy Cefaclor Ranbaxy Cefaclor Zinacef PSM Chlorsig Chlorsig Orion Orion Orion Hygroton 2009 2010

Apomorphine hydrochloride Amantadine hydrochloride Amoxycillin

2009 2011 2010 2009 2009 2010 2009 2009 2009 2009 2009 2010 2011 2010 2009 2009 2011 2010 2010 2011 2010 2009 2011 2009 2009

Ascorbic acid Aspirin Atenolol Atropine sulphate Azithromycin Beclomethasone dipropionate Betamethasone valerate Bisacodyl Brimonidine tartrate Bupivicaine hydrochloride Calamine Calcitriol Calcium folinate Captopril Cefaclor monohydrate Cefuroxime sodium Cetomacrogol Chloramphenicol Chlorhexidine gluconate

Chlorthalidone

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 11

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Clarithromycin Clobetasol propionate Clotrimazole Codeine phosphate Colchicine Colestipol hydrochloride Colistin sulphomethate Compound electrolytes Cyclizine hydrochloride Cyclophosphamide Cyproterone acetate Dantrolene sodium Desferrioxamine mesylate Desmopressin Dexamethasone sodium phosphate Dexamphetamine sulphate Dextrose Dextrose with electrolytes

Presentation

Tab 250 mg Grans for oral liq 125 mg per 5 ml Crm 0.05% Crm 1% Vaginal crm 1% with applicator(s) Tab 15 mg, 30 mg & 60 mg Tab 500 µg Sach 5 g Inj 150 mg Powder for soln for oral use Tab 50 mg Tab 50 mg Tab 50 mg Cap 25 mg & 50 mg Inj 500 mg Nasal spray 10 mcg per dose Inj 4 mg per ml, 1 ml Inj 4 mg per ml, 2 ml Tab 5 mg Inj 50%, 10 ml Oral soln with electrolytes

Brand Name Expiry Date*

Klamycin Klacid Dermol Clomazol Clomazol PSM Colgout Colestid Colistin-Link Enerlyte Nausicalm Cycloblastin Siterone Dantrium Mayne Desmopressin-PH&T Mayne PSM Biomed Pedialyte – Plain Pedialyte – Bubblegum Pedialyte – Fruit Voltaren Ophtha Voltaren Voltaren Voltaren Voltaren Voltaren Apo-Diclo Apo-Diclo SR Videx EC Pytazen SR Apo-Doxazosin AFT m-Enalapril Mayne Cafergot 2010 2009 2011 2010 2010 2010 2010 2010 2010 2009 2010 2009 2009 2010 2011 2009 2010 2011 2010

Dicloflenac sodium

Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg Suppos 25 mg Suppos 50 mg Suppos 100 mg Tab EC 25 mg & 50 mg Tab long-acting 75 mg & 100 mg Cap 125 mg, 200 mg, 250 mg & 400 mg Tab long-acting 150 mg Tab 2 mg & 4 mg Oint BP Tab 5 mg, 10 mg & 20 mg Inj 500 µg per ml, 1 ml Tab 1 mg with caffeine 100 mg

2011

2009 2009 2011 2010 2011 2009 2009 2009

Didanosine (DDI) Dipyridamole Doxazosin mesylate Emulsifying ointment Enalapril Ergometrine maleate Ergotamine tartrate with caffeine

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 12

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Ethinyloestradiol Ethinyloestradiol with norethisterone

Presentation

Tab 10 µg Tab 35 µg with norethisterone 500 µg Tab 35 µg with norethisterone 1 mg Tab 35 µg with norethisterone 1 mg and 7 inert tab Cap 50 mg & 100 mg Oral liq 150 mg per 5 ml Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap 50 mg Cap 150 mg Cap 200 mg Oint 950 µg, with fluocortolone pivalate 920 µg, and cinchocaine hydrochloride 5 mg per g Suppos 630 µg, with fluocortolone pivalate 610 µg, and cinchocaine hydrochloride 1 mg Eye drops 0.1% Cap 20 mg Tab disp 20 mg, scored Tab 0.8 mg & 5 mg Crm 2% & Oint 2% Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg Oral pump spray 400 µg per dose TDDS 5 mg TDDS 10 mg Oral liq 2 mg per ml Tab 500 µg, 1.5 mg & 5 mg Inj 5 mg per ml, 1 ml Inj 10 iu per ml, 5 ml Crm 1% Tab 5 mg & 20 mg Rectal foam 10%, CFC-Free Scalp lotn 0.1% Lotn 1% with wool fat hydrous 3% and mineral oil

Brand Name Expiry Date*

New Zealand Medical and Scientific Brevinor 21 Brevinor 1/21 Brevinor 1/28 Vepesid Ferodan Staphlex AFT AFT Pacific Pacific Pacific Ultraproct Ultraproct 2009 2010 2009 2009 2010

Etoposide Ferrous sulphate Flucloxacillin sodium

Fluconazole

2011

Fluocortolone caproate with fluocortolone pivalate and cinchocaine

2010

Fluorometholone Fluoxetine hydrochloride Folic Acid Fusidic acid Gentamicin sulphate Gliclazide Glipizide Glyceryl trinitrate

Flucon Fluox Fluox Apo-Folic Acid Foban Pfizer Apo-Gliclazide Minidiab Nitrolingual pumpspray Nitroderm TTS 5 Nitroderm TTS 10 Serenace Serenace Serenace AstraZeneca PSM Douglas Colifoam Locoid DP Lotn HC

2009 2010 2009 2010 2009 2011 2011 2011

Haloperidol

2010 2009 2009 2011 2009 2009 2010 2011

Heparinised saline Hydrocortisone Hydrocortisone acetate Hydrcortisone butyrate Hydrocortisone with wool fat and mineral oil

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 13

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Ibuprofen Imipramine hydrochloride Indapamide Ipratropium bromide

Presentation

Oral liq 100 mg per 5 ml, 200 ml Tab 10 mg & 25 mg Tab 2.5 mg Aqueous nasal spray, 0.03% Nebuliser soln, 250 µg per ml, 1 ml Nebuliser soln, 250 µg per ml, 2 ml Tab long-acting 60 mg Cap 10 mg Cap 20 mg Cap 100 mg Oral liq 10 g per 15 ml Eye drops 0.25% & 0.5% Cap 50 mg with benserazide 12.5 mg Tab dispersible 50 mg with benserazide 12.5 mg Cap 100 mg with benserazide 25 mg Cap long-acting 100 mg with benserazide 25 mg Cap 200 mg with benserazide 50 mg Inj 0.5%, 5 ml Inj 1%, 5 ml Inj 1%, 20 ml Crm 2.5% with prilocaine 2.5%; 30 g OP Crm 2.5% with prilocaine 2.5%; 5 g Tab 5 mg, 10 mg & 20 mg Tab 2 mg Tab 10 mg Oral liq 1 mg per ml

Brand Name Expiry Date*

Fenpaed Tofranil Napamide Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Duride Isotane 10 Isotane 20 Sporanox Duphalac Betagan Madopar 62.5 Madopar Dispersible Madopar 125 Madopar HBS Madopar 250 Xylocaine Xylocaine Xylocaine EMLA EMLA Arrow-Lisinopril Nodia Loraclear Hayfever Relief Lorapaed Ativan Mayne Derbac M A-Lices Ludiomil Provera Pentasa Arrow-Metformin Methatabs AFT 2009 2010 2010 2010 2010 2009 2009 2010

Isosorbide mononitrate Isotretinoin Itraconazole Lactulose Levobunolol Levodopa with benserazide

2009 2009 2010 2010 2010 2009

Lignocaine hydrochloride

Lignocaine with prilocaine

2010

Lisinopril Loperamide hydrochloride Loratadine

Lorazepam Magnesium sulphate Malathion Maldison Maprotiline hydrochloride Medroxyprogesterone acetate Mesalazine Metformin hydrochloride Methadone hydrochloride

Tab 1 mg & 2.5 mg Inj 49.3% Liq 0.5% Shampoo 1% Tab 25 mg & 75 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Enema 1 g per 100 ml Tab 500 mg & 850 mg Tab 5 mg Powder 1 g

2009 2009 2010 2010 2009 2010 2009 2009 2010 2009

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 14

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Methotrexate Methylphenidate hydrochloride

Presentation

Tab 2.5 mg & 10 mg Tab long-acting 20 mg Tab 5 mg & 20 mg Tab 10 mg Tab 4 mg & 100 mg Crm 0.1% and oint 0.1% Inj 40 mg per ml, 1 ml Inj 40 mg per ml with lignocaine 1 ml Inj 40 mg per ml, 1 ml Inj 62.5 mg per ml, 1 ml Inj 500 mg & 1 g Inj 5 mg per ml, 2 ml Tab long-acting 200 mg Cap 250 mg Crm 2% Tab 2.5 mg & 5 mg Tab 200 µg Tab 150 mg & 300 mg Oral liq 1 mg per ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Inj 5 mg per ml, 1 ml Inj 15 mg per ml, 1 ml Cap long-acting 10 mg, 30 mg, 60 mg, 100 mg & 200 mg Tab immediate release 10 mg & 20 mg Inj 80 mg per ml, 1.5 ml & 5 ml Tab 40 mg & 80 mg Tab 50 mg Tab 250 mg Tab 500 mg Tab 275 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Tab 50 mg & 500 mg

Brand Name Expiry Date*

Methoblastin Rubifen SR Rubifen Rubifen Medrol Advantan Depo-Medrol Depo-Medrol with Lidocaine Solu-Medrol Solu-Medrol Solu-Medrol Pfizer Slow-Lopresor Metopirone Multichem Gutron Cytotec Apo-Moclobemide RA-Morph RA-Morph RA-Morph RA-Morph Mayne Mayne Mayne Mayne m-Eslon Sevredol Mayne Apo-Nadolol ReVia Noflam 250 Noflam 500 Sonaflam AstraZeneca Viramune Suspension Apo-Nicotinic Acid 2009 2010 2010 2009 2010 2010 2009 2009 2009 2009

Methylprednisolone Methylprednisolone aceponate Methylprednisolone acetate Methylprednisolone acetate with lignocaine Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol tartrate Metyrapone Miconazole nitrate Midodrine Misoprostol Moclobemide Morphine hydrochloride

2009 2009 2011 2011 2009

2011 2009 2009 2011 2009 2009 2009 2009

Morphine sulphate

2011 2009

Morphine tartrate Nadolol Naltrexone hydrochloride Naproxen Naproxen sodium Neostigmine Nevirapine Nicotinic acid

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 15

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Nifedipine Norethisterone Nystatin

Presentation

Tab long-acting 20 mg Tab 5 mg Tab 350 µg Cap 500,000 u Tab 500,000 u Vaginal crm 100,000 u per 5 g with applicators Tab 4 mg & 8 mg Tab disp 4 mg & 8 mg Tab 5 mg Oral liq 5 mg per 5 ml Inj 10 mg per ml, 1 ml and 2 ml Oral liq 5 mg per 5 ml Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml Tab 20 mg Tab 40 mg

Brand Name Expiry Date*

Nyefax Retard Primolut N Noriday 28 Nilstat Nilstat Nilstat Zofran Zofran Zydis Apo-Oxybutynin Apo-Oxybutynin OxyNorm OxyNorm Syntocinon Syntocinon Syntometrine Pamisol Pamisol Pamisol Dr Reddy’s Pantoprazole Dr Reddy’s Pantoprazole Lacri-Lube Loxamine Permax Permax Pexsig AFT AFT Cilicaine VK Cilicaine VK Prefrin Span-K Apo-Prazo MDS Quick Card Apo-Pyridoxine Accupril 2009 2011 2009 2010 2009 2010 2010 2010 2009

Ondansetron Oxybutynin Oxycodone hydrochloride Oxytocin

Pamidronate disodium

2011

Pantoprazole

2010

Paraffin liquid with soft white paraffin Paroxetine hydrochloride Pergolide Perhexiline maleate Phenoxymethylpenicillin (Penicillin V)

Eye oint with soft white paraffin Tab 20 mg Tab 0.25 mg Tab 1 mg Tab 100 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap potassium salt 250 mg Cap potassium salt 500 mg Eye drops 0.12% Tab long-acting 600 mg Tab 1 mg, 2 mg & 5 mg Cassette Tab 50 mg Tab 5 mg; 10 mg & 20 mg

2010 2010 2011 2009 2010

Phenylephrine hydrochloride Potassium chloride Prazosin hydrochloride Pregnancy tests - HCG urine Pyridoxine hydrochloride Quinapril

2010 2009 2010 2009 2009 2011

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 16

Sole Subsidised Supply Products – cumulative to November 2008

Generic Name

Quinapril with hydroclorothiazide

Presentation

Tab 10 mg with hydroclorothiazide 12.5 mg Tab 20 mg with hydroclorothiazide 12.5 mg Tab 200 mg Tab 300 mg Oral liq 150 mg per 10 ml Cap 150 mg Tab 150 mg & 300 mg Nebuliser soln 1 mg per ml, 2.5 ml Nebuliser soln 2 mg per ml, 2.5 ml Oral liq 2 mg per 5 ml Nebuliser soln, 2.5 mg with ipratropium bromide 0.5 mg Tab 5 mg Inj 0.9%, 5 ml & 10 ml Grans eff 4 g sachets Nasal spray 4% Tab 500 mg Tab EC 500 mg Liq Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Inj 250 mcg Inj 1 mg per ml, 1 ml Eye drops 0.25% Eye drops 0.5% Tab 10 mg Tab 50 mg 0.1% in Dental Paste USP Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 mcg per g Cap 300 mg Inj 1 mg per ml, 1 ml Inj 1 mg per ml, 2 ml Tab (BPC cap strength) Tab, strong, BPC Purified for injection 20 ml

Brand Name Expiry Date*

Accuretic 10 Accuretic 20 Q 200 Q 300 Peptisoothe Mycobutin Arrow-Roxithromycin Asthalin Asthalin Salapin Duolin Apo-Selegiline AstraZeneca Ural Rex Salazopyrin Salazopyrin EN Midwest Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timop Apo-Timop Apo-Timol Apo-Thiamine Oracort Kenacomb 2009 2010 2010 2009 2009 2010 2009 2009 2009 2010 2009 2009 2010 2011 2011 2011 2011 2009 2009 2011 2009 2011

Quinine sulphate Ranitidine hydrochloride Rifabutin Roxithromycin Salbutamol

Salbutamol with ipratropium bromide Selegiline hydrochloride Sodium chloride Sodium citro-tartrate Sodium cromoglycate Sulphasalazine Syrup (pharmaceutical grade) Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate

Thiamine hydrochloride Triamcinolone acetonide Triamcinolone acetonide with gramicidin, neomycin and nystatin Ursodeoxycholic acid Vincristine sulphate Vitamins Vitamin B complex Water November changes in bold type.

Actigall Mayne Mayne Healtheries Apo-B-Complex Multichem

2011 2009 2009 2009 2009

*Expiry date of the Sole Subsidised Supply period is 30 June of the year indicated. 17

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 November 2008

29 53 66 76 82 84 INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE s Inj lispro 25% with insulin lispro protamine 75%, 100 u per ml, 3 ml .............................................................. 52.15 s Inj lispro 50% with insulin lispro protamine 50%, 100 u per ml, 3 ml .............................................................. 52.15 DOXAZOSIN MESYLATE ❋ Tab 2 mg ............................................................................... 22.85 AQUEOUS CREAM ❋ Crm........................................................................................... 2.28 CLOTRIMAZOLE ❋ Vaginal crm 2% with applicators ............................................... 2.75 OESTRADIOL VALERATE – See prescribing guideline ❋ Tab 2 mg ................................................................................. 8.24 THYROXINE ❋ Tab 50 µg ................................................................................. 1.71 ‡ Safety cap for extemporaneously compounded oral liquid preparations. ❋ Tab 100 µg ............................................................................... 1.78 ‡ Safety cap for extemporaneously compounded oral liquid preparations. AMOXYCILLIN Drops 100 mg per 1 ml ............................................................ 4.00 Inj 250 mg ............................................................................. 12.42 Inj 500 mg ............................................................................. 14.24 Inj 1 g – Up to 5 inj available on a PSO..................................... 21.62 CIPROFLOXACIN Tab 250 mg – Up to 5 tab available on a PSO ............................ 3.35 Tab 500 mg – Up to 5 tab available on a PSO ............................ 4.90 Tab 750 mg – Retail pharmacy-Specialist ................................. 7.54 CITALOPRAM HYDROBROMIDE ❋ Tab 20 mg ............................................................................... 3.78 CARBOPLATIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.13 CARMUSTINE – PCT only – Specialist Inj 100 mg for ECP ............................................................... 204.13 CYCLOPHOSPHAMIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.02 CISPLATIN – PCT only – Specialist Inj 1 mg for ECP ........................................................................ 0.46

5 5 500 500 g 20 g OP 56 28 28

✔ Humalog Mix 25 ✔ Humalog Mix 50 ✔ Apo-Doxazosin ✔ AFT ✔ Clomazol ✔ Progynova ✔ Goldshield ✔ Goldshield

30 ml OP 10 10 10 30 30 30 84 1 mg

✔ Ospamox ✔ Ibiamox ✔ Ibiamox ✔ Ibiamox ✔ Rex Medical ✔ Rex Medical ✔ Rex Medical ✔ Arrow-Citalopram ✔ Biomed

110 130 130 130 130

100 mg OP ✔ Biomed 1 mg 1 mg ✔ Biomed ✔ Biomed

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 November 2008 (continued)

130 130 131 132 132 IFOSFAMIDE – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.09 OXALIPLATIN – PCT only – Specialist – Special Authority see SA0900 Inj 1 mg for ECP ....................................................................... 8.74 CALCIUM FOLINATE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 CLADRIBINE – PCT only – Specialist Inj 10 mg for ECP ................................................................. 749.96 CYTARABINE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.03 Inj 100 mg intrathecal syringe for ECP – PCT only – Specialist ....................................................... 16.00 FLUDARABINE PHOSPHATE – PCT only – Specialist Inj 50 mg for ECP ................................................................. 299.25 FLUOROURACIL SODIUM Inj 1 mg for ECP – PCT only – Specialist ................................... 0.01 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed

10 mg OP ✔ Biomed 1 mg ✔ Biomed

100 mg OP ✔ Biomed 50 mg OP ✔ Biomed 1 mg ✔ Biomed

132 132 132 132 133 134 134 134 134 134 134

GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA0877 Inj 1 mg for ECP ........................................................................ 0.38 1 mg ✔ Biomed IRINOTECAN – PCT only – Specialist – Special Authority see SA0878 Inj 1 mg for ECP ........................................................................ 3.19 METHOTREXATE ❋ Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 ❋ Inj 5 mg intrathecal syringe for ECP – PCT only – Specialist .................................................................... 4.73 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 1,000 iu for ECP .................................................................. 5.26 1 mg 1 mg 5 mg OP 1,000 iu ✔ Biomed

✔ Biomed ✔ Biomed ✔ Biomed

COLASPASE (L-ASPARAGINASE) – PCT only – Specialist Inj 10,000 iu for ECP ............................................................ 102.32 10,000 iu OP ✔ Biomed DACARBAZINE – PCT only – Specialist Inj 200 mg for ECP ................................................................. 43.86 DACTINOMYCIN (ACTINOMYCIN D) – PCT only – Specialist Inj 0.5 mg for ECP .................................................................. 13.52 DAUNORUBICIN – PCT only – Specialist Inj 20 mg for ECP ................................................................... 99.00 DOCETAXEL – PCT only – Specialist – Special Authority see SA0880 Inj 1 mg for ECP ..................................................................... 23.81 200 mg OP ✔ Biomed 0.5 mg OP ✔ Biomed 20 mg OP ✔ Biomed 1 mg ✔ Biomed

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

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Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 November 2008 (continued)

135 135 135 135 135 136 136 136 136 136 137 137 137 139 DOXORUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.87 EPIRUBICIN – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 2.74 ETOPOSIDE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.30 ETOPOSIDE PHOSPHATE – PCT only – Specialist Inj 1 mg (of etoposide base) for ECP ........................................ 0.47 IDARUBICIN HYDROCHLORIDE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 37.74 MESNA – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.02 MITOMYCIN C – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 11.85 MITOZANTRONE – PCT only – Specialist Inj 1 mg for ECP ..................................................................... 12.43 PACLITAXEL – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 1.32 TENIPOSIDE – PCT only – Specialist Inj 50 mg for ECP ................................................................... 84.51 VINBLASTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................... 3.05 VINCRISTINE SULPHATE Inj 1 mg for ECP – PCT only – Specialist ................................. 21.46 VINORELBINE – PCT only – Specialist – Special Authority see SA0901 Inj 1 mg for ECP ....................................................................... 4.75 BICALUTAMIDE – Special Authority see SA0941 below Tab 50 mg .............................................................................. 27.10 1 mg 1 mg 1 mg 1 mg 1 mg 1 mg 1 mg 1 mg 1 mg ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed ✔ Biomed

50 mg OP ✔ Biomed 1 mg 1 mg 1 mg 30 ✔ Biomed

✔ Biomed ✔ Biomed ✔ Bicalox

➽ SA0941 Special Authority for Subsidy Initial application from any medical practitioner. Approvals valid without further renewal unless notified where the patient has advanced prostate cancer. 139 OCTREOTIDE (SOMATOSTATIN ANALOGUE) – Special Authority see SA0563 – Hospital pharmacy [HP3] Inj 50 µg per ml, 1 ml ............................................................. 25.65 5 ✔ Hospira Inj 100 µg per ml, 1 ml ........................................................... 48.50 5 ✔ Hospira Inj 500 µg per ml, 1 ml ......................................................... 175.00 5 ✔ Hospira

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

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

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Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 November 2008 (continued)

144 RITUXIMAB – PCT only – Specialist – Special Authority see SA0884 See prescribing guideline Inj 1 mg for ECP ....................................................................... 6.27 TRASTUZUMAB – PCT only – Specialist – Special Authority see SA0885 See prescribing guideline Inj 1 mg for ECP ....................................................................... 9.36

1 mg

✔ Biomed

144

1 mg

✔ Biomed

153

SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices also available to paediatricians employed by a DHB on a wholesale supply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via a hospital pharmacy. 2) Only available for children aged six years and under. 3) For Space Chamber and Foremount Child’s Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. 4) Distributed by Airflow Products. Forward orders to: Airflow Products Telephone: 04 499 1240 or 0800 AIR FLOW PO Box 1485, Wellington Facsimile: 04 499 1245 or 0800 323 270 230 ml (single patient) .............................................................. 8.38 1 ✔ Space Chamber

Effective 1 October 2008

50 77 SIMVASTATIN - see prescribing guidelines on the preceding page ❋ Tab 80 mg ................................................................................ 3.18 30 ✔ SimvaRex

FINASTERIDE Special Authority see SA0928 – Retail Pharmacy Tab 5 mg ................................................................................ 19.20 30 ✔ Fintral ➽ SA0928 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has symptomatic benign prostatic hyperplasia; and 2 Either: 2.1 The patient is intolerant of non-selective alpha blockers or these are contraindicated; or 2.2 Symptoms are not adequately controlled with non-selective alpha blockers Note: patients with enlarged prostates are the appropriate candidates for therapy with finasteride. CEFAZOLIN SODIUM – Hospital Pharmacy [HP3] – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patients and the prescription is endorsed accordingly. Inj 500 mg ................................................................................ 5.00 5 ✔ Hospira Inj 1 g ....................................................................................... 8.00 5 ✔ Hospira FLUCLOXACILLIN SODIUM Inj 250 mg ................................................................................ 9.00 Inj 500 mg .............................................................................. 10.40 Inj 1 g – Up to 5 inj available on a PSO..................................... 14.00 10 10 10

✔ Flucloxin ✔ Flucloxin ✔ Flucloxin

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 October 2008 (continued)

119 CLOZAPINE – Hospital pharmacy [HP4] – Specialist prescription Tab 25 mg .............................................................................. 35.20 Tab 50 mg .............................................................................. 45.60 Tab 100 mg ............................................................................ 91.20 Tab 200 mg .......................................................................... 145.92 RISPERIDONE Tab 0.5 mg ............................................................................. 15.60 100 100 100 100 60 ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Ridal

120 173

PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA0896 – Hospital Pharmacy [HP3] Liquid (strawberry) .................................................................... 1.07 200 ml OP ✔ Pediasure Liquid (chocolate) ..................................................................... 1.07 200 ml OP ✔ Pediasure ADULT PRODUCTS STANDARD ENTERAL FEED 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.24 250 ml OP ✔ Isosource HN – Unflavoured 5.29 1000 ml OP ✔ Isosource HN – Unflavoured ENTERAL FEED WITH FIBRE 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.24 250 ml OP ✔ Fibersource HN – Unflavoured 5.29 1,000 ml OP ✔ Fibersource HN – Unflavoured PHENYL FREE PASTA – Special Authority see SA0733 – Hospital Pharmacy [HP3] Animal shapes......................................................................... 10.65 500 g OP (11.91) Lasagne .................................................................................... 5.32 250 g OP (5.99) Penne...................................................................................... 10.65 500g OP (11.91) Macaroni ................................................................................... 5.32 250 g OP (5.95)

176

177

182

Loprofin Loprofin Loprofin Loprofin

182

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital Pharmacy [HP3] Liquid (berry) .......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (berry) .......................................................................... 31.20 125 ml OP ✔ Lophlex LQ Liquid (citrus) .......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (citrus) .......................................................................... 31.20 125 ml OP ✔ Lophlex LQ Liquid (orange) ........................................................................ 15.65 62.5 ml OP ✔ Lophlex LQ Liquid (orange) ........................................................................ 31.20 125 ml OP ✔ Lophlex LQ

Effective 1 September 2008

29 43 INSULIN GLARGINE – Special Authority see SA0834 – Retail pharmacy s nj 100 iu per ml, 3 ml disposable pen ..................................... 94.50 I 5 ✔ Lantus SoloStar

ERYTHROPOIETIN ALPHA – Special Authority SA0922 – Hospital pharmacy [HP3] Inj human recombinant 5,000 iu, pre-filled syringe ................. 243.26 6 Inj human recombinant 6,000 iu, pre-filled syringe ................. 291.92 6

✔ Eprex ✔ Eprex

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

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

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Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 September 2008 (continued)

45 55 56 CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy Tab 75 mg .............................................................................. 35.00 LOSARTAN – Special Authority see SA0911 – Retail pharmacy ❋ Tab 25 mg .............................................................................. 21.76 ATENOLOL ❋ Tab 50 mg ................................................................................ 6.50 ❋ Tab 100 mg ............................................................................ 11.30 NICOTINE – Only on a Quitcard Lozenge 1 mg ......................................................................... 11.08 Lozenge 2 mg ......................................................................... 11.08 28 30 500 500 36 36 ✔ Apo-Clopidogrel

✔ Cozaar ✔ Pacific Atenolol ✔ Pacific Atenolol ✔ Habitrol ✔ Habitrol

IMIQUIMOD – Special Authority see SA0923 – Retail pharmacy Crm 5 % ................................................................................ 110.40 12 sachets ✔ Aldara ➽ SA0923 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 4 months for Applications meeting the following criteria: Either: 1 The patient has external anogenital warts and podophyllotoxin has been tried and failed (or is contraindicated); or 2 The patient has external anogenital warts and podophyllotoxin is unable to be applied accurately to the site; or 3 The patient has confirmed superficial basal cell carcinoma where other standard treatments, including surgical excision, are contraindicated or inappropriate. Note Superficial basal cell carcinoma Surgical excision remains remains first-line treatment for superficial basal cell carcinoma as it has a higher cure rate than imiquimod and allows histological assessment of tumour clearance. Imiquimod has not been evaluated for the treatment of superficial basal cell carcinoma within 1 cm of the hairline, eyes, nose, mouth or ears. Imiquimod is not indicated for recurrent, invasive, infiltrating, or nodular basal cell carcinoma. External anogenital warts Imiquimod is only indicated for external genital and perianal warts (condyloma acuminata). Renewal from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria: Any of the following: 1 Inadequate response to initial treatment for anogenital warts; or 2 New confirmed superficial basal cell carcinoma where other standard treatments, including surgical excision, are contraindicated or inappropriate; or 3 Inadequate response to initial treatment for superficial basal cell carcinoma. Note Confirmation that the lesion is a superficial basal cell carcinoma should be obtained using a biopsy.

109

AMITRIPTYLINE Tab 10 mg ................................................................................ 2.77

✔ Amirol

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings - effective 1 September 2008 (continued)

128 METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE – Special Authority SA0924 – Retail Pharmacy Only on a controlled drug form Tab extended-release 18 mg .................................................... 58.96 30 ✔ Concerta Tab extended-release 27 mg .................................................... 65.44 30 ✔ Concerta Tab extended-release 36 mg .................................................... 71.93 30 ✔ Concerta Tab extended-release 54 mg .................................................... 86.24 30 ✔ Concerta ➽ SA0924 Special Authority for Subsidy Initial application only from a paediatrician, psychiatrist or any other medical practitioner on the recommendation of a relevant specialist. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficit and Hyperactivity Disorder); and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Either: 3.1 Applicant is a paediatrician or psychiatrist; or 3.2 Both 3.2.1 Applicant is a medical practitioner and confirms that a relevant specialist has been consulted within the last 2 years and has recommended treatment for the patient; and 3.2.2 Provide name of the recommending specialist; and 4 Either: 4.1 Patient is taking a currently subsidised formulation of methylphenidate hydrochloride (immediaterelease or sustained-release) which has not been effective due to significant administration and/or compliance difficulties; or 4.2 There is significant concern regarding the risk of diversion or abuse of immediate-release methylphenidate hydrochloride. Renewal only from a paediatrician, psychiatrist or any other medical practitioner on the recommendation of a relevant specialist. Approvals valid for 24 months for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 Applicant is a paediatrician or psychiatrist; or 2.2 Both: 2.2.1 Applicant is a medical practitioner and confirms that a relevant specialist has been consulted within the last 2 years and has recommended treatment for the patient; and 2.2.2 Provide name of the recommending specialist

Effective 1 August 2008

75 MEDROXYPROGESTERONE ACETATE ❋ Inj 150 mg per ml, 1ml – Up to 5 inj available on a PSO ............. 8.05 1 ✔ Depo-Provera

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

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions

Effective 1 November 2008

44 FOLIC ACID Oral liq 50 µg per ml – Retail pharmacy-Specialist .................. 21.05 Specialist must be a paediatrician or paediatric cardiologist. 25 ml OP ✔ Biomed

DIPYRIDAMOLE ❋ Tab 25 mg – Additional subsidy by Special Authority see SA0930 0648 below – Retail pharmacy ................................ 0.16 84 (8.36) Persantin ❋ Tab long-acting 150 mg – Special Authority see SA0929 0649 below – Retail pharmacy ..................................................... 11.52 60 ✔ Pytazen SR ➽ SA0930 0648 Special Authority for Manufacturers Price Initial application — (Conditions other than transient ischaemic episodes) from any relevant practitioner only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves – as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft – as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Initial application — (Transient ischaemic episodes) from any relevant practitioner only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where the patient continues to have transient ischaemic episodes despite aspirin therapy or has transient ischaemic episodes and is aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Renewal — (Existing 2 year approvals) from any relevant practitioner only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. ➽ SA0929 0649 Special Authority for Subsidy Initial application — (Conditions other than transient ischaemic episodes) from any relevant practitioner only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves – as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft – as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Initial application — (Transient ischaemic episodes) from any relevant practitioner only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where the patient continues to have transient ischaemic episodes despite aspirin therapy or has transient ischaemic episodes and is aspirin intolerant. Note: Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruising. Renewal — (Existing 2 year approvals) from any relevant practitioner only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2008 (continued)

47 HEPARIN SODIUM Inj 25,000 iu per ml, 0.2 ml – Hospital pharmacy [HP3]Specialist .............................................................................. 9.50 CALCIUM POLYSTYRENE SULPHONATE – Retail pharmacy-Specialist Powder ................................................................................. 169.85 POTASSIUM BICARBONATE – Retail pharmacy-Specialist Tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg - for phosphate supplementation ................................................................ 75.00 ACIPIMOX – Retail pharmacy-Specialist ❋ Cap 250 mg ........................................................................... 18.75 SODIUM POLYSTYRENE SULPHONATE – Retail pharmacy-Specialist Powder ................................................................................... 89.10

5 300 g OP

✔ Mayne ✔ Calcium Resonium

48 48

100 30 450 g OP

✔ Phosphate-Sandoz ✔ Olbetam ✔ Resonium-A

49 49 50

PRAVASTATIN – Special Authority see SA0932 0849 below – Retail pharmacy See prescribing guideline Tab 10 mg ............................................................................. 27.46 30 ✔ Pravachol Tab 20 mg ............................................................................. 42.58 30 ✔ Pravachol Tab 40 mg ............................................................................. 65.31 30 ✔ Pravachol ➽ SA0932 0849 Special Authority for Subsidy Initial application — (Confirmed HIV/AIDS) from any relevant practitioner only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater; and 2 Confirmed HIV infection; and 3 Patient is being treated with an HIV protease inhibitor. CANDESARTAN – Special Authority see SA0933 0862 below – Retail pharmacy ❋ Tab 4 mg – No more than 1.5 tab per day ............................... 16.22 30 ✔ Atacand ❋ Tab 8 mg – No more than 1.5 tab per day ............................... 19.30 30 ✔ Atacand ❋ Tab 16 mg – No more than 1 tab per day ................................ 23.54 30 ✔ Atacand ❋ Tab 32 mg – No more than 1 tab per day ................................ 38.50 30 ✔ Atacand ➽ SA0933 0862 Special Authority for Subsidy Initial application from any relevant practitioner only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Both: 1.1 Patient with congestive heart failure; and 1.2 Either: 1.2.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 1.2.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years; or 2 All of the following: 2.1 Patient with raised blood pressure; and 2.2 Use of fully funded beta blockers or diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 2.3 Either: continued...

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

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

S29

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2008 (continued)

continued... 2.3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 2.3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years.

MIDODRINE – Special Authority see SA0934 0361 below – Hospital pharmacy [HP3] Tab 2.5 mg ............................................................................ 53.00 100 ✔ Gutron Tab 5 mg ............................................................................... 79.00 100 ✔ Gutron ➽ SA0934 0361 Special Authority for Subsidy Initial application from any relevant practitioner only from a geriatrician, neurologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Disabling orthostatic hypotension not due to drugs; and 2 Patient has tried fludrocortisone (unless contra-indicated) with unsatisfactory results; and 3 Patient has tried non pharmacological treatments such as support hose, increased salt intake, exercise, and elevation of head and trunk at night. Notes: Treatment should be started with small doses and titrated upwards as necessary. Hypertension should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg. Renewal from any relevant practitioner only from a geriatrician, neurologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. AMILORIDE ‡ Oral liq 1 mg per ml – Retail pharmacy-Specialist ................... 26.20 Specialist must be a paediatrician or paediatric cardiologist. FRUSEMIDE ❋ Tab 500 mg – Retail pharmacy-Specialist ............................... 12.00 ❋ Infusion 10 mg per ml, 25 ml – Retail pharmacy-Specialist ..... 48.14 CHLOROTHIAZIDE ‡ Oral liq 50 mg per ml – Retail pharmacy-Specialist ................. 22.60 Specialist must be a paediatrician or paediatric cardiologist. SPIRONOLACTONE ‡ Oral liq 5 mg per ml – Retail pharmacy-Specialist ................... 26.80 Specialist must be a paediatrician or paediatric cardiologist. 25 ml OP ✔ Biomed

59 60

100 5 25 ml OP

✔ Diurin 500 ✔ Lasix ✔ Biomed

25 ml OP

✔ Biomed

102

LEFLUNOMIDE – Special Authority see SA0635 – Retail pharmacy Tab 10 mg ............................................................................. 55.00 30 ✔ AFT-Leflunomide 79.27 ✔ Arava Tab 20 mg ............................................................................. 76.00 30 ✔ AFT-Leflunomide 108.60 ✔ Arava Tab 100 mg ........................................................................... 54.44 3 ✔ Arava ➽ SA0635 Special Authority for Subsidy Initial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Rheumatoid arthritis; and 2 Patient is not a pregnant woman, or a woman of child-bearing age without adequate contraception; and 3 Patient has been unable to tolerate or has a contraindication to or has had an inadequate response to sulphasalazine and methotrexate (individually or in combination) . Renewal only from a rheumatologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: continued... ❋ Three months or six months, as applicable, dispensed all-at-once

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

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 November 2008 (continued)

continued... Both: 1 Compliance (prescriber determined) with medication; and 2 Improved rheumatoid arthritis symptom control. Note: Patient should have full blood count and liver function tests regularly monitored. FENTANYL – Special Authority see SA0935 0743 – Retail pharmacy a) Only on a controlled drug form b) No patient co-payment payable Transdermal patch, matrix 25 µg per hour .............................. 55.23 5 ✔ Durogesic Transdermal patch, matrix 50 µg per hour ............................ 100.52 5 ✔ Durogesic Transdermal patch, matrix 75 µg per hour ............................ 139.18 5 ✔ Durogesic Transdermal patch, matrix 100 µg per hour .......................... 171.22 5 ✔ Durogesic ➽ SA0935 0743 Special Authority for Subsidy Initial application only from a relevant specialist from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is terminally ill and is opioid-responsive; and 2 Either: 2.1 is unable to take oral medication; or 2.2 is intolerant to morphine, or morphine is contraindicated. Renewal only from a relevant specialist or general practitioner from any relevant practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. GABAPENTIN – Special Authority see SA0936 0873 – Retail pharmacy s Tab 600 mg ........................................................................... 79.79 100 ✔ Neurontin s Cap 100 mg ........................................................................... 13.26 100 ✔ Nupentin 15.67 ✔ Neurontin s Cap 300 mg ........................................................................... 39.76 100 ✔ Nupentin 47.00 ✔ Neurontin s Cap 400 mg ........................................................................... 53.01 100 ✔ Nupentin 62.66 ✔ Neurontin ➽ SA0936 0873 Special Authority for Subsidy Initial application - (Epilepsy - new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Either: 1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents. Note: "Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Initial application - (Epilepsy - patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life from gabapentin, topiramate, vigabatrin and/or lamotrigine. Note: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Initial application - (Neuropathic pain - new patients) from any relevant practitioner. Approvals valid for 3 months where the patient has tried and failed, or has been unable to tolerate, treatment with a tricyclic antidepressant AND an anticonvulsant agent. Initial application - (Neuropathic pain - patient has had an approval for gabapentin for neuropathic pain prior to 1 continued...

107

112

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

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

S29

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 November 2008 (continued)

continued... August 2007) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Renewal - (Epilepsy) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Renewal - (Neuropathic pain) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either 1 The patient has demonstrated a marked improvement in their control of pain (prescriber determined); or 2 The patient has previously demonstrated clinical responsiveness to gabapentin and has now developed neuropathic pain in a new site. Note: If the patient had an approval for gabapentin for neuropathic pain prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. 114 VIGABATRIN – Special Authority see SA0937 0875 – Retail pharmacy s Tab 500 mg ......................................................................... 119.30 100 ✔ Sabril ➽ SA0937 0875 Special Authority for Subsidy Initial application - (new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Both: 1 Either: 1.1 The patient has infantile spasms; or 1.2 Both 11.2.1 The patient has epilepsy; and 21.2.2 Either: 2.11.2.2.1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2.21.2.2.2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents; and 32 Either: 3.12.1 Patient is, or will be, receiving regular automated visual field testing (ideally before starting therapy and on a 6-monthly basis thereafter); or 3.22.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: "Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. Initial application - (patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life from gabapentin, topiramate, vigabatrin and /or lamotrigine; and continued... 2 Either: ❋ Three months or six months, as applicable, dispensed all-at-once

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

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 November 2008 (continued)

continued... 2.1 Patient is receiving regular automated visual field testing (ideally every 6 months) on an ongoing basis for the duration of treatment with vigabatrin; or 2.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. Renewal from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has demonstrated a significant and sustained improvement in seizure rate or severity and/or quality of life; and 2 Either: 2.1 Patient is receiving regular automated visual field testing (ideally every 6 months) on an ongoing basis for the duration of treatment with vigabatrin; or 2.2 It is impractical or impossible (due to comorbid conditions) to monitor the patient's visual fields. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective. Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. 116 116 BETAHISTINE DIHYDROCHLORIDE – Retail pharmacy-Specialist ❋ Tab 16 mg ............................................................................... 7.56 84 ✔ Vergo 16

DOMPERIDONE – Additional subsidy by Special Authority see SA0938 0435 – Retail pharmacy ❋ Tab 10 mg ............................................................................... 3.90 100 (7.99) Motilium ➽ SA0938 0435 Special Authority for Manufacturers Price Initial application from any relevant medical practitioner. Approvals valid for 6 months where the patient is terminally ill and requires control of nausea and vomiting. Renewal from any relevant medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. HYOSCINE (SCOPOLAMINE) – Special Authority see SA0939 0727 – Hospital pharmacy [HP3] Patches, 1.5 mg ....................................................................... 9.56 2 (12.40) Scopoderm TTS ➽ SA0939 0727 Special Authority for Subsidy Initial application from any relevant medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Control of intractable nausea, vomiting, or inability to swallow saliva in the treatment of malignancy or chronic disease; and 2 Patient cannot tolerate or does not adequately respond to oral anti-nausea agents; and 3 The applicant must specify the underlying malignancy or chronic disease. Renewal from any relevant medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. PERGOLIDE – Retail pharmacy-Specialist s Tab 0.25 mg .......................................................................... 48.00 s Tab 1 mg ............................................................................. 170.00 100 100 ✔ Permax ✔ Permax

116

118

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

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

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 November 2008 (continued)

119 CLOZAPINE – Hospital pharmacy [HP4]-Specialist prescription Tab 25 mg ............................................................................. 17.60 35.20 Tab 50 mg ............................................................................. 22.80 45.60 Tab 100 mg ........................................................................... 45.60 91.20 Tab 200 mg ........................................................................... 72.96 145.92 50 100 50 100 50 100 50 100 ✔ Clopine ✔ Clozaril ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clopine ✔ Clozaril ✔ Clopine ✔ Clopine ✔ Clopine

152

SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices also available to paediatricians employed by a DHB on a wholesale supply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via a hospital pharmacy. 2) Only available for children aged six years and under. 3) For Space Chamber and Foremount Child’s Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. 4) Distributed by Airflow Products. Forward orders to: Airflow Products Telephone: 04 499 1240 or 0800 AIR FLOW PO Box 1485, Wellington Facsimile: 04 499 1245 or 0800 323 270 230 ml (autoclavable) – Subsidy by endorsement ................... 11.60 1 ✔ Space Chamber Available where the prescriber requires a spacer device that is capable of sterilisation in an autoclave and the WSO is endorsed accordingly

Effective 1 October 2008

25 108 DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE ❋ Tab 2.5 with atropine sulphate 25 mcg ..................................... 3.90 100 ✔ Diastop S29

METHADONE HYDROCHLORIDE a) Only on a controlled drug form b) No patient co-payment payable c) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets). d) For methadone hydrochloride oral liquid refer, page 162 Inj 10 mg per ml, 1 ml ............................................................ 52.00 10 ✔ AFT S29 RISPERIDONE Oral liquid 1 mg per ml ........................................................... 45.92 30 ml OP ✔ Risperdal

120 121

RISPERIDONE – Special Authority see SA0926 below – Retail pharmacy Subject to budgetary cap. Applications will be considered and approved subject to funding availability. Microspheres for injection 25 mg .......................................... 175.00 1 ✔ Risperdal Consta Microspheres for injection 37.5 mg ....................................... 230.00 1 ✔ Risperdal Consta Microspheres for injection 50 mg .......................................... 280.00 1 ✔ Risperdal Consta

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

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 September 2008

29 ACARBOSE - Special Authority see SA04900925 – Retail pharmacy ❋ Tab 50 mg .............................................................................. 22.00 90 ✔ Glucobay ❋ Tab 100 mg ............................................................................ 31.00 90 ✔ Glucobay ➽ SA08740925 Special Authority for Subsidy Initial application only from a relevant practioner specialist. Approvals valid for 2 years without renewal for applications meeting the following criteria: 1 The patient has type 2 diabetes; and 2 Either: 2.1 Metformin is not tolerated, or is contraindicated; or 2.2 The patient has not responded to the maximum appropriate dose of metformin. Any of the following: 1 Requires but is not able to tolerate metformin therapy; or 2 Requires metformin but metformin is contraindicated; or 3 Has not responded to or tolerated the maximum appropriate dose of metformin. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. ERYTHROPOIETIN ALPHA – Special Authority see SA09220626 – Hospital pharmacy [HP3] ➽ SA0626 Special Authority for Subsidy Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Dependent on regular blood transfusion but cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either: 4.6.2.1 Heart failure (low cardiac output, LV ejection fraction <40%); or 4.6.2.2 Persistent angina Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. ➽ SA0922 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin ≤ 100g/L; and 2 Any of the following: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate ≤ 30ml/min; or continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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 September 2008 (continued)

continued... 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate ≤ 45ml/min; or 2.3 patient is on haemodialysis or peritoneal dialysis. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Notes: Erythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over: GFR (ml/min) (male) = (140 - age) × Ideal Body Weight (kg) / 814 × serum creatinine (mmol/l) GFR (ml/min) (female) = Estimated GFR (male) × 0.85 84 GROWTH HORMONE BIOSYNTHETIC HUMAN – Special Authority see SA0755 (addition of stat dispensing) ❋ Cartridge 16 iu per vial........................................................ 1,600.00 5 ✔ Genotropin ❋ Cartridge 36 iu per vial........................................................ 3,600.00 5 ✔ Genotropin RECOMBINANT HUMAN GROWTH HORMONE – Special Authority see SA0755 (addition of stat dispensing) ❋ Inj 5 mg ................................................................................ 300.00 1 ✔ Norditropin SimpleXx 5mg ❋ Inj 10 mg .............................................................................. 600.00 1 ✔ Norditropin SimpleXx 10mg ❋ Inj 15 mg .............................................................................. 900.00 1 ✔ Norditropin SimpleXx 15mg TOPIRAMATE – Special Authority see SA0874 – Retail pharmacy ➽ SA0874 Special Authority for Subsidy Initial application — (new patients) from any relevant practitioner. Approvals valid for 15 months for applications meeting the following criteria: Both: 1 Patient has epilepsy; and 2 Either: 2.1 Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents; or 2.2 Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatmentwith other antiepilepsy agents. Note: “Optimal treatment with other antiepilepsy agents” is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient’s age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Initial application — (patient has had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy priorto 1 August 2007) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient hasdemonstrated a significant and sustained improvement in seizure rate or severity and or quality of life from gabapentin, topiramate,vigabatrin and or lamotrigine. Note: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success withanticonvulsant therapy and have assessed quality of life from the patient’s perspective. Renewal from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has demonstrateda significant and sustained improvement in seizure rate or severity and or quality of life. Notes: As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success withanticonvulsant therapy and have assessed quality of life from the patient’s perspective. If the patient had an approval for gabapentin, lamotrigine, topiramate or vigabatrin for epilepsy prior to 1 August 2007 the applicant is required to submit a fresh initial application in the first instance, not a renewal application.

114

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

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 September 2008 (continued)

120 RISPERIDONE – Retail Pharmacy – Speciaist Tab 0.5 mg ............................................................................... 5.20 Tab 1 mg ................................................................................ 30.77 Tab 2 mg ............................................................................... 61.53 Tab 3 mg ............................................................................... 92.32 Tab 4 mg ............................................................................. 123.05 Oral liquid 1 mg per ml ............................................................ 45.92 20 60 60 60 60 30 ml OP ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Ridal ✔ Risperdal ✔ Risperdal

121

RISPERIDONE – Special Authority see SA09260792 – Retail pharmacy Subject to budgetary cap. Applications will be considered and approved subject to funding availability. Microspheres for injection 25 mg........................................... 175.00 1 ✔ Risperdal Consta Microspheres for injection 37.5 mg........................................ 230.00 1 ✔ Risperdal Consta Microspheres for injection 50mg............................................ 280.00 1 ✔ Risperdal Consta ➽ SA09260792 Special Authority for Subsidy Initial application only from a psychiatrist from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has schizophrenia or other psychotic disorder; and 2 Has tried but failed to comply with treatment using oral atypical antipsychotic agents; and 3 Has been admitted to hospital or treated in respite care, or intensive outpatient or home-based treatment for 30 days or more in last 12 months. Renewal only from a psychiatrist from any relevant practitioner. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had less than 12 months treatment with risperidone microspheres; and 1.2 There is no clinical reason to discontinue treatment; or 2 The initiation of risperidone microspheres has been associated with fewer days of intensive intervention than was the case during a corresponding period of time prior to the initiation of risperidone microspheres. Note: Risperidone microspheres should ideally be used as monotherapy (i.e. without concurrent use of any other antipsychotic medication). In some cases, it may be clinically appropriate to attempt to treat a patient with typical antipsychotic agents in depot injectable form before trialing risperidone microspheres.

122

RISPERIDONE – Special Authority see SA09270794 – Retail pharmacy Orally-disintegrating tablets 0.5 mg .......................................... 21.42 Orally-disintegrating tablets 1 mg ............................................. 42.84 Orally-disintegrating tablets 2 mg ............................................. 85.71

28 28 28

✔ Risperdal Quicklet ✔ Risperdal Quicklet ✔ Risperdal Quicklet

➽ SA09270794 Special Authority for Subsidy Initial application - (Acute situations) only from a psychiatrist from any relevant practitioner. Approvals valid for 6 weeks for applications meeting the following criteria: Both: 1 For a non-adherent patient on oral therapy with standard risperidone tablets or risperidone oral liquid; and 2 The patient is under direct supervision for administration of medicine. Initial application - (Chronic situations) only from a psychiatrist from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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 September 2008 (continued)

continued... 1 The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid; and 2 The patient is under direct supervision for administration of medicine. Renewal only from a psychiatrist from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid; and 2 The patient is under direct supervision for administration of medicine.

Note: Initial prescriptions to be written by psychiatrists and subsequent prescriptions can be written by psychiatric registrars or General Practitioners. Risperdal Quicklets cost significantly more than risperidone tablets and should only be used where necessary. 127 METHYLPHENIDATE HYDROCHLORIDE – Special Authority see SA0908 – Retail Pharmacy Only on a controlled drug form Tab immediate-release 5 mg.................................................... 3.20 30 ✔ Rubifen Tab immediate-release 10 mg.................................................. 4.29 30 ✔ Rubifen Tab immediate-release 20 mg.................................................. 7.85 30 ✔ Rubifen 30 ✔ Rubifen SR Tab long acting sustained-release 20 mg ............................... 10.95

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 November 2008

47 HEPARIN SODIUM ( subsidy) Inj 5,000 iu per ml, 5 ml ......................................................... 37.45 Inj 25,000 iu per ml, 0.2 ml ....................................................... 9.50 QUINAPRIL ( subsidy) ❋ Tab 5 mg ................................................................................. 1.60 ❋ Tab 10 mg ............................................................................... 1.75 ❋ Tab 20 mg ............................................................................... 2.35 PREDNISONE ( subsidy) ❋ Tab 20 mg ............................................................................. 29.03 ZOPICLONE – Month Restriction ( subsidy) Tab 7.5 mg ............................................................................ 21.02 FLUDARABINE PHOSPHATE – PCT only – Specialist ( subsidy) Inj 50 mg for ECP ................................................................. 286.00 METHOTREXATE ( subsidy) ❋ Inj 1 mg for ECP – PCT only – Specialist ................................... 0.09 PROMETHAZINE HYDROCHLORIDE ( subsidy) ❋ Tab 10 mg ............................................................................... 2.72 ❋ Tab 25 mg ............................................................................... 4.44 POLYVINYL ALCOHOL ( price) ❋ Eye drops 1.4% ........................................................................ 2.68 ❋ Eye drops 3% ........................................................................... 3.75 10 5 30 30 30 500 500 ✔ Multiparin ✔ Mayne ✔ Accupril ✔ Accupril ✔ Accupril ✔ Apo-Prednisone ✔ Apo-Zopiclone

54 80 126 132 133 148 157 182

50 mg OP ✔ Baxter 1 mg 50 50 15 ml OP 15 ml OP ✔ Baxter ✔ Allersoothe ✔ Allersoothe ✔ Liquifilm Tears ✔ Liquifilm Forte

PHENYL FREE PASTA – Special Authority see SA0733 – Hospital pharmacy [HP3] ( subsidy) See prescribing guideline Animal shapes ........................................................................ 10.65 500 g OP (11.91) Loprofin Penne...................................................................................... 10.65 500 g OP (11.91) Loprofin Lasagne ................................................................................... 5.32 250 g OP (5.95) Loprofin

Effective 1 October 2008

27 27 34 HYOSCINE N-BUTYLBROMIDE ( subsidy) ❋ Tab 10 mg ............................................................................... 1.62 ❋ Inj 20 mg, 1 ml – Up to 5 inj available on a PSO ......................... 8.04 MEBEVERINE HYDROCHLORIDE ( subsidy) ❋ Tab 135 mg ........................................................................... 18.00 POLOXAMER – Only on a prescription ( subsidy) ❋ Oral drops 10% ........................................................................ 3.78 20 5 90 30 ml OP ✔ Gastrosoothe ✔ Buscopan ✔ Colofac ✔ Coloxyl

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 October 2008 (continued)

36 38 45 NYSTATIN ( subsidy) Oral liq 100,000 u per ml .......................................................... 3.19 ZINC SULPHATE ( subsidy) ❋ Cap 220 mg ........................................................................... 10.00 24 ml OP 100 ✔ Nilstat ✔ Zincaps

CLOPIDOGREL – Special Authority see SA0867– Retail pharmacy ( subsidy) Tab 75 mg ............................................................................. 35.00 28 (73.38) HEPARIN SODIUM ( price) Inj 25,000 iu per ml, 0.2 ml – Hospital pharmacy [HP3]Specialist .............................................................................. 7.50 (9.50) POTASSIUM BICARBONATE – Retail pharmacy-Specialist ( subsidy) Tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg ............................................... 82.50 BEZAFIBRATE ( subsidy) ❋ Tab 200 mg ............................................................................. 9.75 METHYLDOPA ( subsidy) ❋ Tab 125 mg ........................................................................... 12.00 ❋ Tab 250 mg ........................................................................... 13.10 ❋ Tab 500 mg ........................................................................... 20.85 TRIAMCINOLONE ACETONIDE ( subsidy) Crm 0.02% ................................................................................ 6.63 Oint 0.02% ................................................................................ 6.69 WOOL FAT WITH MINERAL OIL – Only on a prescription ( price) ❋ Lotn hydrous 3% with mineral oil .............................................. 1.40 (3.50) 5.60 (10.90)

Plavix

Mayne

100 90 100 100 100 100 g OP 100 g OP 250 ml OP

✔ Phosphate-Sandoz ✔ Fibalip ✔ Prodopa ✔ Prodopa ✔ Prodopa ✔ Aristocort ✔ Aristocort

49 59 65

DP Lotion 1,000 ml DP Lotion

TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN – Only on a prescription ( subsidy) ❋ Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ............................................................... 2.90 500 ml ✔ Pinetarsol 5.54 1,000 ml ✔ Pinetarsol KETOCONAZOLE ( subsidy) Shampoo 2% ............................................................................ 3.48 a) Maximum of 100 ml per prescription b) Only on a prescription CALCITONIN – Hospital pharmacy [HP3]-Specialist ( subsidy) ❋ Inj 100 iu per ml, 1 ml .......................................................... 110.00 100 ml OP ✔ Ketopine

✔ Miacalcic

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 October 2008 (continued)

80 90 PREDNISONE ( subsidy) ❋ Tab 1 mg ............................................................................... 10.68 ❋ Tab 2.5 mg ............................................................................ 12.09 ERYTHROMYCIN ETHYL SUCCINATE ( subsidy) Grans for oral liq 200 mg per 5 ml – Up to 200 ml available on a PSO ................................................................. 4.35 Grans for oral liq 400 mg per 5 ml – Up to 200 ml Available on a PSO ................................................................ 5.85 BENZYLPENICILLIN SODIUM (PENICILLIN G) ( subsidy) Inj 1 mega u – Up to 5 inj available on a PSO ........................... 10.49 PROCAINE PENICILLIN ( subsidy) Inj 1.5 mega u – Up to 5 inj available on a PSO ........................ 50.86 TRIMETHOPRIM ( subsidy) ❋ Tab 300 mg – Up to 30 tab available on a PSO .......................... 8.69 500 500 ✔ Apo-Prednisone ✔ Apo-Prednisone

100 ml 100 ml 10 5 50

✔ E-Mycin ✔ E-Mycin ✔ Sandoz ✔ Cilicaine ✔ TMP

91 92 93 93

VANCOMYCIN HYDROCHLORIDE – Hospital pharmacy [HP3] – Subsidy by endorsement ( subsidy) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudomembranous colitis or for prophylaxis of endocarditis and the prescription is endorsed accordingly. Inj 50 mg per ml, 10 ml ............................................................ 5.04 1 ✔ Pacific NORTRIPTYLINE HYDROCHLORIDE ( subsidy) Tab 10 mg ............................................................................... 5.94 Tab 25 mg ............................................................................. 20.06 CLONAZEPAM ( subsidy) Tab 500 µg .............................................................................. 6.26 Tab 2 mg ............................................................................... 11.15 MIDAZOLAM ( price) Tab 7.5 mg – Month Restriction............................................... 10.38 (25.00) TEMAZEPAM – Month Restriction ( subsidy) Tab 10 mg ................................................................................ 0.83 PACLITAXEL – PCT only – Specialist ( subsidy) Inj 1 mg for ECP ....................................................................... 1.32 MASK FOR SPACER DEVICE ( subsidy) Only on a WSO Size 2 ........................................................................................ 3.28 PEAK FLOW METER ( subsidy) Only on a WSO Low range ............................................................................... 13.75 Normal range .......................................................................... 13.75 100 250 100 100 100 Hypnovel 25 1 mg ✔ Normison ✔ Baxter ✔ Norpress ✔ Norpress ✔ Paxam ✔ Paxam

110

112

125

126 136 152

✔ Foremount Child’s Silicone Mask

152

1 1

✔ Breath-Alert ✔ Breath-Alert

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 October 2008 (continued)

152 SPACER DEVICE ( subsidy) Only on a WSO 230 ml (autoclavable) .............................................................. 11.60 ACETAZOLAMIDE ( subsidy) ❋ Tab 250 mg ........................................................................... 10.40 ATROPINE SULPHATE ( subsidy) ❋ Eye drops 1% ........................................................................... 4.40

1 100 15 ml OP

✔ Space Chamber ✔ Diamox ✔ Atropt

156 157 182

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital pharmacy [HP3] ( subsidy) Tabs ....................................................................................... 99.00 75 OP ✔ Phlexy 10 Sachets (pineapple/vanilla) 29 g ........................................... 330.10 30 OP ✔ Minaphlex Sachets (tropical) ................................................................. 324.00 30 ✔ Phlexy 10 Infant formula ....................................................................... 174.72 400 g OP ✔ XP Analog LCP Powder (orange) .................................................................. 221.00 500 g OP ✔ XP Maxamaid 320.00 ✔ XP Maxamum Powder (unflavoured) ........................................................... 221.00 500 g OP ✔ XP Maxamaid 320.00 ✔ XP Maxamum Liquid (forest berries) ............................................................. 30.00 250 ml OP ✔ Easiphen Liquid Liquid (tropical) ...................................................................... 30.00 250 ml OP ✔ Easiphen

Effective 1 September 2008

38 CALCIUM CARBONATE ( subsidy) ❋ Tab dispersible 2.5 g ................................................................. 4.36 IRON POLYMALTOSE ( subsidy) Inj 50 mg per ml, 2 ml ............................................................. 20.95 (29.95) 20 OP ✔ Calci-Tab Effervescent

5 Ferrosig

ERYTHROPOIETIN ALPHA – Special Authority see SA0922 – Hospital pharmacy [HP3] ( subsidy) Inj human recombinant 1,000 iu, pre-filled syringe ................... 48.68 6 ✔ Eprex Inj human recombinant 2,000 iu, pre-filled syringe ................. 120.18 6 ✔ Eprex Inj human recombinant 3,000 iu, pre-filled syringe ................. 166.87 6 ✔ Eprex Inj human recombinant 4,000 iu, pre-filled syringe ................. 193.13 6 ✔ Eprex Inj human recombinant 10,000 iu, pre-filled syringe ............... 395.18 6 ✔ Eprex POTASSIUM BICARBONATE – Retail pharmacy – Specialist ( price) Tab eff 315 mg with sodium acid phosphate with 1.937 g and sodium bicarbonate 350 mg ................................................ 75.00 (82.50) PHENTOLAMINE MESYLATE ( price) ❋ Inj 10 mg per ml, 1 ml ............................................................. 17.97 (31.65) NITROFURANTOIN ( subsidy) ❋ Tab 50 mg .............................................................................. 17.90 ❋ Tab 100 mg ............................................................................ 30.25 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

100 5

Phosphate-Sandoz

Regitine 100 100

✔ Nifuran ✔ Nifuran

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price - effective 1 September 2008 (continued)

107 PARACETAMOL ( subsidy) ❋ Oral liq 120 mg per 5ml ............................................................ 6.80 ❋ Oral liq 250 mg per 5 ml ............................................................ 7.00 TOPIRAMATE ( subsidy) s Tab 25 mg .............................................................................. 26.04 s Tab 50 mg .............................................................................. 44.26 s Tab 100 mg ............................................................................ 75.25 s Tab 200 mg .......................................................................... 129.85 s Sprinkle cap 15 mg ................................................................. 20.84 s Sprinkle cap 25 mg ................................................................. 26.04 LITHIUM CARBONATE ( subsidy) Tab long–acting 400 mg .......................................................... 16.05 RISPERIDONE ( subsidy) Tab 0.5 mg ............................................................................... 5.20 Tab 1 mg ................................................................................ 30.77 Tab 2 mg ................................................................................ 61.53 Tab 3 mg ................................................................................ 92.32 Tab 4 mg .............................................................................. 123.05 CALCIUM FOLINATE ( subsidy) Inj 1 mg for ECP – PCT only – Specialist .................................... 0.10 FLUDARABINE PHOSPHATE – PCT only – Specialist ( subsidy) Tab 10 mg ............................................................................ 650.25 FLUDARABINE PHOSPHATE – PCT only – Specialist ( subsidy) Inj 50 mg ............................................................................ 1430.00 METHOTREXATE – PCT – Hospital pharmacy [HP1] – Specialist ( subsidy) Inj 100 mg per ml, 10 ml – PCT Only – Specialist .................... 27.50 Inj 100 mg per ml, 50 ml – PCT Only – Specialist .................. 135.00 POLYVINYL ALCOHOL ( subsidy) ❋ Eye drops 1.4% ........................................................................ 2.68 ❋ Eye drops 3% ........................................................................... 3.75 1,000 ml 1,000 ml 60 60 60 60 60 60 100 20 60 60 60 60 1 mg 15 5 1 1 ✔ Junior Parapaed ✔ Six Plus Parapaed

114

✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax ✔ Topamax

119 120

✔ Priadel

✔ Risperdal ✔ Risperdal ✔ Risperdal ✔ Risperdal ✔ Risperdal

131 132 132 133

✔ Baxter

✔ Fludara

✔ Fludara ✔ Methotrexate Ebewe ✔ Methotrexate Ebewe ✔ Vistil ✔ Vistil Forte

154

15 ml OP 15 ml OP

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Brand Name

Effective 1 October 2008

91 BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u – Up to 5 inj available on a PSO ............................. 6.99 10 ✔ Sandoz ✔ Novartis

Effective 1 September 2008

43 ERYTHROPOIETIN BETA – Special Authority SA0922 – Hospital pharmacy [HP3) Inj 2,000 iu pre-filled syringe ................................................. 152.04 6 Inj 3,000 iu pre-filled syringe ................................................. 228.06 Inj 4,000 iu pre-filled syringe ................................................. 304.08 Inj 5,000 iu pre-filled syring ................................................... 380.10 Inj 6,000 iu pre-filled syringe ................................................. 456.12 Inj 10,000 iu pre-filled syringe ............................................... 760.20 6 6 6 6 6 ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon ✔ NeoRecormon Recormon

Changes to Description

Effective 1 November 2008

84 THYROXINE LEVOTHYROXINE

Effective 1 October 2008

152 PEAK FLOW METER Peak flow meters-low range Low range Peak flow meters-normal range Normal range SPACER DEVICES AND MASKS Spacer device 230 ml (autoclavable) SPACER DEVICES AND MASK FOR SPACER DEVICE Mask, size 2 Size 2

153 153

Changes to Section F: Part II

Effective 1 November 2008

ALIMENTARY TRACT AND METABOLISM INSULIN ASPART INSULIN GLARGINE INSULIN ISOPHANE INSULIN ISOPHANE WITH INSULIN NEUTRAL INSULIN LISPRO INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE INSULIN NEUTRAL

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules

Effective 1 September 2008

12 “Authority to Substitute” means an authority for the dispensing pharmacist to change a prescribed medicine in accordance with regulation 42(4) of the Medicines Regulations 1984. An authority to substitute letter, which may be used by Practitioners, is available on the final page of the Schedule. 4.7 Substitution Where a Practitioner has prescribed a brand of a Community Pharmaceutical that has no Subsidy or has a Manufacturer’s Price that is greater than the Subsidy and there is an alternative fully subsidised Community Pharmaceutical available, a Contractor may dispense the fully subsidised Community Pharmaceutical, subject to: a) the Contractor having received a general Authority to Substitute from the Practitioner in relation to the particular medicine or medicines in general; or b) the Practitioner having indicated their Authority to Substitute on the prescription; or c) the Practitioner having given their Authority to Substitute in relation to the particular prescription. Such an Authority to Substitute is valid whether or not there is a financial implication for the Pharmaceutical Budget. When dispensing a subsidised alternative brand, the Contractor must annotate and initial the prescription. 4.8 Alteration to Presentation of Pharmaceutical Dispensed A Contractor, when dispensing a Community Pharmaceutical, may alter the presentation of a Pharmaceutical dispensed but may not alter the total daily dose. If the change will result in additional cost to the DHBs, then: a) the Practitioner must authorise and initial the alteration; or b) in cases where PHARMAC has approved and notified in writing such a change in dispensing of a named Pharmaceutical due to an out of stock event or short supply, the Contractor must annotate and initial the alteration. 4.9 4.7 Amendment of the Schedule PHARMAC may amend the terms of the Schedule from time to time by notice in writing given in such manner as PHARMAC thinks fit, and in accordance with such protocols as agreed with the Pharmacy Guild of New Zealand (inc) from time to time. 4.10 4.8 Conflict of Provisions If any rules in Sections B-G of this Schedule conflict with the rules in Section A, the rules in Sections B-G apply.

Changes to Sole Subsidised Supply

Effective 1 November 2008

For the list of new Sole Subsidised Supply products effective 1 November 2008 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 11-17.

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items

Effective 1 November 2008

44 59 90 APROTININ – Hospital pharmacy [HP3]-Specialist ❋ Inj 10,000 µg per ml 50 ml ..................................................... 63.60 (73.40) VERAPAMIL HYDROCHLORIDE ❋ Tab 80 mg ............................................................................... 6.00 1 Trasylol 100 ✔ Verpamil

CEFUROXIME SODIUM – Hospital pharmacy [HP3] Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ................................................................... 21.42 10 (56.47) Mayne Inj 1.5 g – Hospital pharmacy [HP3]-Specialist – Subsidy by endorsement ....................................................................... 40.40 10 (123.55) Mayne Only if prescribed for a dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. RITONAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 100 mg .......................................................................... 242.55 Note – the 84 pack size continues to be listed fully subsidised. 168 ✔ Norvir

Effective 1 October 2008

106 NEFOPAM HYDROCHLORIDE Inj 20 mg per ml, 1 ml .............................................................. 9.10 (72.50) PACLITAXEL – PCT only – Specialist Inj 30 mg ................................................................................ 90.00 Inj 100 mg ............................................................................ 299.70 SALBUTAMOL Tab long-acting 8 mg ............................................................. 15.30 5 Acupan 1 1 56 ✔ Taxol ✔ Taxol ✔ Volmax

136

150 180

GLUTEN FREE PASTA – Special Authority see SA0722 – Hospital pharmacy [HP3] Tomato and Basil Spirals .......................................................... 2.00 250 g OP (2.63)

Orgran

Effective 1 September 2008

37 ASCORBIC ACID AND SODIUM ASCORBATE a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg ............................................................................. 2.60 PERMETHRIN Lotion 5% .................................................................................. 4.50 (7.00)

100 50 ml OP

✔ Healtheries Vitamin C

Quellada-P

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items - effective 1 September 2008 (continued)

76 ECONAZOLE NITRATE Pessaries 150 mg with applicators ........................................... 2.75 (9.71) BENZATHINE BENZYLPENICILLIN Inj 1.2 mega u per 2 ml – Up to 5 inj available on a PSO........... 16.00 160 Note: Bicillin LA continues to be listed fully subsidised ACICLOVIR ❋ Tab 200 mg ............................................................................. 7.92 ❋ Tab 400 mg ........................................................................... 11.86 SAQUINAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 200 mg ......................................................................... 271.00 3 Pevaryl Ovules 1 10 ✔ Bicillin ✔ Bicillin

95 99 106 170

100 100 180

✔ Apo-Acyclovir ✔ Apo-Acyclovir ✔ Fortovase

ASPIRIN ❋ Tab dispersible 300 mg – Up to 30 tab available on a PSO ...... 21.50 (22.50) 1000 Ethics Aspirin ❋ Tab EC 650 mg ........................................................................ 6.88 100 ✔ Ecotrin Note: the 100 tablet pack of Ethics Aspirin, tab dispersible 300 mg will continue to be listed fully subsidised ORAL SUPPLEMENT 1KCAL/ML – Special Authority see SA0583 – Hospital pharmacy [HP3] Powder (vanilla) sachet 54 g ..................................................... 6.91 10 OP ✔ Fortisip Powder

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 December 2008

38 38 38 CALCIUM ❋ Tab eff 1 g................................................................................. 6.54 CALCIUM CARBONATE ❋ Tab dispersible 2.5 g ................................................................. 4.36 (4.98) IRON POLYMALTOSE Inj 50 mg per ml, 2 ml ............................................................. 20.95 (29.95) ZINC AND CASTOR OIL Ointment BP .............................................................................. 5.11 PARACETAMOL ❋‡ Oral liq 120 mg per 5 ml ....................................................... 6.80 a) Up to 200 ml available on a PSO b) Not in combination ❋‡ Oral liq 250 mg per 5 ml ....................................................... 7.00 a) Up to 200 ml available on a PSO b) Not in combination 30 ✔ Calcium-Sandoz 1000

20 OP Calci-Tab Effervescent 5 Ferrosig 500 g 1,000 ml 1,000 ml ✔ Multichem ✔ Junior Parapaed ✔ Six Plus Parapaed

66 107

Effective 1 January 2009

70 KETOCONAZOLE Shampoo 2% ............................................................................ 3.48 a) Maximum of 100 ml per prescription b) Only on a prescription 100 ml OP ✔ Ketopine

Effective 1 February 2009

157 POLYVINYL ALCOHOL ❋ Eye drops 1.4% ........................................................................ 2.68 (3.62) ❋ Eye drops 3% ........................................................................... 3.75 (3.88) 15 ml OP Liquifilm Tears 15 ml OP Liquifilm Forte

Paclitaxel inj 500 mg – not listed

Effective 1 March 2009

43 47 54

ERYTHROPOIETIN BETA – Special Authority see SA0922 – Hospital pharmacy [HP3] Inj 1,000 iu, pre-filled syringe ................................................. 76.02 6 HEPARINISED SALINE ❋ Inj 100 iu per ml, 5 ml .......................................................... 103.76 LOSARTAN ❋ Tab 25 mg .............................................................................. 20.31 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 50 28

✔ Recormon ✔ Mayne ✔ Cozaar

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

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 March 2009 (continued)

56 59 61 ATENOLOL ❋ Tab 50 mg ............................................................................... 6.50 ❋ Tab 100 mg ........................................................................... 11.30 VERAPAMIL HYDROCHLORIDE ❋ Tab 40 mg ................................................................................ 4.75 NICOTINE – Only on a Quitcard Gum 2 mg (Fruit) .................................................................... 23.41 Gum 2 mg (Mint) .................................................................... 23.41 Gum 4 mg (Fruit) ..................................................................... 23.41 Gum 4 mg (Mint)..................................................................... 23.41 ERYTHROMYCIN LACTOBIONATE Inj 300 mg ............................................................................. 70.97 SAQUINAVIR – Special Authority see SA0779 – Hospital pharmacy [HP1] Cap 200 mg .......................................................................... 519.75 AMITRIPTYLINE Tab 10 mg ................................................................................ 3.00 NITRAZEPAM – Month Restriction Tab 5 mg .................................................................................. 2.00 (3.90) SALBUTAMOL Tab long-acting 4 mg .............................................................. 11.18 DIBROMOPROPAMIDINE ISETHIONATE ❋ Eye oint 0.15% ......................................................................... 2.97 (7.99) 500 500 100 96 96 96 96 5 270 100 100 Insoma 56 5 g OP Brolene ✔ Volmax ✔ Loten ✔ Loten ✔ Verpamil ✔ Nicotinell ✔ Nicotinell ✔ Nicotinell ✔ Nicotinell ✔ Mayne ✔ Invirase ✔ Amitrip

90 99 109 125

150 154

Effective 1 April 2009

109 182 DOXEPIN HYDROCHLORIDE Cap 75 mg ............................................................................. 10.99 100 ✔ Anten

PHENYL FREE PASTA – Special Authority see SA0733 – Hospital pharmacy [HP3] Macaroni ................................................................................. 10.65 500 g OP (11.91)

Loprofin

Effective 1 May 2009

28 OMEPRAZOLE ❋ Cap 10 mg ............................................................................. 17.37 ❋ Cap 20 mg ............................................................................. 24.81 ❋ Cap 40 mg ............................................................................. 29.05 ❋ Inj 40 mg ............................................................................... 12.50 30 30 30 1 ✔ Losec ✔ Losec ✔ Losec ✔ Losec

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

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

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 May 2009 (continued)

53 56 DOXAZOSIN MESYLATE ❋ Tab 2 mg ................................................................................. 4.81 Note – the 500 tablet pack listed 1 November 2008 HYDROCORTISONE BUTYRATE Crm 0.1% .................................................................................. 5.00 15.00 OESTRADIOL VALERATE – See prescribing guideline ❋ Tab 2 mg ................................................................................. 4.12 MORPHINE SULPHATE a) Only on a controlled drug form b) No patient co-payment payable Suppos 30 mg ........................................................................ 31.39 100 ✔ Apo-Doxazosin

30 g OP 100 g OP 28

✔ Locoid ✔ Locoid ✔ Progynova

82 108

✔ Martindale 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

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H changes to Part II

Effective 1 November 2008

AMOXYCILLIN (new listing) Drops 100 mg per 1 ml ..................Ospamox 4.00 30 ml 1% Jan-09 Amoxil Paediatric (addition of HSS) Drops Inj 250 mg......................................Ibiamox 12.42 10 1% Jan-09 (B) Inj 500 mg......................................Ibiamox 14.24 10 1% Jan-09 (B) Inj 1 g.............................................Ibiamox 21.62 10 1% Jan-09 (B) Note – the 5 pack of Ibiamox brand of amoxicillin injection 250 mg, 500 mg and 1 g will be delisted 1 January 2009 AQUEOUS (addition of HSS) Crm................................................AFT 2.28 500 g 1% Jan-09 Aderm 500 g Multichem 500 g Multichem 2,000 g Pharmacy Health

Note – Multichem brand of aqueous cream 500 g will be delisted from 1 January 2009 DV limit applies to pack sizes of 500 g or greater BICALUTAMIDE (new listing) Tab 50 mg......................................Bicalox 27.10 30 1% Jan-09 Cosudex Rex Medical

BUPIVACAINE HYDROCHLORIDE WITH FENTANYL (addition of HSS) Inj 0.125% with 2 µg fentanyl per ml, 15 ml prefilled syringe ................Biomed 61.50 10 Inj 0.125% with 2 µg fentanyl per ml, 20 ml prefilled syringe ................Biomed 78.00 10 Inf 0.125% with 2 µg fentanyl per ml, 100 ml bag ................................Bupafen 200.00 10 Inf 0.125% with 2 µg fentanyl per ml, 200 ml bag ................................Bupafen 200.00 10 Note – Biomed and Bupafen single packs to be delisted from 1 January 2009 CITALOPRAM HYDROBROMIDE (new listing and addition of HSS) Tab 20 mg......................................Arrow-Citalopram 3.78 84

1% 1% 1% 1%

Jan-09 Jan-09 Jan-09 Jan-09

(B) (B) (B) (B)

Apo-Citalopram Celapram Cipramil Citalopram-Rex Note – Celapram, Citalopram-Rex and Arrow-Citalopram (28 tablet pack size) to be delisted from 1 January 2009

Jan-09

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 November 2008 (continued)

CIPROFLOXACIN (addition of HSS) Tab 250 mg....................................Rex Medical Tab 500 mg....................................Rex Medical Tab 750 mg....................................Rex Medical 3.35 4.90 7.54 30 30 30 1% 1% 1% Jan-09 Jan-09 Jan-09 Cifran Cipflox Cifran Cipflox Cifran Cipflox

Note – Cipflox tablets 250 mg, 500 mg and 750 mg to be delisted 1 January 2009 CLOTRIMAZOLE ( price) Vaginal crm 2% with applicator(s) ...Clomazol 2.75 20 g 1% Jan-09 Canesten Clotrimaderm 2% Dosan

DOXAZOSIN MESYLATE Tab 2 mg........................................Apo-Doxazosin 22.85 500 1% Note – Apo-Doxazosin tab 2 mg 100 tablet pack to be delisted 1 January 2009. FUSIDIC ACID ( price) Eye drops 1% ................................Fucithalmic HYDROCORTISONE BUTYRATE Crm 0.1% .......................................Locoid Cream Locoid Cream 30 g to be delisted 1 January 2009 9.83 5.00 5g 30 g

Jan-08

INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE (new listing) Inj lispro 25% with insulin lispro protamine 75%, 100 u per ml, 3 ml ...........................................Humalog Mix 25 52.15 Inj lispro 50% with insulin lispro protamine 50%, 100 u per ml, 3 ml ...........................................Humalog Mix 50 52.15

5 5

MORPHINE SULPHATE (new listing) Inj 1 mg per ml, 10 ml prefilled syringe..........................Biomed 34.50 10 Inj 1 mg per ml, 30 ml prefilled syringe..........................Biomed 75.00 10 Inj 1 mg per ml, 50 ml prefilled syringe..........................Biomed 59.50 10 Inj 2 mg per ml, 30 ml prefilled syringe ..............................Biomed 95.00 10 Note - Biomed prefilled syringe single packs to be delisted 1 January 2009

1% 1% 1% 1%

Jan-09 Jan-09 Jan-09 Jan-09

Baxter Baxter Baxter Baxter

OCTREOTIDE (SOMATOSTATIN ANALOGUE) (new listing) Inj 50 µg per ml, 1 ml .....................Hospira 25.65 5 1% Jan-09 Sandostatin Inj 100 µg per ml, 1 ml ...................Hospira 48.50 5 1% Jan-09 Sandostatin Inj 500 µg per ml, 1 ml ...................Hospira 175.00 5 1% Jan-09 Sandostatin Sandostatin inj 50 µg per ml, 1 ml; 100 µg per ml, 1 ml; and 500 µg per ml, 1 ml to be delisted 1 January 2009 PREDNISONE (new listing) Tab 20 mg......................................Apo-Prednisone 29.03 Products with Hospital Supply Status (HSS) are in bold. 500 Douglas Origen (B) – Subject only to part (b) of the definition of “DV Pharmaceutical” 1% Dec-08

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 November 2008 (continued)

PROMETHAZINE HYDROCHLORIDE (new listing) Tab 10 mg......................................Allersoothe Tab 25 mg......................................Allersoothe QUINAPRIL ( price) Tab 5 mg........................................Accupril Tab 10 mg......................................Accupril Tab 20 mg......................................Accupril 2.72 4.44 1.60 1.75 2.35 50 50 30 30 20 1% 1% Jan-09 Jan-09 Phenergan Phenergan

QUINAPRIL WITH HYDROCHLOROTHIAZIDE (new listing) Tab 10 mg with hydrochlorothiazide 12.5 mg ......Accuretic 10 3.37 Tab 20 mg with hydrochlorothiazide 12.5 mg ......Accuretic 20 4.57 ZOPICLONE (new listing) Tab 7.5 mg.....................................Apo-Zopiclone 21.02

30 30 500 1% Jan-09 Imovane

Effective 1 October 2008

ACETAZOLAMIDE (new listing) Tab 250 mg....................................Diamox AMITRIPTYLINE (delisting) Tab 10 mg .....................................Amitrip ATROPINE SULPHATE ( price and addition of HSS) Eye drops 1% .................................Atropt 10.40 3.00 4.40 100 100 15 ml 1% Dec-08 (B) 1% Dec-08 (B)

BENZYLPENICILLIN SODIUM (amended brand name,  price and addition of HSS) Inj 1 mega u ...................................Novartis Sandoz 10.49 10 1% Dec-08 Benpen Please note that the Benpen brand of benzylpenicillin sodium inj 1 mega u will be delisted from 1 December 2008 BEZAFIBRATE (addition of HSS) Tab 200 mg....................................Fibalip CALCITONIN (new listing) Inj 100 u per ml, 1 ml .....................Miacalcic 9.75 110.00 90 5 1% 1% Dec-08 Dec-08 (B) (B)

CEFAZOLIN SODIUM (new listing) Inj 500 mg .....................................Hospira 5.00 5 1% Dec-08 m-Cefazolin Inj 1 g.............................................Hospira 8.00 5 1% Dec-08 m-Cefazolin Please note that the m-Cefazolin brand of cefazolin injections 500 mg and 1 g will be delisted from 1 December 2008 CLONAZEPAM (new listing) Tab 500 mcg ..................................Paxam Tab 2 mg........................................Paxam 6.26 11.15 100 100 1% 1% Dec-08 Dec-08 (B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 October 2008 (continued)

CLOZAPINE (new listing) Tab 25 mg......................................Clopine Tab 50 mg......................................Clopine Tab 100 mg....................................Clopine Tab 200 mg....................................Clopine ERYTHROMYCIN ETHYL SUCCINATE (new listing) Grans for oral liq 200 mg per 5 ml ..E-Mycin Grans for oral liq 400 mg per 5 ml ..E-Mycin FINASTERIDE (new listing and addition of HSS) Tab 5 mg........................................Fintral 35.20 45.60 91.20 145.92 4.35 5.85 19.20 100 100 100 100 100 ml 100 ml 30 1% 1% 1% (B) (B) Dec-08 Proscar

FLUCLOXACILLIN SODIUM (addition of HSS) Inj 250 mg......................................Flucloxin 9.00 10 1% Feb-09 Floxapen Inj 500 mg......................................Flucloxin 10.40 10 1% Feb-09 Floxapen Inj 1 g ............................................Flucloxin 14.00 10 1% Feb-09 Floxapen Please note the 5 pack of Flucloxin brand of flucloxacillin injection 250 mg, 500 mg and 1 g will be delisted from 1 December 2008 HYOSCINE N-BUTYLBROMIDE ( price and addition of HSS) Inj 20 mg per ml, 1ml .....................Buscopan 8.04 HYOSCINE N-BUTYLBROMIDE (new listing) Tab 10 mg......................................Gastrosoothe MEBEVERINE HYDROCHLORIDE (new listing) Tab 135 mg....................................Colofac METHYLDOPA (new listing) Tab 125 mg....................................Prodopa Tab 250 mg....................................Prodopa Tab 500 mg....................................Prodopa NORTRIPTYLINE HYDROCHLORIDE (new listing) Tab 10 mg......................................Norpress Tab 25 mg......................................Norpress NYSTATIN (addition of HSS) Oral liquid 100,000 u per ml ...........Nilstat POLOXAMER (new listing) Oral drops 10% ..............................Coloxyl 1.62 18.00 12.00 13.10 20.85 5.94 20.06 3.19 3.78 5 20 90 100 100 100 100 250 24 ml 30 ml 500 500 500 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 (B) Buscopan (B) (B) (B) (B) (B) (B) (B) (B) Douglas Origen Douglas Origen Douglas Origen

PREDNISONE (new listing) Tab 1 mg........................................Apo-Prednisone 10.68 Tab 2.5 mg.....................................Apo-Prednisone 12.09 Tab 5 mg........................................Apo-Prednisone 11.09 Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 October 2008 (continued)

PROCAINE PENICILLIN ( price and addition of HSS) Inj 1.5 mega u ................................Cilicaine RISPERIDONE (new listing) Tab 0.5 mg.....................................Ridal SALBUTAMOL (removal of DV pharmaceutical) Nebuliser soln 1 mg per ml, 2.5 ml .Asthalin SIMVASTATIN (new listing) Tab 80 mg .....................................SimvaRex STREPTOKINASE ( price and addition of HSS) Inj 250,000 IU ................................Streptase Inj 1,500,000 IU .............................Streptase 50.86 15.60 3.70 5 60 20 1% July-07 Ventolin nebules (B) 1% Dec-08 (B)

3.18 117.70 188.10

30 1 1 1% 1% Dec-08 Dec-08 (B) (B)

TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN (new listing) Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ......................................Pinetarsol 2.90 500 ml 1% Pinetarsol 5.45 1000 ml TEMAZEPAM (new listing) Tab 10 mg......................................Normison TERLIPRESSIN (new listing) Inj 1 mg..........................................Glypressin TRIAMCINOLONE ACETONIDE (new listing) Crm 0.02% .....................................Aristocort Oint 0.02% .....................................Aristocort TRIAMCINOLONE ACETONIDE (addition of HSS) Inj 40 mg per ml, 1 ml ....................Kenacort-A40 TRIMETHOPRIM (new listing) Tab 300 mg....................................TMP 0.83 450.00 6.63 6.69 28.09 8.69 25 5 100 g 100 g 5 50 1 100 1% 1% 1% 1% 1% 1% 1% 1%

Dec-08

(B)

Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08 Dec-08

(B) (B) (B) (B) Baxter (B) Hospira (B)

VANCOMYCIN HYDROCHLORIDE ( price and addition of HSS) Inj 50 mg per ml, 10 ml .................Pacific 5.04 ZINC SULPHATE (new listing) Cap 220 mg ...................................Zincaps 10.00

Effective 1 September 2008

AMANTADINE HYDROCHLORIDE Cap 100 mg ...................................Symmetrel 47.81 60 1% Oct-08 (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 September 2008 (continued)

AMITRIPTYLINE Tab 10 mg......................................Amirol ATENOLOL Tab 50 mg......................................Pacific Atenolol Tab 50 mg......................................Loten Tab 100 mg ...................................Pacific Atenolol 2.77 6.50 50 500 1% Sept-06 Anselol Apo-Atenolol Golbal Atenolol Anselol Apo-Atenolol Golbal Atenolol

11.30

500

Sept-06

Tab 100 mg....................................Loten Please note that the Loten brand of atenolol tablets 50 mg and 100 mg will be delisted from 1 September 2008. AQUEOUS (new listing) Cream ............................................AFT 1.49 100 g 1% Nov 08 Orion Multichem PSM

Note – Multichem brand of aqueous cream 100 g will be delisted from 1 November 2008 DV limit applies to pack sizes of 100 g or less CLOPIDOGREL (new listing) Tab 75 mg......................................Apo-Clopidogrel DIPYRIDAMOLE Tab long-acting 150 mg..................Pytazen SR EMULSIFYING OINTMENT (new listing) Ointment BP ...................................AFT ERYTHROPOIETIN ALPHA (new listing) Inj human recombinant 1,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 2,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 3,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 4,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 5,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 6,000 iu, pre-filled syringe ........................Eprex Inj human recombinant 10,000 iu, pre-filled syringe ........................Eprex 35.00 11.52 2.50 28 60 100 g 1% 1% Oct-08 Nov 08 Persantin (B)

48.68 120.18 166.87 193.13 243.26 291.92 395.18

6 6 6 6 6 6 6

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 September 2008 (continued)

ERYTHROPOIETIN BETA (change to brand name) Inj 2,000 iu prefilled syringe ............NeoRecormon Recormon Inj 3,000 iu prefilled syringe ............NeoRecormon Recormon Inj 4,000 iu prefilled syringe ............NeoRecormon Recormon Inj 5,000 iu prefilled syringe ............NeoRecormon Recormon Inj 6,000 iu prefilled syringe ............NeoRecormon Recormon Inj 10,000 iu prefilled syringe ..........NeoRecormon Recormon FLUDARABINE ( price) Tab 10 mg......................................Fludara FLUDARABINE PHOSPHATE ( price) Inj 50 mg........................................Fludara IMIQUIMOD (new listing) Cream 5 %, sachet .........................Aldara INSULIN GLARGINE Inj 100 iu per ml, 3 ml ....................Lantus SoloStar METHOTREXATE ( price and HSS addition) Inj 100 mg per ml, 10 ml ................Methotrexate Ebewe Inj 100 mg per ml, 50 ml ................Methotrexate Ebewe 152.04 228.06 304.08 380.10 456.12 760.20 6 6 6 6 6 6 5% 5% 5% 5% 5% 5% Apr-06 Apr-06 Apr-06 Apr-06 Apr-06 Apr-06 (B) (B) (B) (B) (B) (B)

650.25 1430.00 110.40 94.50 27.50 135.00

15 5 12 5 1 1

1% 1%

Nov 08 Nov 08

(B) (B)

1% 1%

Nov-08 Nov-08

Hospira Hospira

METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE (new listing) Tablet extended-release 18 mg .......Concerta 58.96 30 Tablet extended-release 27 mg .......Concerta 65.44 30 Tablet extended-release 36 mg .......Concerta 71.93 30 Tablet extended-release 54 mg .......Concerta 86.24 30 NICOTINE Lozenge 1 mg ................................Habitrol Lozenge 2 mg ................................Habitrol PRILOCAINE HYDROCHLORIDE Inj 0.5%, 50 ml ...............................Citanest Inj 0.5%, 50 ml ...............................Citanest 11.08 11.08 80.00 160 36 36 5 10

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 September 2008 (continued)

RISPERIDONE ( price) Tab 0.5 mg.....................................Risperdal Tab 1 mg........................................Risperdal Tab 2 mg........................................Risperdal Tab 3 mg........................................Risperdal Tab 4 mg........................................Risperdal SODIUM CHLORIDE (new listing) Soln 0.9% for irrigation ...................Pfizer TOPIRAMATE (new listing) Tab 25 mg......................................Topamax Tab 50 mg......................................Topamax Tab 100mg.....................................Topamax Tab 200mg.....................................Topamax Sprinkle cap 15 mg.........................Topamax Sprinkle cap 25 mg.........................Topamax 5.20 30.77 61.53 92.32 123.05 20.00 26.04 44.26 75.25 129.85 20.84 26.04 20 60 60 60 60 30 ml 60 60 60 60 60 60 1% Nov 08 Orion

Effective 1 August 2008

ADALIMUMAB (new listing) Inj 40 mg per 0.8 ml prefilled pen ...............................HumiraPen ARIPIPRAZOLE (new listing) Tab 10 mg......................................Abilify Tab 15 mg......................................Abilify Tab 20 mg......................................Abilify Tab 30 mg......................................Abilify

1,799.92 123.54 175.28 213.42 260.07

2 30 30 30 30 Oct-08 Oct-08 Oct-08 AFT AFT AFT

CEFOTAXIME (new listing) Inj 500 mg......................................Cefotaxime Sandoz 1.69 1 1% Inj 1 g.............................................Cefotaxime Sandoz 1.90 1 1% Inj 2 g.............................................Cefotaxime Sandoz 2.60 1 1% Note - AFT brand of cefotaxime inj, 1 g & 2 g will be delisted 1 October 2008. GLYCERYL TRINITRATE Tab 600 µg ....................................Lycinate IVERMECTIN (new listing) Tab 3 mg........................................Stromectol KETOCONAZOLE (new listing) Shampoo 2 % .................................Sebizole METHOTREXATE Inj 100 mg per ml, 5 ml ..................Methotrexate Ebewe 8.00 25.96 3.48 100 4 100 ml 1% 1% 1%

Sept-08 Oct-08 Oct-08

(B) (B) Ketopine Nizoral

18.00

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) (ex man. excl. GST)

Per

DV Limit

DV Limit DV applies Pharmaceutical from

Section H - effective 1 August 2008 (continued)

METRONIDAZOLE Suppos 1 g.....................................Flagyl 33.31 10 1 1 1 1 1 1% 1% 1% 1% 1% Oct-08 Oct-08 Oct-08 Oct-08 Oct-08 Anzatax Taxol Anzatax Taxol (B) Anzatax Taxol Anzatax Taxol

PACLITAXEL (new listing) Inj 30 mg .......................................Paclitaxel Ebewe 37.95 Inj 100 mg......................................Paclitaxel Ebewe125.35 Inj 600 mg......................................Paclitaxel Ebewe724.50 PACLITAXEL ( price and addition of HSS) Inj 150 mg......................................Paclitaxel Ebewe188.03 Inj 300 mg......................................Paclitaxel Ebewe376.05

Note - The Taxol brand of paclitaxel inj 150 mg & 300 mg will be delisted from 1 October 2008.

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Chemical and presentation

Brand

Section H changes to Part IV

Effective 1 October 2008

CHLORHEXIDINE Eye drops 0.02% For a period of 3 months for treatment of acanthamoeba keratitis. ONDANSETRON HYDROCHLORIDE Tab 4 mg Zofran Tab 8 mg Zofran Tab dispersible 4 mg Zofran Zydis Tab dispersible 8 mg Zofran Zydis For treatment of patients with hyperemesis gravidarum for the term of the pregnancy following failure of other antiemetic regimens. POLYHEXAMETHYLENE BIGUANIDE Eye drops 0.02% For a period of 3 months for treatment of acanthamoeba keratitis. PYRIMETHAMINE Tab 25 mg (Section 29) For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; For pregnant patients for the term of the pregnancy; For infants with congenital toxoplasmosis until 12 months of age. SULPHADIAZINE Tab 500 mg (Section 29) For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; For pregnant patients for the term of the pregnancy; For infants with congenital toxoplasmosis until 12 months of age.

Effective 1 September 2008

CEFUROXIME AXETIL Tab 250 mg Oral liq 125 mg per 5 ml Up to 2 weeks supply for any appropriate indication CEFUROXIME SODIUM Tab 250 mg Oral liq 125 mg per 5 ml Up to 2 weeks supply for any appropriate indication Inj 250 mg Inj 750 mg Inj 1.5 g For any indication approved by the hospital service, with review at 6 weeks.

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Index

Pharmaceuticals and brands A Abilify ................................................................ 55 Acarbose ........................................................... 32 Acipimox ........................................................... 26 Acupan .............................................................. 43 Aldara .......................................................... 23, 54 Accupril ....................................................... 36, 50 Accuretic 10 ...................................................... 50 Accuretic 20 ...................................................... 50 Acetazolamide ............................................. 39, 50 Aciclovir ............................................................ 44 Adalimumab....................................................... 55 AFT-Leflunomide ................................................ 27 Alimentary tract and metabolism ........................ 41 Allersoothe................................................... 36, 50 Amantadine hydrochloride .................................. 52 Amiloride ........................................................... 27 Aminoacid formula without phenylalanine ..... 22, 39 Amirol .......................................................... 23, 53 Amitrip ......................................................... 46, 50 Amitriptyline ..................................... 23, 46, 50, 53 Amoxycillin .................................................. 18, 48 Anten ................................................................. 46 Apo-Acyclovir .................................................... 44 Apo-Clopidogrel ........................................... 23, 53 Apo-Doxazosin....................................... 18, 47, 49 Apo-Prednisone ............................... 36, 38, 49, 51 Apo-Zopiclone.............................................. 36, 50 Aprotinin ............................................................ 43 Aqueous ...................................................... 48, 53 Aqueous cream .................................................. 18 Arava ................................................................. 27 Aripiprazole ........................................................ 55 Aristocort ..................................................... 37, 52 Arrow-Citalopram ......................................... 18, 48 Ascorbic acid and sodium ascorbate .................. 43 Aspirin ............................................................... 44 Asthalin ............................................................. 52 Atacand ............................................................. 26 Atenolol ................................................. 23, 46, 53 Atropine sulphate ......................................... 39, 50 Atropt .......................................................... 39, 50 B Benzathine benzylpenicillin ................................. 44 Benzylpenicillin sodium ...................................... 50 Benzylpenicillin sodium (penicillin g) ............ 38, 41 Betahistine dihydrochloride................................. 30 Bezafibrate ................................................... 37, 50 Bicalox......................................................... 20, 48 Bicalutamide ................................................ 20, 48 Bicillin ................................................................ 44 Bleomycin sulphate ............................................ 19 Breath-Alert........................................................ 38 Brolene .............................................................. 46 Bupafen ............................................................. 48 Bupivacaine hydrochloride with fentanyl ............. 48 Buscopan .................................................... 36, 51 C Calci-Tab Effervescent ....................................... 39 Calcitonin..................................................... 37, 50 Calcium ............................................................. 45 Calci-Tab Effervescent ....................................... 45 Calcium-Sandoz 1000 ........................................ 45 Calcium carbonate ....................................... 39, 45 Calcium folinate ........................................... 19, 40 Calcium polystyrene sulphonate ......................... 26 Calcium Resonium ............................................. 26 Candesartan....................................................... 26 Carboplatin ........................................................ 18 Carmustine ........................................................ 18 Cefazolin sodium ......................................... 21, 50 Cefotaxime......................................................... 55 Cefotaxime Sandoz ............................................ 55 Cefuroxime axetil................................................ 57 Cefuroxime sodium ...................................... 43, 57 Chlorhexidine ..................................................... 57 Chlorothiazide .................................................... 27 Cilicaine ....................................................... 38, 52 Ciprofloxacin ................................................ 18, 49 Cisplatin............................................................. 18 Citalopram hydrobromide ............................. 18, 48 Citanest ............................................................. 54 Cladribine........................................................... 19 Clomazol...................................................... 18, 49 Clonazepam ................................................. 38, 50 Clopidogrel ............................................ 23, 37, 53 Clopine .................................................. 22, 31, 51 Clotrimazole ................................................. 18, 49 Clozapine ............................................... 22, 31, 51 Clozaril .............................................................. 31 Concerta ...................................................... 24, 54 Colaspase (l-asparaginase) ................................ 19 Colofac ........................................................ 36, 51 Coloxyl ........................................................ 36, 51 Cozaar ......................................................... 23, 45 Cyclophosphamide ............................................ 18 Cytarabine ......................................................... 19 D Depo-Provera ..................................................... 24 Diastop .............................................................. 31 Diphenoxylate hydrochloride with atropine sulphate............................................. 31 Domperidone ..................................................... 30 Doxepin hydrochloride........................................ 46

Index

Pharmaceuticals and brands Dacarbazine ....................................................... 19 Dactinomycin (actinomycin d) ............................ 19 Daunorubicin ..................................................... 19 Diamox ........................................................ 39, 50 Dibromopropamidine isethionate ........................ 46 Dipyridamole................................................ 25, 53 Diurin 500 .......................................................... 27 Docetaxel ........................................................... 19 Doxazosin mesylate ............................... 18, 47, 49 Doxorubicin ....................................................... 20 DP Lotion ........................................................... 37 Durogesic .......................................................... 28 E Easiphen ............................................................ 39 Ecotrin ............................................................... 44 Emulsifying ointment .......................................... 53 E-Mycin ....................................................... 38, 51 Easiphen Liquid.................................................. 39 Econazole nitrate ................................................ 44 Enteral feed 1kcal/ml .......................................... 22 Enteral feed with fibre 1kcal/ml ........................... 22 Epirubicin........................................................... 20 Eprex ..................................................... 22, 39, 53 Erythromycin ethyl succinate ........................ 38, 51 Erythromycin lactobionate .................................. 46 Erythropoietin alpha.......................... 22, 32, 39, 53 Erythropoietin beta ................................. 41, 45, 54 Ethics Aspirin ..................................................... 44 Etoposide........................................................... 20 Etoposide phosphate .......................................... 20 F Fentanyl ............................................................. 28 Ferrosig ....................................................... 39, 45 Fibalip .......................................................... 37, 50 Fibersource HN - Unflavoured ............................. 22 Finasteride ......................................................... 51 Fintral .......................................................... 21, 51 Flagyl ................................................................. 56 Flucloxacillin sodium .................................... 21, 51 Flucloxin ...................................................... 21, 51 Fludara......................................................... 40, 54 Fludarabine ........................................................ 54 Fludarabine phosphate ..................... 19, 36, 40, 54 Fluorouracil sodium............................................ 19 Folic acid ........................................................... 25 Foremount Child’s Silicone Mask ........................ 38 Fortisip Powder .................................................. 44 Fortovase ........................................................... 44 Frusemide .......................................................... 27 Fucithalmic ........................................................ 49 Fusidic acid........................................................ 49 G Gabapentin ........................................................ 28 Gastrosoothe ............................................... 36, 51 Gemcitabine hydrochloride ................................. 19 Genotropin ......................................................... 33 Glucobay ........................................................... 32 Gluten free pasta ................................................ 43 Glyceryl trinitrate ................................................ 55 Glypressin.......................................................... 52 Goldshield.......................................................... 18 Growth hormone biosynthetic human ................. 33 Gutron ............................................................... 27 H Habitrol ........................................................ 23, 54 Healtheries Vitamin C ......................................... 43 Heparinised saline .............................................. 45 Heparin sodium...................................... 26, 36, 37 Humalog Mix 25........................................... 18, 49 Humalog Mix 50........................................... 18, 49 HumiraPen ......................................................... 55 Hydrocortisone butyrate ............................... 47, 49 Hyoscine (scopolamine)..................................... 30 Hyoscine n-butylbromide ............................. 36, 51 Hypnovel ........................................................... 38 I Imiquimod ................................................... 23, 54 Insoma .............................................................. 46 Insulin Glargine .................................................. 41 Insulin lispro with insulin lispro protamine .................................. 18, 41, 49 Ibiamox........................................................ 18, 48 Idarubicin hydrochloride ..................................... 20 Ifosfamide.......................................................... 19 Insulin aspart ..................................................... 41 Insulin glargine ............................................. 22, 54 Insulin isophane ................................................. 41 Insulin isophane with insulin neutral.................... 41 Insulin lispro ...................................................... 41 Insulin lispro with insulin lispro protamine ..... 18, 41 Insulin neutral .................................................... 41 Invirase .............................................................. 46 Irinotecan........................................................... 19 Iron polymaltose .......................................... 39, 45 Isosource HN - Unflavoured................................ 22 Ivermectin .......................................................... 55 J Junior Parapaed ........................................... 40, 45 K Kenacort-A40..................................................... 52 Ketoconazole ......................................... 37, 45, 55 Ketopine ...................................................... 37, 45

Index

Pharmaceuticals and brands L Lantus SoloStar ........................................... 22, 54 Lasix .................................................................. 27 Leflunomide ....................................................... 27 Levothyroxine .................................................... 41 Liquifilm Forte .............................................. 36, 45 Liquifilm Tears ............................................. 36, 45 Lithium carbonate .............................................. 40 Locoid ............................................................... 47 Locoid Cream .................................................... 49 Lophlex LQ......................................................... 22 Loprofin ................................................. 22, 36, 46 Losartan ...................................................... 23, 45 Losec ................................................................ 46 Loten ........................................................... 46, 53 Lycinate ............................................................. 55 M Mask for spacer device ...................................... 38 Medroxyprogesterone acetate............................. 24 Methylphenidate hydrochloride extended release ....................................... 24, 54 Mebeverine hydrochloride ............................ 36, 51 Mesna ............................................................... 20 Methadone hydrochloride ................................... 31 Methotrexate .............................. 19, 36, 40, 54, 55 Methotrexate Ebewe ............................... 40, 54, 55 Methyldopa .................................................. 37, 51 Methylphenidate hydrochloride ........................... 35 Metronidazole .................................................... 56 Miacalcic ..................................................... 37, 50 Midazolam ......................................................... 38 Midodrine .......................................................... 27 Minaphlex .......................................................... 39 Mitomycin C ...................................................... 20 Mitozantrone ...................................................... 20 Morphine sulphate.............................................. 49 Motilium ............................................................ 30 Multiparin........................................................... 36 N Nefopam hydrochloride ...................................... 43 NeoRecormon .............................................. 41, 54 Neurontin ........................................................... 28 Nicotine ................................................. 23, 46, 54 Nicotinell ............................................................ 46 Nifuran ............................................................... 39 Nilstat .......................................................... 37, 51 Nitrazepam......................................................... 46 Nitrofurantoin ..................................................... 39 Norditropin SimpleXx 10mg ................................ 33 Norditropin SimpleXx 15mg ................................ 33 Norditropin SimpleXx 5mg .................................. 33 Normison ..................................................... 38, 52 Norpress ...................................................... 38, 51 Nortriptyline hydrochloride............................ 38, 51 Norvir ................................................................ 43 Nupentin ............................................................ 28 Nystatin ....................................................... 37, 51 O Octreotide (somatostatin analogue) .............. 20, 49 Oestradiol valerate........................................ 18, 47 Olbetam ............................................................. 26 Omeprazole........................................................ 46 Ondansetron hydrochloride................................. 57 Oral supplement 1kcal/ml ................................... 44 Orgran ............................................................... 43 Ospamox ..................................................... 18, 48 Oxaliplatin .......................................................... 19 P Pacific Atenolol ............................................ 23, 53 Paclitaxel ......................................... 20, 38, 43, 56 Paclitaxel Ebewe ................................................ 56 Paediatric oral feed 1kcal/ml............................... 22 Paracetamol................................................. 40, 45 Paxam ......................................................... 38, 50 Peak flow meter ........................................... 38, 41 Pediasure........................................................... 22 Pergolide ........................................................... 30 Permax .............................................................. 30 Permethrin ......................................................... 43 Persantin ........................................................... 25 Pevaryl Ovules ................................................... 44 Phentolamine mesylate ...................................... 39 Phenyl free pasta ................................... 22, 36, 46 Phlexy 10........................................................... 39 Phosphate-Sandoz ................................. 26, 37, 39 Pinetarsol..................................................... 37, 52 Plavix ................................................................. 37 Poloxamer ................................................... 36, 51 Polyhexamethylene biguanide ............................. 57 Polyvinyl alcohol .................................... 36, 40, 45 Potassium bicarbonate ........................... 26, 37, 39 Pravachol........................................................... 26 Pravastatin ......................................................... 26 Prednisone....................................... 36, 38, 49, 51 Priadel ............................................................... 40 Prilocaine hydrochloride ..................................... 54 Procaine penicillin ........................................ 38, 52 Prodopa ....................................................... 37, 51 Progynova ................................................... 18, 47 Promethazine hydrochloride ......................... 36, 50 Pyrimethamine ................................................... 57 Pytazen SR .................................................. 25, 53

Index

Pharmaceuticals and brands Q Quellada-P ......................................................... 43 Quinapril ...................................................... 36, 50 Quinapril with hydrochlorothiazide ...................... 50 R Recombinant human growth hormone ................ 33 Recormon .................................................... 45, 54 Regitine ............................................................. 39 Resonium-A ....................................................... 26 Rex Medical ................................................. 18, 49 Ridal ...................................................... 22, 34, 52 Risperdal ......................................... 31, 34, 40, 55 Risperdal Consta .......................................... 31, 34 Risperdal Quicklet .............................................. 34 Risperidone.......................... 22, 31, 34, 40, 52, 55 Ritonavir ............................................................ 43 Rituximab .......................................................... 21 Rubifen .............................................................. 35 Rubifen SR ........................................................ 35 S Sabril ................................................................. 29 Salbutamol............................................. 43, 46, 52 Sandoz .................................................. 38, 41, 50 Saquinavir .................................................... 44, 46 Scopoderm TTS ................................................. 30 Sebizole ............................................................. 55 SimvaRex .................................................... 21, 52 Simvastatin .................................................. 21, 52 Six Plus Parapaed ........................................ 40, 45 Sodium chloride ................................................. 55 Sodium polystyrene sulphonate .......................... 26 Space Chamber ..................................... 21, 31, 39 Spacer device ........................................ 21, 31, 39 Spacer devices .................................................. 41 Spacer devices and masks ................................. 41 Spironolactone ................................................... 27 Streptase ........................................................... 52 Streptokinase ..................................................... 52 Stromectol ......................................................... 55 Sulphadiazine ..................................................... 57 Symmetrel ......................................................... 52 T Tar with triethanolamine lauryl sulphate and fluorescein ......................................... 37, 52 Taxol ................................................................. 43 Temazepam ................................................. 38, 52 Teniposide ......................................................... 20 Terlipressin ........................................................ 52 Thyroxine ..................................................... 18, 41 TMP................................................................... 38 Topamax...................................................... 40, 55 Topiramate............................................. 33, 40, 55 Trastuzumab ...................................................... 21 Trasylol.............................................................. 43 Triamcinolone acetonide .............................. 37, 52 Trimethoprim ............................................... 38, 52 V Vancomycin hydrochloride ........................... 38, 52 Verapamil hydrochloride ............................... 43, 46 Vergo 16 ............................................................ 30 Verpamil ...................................................... 43, 46 Vigabatrin .......................................................... 29 Vinblastine sulphate ........................................... 20 Vincristine sulphate ............................................ 20 Vinorelbine ......................................................... 20 Vistil .................................................................. 40 Vistil Forte .......................................................... 40 Volmax ........................................................ 43, 46 W Wool fat with mineral oil ..................................... 37 X XP Analog LCP ................................................... 39 XP Maxamaid ..................................................... 39 XP Maxamum .................................................... 39 Z Zinc and castor oil .............................................. 45 Zincaps ........................................................ 37, 52 Zinc sulphate................................................ 37, 52 Zofran ................................................................ 57 Zofran Zydis ....................................................... 57 Zopiclone ..................................................... 36, 50

Pharmaceutical Management Agency Level 9, Cigna House, 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

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.

Metadata

Title

Schedule Update - effective 1 November 2008

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 November 2008 Cumulative for September, October and November 2008 Section H cumulative for August, September, October and November 2008 Contents Summary of PHARMAC decisions effective 1 November 2008 ….. 3…

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