Schedule Update - effective 1 December 2009 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 December 2009 Cumulative for September, October, November and December 2009 Section H for December 2009

Contents

Summary of PHARMAC decisions effective 1 Decembr 2009 ......................... 3 Access changes to tenofovir .......................................................................... 5 Letrozole fully subsidised without Special Authority ..................................... 6 Calcium tab effervescent – paid in multiples ................................................. 6 Permethrin – removal of prescribing note ..................................................... 6 Clomipramine tablets – new listing ............................................................... 6 Cephalexin oral liquids – new listing ............................................................. 7 Diclofenac sodium – new listing .................................................................... 7 Bleomycin sulphate - new listing ................................................................... 7 Tender News .................................................................................................. 8 Looking Forward ........................................................................................... 9 Sole Subsidised Supply products cumulative to December 2009 ................. 11 New Listings ................................................................................................ 18 Changes to Restrictions ............................................................................... 23 Changes to Subsidy and Manufacturer’s Price............................................. 35 Changes to Brand Name ............................................................................. 41 Changes to Sole Subsidised Supply ............................................................. 41 Delisted Items ............................................................................................. 42 Items to be Delisted .................................................................................... 46 Section H changes to Part II ........................................................................ 50 Index ........................................................................................................... 52

Summary of PharmaC decisions

effeCtive 1 DeCember 2009 New listings (pages 18 to 22) • Insulin pen needles (Fine-Ject) 31 g x 6 mm – maximum of 100 dev per prescription • Calcitriol (Airflow) cap 0.25 µg and 0.5 µg • Furosemide (Urex Forte) tab 500 mg – Section 29 • Permethrin (A-Scabies) lotn 5%, 30 ml OP • Cephalexin monohydrate (Cefalexin Sandoz) grans for oral liq 125 mg per 5 ml and 250 mg per 5 ml – Hospital pharmacy [HP3] • Amoxycillin (Ospamox) grans for oral liq 125 mg per 5 ml and 250 mg per 5 ml – up to 200 ml available on a PSO • Ethambutol hydrochloride (Myambutol) tab 100 mg – Section 29 – no patient co-payment payable • Diclofenac sodium (Diclax-SR) tab long-acting 75 mg and 100 mg • Clomipramine hydrochloride (Apo-Clomipramine) tab 10 mg and 25 mg • Bromocriptine mesylate (Apo-Bromocriptine) tab 2.5 mg • Bleomycin sulphate (DBL Bleomycin Sulfate) inj 15,000 iu – PCT only – Specialist • Docetaxel (Docetaxel Ebewe) inj 20 mg and 80 mg – PCT only – Specialist – Special Authority Changes to restrictions (pages 23 to 34) • Permethrin crm 5% (Lyderm) and lotn 5% (A-Scabies) – removal of note for use as second line therapy • Tenofovir disoproxil fumarate (Viread) tab 300 mg – removal of antiretroviral Special Authority – addition of endorsement for treatment of HIV/AIDS – addition of Special Authority for the treatment of drug-resistant chronic Hepatitis B • Antiretrovirals – amended notes in Special Authority criteria • Midazolam – subsidy if injection prescribed for intranasal administration • Letrozole (Femara) tab 2.5 mg – removal of Special Authority for Alternate Subsidy • Atropine sulphate (Atropt) eye drops 1% - removal of Sole Subsidised Supply status Decreased subsidy (page 35) • Quetiapine (Quetapel) tab 25 mg, 100 mg, 200 mg and 300 mg • Latanoprost (Xalatan) eye drops 50 µg per ml, 2.5 ml

Summary of PharmaC decisions – effective 1 December 2009 (continued) increased subsidy (page 35) • Bleomycin sulphate (Baxter) inj 1,000 iu for ECP • Azathioprine (Azamun) tab 50 mg • Atropine sulphate (Atropt) eye drops 1%

Pharmaceutical Schedule - Update News

Access change to tenofovir

Access to tenofovir disoproxil fumarate (Viread) 300 mg tablets will be widened, via Special Authority to include the treatment of Hepatitis B under Special Authority. From 1 December 2009 funding for tenofovir for HIV/AIDS will be via endorsement rather Special Authority. The endorsement criteria for the HIV/AIDS subsidy will be met when tenofovir is co-prescribed with another antiretroviral that is subsidised under Special Authority SA0779, and the prescription is annotated accordingly by the pharmacist or prescriber. Subsidy for tenofovir for Hepatitis B will be via a Special Authority. Subsidised treatment under Special Authority is only for patients with drug-resistant chronic hepatitis B (CHB) infection. See page 23 for further information. Special Authority approvals for HIV/AIDS will no long apply to tenofovir from 1 December 2009. Any outstanding repeats for tenofovir from 1 December will not be funded if tenofovir is dispensed using current Special Authority approvals after this date. Pharmacy [HP1} Pharmacy will need to manually annotate any repeats for tenofovir if the original prescription was dispensed under the Special Authority. If the prescription is not annotated with the required endorsement

in the claim, it will not be funded and would require resubmission after endorsement for claiming. Pharmacy computer software will need to be adjusted to implement the changed criteria. For more information regarding this, please contact your software vendor. All new prescriptions for tenofovir for HIV/ AIDS should be claimed via endorsement and annotated accordingly. All new prescriptions for tenofovir for Hepatitis B will need a Special Authority – it is only those prescriptions for tenofovir in conjunction with another anti-retroviral subsidised that no longer need the Special Authority but instead need an endorsement. It is important to note that tenofovir when prescribed under endorsement for the treatment of HIV/AIDS is included in the count of up to three subsidised antiretrovirals for the purposes of Special Authority SA0779.

6 Pharmaceutical Schedule - Update News

Letrozole fully subsidised without Special Authority

Novartis New Zealand Ltd has reduced the price of Femara (letrozole) 2.5 mg tablets to match the level of the current subsidy. This means that patients no longer require Special Authority approval to access fully subsidised letrozole tablets.

Calcium tab effervescent – paid in multiples

From 1 December 2009 the Calsource brand of calcium tab effervescent 1 g (elemental) will be paid in multiples of 10 tablets. It will not be listed as an original pack (OP). The multiple tablet payment is to acknowledge that the original tube containers come with their own desiccants in the lid and once tablets have been removed from the tubes their integrity may be compromised. This is a computer change only and is not printed in the Pharmaceutical Schedule. Other products paid in this manner are calendar packed oral contraceptive tablets.

Permethrin – removal of prescribing note

The additional information in the listing in the Pharmacutical Schedule for permethrin noting that it should be strictly reserved for second line therapy will be removed from 1 December 2009. Clinical advice from BPAC’s Best Practice publication and the Cochrane review (2007) suggests permethrin should be used as a first line therapy.

Clomipramine tablets – new listing

Apo-Clomipramine 10 mg and 25 mg tablets will be listed fully subsidised on the Pharmaceutical Schedule from 1 December 2009. This follows the discontinuation of Mylan New Zealand’s Clopress brand.

Pharmaceutical Schedule - Update News

Cephalexin oral liquids – new listing

The Cephalexin Sandoz brand of cephalexin monohydrate grans for oral liquid 125 mg per 5 ml and 250 mg per 5 ml will be listed fully subsidised on the Pharmaceutical Schedule from 1 December 2009. Previously subsidised cephalexin oral liquids were discontinued in 2006 so PHARMAC are pleased to be funding a first generation oral cephalosporin treatment option.

Diclofenac sodium – new listing

From 1 December 2009 Diclax SR (diclofenac sodium) long-acting 75 mg and long-acting 100 mg tablets will be listed fully subsidised. These listings are due to a short supply of diclofenac sodium tablets. Please note that it is highly likely that Diclax SR 75 mg tablets will not be available until the week of 21 December 2009. We are listing it in the Pharmaceutical Schedule from 1 December because of the potential for an out-of-stock situation if we were to wait for 1 January 2010 to list this presentation. Douglas Pharmaceuticals will notify wholesalers as soon as Diclax SR is available. Please note that pharmacist authorisation to endorse prescriptions Close Control monthly continues to apply for all subsidised brands of diclofenac sodium long-acting 75 mg and long-acting 100 mg tablets. PHARMAC will notify at a later date when authorisation is to be revoked.

Bleomycin sulphate - new listing

From 1 December 2009 a new brand of bleomycin sulphate injection 15,000 iu (DBL Bleomycin Sulfate, Hospira) will be listed in the Pharmaceutical Schedule at a price and subsidy of $120.00 per vial. The price and subsidy of bleomycin sulphate injection 1,000 iu for ECP (Baxter) will also be increased to $9.28. Bleomycin sulphate is a Pharmaceutical Cancer Treatment. This new brand has been listed following discontinuation of the current Blenoxane brand (Bristol Myers Squibb).

tender News

Sole Subsidised Supply changes – effective 1 January 2010

Chemical Name Atropine sulphate Baclofen Betamethasone valerate Calamine Calamine Clobetasol propionate Clobetasol propionate Clobetasol propionate Clonidine Clonidine Clonidine Clonidine hydrochloride Clonidine hydrochloride Clonidine hydrochloride Flucloxacillin sodium Flucloxacillin sodium Gentamicin sulphate Hydrocortisone Hydrocortisone Hydrocortisone acetate Presentation; Pack size Inj 600 µg, 1 ml; 50 inj Tab 10 mg; 100 tab Scalp app 0.1%; 100 ml OP Crm, aqueous, BP; 100 g Lotn, BP; 2,000 ml Crm 0.05%; 30 g OP Oint 0.05%; 30 g OP Scalp app 0.05%; 30 ml OP TDDS 2.5 mg, 100 µg per day; 4 each TDDS 5 mg, 200 µg per day; 4 each TDDS 7.5 mg, 300 µg per day; 4 each Inj 150 µg per ml, 1 ml; 5 inj Tab 150 µg; 100 tab Tab 25 µg; 100 tab Grans for oral liq 125 mg per 5 ml; 100 ml Grans for oral liq 250 mg per 5 ml; 100 ml Inj 40 mg per ml, 2 ml; 10 inj Tab 5 mg; 100 tab Tab 20 mg; 100 tab Rectal foam 10%, CFC-Free (14 applications); 21.1 g OP Sole Subsidised Supply brand (and supplier) AstraZeneca (AstraZeneca) Pacifen (Mylan) Beta Scalp (Mylan) healthE (Jaychem) API (API) Dermol (Mylan) Dermol (Mylan) Dermol (Mylan) Catapres-TTS-1 (Boehringer Ingelheim) Catapres-TTS-2 (Boehringer Ingelheim) Catapres-TTS-3 (Boehringer Ingelheim) Catapres (Boehringer Ingelheim) Catapres (Boehringer Ingelheim) Dixarit (Boehringer Ingelheim) AFT (AFT) AFT (AFT) Pfizer (Pfizer) Douglas (Douglas) Douglas (Douglas) Colifoam (Aspen) Solu-Medrol (Pfizer) Solu-Medrol (Pfizer) Solu-Medrol (Pfizer) Solu-Medrol (Pfizer) RA-Morph (Pfizer) RA-Morph (Pfizer) RA-Morph (Pfizer) RA-Morph (Pfizer)

Methylprednisolone sodium succinate Inj 40 mg per ml, 1 ml; 25 inj Methylprednisolone sodium succinate Inj 62.5 mg per ml; 25 inj Methylprednisolone sodium succinate Inj 500 mg; 1 inj Methylprednisolone sodium succinate Inj 1 g; 1 inj Morphine hydrochloride Morphine hydrochloride Morphine hydrochloride Morphine hydrochloride Oral liq 1 mg per ml; 200 ml Oral liq 2 mg per ml; 200 ml Oral liq 5 mg per ml; 200 ml Oral liq 10 mg per ml; 200 ml

Sole Subsidised Supply changes – effective 1 January 2010 (continued)

Morphine sulphate Morphine sulphate Naproxen Naproxen Oxycotin Oxycotin Oxycotin Potassium chloride Quinine sulphate Sodium cromoglycate Tab immediate release 10 mg; 10 tab Tab immediate release 20 mg; 10 tab Tab 250 mg; 500 tab Tab 500 mg; 250 tab Inj 5 iu per ml, 1 ml; 5 inj Inj 10 iu per ml, 1 ml; 5 inj Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml; 5 inj Tab long-acting 600 mg; 200 tab Tab 300 mg; 500 tab Nasal spray, 4%; 22 ml OP Sevredol (Douglas) Sevredol (Douglas) Noflam 250 (Mylan) Noflam 500 (Mylan) Syntocinon (Novartis) Syntocinon (Novartis) Syntometrine (Novartis) Span-K (Aspen) Q 300 (Mylan) Rex (Rex)

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for implementation 1 January 2010 • Alprazolam (Arrow-Alprazolam) tab 250 µg, 500 µg and 1 mg – price and subsidy decrease • Blood glucose diagnostic test meter (On Call Advanced) meter – new listing • Blood glucose diagnostic test strips (On Call Advanced) blood glucose test strip x 50 with lancets x 5 – new listing • Cabergoline (Dostinex) tab 0.5 mg, 2 and 8 tab packs – price and subsidy decrease • Cholecalciferol (Cal-d-Forte) tab 1.25 mg (50,000 iu) – price and subsidy decrease • Clindamycin (Dalacin C) inj phosphate 150 mg per ml, 4 ml – price and subsidy decrease • Codeine phosphate (PSM) tab 15 mg, 30 mg and 60 mg – price and subsidy decrease • Cyclosporin A (Neoral) cap 25 mg, 50 mg and 100 mg, and oral liq 100 mg per ml – price and subsidy decrease • Danazol (Azol) cap 200 mg – new listing – Retail pharmacy-Specialist • Dexamphetamine sulphate (PSM) tab 5 mg – price and subsidy decrease • Glycerol (PSM) suppos 3.6 g – price and subsidy increase

Looking forward – effective 1 January 2010 (continued) • Hydrocortisone butyrate lipocream 0.1% 30 g OP and 100 mg OP (Locoid Lipocream), oint 0.1% 100 g OP (Locoid), milky emulsion 0.1% 100 ml OP (Locoid Crelo), and scalp lotion 0.1% (Locoid) – price and subsidy decrease • Hydrocortisone with natamycin and neomycin (Pimafucort) crm and oint 15 g OP – price and subsidy decrease • Isoniazid (PSM) tab 100 mg – price and subsidy decrease • Medroxyprogesterone acetate (Depo-Provera) inj 150 mg per ml, 1 ml – price and subsidy decrease • Medroxyprogesterone acetate (Provera) tab 2.5 mg – price and subsidy increase • Medroxyprogesterone acetate (Provera) tab 5 mg, 10 mg, 100 mg and 200 mg – price and subsidy decrease • Mesalazine (Asamax) tab EC 500 mg – new listing • Pethidine hydrochloride (PSM) tab 50 mg and 100 mg – price and subsidy increase • Phenobarbitone (PSM) tab 15 mg and 30 mg – price and subsidy increase • Risperidone (Apo-Risperidone) tab 0.5 mg, 1 mg, 2 mg, 3 mg and 4 mg, and oral liquid 1 mg per ml – new listing • Silver sulphadiazine (Flamazine) crm 1% - new listing • Solifenacin (Vesicare) tab 5 mg and 10 mg – new listing with Special Authority criteria • Somatropin (Genotropin) inj 16 iu and 36 iu – price and subsidy decrease • Topiramate (Apo-Topiramate) tab 25 mg, 50 mg, 100 mg and 200 mg – new listing Possible decisions for implementation 1 february 2010 • Anastrozole (Arimidex) tab 1 mg - subsidy decrease • Exemestane (Aromasin) tab 25 mg - subsidy decrease • Letrozole (Letara) tab 2.5 mg - new listing • Metoprolol succinate (Betaloc CR) tab long-acting 23.75 mg, 47.5 mg, 95 mg and 190 mg – price and subsidy decrease

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Acarbose Acetazolamide Allopurinol Alprazolam Amantadine hydrochloride Amlodipine Amoxycillin

Presentation

Tab 50 mg & 100 mg Tab 250 mg Tab 100 mg & 300 mg Tab 250 µg, 500 µg & 1 mg Cap 100 mg Tab 5 mg & 10 mg Drops 125 mg per 1.25 ml Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg

Brand Name Expiry Date*

Glucobay Diamox Apo-Allopurinol Arrow-Alprazolam Symmetrel Apo-Amlodipine Ospamox Paediatric Drops Ibiamox Apo-Amoxi Synermox AFT Ethics Aspirin Ethics Aspirin EC Pacific Atenolol Arrow-Azithromycin Sandoz Fibalip Bicalox Lax-Tabs AFT Marcain Isobaric Marcain Heavy Miacalcic Calsource Calcium Folinate Ebewe Apo-Captopril Ranbaxy-Cefaclor Ranbaxy-Cefaclor Hospira Zinacef PSM Zetop Cetirizine-AFT Chlorsig Orion 2012 2011 2011 2010 2011 2011 2011 2010 2011 2011 2010 2012 2012 2011 2011 2011 2010 2011 2010 2011 2011 2011 2010 2010 2011 2011 2010 2011 2012 2011

Amoxycillin clavulanate Aqueous cream Aspirin Atenolol Azithromycin Benzylpenicillin sodium (Penicillin G) Bezafibrate Bicalutamide Bisacodyl Brimonidine tartrate Bupivicaine hydrochloride Calcitonin Calcium Calcium folinate Captopril Cefaclor monohydrate Cefazolin sodium Cefuroxime sodium Cetomacrogol Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate

Tab amoxycillin 500 mg with potassium clavulanate 125 mg Crm 500 g Tab dispersible 300 mg Tab 100 mg Tab 50 mg & 100 mg Tab 500 mg Inj 1 mega u Tab 200 mg Tab 50 mg Tab 5 mg Eye drops 0.2% Inj 0.5%, 4 ml Inj 0.5%, 8% glucose, 4 ml Inj 100 iu per ml, 1 ml Tab eff 1 g Inj 50 mg Tab 12.5 mg, 25 mg & 50 mg Cap 250 mg Grans for oral liq 125 mg per 5 ml Inj 500 mg & 1 g Inj 750 mg & 1.5 g Crm BP Tab 10 mg Oral liq 1 mg per ml Eye oint 1% Soln 4%

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

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Ciclopiroxolamine Ciprofloxacin Citalopram Clarithromycin Clonazepam Clotrimazole

Presentation

Nail soln 8% Tab 250 mg, 500 mg & 750 mg Tab 20 mg Tab 250 mg Grans for oral liq 125 mg per 5 ml Tab 500 µg & 2 mg Vaginal crm 2% with applicators(s) 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 & 100 mg Inj 500 mg Nasal spray 10 mcg per dose Tab 5 mg Inj 50%, 10 ml Oral soln with electrolytes

Brand Name Expiry Date*

Batrafen Rex Medical Arrow-Citalopram Klamycin Klacid Paxam Clomazol Clomazol Clomazol PSM Colgout Colestid Colistin-Link Enerlyte Nausicalm Cycloblastin Siterone Mayne Desmopressin-PH&T PSM Biomed Pedialyte – Plain Pedialyte – Bubblegum Pedialyte – Fruit Voltaren Ophtha Voltaren Voltaren Dilzem Cardizem CD Pytazen SR Apo-Doxazosin AFT Clexane Comtan 2012 2011 2011 2010 2011 2010

Codeine phosphate Colchicine Colestipol hydrochloride Colistin sulphomethate Compound electrolytes Cyclizine hydrochloride Cyclophosphamide Cyproterone acetate Desferrioxamine mesylate Desmopressin Dexamphetamine sulphate Dextrose Dextrose with electrolytes

2010 2010 2010 2010 2010 2012 2010 2012 2010 2011 2010 2011 2010

Diclofenac sodium

Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab 30 mg & 60 mg Cap long-acting 120 mg, 180 mg & 240 mg Tab long-acting 150 mg Tab 2 mg & 4 mg Oint BP Inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg & 150 mg Tab 200 mg

2011

Diltiazem hydrochloride

2011

Dipyridamole Doxazosin mesylate Emulsifying ointment Enoxaparin sodium (low molecular weight heparin) Entacapone

2011 2010 2011 2012 2012

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Erythromycin ethyl succinate

Presentation

Tab 400 mg Grans for oral liq 200 mg per 5 ml Grans for oral liq 400 mg per 5 ml 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 Tab long-acting 5 mg Tab long-acting 10 mg Oral liq 150 mg per 5 ml Tab 5 mg Inj 250 mg, 500 mg & 1 g Cap 50 mg, 150 mg & 200 mg Inj 50 mg Tab 10 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 40 mg Crm 2% Oint 2% Cap 100 mg, 300 mg & 400 mg Tab 80 mg Tab 5 mg Tab 600 µg Oral pump spray 400 µg per dose TDDS 5 mg & 10 mg

Brand Name Expiry Date*

E-Mycin E-Mycin E-Mycin NZ Medical and Scientific Brevinor 21 Brevinor 1/21 Brevinor 1/28 Felo 5 ER Felo 10 ER Ferodan Fintral Flucloxin Pacific Fludara Fludara Oral Ultraproct Ultraproct 2012 2010 2011 2011 2011 2011 2010 2012 2011 2012 2010

Ethinyloestradiol Ethinyloestradiol with norethisterone

Felodipine Ferrous sulphate Finasteride Flucloxacillin Fluconazole Fludarabine phosphate Fluocortolone caproate with fluocortolone pivalate and cinchocaine

Fluoromethalone Fluoxetine hydrochloride Furosemide Fusidic acid Gabapentin Gliclazide Glipizide Glyceryl trinitrate

FML Fluox Fluox Diurin 40 Foban Foban Nupentin Apo-Gliclazide Minidiab Lycinate Nitrolingual pumpspray Nitroderm TTS Serenace Serenace ABM PSM Locoid

2012 2010 2012 2010 31/7/12 2011 2011 2011

Haloperidol Hydrocortisone Hydrcortisone butyrate

Oral liq 2 mg per ml Tab 500 µg, 1.5 mg & 5 mg Powder Crm 1% Scalp lotn 0.1%

2010 2011 2010

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Hydrocortisone with wool fat and mineral oil Hydroxychloroquine sulphate Hypromellose Hysocine N-butylbromide Ibuprofen Ipratropium bromide

Presentation

Lotn 1% with wool fat hydrous 3% and mineral oil Tab 200 mg Eye drops 0.5% Inj 20 mg, 1 ml Tab 20 mg Tab 200 mg Oral liq 100 mg per 5 ml Aqueous nasal spray, 0.03% Nebuliser soln, 250 µg per ml, 1 ml Nebuliser soln, 250 µg per ml, 2 ml Inj 50 mg per ml, 2 ml Cap 100 mg Shampoo 2% Oral liq 10 g per 15 ml Eye drops 0.25% & 0.5% 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*

DP Lotn HC Plaquenil Methopt Buscopan Gastrosoothe Ethics Ibuprofen Fenpaed Apo-Ipravent Ipratripium Steri-Neb Ipratripium Steri-Neb Ferrum H Sporanox Sebizole Duphalac Betagan Xylocaine Xylocaine Xylocaine EMLA EMLA Arrow-Lisinopril Nodia Loraclear Hayfever Relief Lorapaed Derbac M A-Lices Foremount Child’s Silicone Mask De-Worm Colofac Provera Pentasa Biodone Biodone Forte Biodone Extra Forte Methatabs 2012 2010 2010 2011 2012 2011 2011 2012 2010 2010

Iron polymaltose Itraconazole Ketoconazole Lactulose Levobunolol Lignocaine hydrochloride

2011 2010 2011 2010 2010 2010

Lignocaine with prilocaine

2010

Lisinopril Loperamide hydrochloride Loratadine

Malathion Mask for Spacer Device Mebendazole Mebeverine hydrochloride Medroxyprogesterone acetate Mesalazine Methadone hydrochloride

Liq 0.5% Shampoo 1% Device Tab 100 mg Tab 135 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Enema 1 g per 100 ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Tab 5 mg

2010 2011 30/9/11 2011 2011 2010 2012 2012 2010

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Methotrexate

Presentation

Tab 2.5 mg & 10 mg Inj 100 mg per ml, 10 ml Inj 100 mg per ml, 50 ml Tab 125 mg, 250 mg, 500 mg Tab 4 mg & 100 mg Inj 40 mg per ml, 1 ml Inj 40 mg per ml with lignocaine 1 ml Inj 5 mg per ml, 2 ml Crm 2% Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Tab 40 mg & 80 mg Tab 50 mg Tab 275 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Tab 200 mg

Brand Name Expiry Date*

Methoblastin Methotrexate Ebewe Methotrexate Ebewe Prodopa Medrol Depo-Medrol Depo-Medrol with Lidocaine Pfizer Multichem Mayne Mayne Apo-Nadolol ReVia Sonaflam AstraZeneca Viramune Suspension Viramune Habitrol Habitrol Habitrol Habitrol Noriday 28 Primolut N Norpress Nilstat Nilstat Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Zofran Zofran Zydis Apo-Oxybutynin Apo-Oxybutynin OxyNorm OxyNorm Pamisol Pamisol Pamisol 2012 2011 2011 2012 2011 2011 2011 2011 2011 2010 2010 2010 2010 2012

Methyldopa Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Metoclopramide hydrochloride Miconazole nitrate Morphine sulphate Nadolol Naltrexone hydrochloride Naproxen sodium Neostigmine Nevirapine

Nicotine

Patch 7 mg, 14 mg and 21 mg Lozenge 1 mg and 2 mg Gum 2 mg & 4 mg (Fruit) Gum 2 mg & 4 mg (Mint) Tab 350 µg Tab 5 mg Tab 10 mg & 25 mg Oral liq 100,000 u per ml, 24 ml OP Cap 500,000 u Tab 500,000 u Cap 10 mg, 20 mg & 40 mg Inj 40 mg

2010

Norethisterone Nortriptyline hydrochloride Nystatin

2012 2011 2011 2011 2010 2011

Omeprazole

Ondansetron Oxybutynin Oxycodone hydrochloride Pamidronate disodium

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 & 2 ml Oral liq 5 mg per 5 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml

2010 2010 2010 2011

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Pantoprazole

Presentation

Inj 40 mg Tab 20 mg & 40 mg Tab 500 mg Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml Eye oint with soft white paraffin Tab 20 mg Low range and Normal range Tab 0.25 mg & 1 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Cap potassium salt 250 mg & 500 mg Eye drops 0.12% Tab 15 mg, 30 mg and 45 mg Oral drops 10% Eye drops 1.4% Eye drops 3% Tab 1 mg, 2 mg & 5 mg Tab 1 mg, 2.5 mg, 5 mg & 20 mg Oral liq 5 mg per ml Inj 1.5 mega u Tab 10 mg & 25 mg Tab 5 mg, 10 mg & 20 mg Tab 10 mg with hydroclorothiazide 12.5 mg Tab 20 mg with hydroclorothiazide 12.5 mg Oral liq 150 mg per 10 ml Cap 150 mg Tab 0.25 mg, 1 mg, 2 mg and 5 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 ipratopium bromide 0.5 mg per vial, 2.5 ml

Brand Name Expiry Date*

Pantocid IV Dr Reddy’s Pantoprazole Pharmacare Paracare Junior Paracare Double Strength Lacri-Lube Loxamine Breath-Alert Permax AFT AFT Cilicaine VK Prefrin Pizaccord Coloxyl Vistil Vistil Forte Apo-Prazo Apo-Prednisone Redipred Cilicaine Allersoothe Accupril Accuretic 10 Accuretic 20 Peptisoothe Mycobutin Ropin ArrowRoxithromycin Asthalin Asthalin Salapin Duolin 2010 2010 2010 2012 2012 2010 2012 2010

Paracetamol

2011

Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak Flow Meter Pergolide Phenoxymethylpenicillin (Penicillin V) Phenylephrine hydrochloride Pioglitazone Poloxamer Polyvinyl alcohol Prazosin hydrochloride Prednisone Prednisone sodium phosphate Procaine penicillin Promethazine Quinapril Quinapril with hydroclorothiazide

2010 2010 30/9/11 2011 2010

2010 2012 2011 2011 2010 2011 2012 2011 2011 2011 2011

Ranitidine hydrochloride Rifabutin Ropinirole hydrochloride Roxithromycin Salbutamol

Salbutamol with ipratropium bromide

Sole Subsidised Supply Products – cumulative to December 2009

Generic Name

Selegiline hydrochloride Simvastatin

Presentation

Tab 5 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Grans eff 4 g sachets Tab 80 mg & 160 mg 230 ml Liq Soln 2.3% Tab 10 mg Tab 2 mg & 5 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Inj 250 mcg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.25% & 0.5% Crm 0.02% Oint 0.02% Inj 40 mg per ml, 1 ml 0.1% in Dental Paste USP Tab 300 mg Cap 300 mg Inj 50 mg per ml, 10 ml Ointment BP Cap 220 mg Tab 7.5 mg

Brand Name Expiry Date*

Apo-Selegiline Arrow-Simva 10 mg Arrow-Simva 20 mg Arrow-Simva 40 mg Arrow-Simva 80 mg Ural Mylan Space Chamber Midwest Pinetarsol Normison Apo-Terazosin Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timol Apo-Timop Aristocort Aristocort Kenacort-A40 Oracort TMP Actigall Pacific PSM Zincaps Apo-Zopiclone 2012 2011

Sodium citro-tartrate Sotalol Spacer Device Syrup (pharmaceutical grade) Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terazosin hydrochloride Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate Triamcinolone acetonide

2010 2012 30/9/11 2010 2011 2011 2010 2011 2011 2011 2012 2011 2011 2011 2011 2011 2011 2011 2011 2011

Trimethoprim Ursodeoxycholic acid Vancomycin hydrochloride Zinc and castor oil Zinc sulphate Zopiclone December changes in bold

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 December 2009

32 36 54 65 83 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ❋ 31 g × 6 mm ......................................................................... 11.75 CALCITRIOL ❋ Cap 0.25 µg ............................................................................. 3.03 ❋ Cap 0.5 µg ............................................................................... 5.62 FUROSEMIDE ❋ Tab 500 mg ........................................................................... 50.00 PERMETHRIN Lotn 5% .................................................................................... 3.65 CEPHALEXIN MONOHYDRATE – Hospital pharmacy [HP3] Grans for oral liq 125 mg per 5 ml ............................................. 8.50 Grans for oral liq 250 mg per 5 ml ........................................... 11.50 AMOXYCILLIN Grans for oral liq 125 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 1.55 Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 1.10 ETHAMBUTOL HYDROCHLORIDE – No patient co-payment payable Tab 100 mg ........................................................................... 57.81 DICLOFENAC SODIUM ❋ Tab long-acting 75 mg ............................................................ 32.80 ❋ Tab long-acting 100 mg .......................................................... 63.22 CLOMIPRAMINE HYDROCHLORIDE Tab 10 mg ............................................................................. 12.60 Tab 25 mg ................................................................................ 8.68 BROMOCRIPTINE MESYLATE ❋ Tab 2.5 mg ............................................................................ 32.08 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 15,000 iu ......................................................................... 120.00 DOCETAXEL – PCT only – Specialist – Special Authority see SA0880 Inj 20 mg ............................................................................. 325.00 Inj 80 mg .......................................................................... 1,300.00 100 30 30 50 30 ml OP 100 ml 100 ml ✔ Fine-Ject

✔ Airflow ✔ Airflow ✔ Urex Forte S29 ✔ A-Scabies ✔ Cefalexin Sandoz ✔ Cefalexin Sandoz

100 ml 100 ml 56 500 500 100 100 100 1

✔ Ospamox ✔ Ospamox ✔ Myambutol S29 ✔ Diclax SR ✔ Diclax SR ✔ Apo-Clomipramine ✔ Apo-Clomipramine ✔ Apo-Bromocriptine ✔ DBL Bleomycin Sulfate ✔ Docetaxel Ebewe ✔ Docetaxel Ebewe

88 99 111

119 138

138

1 1

Effective 1 November 2009

30 METFORMIN HYDROCHLORIDE ❋ Tab immediate–release 500 mg ................................................ 8.09 ❋ Tab immediate–release 850 mg ................................................ 6.67 500 250 ✔ Apotex ✔ Apotex

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

New listings - effective 1 November 2009 (continued)

62 MOMETASONE FUROATE Crm 0.1% ................................................................................. 2.38 4.55 Oint 0.1% ................................................................................. 2.38 4.55 CYPROTERONE ACETATE WITH ETHINYLOESTRADIOL ❋ Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs .............. 4.91 AMOXYCILLIN CLAVULANATE Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml – Up to 200 ml available on a PSO............ 2.20 Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml – Up to 200 ml available on a PSO.............. 3.85 15 g OP 45 g OP 15 g OP 45 g OP 84 ✔ m-Mometasone ✔ m-Mometasone ✔ m-Mometasone ✔ m-Mometasone ✔ Ginet 84

72 85

100 ml 100 ml

✔ Curam ✔ Curam

107

ETIDRONATE DISODIUM 100 ✔ Arrow-Etidronate ❋ Tab 200 mg ........................................................................... 23.95 Prescribing Guidelines Etidronate for osteoporosis should be prescribed for 14 days (400 mg in the morning) and repeated every three months. It should not be taken at the same time of the day as any calcium supplementation (minimum dose – 500 mg per day of elemental calcium). Etidronate should be taken at least 2 hours before or after any food or fluid, except water. MIRTAZAPINE – Special Authority see SA0994– Retail pharmacy Tab 30 mg .............................................................................. 22.00 Tab 45 mg .............................................................................. 35.00 30 30 ✔ Avanza ✔ Avanza

112

➽ SA0994 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has a severe major depressive episode; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and was unable to tolerate the treatments or failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and either could not tolerate it or failed to respond to an adequate dose over an adequate period of time. Renewal from any relevant practitioner. Approvals valid for 2 years where the patient has a high risk of relapse (prescriber determined). 134 OXALIPLATIN – PCT only – Specialist – Special Authority see SA0900 Inj 50 mg ............................................................................... 65.00 Inj 100 mg ........................................................................... 130.00 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab 2 mg ................................................................................. 1.01 (4.93) 2.02 (7.99) 1 1 20 Polaramine 40 Polaramine ✔ Oxaliplatin Ebewe ✔ Oxaliplatin Ebewe

151

▲

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

New listings - effective 1 November 2009 (continued)

167 PHENOBARBITONE SODIUM Powder – Only in combination ................................................ 52.50 10 g a) Only in children up to 12 years b) ‡ Safety cap for extemporaneously compounded oral liquid preparations. ✔ MidWest

Effective 13 October 2009

112 MOCLOBEMIDE Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. Tab 150 mg ............................................................................. 8.31 60 ✔ GenRx Moclobemide Tab 300 mg ........................................................................... 18.80 60 ✔ GenRx Moclobemide

Effective 1 October 2009

27 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 23.30 14 ✔ Klamycin a) Maximum of 14 tablets per prescription b) Subsidised only if prescribed for helicobacter pylori eradication and prescription is endorsed accordingly. Note: the prescription is considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxycillin or metronidazole. BLOOD GLUCOSE DIAGNOSTIC TEST METER – Subsidy by endorsement a) Maximum of 1 meter per prescription b) 1) A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005 or is prescribed for a pregnant woman with diabetes. 2) Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly. Meter ....................................................................................... 6.00 1 ✔ CareSens POP 9.00 ✔ CareSens II BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood glucose test strips x 50 and lancets x 5 .......................... 19.60 1 OP ✔ CareSens HEPARIN SODIUM Inj 1,000 iu per ml, 5 ml ......................................................... 11.44 46.30 Inj 5,000 iu per ml, 5 ml ....................................................... 118.50 HEPARINISED SALINE ❋ Inj 10 iu per ml, 5 ml .............................................................. 32.50 10 50 50 50 ✔ Pfizer ✔ Pfizer ✔ Pfizer ✔ Pfizer

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

New listings - effective 1 October 2009 (continued)

93 99 106 117 RALTEGRAVIR POTASSIUM – Special Authority see SA0779 – Hospital pharmacy [HP1] Tab 400 mg ....................................................................... 1,350.00 60 ✔ Isentress DICLOFENAC SODIUM ❋ Tab EC 25 mg .......................................................................... 1.63 ❋ Tab EC 50 mg .......................................................................... 2.13 ❋ Tab long-acting 75 mg ............................................................. 3.10 19.60 50 50 30 100 ✔ Diclohexal ✔ Diclohexal ✔ Diclax SR ✔ Voltaren SR

ALENDRONATE SODIUM WITH CHOLECALCIFEROL – Special Authority see SA0990 – Retail pharmacy Tab 70 mg with cholecalciferol 5600 iu ................................... 35.91 4 ✔ Fosamax Plus APREPITANT – Special Authority see SA0987 – Retail pharmacy Cap 2 x 80 mg and 1 x 125 mg ............................................. 116.00 3 OP ✔ Emend Tri-Pack ➽ SA0987 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 12 months where the patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy. Renewal from any relevant practitioner. Approvals valid for 12 months where the patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy.

123 159 186

RISPERIDONE Oral liq 1 mg per ml ................................................................ 18.35 LATANOPROST – Retail pharmacy-Specialist See prescribing guideline ▲ Eye drops 50 µg per ml, 2.5ml ................................................. 9.75

30 ml

✔ Risperon

2.5 ml OP ✔ Hysite

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA0733 – Hospital pharmacy [HP3] See prescribing guideline Infant formula ........................................................................ 174.72 400 g OP ✔ PKU Anamix Infant Liquid (berry) .......................................................................... 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ Liquid (citrus) .......................................................................... 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ Liquid (orange) ........................................................................ 15.65 62.5 ml OP ✔ PKU Lophlex LQ 31.20 125 ml OP ✔ PKU Lophlex LQ ELEMENTAL FORMULA – Special Authority see SA0603 – Hospital pharmacy [HP3] Powder ................................................................................... 11.72 450 g OP (15.21)

187

Pepti Junior Gold

▲

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

New listings - effective 1 September 2009

32 32 40 58 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ❋ 29 g × 12.7 mm .................................................................... 11.75 ❋ 31 g × 5 mm ......................................................................... 11.75 ❋ 31 g × 8 mm ......................................................................... 11.75 100 100 100 ✔ SC Profi-Fine ✔ SC Profi-Fine ✔ SC Profi-Fine

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE – Maximum of 100 dev per prescription ❋ Syringe 0.3 ml with 29 g × 12.7 mm needle .......................... 13.00 100 ✔ DM Ject ❋ Syringe 0.3 ml with 31 g × 8 mm needle ............................... 13.00 100 ✔ DM Ject ❋ Syringe 0.5 ml with 29 g × 12.7 mm needle .......................... 13.00 100 ✔ DM Ject ❋ Syringe 0.5 ml with 31 g × 8 mm needle ............................... 13.00 100 ✔ DM Ject ❋ Syringe 1 ml with 29 g × 12.7 mm needle ............................. 13.00 100 ✔ DM Ject ❋ Syringe 1 ml with 31 g × 8 mm needle .................................. 13.00 100 ✔ DM Ject CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy Tab 75 mg .............................................................................. 25.00 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg .............................................................................. 48.48 Cap 20 mg ............................................................................. 69.70 TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist Cap 40 mg .............................................................................. 60.71 BROMOCRIPTINE MESYLATE ❋ Cap 5 mg ............................................................................... 60.43 ZUCLOPENTHIXOL HYDROCHLORIDE Tab 10 mg .............................................................................. 31.45 28 180 180 60 100 ✔ Arrow-Clopidogrel ✔ Oratane ✔ Oratane ✔ Andriol Testocaps ✔ Apo-Bromocriptine

S29

76 119 123

100

✔ Clopixol

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 December 2009

65 PERMETHRIN 1) Should be strictly reserved for use as second line therapy in: 1) patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema; 2) cases of scabies which are resistent to gamma benzene hexachloride and resistant to malathion. 2) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: 1) a definite diagnosis of scabies should be made; 2) it should be ascertained that the medication was administered properly; 3) the possibility of reinfestation should have been excluded. Crm 5% .................................................................................... 4.20 30 g OP ✔ Lyderm Lotn 5% .................................................................................... 3.65 30 ml OP ✔ A-Scabies TENOFOVIR DISOPROXIL FUMARATE – Special Authority see SA0779 – Hospital pharmacy [HP1] – Subsidy by endorsement; can be waived by Special Authority see SA0997 Tab 300 mg ......................................................................... 531.00 30 ✔ Viread Endorsement for treatment of HIV/AIDS: Prescription is deemed to be endorsed if tenofovir disoproxil fumarate is co-prescribed with another anti-retroviral subsidised under Special Authority SA0779 and the prescription is annotated accordingly by the Pharmacist or endorsed by the prescriber. Note: • Tenofovir disoproxil fumarate prescribed under endorsement for the treatment of HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals for the purposes of Special Authority SA0779 • Subsidy for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. ➽ SA0997 Special Authority for Waiver of Rule Initial application - (Drug-Resistant Chronic Hepatitis B) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1. Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2. Patient has had previous lamivudine, adefovir or entecavir therapy; and 3. Both of the following: Documented drug resistance, defined as all of the following: 3.1. ALT greater than upper limit of normal; or ≥ Metavir Stage F3; and 3.2. HBV DNA greater than 20,000 IU/mL or increased ≥ 10 fold over nadir; and 4. Any of the following: 4.1. Hepatitis B virus resistant to lamivudine with detection of M204I/V mutation; or 4.2. Hepatitis B virus resistant to adefovir with detection of A181T/V or N236T mutation; or 4.3. Hepatitis B virus resistant to entecavir with detection of I169T, L180M T184S/A/I/L/G/C/M, S202C/G/I, M204V or M250I/V mutation. Renewal - (Drug-Resistant Chronic Hepatitis B) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Note • Tenofovir disoproxil fumarate should be stopped 6 months following HBeAg seroconversion for patients who were HBeAg positive prior to commencing tenofovir disoproxil fumarate. • The recommended dose of tenofovir disoproxil fumarate for the treatment of hepatitis B is 300 mg once daily. • In patients with renal insufficiency (calculated creatinine clearance less than 50 ml/min), the tenofovir disoproxil fumarate dose should be reduced in accordance with the approved Medsafe datasheet continued... guidelines.

▲

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 December 2009 (continued)

continued... • Tenofovir disoproxil fumarate is not approved for use in children. ➽ SA0779 Special Authority for Subsidy Initial application — (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 × total lymphocyte count; or 2.3.2.3 Viral load counts > 100000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 cells/mm3. Note: Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application — (Percutaneous exposure) only from a named specialist. Approvals valid for 6 weeks where the patient has percutaneous exposure to blood known to be HIV positive. Note: Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application — (Prevention of maternal transmission) only from a named specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Prevention of maternal foetal transmission; or 2 Treatment of the newborn for up to eight weeks. Notes: Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Some antiretrovirals are unapproved or contraindicated for this indication. Practitioners prescribing these medications should exercise their own skill, judgement, expertise and discretion, and make their own prescribing decisions with respect to the use of a Pharmaceutical for an indication for which it is not approved or contraindicated. Renewal — (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. 91 ANTIRETROVIRALS ➽ SA0779 Special Authority for Subsidy Initial application — (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 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

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 December 2009 (continued)

continued... 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 × total lymphocyte count; or 2.3.2.3 Viral load counts > 100000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 cells/mm3. Note: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals. Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application — (Percutaneous exposure) only from a named specialist. Approvals valid for 6 weeks where the patient has percutaneous exposure to blood known to be HIV positive. Note: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals. Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Initial application — (Prevention of maternal transmission) only from a named specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Prevention of maternal foetal transmission; or 2 Treatment of the newborn for up to eight weeks. Notes: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals. Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or saquinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. Some antiretrovirals are unapproved or contraindicated for this indication. Practitioners prescribing these medications should exercise their own skill, judgement, expertise and discretion, and make their own prescribing decisions with respect to the use of a Pharmaceutical for an indication for which it is not approved or contraindicated. Renewal — (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.

128

MIDAZOLAM Note – Midazolam injection will be funded if prescribed for intranasal administration for use in palliative care. Note that only the Hypnovel brand is currently indicated for intranasal administration. Tab 7.5 mg – Month Restriction............................................... 10.38 100 (25.00) Hypnovel ‡ Safety cap for extemporaneously compounded oral liquid preparations. Inj 1 mg per ml, 5 ml .............................................................. 10.75 10 ✔ Hypnovel (14.73) Pfizer Inj 5 mg per ml, 3 ml .............................................................. 11.90 5 ✔ Hypnovel (19.64) Pfizer

▲

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 December 2009 (continued)

144 LETROZOLE Tab 2.5 mg – Higher subsidy of $200.00 per 30 with Special Authority see SA0943 ........................................................... 146.46 30 ✔ Femara ➽ SA0943 Special Authority for Alternate Subsidy Initial application — (New patients) only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal woman; and 2 Patient has hormone receptor positive early breast cancer; and 3 Either: 3.1 The patient has a very clear history of intolerance to tamoxifen; or 3.2 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Initial application — (Patient has had a Special Authority approval for letrozole prior to 1 December 2008) only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. Note: If the patient had an approval for letrozole prior to 1 December 2008 the applicant is required to submit a fresh initial application in the first instance, not a renewal application. Please phone Ministry of Health Sector Services on 0800 243 666 for clarification if needed. ATROPINE SULPHATE ❋ Eye drops 1% ......................................................................... 17.36 15 ml OP Note – Sole Subsidised Supply status was removed effective 1 December 2009. ✔ Atropt

160

Effective 1 November 2009

30 37 METFORMIN HYDROCHLORIDE ❋ Tab immediate–release 500 mg .............................................. 8.09 9.75 ❋ Tab immediate–release 850 mg .............................................. 6.67 8.00 500 250 ✔ Apotex ✔ Arrow-Metformin ✔ Apotex ✔ Arrow-Metformin

MULTIVITAMINS – Special Authority see SA0963 – Retail pharmacy Tab ........................................................................................ 19.65 100 ✔ Ketovite Powder .................................................................................. 36.00 100 g OP ✔ Paediatric Seravit Oral liq ................................................................................... 13.50 150 ml OP ✔ Ketovite Liquid ➽ SA0963 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 The patient has inborn errors of metabolism; or 2 For use as a supplement to a ketogenic diet in patients diagnosed with epilepsy. Note: Use of Paediatric Seravit is not recommended as a supplement to a ketogenic diet. Renewal application from any relevant practitioner. Approvals valid without further renewal unless notified for applications where the patient has had a previous approval for multivitamins.

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 2009 (continued)

98 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] 1) Subsidy is available between 1 March and 30 June 30 September of each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii)diabetes; iv)chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi)the following other conditions: a) autoimmune disease, b) immune suppression, c) HIV, d) transplant recipients, e) neuromuscular and CNS diseases, f) haemoglobinopathies, or g) children on long term aspirin. The following conditions are excluded from funding: a) asthma not requiring regular preventative therapy, b) hypertension and/or dyslipidaemia without evidence of end-organ disease, c) pregnancy in the absence of another risk factor. 2) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under (1) above for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. 3) Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor. 43) Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder. Inj ............................................................................................ 9.00 1 ✔ Fluvax ✔ Fluarix 90.00 10 ✔ Fluarix ✔ Vaxigrip ANASTROZOLE-DP Tab 1 mg ............................................................................... 29.50 30 ✔ DP-Anastrozole

143 186

AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA0962 – Retail pharmacy See prescribing guideline Powder .................................................................................. 58.44 250 g OP ✔ Metabolic Mineral Mixture ➽ SA0962 Special Authority for Subsidy 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 2009 (continued)

continued... Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Dietary management of phenylketonuria (PKU); or 2 For use as a supplement to the ketogenic diet in patients diagnosed with epilepsy; or 3 Patient has had a previous approval for metabolic mineral mixture.

Effective 1 October 2009

40 PHYTOMENADIONE Inj 2 mg per 0.2 ml – Up to 5 inj available on a PSO ................... 8.00 May be administered orally Inj 10 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 9.21 May be administered orally 5 5 ✔ Konakion MM ✔ Konakion MM

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA0988 0657 Tab 250 mg ............................................................................. 7.75 14 ✔ Klamycin Grans for oral liquid 125 mg per 5 ml ...................................... 23.12 70 ml ✔ Klacid ➽ SA0988 0657 Special Authority for Waiver of Rule Initial application — (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. Note: Maximum of two prescriptions (two courses) per patient. Initial application — (Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count ≤ 50 cells/mm3. Renewal —(Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.

105

ALENDRONATE FOR OSTEOPOROSIS ➽ SA0990 0948 Special Authority for Subsidy Initial application — (Underlying cause – Osteoporosis) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5); or 2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 3 History of two significant osteoporotic fractures demonstrated radiologically; or continued... Patients pay a manufacturer’s surcharge when S29 Unapproved medicine supplied under Section 29 the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supply

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2009 (continued)

continued... 4 Documented T-Score ≤ -3.0; or 5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Dubbo) which incorporates BMD measurements. Initial application — (Underlying cause – glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is receiving systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents) and has already received or is expected to receive therapy for at least three months; and 2 Either: 2.1 The patient has documented BMD ≥ 1.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -1.5); or 2.2 The patient has a history of one significant osteoporotic fracture demonstrated radiologically. Renewal —(Underlying cause was, and remains, glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year where the patient is continuing systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents). Renewal — (Underlying cause was glucocorticosteroid therapy but patient now meets the ’Underlying cause osteoporosis’ criteria) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5); or 2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 3 History of two significant osteoporotic fractures demonstrated radiologically; or 4 Documented T-Score ≤ -3.0; or 5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Dubbo) which incorporates BMD measurements. Notes: a) Evidence used by National Institute for Health and Clinical Excellence (NICE) guidance indicates that patients aged 75 years and over who have a history of significant osteoporotic fracture demonstrated radiologically are very likely to have a T-Score ≤ -2.5, and therefore do not require BMD measurement for treatment with bisphosphonates. b) Osteoporotic fractures are the incident events for severe (established) osteoporosis, and can be defined using the WHO definitions of osteoporosis and fragility fracture. The WHO defines severe (established) osteoporosis as a T-score below -2.5 with one or more associated fragility fractures. Fragility fractures are fractures that occur as a result of mechanical forces that would not ordinarily cause fracture (minimal trauma). The WHO has quantified this as forces equivalent to a fall from a standing height or less. c) In line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. 119 LEVODOPA WITH CARBIDOPA ❋ Tab long-acting 200 mg with carbidopa 50 mg – Retail pharmacy-Specialist ................................................................ 47.50

100

✔ Sinemet CR

▲

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

Changes to Restrictions - effective 1 October 2009 (continued)

156 MASK FOR SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices and masks 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. 12) Only available for children aged six years and under. 23) 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. 34) 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 Size 2 ........................................................................................ 3.28 1 ✔ Foremount Child’s Silicone Mask SPACER DEVICE a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Spacer devices and masks 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. 12) 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. Space Chamber distributed by Airflow Products. Forward orders to: Airflow Products - PO Box 1485, Wellington Telephone: 04 499 1240 or 0800 AIR FLOW, Facsimile: 04 499 1245 or 0800 323 270 Volumatic Distributed by GlaxoSmithKline. Forward orders to: Telephone: 0800 877 789 Facsimile: 0800 877 785 230 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. 230 ml (single patient) .............................................................. 8.38 1 ✔ Space Chamber 800 ml ..................................................................................... 8.50 1 ✔ Volumatic

156

Effective 1 September 2009

31 KETONE BLOOD BETA-KETONE ELECTRODES – Subsidy by endorsement Patient has type 1 diabetes and has had one or more episodes of ketoacidosis (excluding first presentation). Maximum quantity of 2 packs per annum. No further prescriptions will be subsidised. The prescription must be endorsed accordingly. Test strip – Not on a BSO .......................................................... 8.50 10 strip OP ✔ Optium Blood Ketone Test Strips METOPROLOL SUCCINATE Additional subsidy by endorsement for Betaloc CR is available for patients who: 1) were being prescribed metoprolol succinate prior to 1 October 2007; or 2) have experienced a myocardial infarction; or 3) have experienced heart failure and are either intolerant of carvedilol or it is contra-indicated. Pharmacists may annotate prescriptions for patients who were being prescribed metoprolol succinate prior to 1 October 2007 in which case the prescription is deemed to be endorsed. The pharmacist must be able to show a clear documented dispensing history for the patient. The prescription must be endorsed accordingly. 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

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 2009 (continued)

continued... ❋ Tab long-acting 23.75 mg – Higher subsidy of up to $6.20 per 30 with Endorsement ............................................................. 3.61 ❋ Tab long-acting 47.5 mg – Higher subsidy of up to $7.80 per 30 with Endorsement ............................................................. 4.50 ❋ Tab long-acting 95 mg – Higher subsidy of up to $13.20 per 30 with Endorsement ............................................................. 7.40 ❋ Tab long-acting 190 mg – Higher subsidy of up to $21.00 per 30 with Endorsement ........................................................... 12.50 57 30 30 30 30 ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR

NICOTINE – Only on a Quitcard a) Maximum of 28 patch per dispensing b) Maximum of 56 patch per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Patch 7 mg ............................................................................ 10.53 7 OP ✔ Habitrol Patch 14 mg .......................................................................... 11.63 7 OP ✔ Habitrol Patch 21 mg .......................................................................... 12.32 7 OP ✔ Habitrol NICOTINE – Only on a Quitcard a) Maximum of 216 loz per dispensing b) Maximum of 432 loz per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Lozenge 1 mg ........................................................................ 11.08 36 OP ✔ Habitrol Lozenge 2 mg ........................................................................ 11.08 36 OP ✔ Habitrol NICOTINE – Only on a Quitcard a) Maximum of 384 piece per dispensing b) Maximum of 768 piece per prescription c) For the avoidance of doubt Nicotine will not be funded Close Control in amounts less than 4 weeks. Gum 2 mg (Fruit) .................................................................... 14.97 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 2 mg (Mint) .................................................................... 14.97 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 4 mg (Fruit) .................................................................... 20.02 96 OP ✔ Habitrol 23.41 ✔ Nicotinell Gum 4 mg (Mint) .................................................................... 20.02 96 OP ✔ Habitrol 23.41 ✔ Nicotinell GOSERELIN ACETATE – Special Authority see SA0839 – Hospital pharmacy [HP3] Inj 3.6 mg ............................................................................. 221.60 1 ✔ Zoladex Inj 10.8 mg .......................................................................... 554.70 1 ✔ Zoladex ➽ SA0839 Special Authority for Subsidy Initial application — (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application — (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or 2 Neoadjuvant or adjuvant treatment of locally advanced prostatic cancer. Note: Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiated. Initial application — (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: continued... Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. ❋ Three months or six months, as applicable, dispensed all-at-once

▲

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2009 (continued)

continued... Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note: The maximum treatment period for a GnRH analogue is: • 3 months to assess whether surgery is appropriate • 3 months for infertile patients after surgery • 6 months for patients with symptoms of endometriosis After the first 3 months patients should be assessed to determine whether there has been a satisfactory response to the first 3 months treatment. Initial application — (Precocious puberty) only from a paediatrician or endocrinologist. Approvals valid for 1 year where the patient is affected by gonadotropin dependent precocious puberty. Renewal — (Breast or prostate cancer) from any medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. Renewal — (Endometriosis) from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Either: 1 Both: 1.1 There has been a satisfactory response to the first 3 months treatment; and 1.2 Surgery is inappropriate; or 2 The first three months of therapy did not follow surgery for infertility. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. Renewal — (Precocious puberty) only from a paediatrician or endocrinologist. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment. Note: If a patient had an approval for any GnRH analogue prior to 1 July 2006 the applicant is required to submit a fresh initial application, not a renewal application. 83 AZITHROMYCIN – Subsidy by endorsement a) Maximum of 2 tab per prescription; can be waived by Special Authority see SA0964 b) Up to 4 tab available on a PSO c) Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly; can be waived by Special Authority see SA0964. Tab 500 mg ............................................................................. 5.95 2 OP ✔ Arrow-Azithromycin ENTECAVIR – Special Authority see SA0977 – Retail pharmacy Tab 0.5 mg ........................................................................... 400.00 30 ✔ Baraclude ➽ SA0977 Special Authority for Subsidy Initial application only from a gastroenterologist or infectious disease specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 Patient is Hepatitis B nucleoside analogue treatment-naive; and 3 Entecavir dose 0.5 mg/day; and 4 Either: 4.1 ALT greater than upper limit of normal; or 4.2 Bridging fibrosis or cirrhosis (Metavir stage 3 or greater) on liver histology; and 5 Either: continued...

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2009 (continued)

continued... 5.1 HBeAg positive; or 5.2 patient has ≥ 2,000 IU HBV DNA units per ml and fibrosis (Metavir stage 2 or greater) on liver histology; and 6 No continuing alcohol abuse or intravenous drug use; and 7 Not co-infected with HCV, HIV or HDV; and 8 Neither ALT nor AST greater than 10 times upper limit of normal; and 9 No history of hypersensitivity to entecavir; and 10 No previous documented lamivudine resistance (either clinical or genotypic). Notes: • Entecavir should be continued for 6 months following documentation of complete HBeAg seroconversion (defined as loss of HBeAg plus appearance of anti-HBe plus loss of serum HBV DNA) for patients who were HBeAg positive prior to commencing this agent. This period of consolidation therapy should be extended to 12 months in patients with advanced fibrosis (Metavir Stage F3 or F4). • Entecavir should be taken on an empty stomach to improve absorption. TRANYLCYPROMINE SULPHATE Tab 10 mg ............................................................................. 22.94 Note – removal of Section 29 annotation 50 ✔ Parnate S29 S29

112

143

ANASTROZOLE-DP – Subsidy by endorsement Subsidised only for patients with hormone receptor positive advanced breast cancer and the prescription is endorsed accordingly. Tab 1 mg ............................................................................... 29.50 30 ✔ DP-Anastrozole CYCLOSPORIN A – Special Authority see SA0470 – Hospital pharmacy [HP3] Cap 25 mg ............................................................................. 85.00 50 ✔ Neoral Cap 50 mg ........................................................................... 169.34 50 ✔ Neoral Cap 100 mg ......................................................................... 338.69 50 ✔ Neoral Oral liq 100 mg per ml .......................................................... 377.38 50 ml OP ✔ Neoral ➽ SA0470 Special Authority for Subsidy Initial application — (Organ transplant) only from a relevant specialist. Approvals valid without further renewal unless notified where the patient is an organ transplant recipient. Initial application — (Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Bone marrow transplant; or 2 Graft v host disease. Initial application — (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Psoriasis; and 2 Applicant must state which systemic and topical therapies have failed. Initial application — (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not responsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application — (Nephrotic Syndrome) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Nephrotic Syndrome; and 2 Corticosteroid dependent patients who have failed on cytotoxic therapy. continued... ❋ Three months or six months, as applicable, dispensed all-at-once

147

▲

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 September 2009 (continued)

continued... Initial application — (Endogenous uveitis) only from a relevant specialist. Approvals valid for 2 years where the patient suffers from endogenous uveitis. Initial application — (Severe rheumatoid arthritis) only from a rheumatologist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe rheumatoid arthritis; and 2 The patient must be either unresponsive to or unable to tolerate, both sulphasalazine and methotrexate; and 3 Patients must have 2 serum creatinine test results within the normal range within the three months prior to initiation of therapy. Renewal — (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal — (Indications other than severe atopic dermatitis) only from a dermatologist, rheumatologist or relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Guidelines for use of cyclosporin A in rheumatoid arthritis Monitoring: All patients require frequent monitoring for creatinine levels and blood pressure: • fortnightly, in the first three months of therapy and then monthly, if results are stable; • if dose is increased or there is a rise in serum creatinine or blood pressure, then more frequent monitoring is required. Contraindications: Cyclosporin A is contraindicated in patients with the following conditions: • current or past malignancy; • uncontrolled hypertension; • renal dysfunction (abnormal serum creatinine for age and sex); • immunodeficiency and neutropenia; • abnormally low white blood cell count or platelet count; or • liver function tests more than twice the upper limit of normal. Caution in use: • age above 65 years; • controlled hypertension; • use of anti-epileptic medications; • use of ketoconazole, fluconazole, trimethoprim, erythromycin, verapamil, and diltiazem; • concurrent or previous use of alkylating agents such as cyclophosphamide; • use of any experimental drug within the past three months; • premalignant conditions such as leukoplakia, monoclonal paraproteinaemia, myelodysplastic syndrome and dysplastic naevi; • active infection may necessitate temporary discontinuation; • pregnancy and lactation. Therapy should be discontinued if there has been no improvement after 6 months with the patient on the maximum tolerated dose. For further information please consult the data sheet. 166 PILOCARPINE ORAL LIQUID Pilocarpine 4% 6% eye drops qs Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days.)

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

Changes to Subsidy and Manufacturer’s Price

Effective 1 December 2009

99 DICLOFENAC SODIUM ( subsidy) ❋ Tab EC 25 mg ........................................................................... 3.26 (3.51) ❋ Tab EC 50 mg ......................................................................... 21.30 (25.88) QUETIAPINE ( subsidy) Tab 25 mg ............................................................................. 16.78 Tab 100 mg ........................................................................... 32.59 Tab 200 mg ........................................................................... 56.70 Tab 300 mg ........................................................................... 95.40 BLEOMYCIN SULPHATE – PCT only – Specialist ( subsidy) Inj 1,000 iu for ECP ................................................................... 9.28 LETROZOLE ( price) Tab 2.5 mg ........................................................................... 146.46 AZATHIOPRINE – Retail pharmacy-Specialist ( subsidy) ❋ Tab 50 mg ............................................................................. 26.75 LATANOPROST - Retail pharmacy – Specialist ( subsidy) ▲ Eye drops 50 µg per ml, 2.5 ml ................................................ 9.75 (19.50) ATROPINE SULPHATE ( subsidy) ❋ Eye drops 1% ......................................................................... 17.36 100 Apo-Diclo 500 Apo-Diclo 90 90 90 90 1,000 iu 30 100 2.5ml OP Xalatan 15 ml OP ✔ Atropt ✔ Quetapel ✔ Quetapel ✔ Quetapel ✔ Quetapel ✔ Baxter ✔ Femara ✔ Azamun

122

138 144 145 159

160 182

GLUTEN FREE BREAD MIX – Special Authority see SA0722 – Hospital pharmacy [HP3] ( price) Powder .................................................................................... 3.93 1,000 g OP (7.32) NZB Low Gluten Bread Mix 4.77 (8.71) Bakels Gluten Free Health Bread Mix 3.51 (10.87) Horleys Bread Mix GLUTEN FREE FLOUR – Special Authority see SA0722 – Hospital pharmacy [HP3] ( price) Powder ..................................................................................... 5.62 2,000 g OP (18.10) Horleys Flour

182

Effective 1 November 2009

26 27

▲

MESALAZINE ( subsidy) Tab long-acting 500 mg ......................................................... 59.05 LANSOPRAZOLE ( subsidy) ❋ Cap 15 mg ............................................................................... 3.50 ❋ Cap 30 mg ............................................................................... 4.65 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

100 28 28

✔ Pentasa ✔ Solox ✔ Solox

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price – effective 1 November 2009 (continued)

58 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy ( subsidy) Cap 10 mg ............................................................................. 26.93 100 Cap 20 mg ............................................................................. 38.72 100 ZINC ( price) Crm BP .................................................................................... 6.55 (12.00) 500 g PSM ✔ Isotane 10 ✔ Isotane 20

SUNSCREENS, PROPRIETARY – Subsidy by endorsement ( price) Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Crm .......................................................................................... 1.28 50 g OP (5.50) Aquasun Oil Free Faces SPF30+ Lotn ......................................................................................... 3.19 125 ml OP (6.94) Aquasun 30+ LITHIUM CARBONATE ( subsidy) Cap 250 mg ............................................................................. 7.73 OXAZEPAM – Month Restriction ( price) Tab 10 mg ............................................................................... 1.98 (5.89) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 15 mg ............................................................................... 2.45 (8.13) ‡ Safety cap for extemporaneously compounded oral liquid preparations. NITRAZEPAM – Month Restriction ( price) Tab 5 mg ................................................................................. 2.00 (4.98) ‡ Safety cap for extemporaneously compounded oral liquid preparations. IDARUBICIN HYDROCHLORIDE - PCT only - Specialist ( subsidy) Cap 5 mg .............................................................................. 115.00 100 100 Ox-Pam 100 Ox-Pam ✔ Douglas

122 126

128

100 Nitrados

139 167

✔ Zavedos

CODEINE PHOSPHATE ( price) Powder – Only in combination ................................................ 63.09 25 g (90.09) Douglas a) Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric. b) ‡ Safety cap for extemporaneously compounded oral liquid preparations.

Effective 1 October 2009

26 27 HYDROCORTISONE ACETATE ( subsidy) Rectal foam 10 %, CFC-Free (14 applications) ........................ 23.00 ATROPINE SULPHATE ( subsidy) ❋ Inj 600 µg, 1 ml – Up to 5 inj available on a PSO...................... 52.00 21.1 g OP ✔ Colifoam 50 ✔ AstraZeneca

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

Changes to Subsidy and Manufacturer's Price – effective 1 October 2009 (continued)

30 PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy ( subsidy) Tab 15 mg ............................................................................... 2.61 28 (45.78) Tab 30 mg ............................................................................... 5.23 28 (70.43) Tab 45 mg ............................................................................... 7.80 28 (89.39)

Actos Actos Actos

BLOOD GLUCOSE DIAGNOSTIC TEST STRIP ( subsidy) The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood glucose test strips ........................................................ 21.65 50 test OP ✔ Accu-Chek Performa VITAMIN A WITH VITAMINS D AND C ( subsidy and  price) Soln 1000 u with Vitamin D 400 u and ascorbic acid 30 mg per 10 drops ......................................................................... 4.50 HEPARIN SODIUM ( subsidy) Inj 5,000 iu per ml, 1 ml ......................................................... 14.20 POTASSIUM CHLORIDE ( subsidy) ❋ Tab long-acting 600 mg ........................................................... 7.00 CLONIDINE ( subsidy) ❋ TDDS 2.5 mg, 100 µg per day – Only on a prescription............ 23.30 ❋ TDDS 5 mg, 200 µg per day – Only on a prescription............... 32.80 ❋ TDDS 7.5 mg, 300 µg per day – Only on a prescription............ 41.20 CLONIDINE HYDROCHLORIDE ( subsidy) ❋ Tab 150 µg ............................................................................ 33.00 ❋ Inj 150 µg per ml, 1 ml ........................................................... 15.45 CALAMINE ( subsidy) a) Only on a prescription b) Not in combination Crm, aqueous, BP .................................................................... 2.78 (3.02) Lotn, BP ................................................................................. 16.70 (19.44) CLOBETASOL PROPIONATE ( subsidy) ❋ Crm 0.05% ............................................................................... 3.48 ❋ Oint 0.05% ............................................................................... 3.48 WOOL FAT WITH MINERAL OIL – Only on a prescription ( price) ❋ Lotn hydrous 3% with mineral oil .............................................. 5.60 (20.53)

10 ml OP 5 200 4 4 4 100 5

✔ Vitadol C ✔ Mayne ✔ Span-K ✔ Catapres-TTS-1 ✔ Catapres-TTS-2 ✔ Catapres-TTS-3 ✔ Catapres ✔ Catapres

42 44 54 54 60

100 g ABM 2,000 ml ABM 30 g OP 30 g OP 1,000 ml Alpha-Keri Lotion ✔ Dermol ✔ Dermol

61 64

▲

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price – effective 1 October 2009 (continued)

66 66 73 BETAMETHASONE VALERATE ( subsidy) ❋ Scalp app 0.1% ........................................................................ 7.22 CLOBETASOL PROPIONATE ( subsidy) ❋ Scalp app 0.05% ...................................................................... 6.36 OXYTOCIN – Up to 5 inj available on a PSO ( subsidy) Inj 5 iu per ml, 1 ml .................................................................. 5.94 Inj 10 iu per ml, 1 ml ................................................................ 7.48 Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ............. 10.12 HYDROCORTISONE ( subsidy) ❋ Tab 5 mg ................................................................................. 8.35 ❋ Tab 20 mg ............................................................................. 20.95 100 ml OP ✔ Beta Scalp 30 ml OP 5 5 5 100 100 ✔ Dermol ✔ Syntocinon ✔ Syntocinon ✔ Syntometrine ✔ Douglas ✔ Douglas

75 75 82

METHYLPREDNISOLONE SODIUM SUCCINATE – Retail pharmacy-Specialist ( subsidy) Inj 500 mg ............................................................................. 20.80 1 ✔ Solu-Medrol LEUPRORELIN – Hospital pharmacy [HP3] ( subsidy) Inj 7.5 mg ............................................................................ 166.20 Inj 22.5 mg .......................................................................... 443.76 Inj 30 mg ............................................................................. 591.68 Inj 45 mg ............................................................................. 832.05 FLUCLOXACILLIN SODIUM ( subsidy) Grans for oral liq 125 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 3.12 Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 3.55 1 1 1 1 ✔ Eligard ✔ Eligard ✔ Eligard ✔ Eligard

100 ml 100 ml

✔ AFT ✔ AFT

GENTAMICIN SULPHATE ( subsidy) Inj 40 mg per ml, 2 ml – Hospital pharmacy [HP3] – Subsidy by endorsement ..................................................................... 9.00 10 ✔ Pfizer Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly. NAPROXEN ( subsidy) ❋ Tab 250 mg ........................................................................... 23.70 ❋ Tab 500 mg ........................................................................... 24.88 BACLOFEN ( subsidy) ❋ Tab 10 mg ............................................................................... 4.75 QUININE SULPHATE ( subsidy) ❋ Tab 300 mg ........................................................................... 54.06 ‡ Safety cap for extemporaneously compounded oral liquid preparations. 500 250 100 500 ✔ Noflam 250 ✔ Noflam 500 ✔ Pacifen ✔ Q 300

100 107 107

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 2009 (continued)

110 MORPHINE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable ‡ Oral liq 1 mg per ml .................................................................. 8.84 ‡ Oral liq 2 mg per ml ................................................................ 11.62 ‡ Oral liq 5 mg per ml ................................................................ 14.65 ‡ Oral liq 10 mg per ml .............................................................. 21.55 MORPHINE SULPHATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Tab immediate-release 10 mg ................................................... 2.80 Tab immediate-release 20 mg ................................................... 5.52

200 ml 200 ml 200 ml 200 ml

✔ RA-Morph ✔ RA-Morph ✔ RA-Morph ✔ RA-Morph

110

10 10

✔ Sevredol ✔ Sevredol

112

MOCLOBEMIDE ( subsidy) Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. Tab 150 mg ........................................................................... 69.23 500 ✔ Apo-Moclobemide Tab 300 mg ........................................................................... 31.33 100 ✔ Apo-Moclobemide CLONIDINE HYDROCHLORIDE ( subsidy) ❋ Tab 25 µg .............................................................................. 19.25 LEVODOPA WITH CARBIDOPA ( subsidy) ❋ Tab long-acting 200 mg with carbidopa 50 mg ....................... 47.50 ❋ Tab 250 mg with carbidopa 25 mg ......................................... 40.00 CARBOPLATIN – PCT only – Specialist Inj 10 mg per ml, 5 ml ( subsidy) ........................................... 20.00 Inj 10 mg per ml, 15 ml ( subsidy) ......................................... 22.50 Inj 10 mg per ml, 45 ml ( subsidy) ......................................... 55.00 Inj 10 mg per ml, 100 ml ( subsidy) ..................................... 120.00 Inj 1 mg for ECP ( subsidy) ...................................................... 0.15 SODIUM CROMOGLYCATE ( subsidy) Nasal spray, 4% ..................................................................... 15.85 DORZOLAMIDE HYDROCHLORIDE WITH TIMOLOL MALEATE ( subsidy) ❋ Eye drops 2% with timolol maleate 0.5% ................................. 15.50 100 100 100 1 1 1 1 1 mg 22 ml OP 5 ml OP ✔ Dixarit ✔ Sinemet CR ✔ Sinemet ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Carboplatin Ebewe ✔ Baxter ✔ Rex ✔ Cosopt

117 119 134

155 159

Effective 1 September 2009

32 40 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ( subsidy) ❋ 31 g × 5 mm ......................................................................... 11.75 100 ✔ B-D Micro-Fine ✔ Apo-Clopidogrel Plavix

CLOPIDOGREL – Special Authority see SA0867 – Retail pharmacy ( subsidy) Tab 75 mg ............................................................................. 25.00 28 (73.38)

▲

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 September 2009 (continued)

52 64 METOPROLOL SUCCINATE ( subsidy) ❋ Tab long-acting 23.75 mg ......................................................... 3.61 ❋ Tab long-acting 47.5 mg ........................................................... 4.50 ❋ Tab long-acting 95 mg .............................................................. 7.40 ❋ Tab long-acting 190 mg .......................................................... 12.50 POVIDONE IODINE ( subsidy) Skin preparation, povidone iodine 10% with 30% alcohol ....................................................................... 10.00 DANAZOL – Retail pharmacy-Specialist ( subsidy) Cap 100 mg ........................................................................... 20.50 68.33 Cap 200 mg ........................................................................... 29.35 BETAHISTINE DIHYDROCHLORIDE ( subsidy) ❋ Tab 16 mg ............................................................................... 9.26 30 30 30 30 ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR ✔ Betaloc CR

500 ml 30 100 30 84

✔ Betadine Skin Prep ✔ D-Zol ✔ Azol ✔ D-Zol ✔ Vergo 16 ✔ Baxter ✔ Flutamin

117 141 143 155

VINORELBINE – PCT only – Specialist – Special Authority see SA0901 ( subsidy) Inj 1 mg for ECP ....................................................................... 2.71 1 mg FLUTAMIDE – Hospital pharmacy [HP3]-Specialist ( subsidy) Tab 250 mg ........................................................................... 48.30 100

BUDESONIDE ( price) Metered aqueous nasal spray, 50 µg per dose .......................... 2.35 200 dose OP (4.00) Metered aqueous nasal spray, 100 µg per dose ........................ 2.61 200 dose OP (4.81) FLUOROMETHOLONE ( subsidy) ❋ Eye drops 0.1% ........................................................................ 4.05 (4.30) 5 ml OP

Butacort Aqueous Butacort Aqueous

158 175

Flucon

ORAL FEED 1KCAL/ML – Special Authority see SA0589 – Hospital pharmacy [HP3] ( subsidy) Liquid ........................................................................................ 1.90 200 ml OP ✔ Fortimel

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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Brand Name

Effective 1 December 2009

175 ORAL FEED 1KCAL/ML – Special Authority see SA0589 – Hospital pharmacy [HP3] Liquid ........................................................................................ 1.90 200 ml OP ✔ Fortimel Regular Fortimel

Effective 1 November 2009

172 PROTEIN SUPPLEMENT – Special Authority see SA0582 – Hospital pharmacy [HP3] Powder .................................................................................... 7.90 225 g OP ✔ Protifar Protifar 90

Effective 1 October 2009

137 AMSACRINE – PCT only – Specialist Inj 75 mg ............................................................................. CBS 6 ✔ Amsidine Amsidyl

S29

Changes to Sole Subsidised Supply

Effective 1 December 2009

For the list of new Sole Subsidised Supply products effective 1 December 2009 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 11-17.

▲

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 December 2009

25 CALCIUM CARBONATE WITH AMINOACETIC ACID ❋ Tab 420 mg with aminoacetic acid 180 mg – Higher subsidy of $38.73 per 1000 with Endorsement ................................. 30.00 (38.73) PIOGLITAZONE – Special Authority see SA0959 – Retail pharmacy Tab 15 mg ............................................................................... 2.61 (45.78) Tab 30 mg ............................................................................... 5.23 (70.43) Tab 45 mg ............................................................................... 7.80 (89.39)

1,000 Titralac 28 Actos 28 Actos 28 Actos

GLUCOSE OXIDASE Urine diagnostic test with peroxidase, sodium nitroprusside and aminoacetic acid – Not on a BSO .................................... 4.53 50 stick OP (8.00) Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid – Not on a BSO .................................................................................... 4.53 50 strip OP (14.87) SODIUM NITROPRUSSIDE ❋ Urine diagnostic strips, buffered – Not on a BSO ........................ 3.39 (6.00) 3.40 (10.94) OIL IN WATER EMULSION ❋ Crm........................................................................................... 2.80 ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab ........................................................................................... 6.62 (9.45) OESTRADIOL WITH LEVONORGESTREL ❋ Tab 2 mg with 75 µg levonorgestrel (36) and tab 2 mg Oestradiol (48) .................................................................... 16.20 EFAVIRENZ – Special Authority see SA0779 – Hospital pharmacy [HP1] Tab 50 mg ............................................................................ 158.33 Tab 200 mg .......................................................................... 474.99 INDOMETHACIN ❋ Cap 25 mg ................................................................................ 5.90 50 strip OP

Keto-Diabur 5000

Keto-Diastix

Ketur-Test Ketostix 500g 84 Triquilar ED ✔ Lemnis Fatty Cream

63 71 78 92

84 30 90 100

✔ Nuvelle ✔ Stocrin ✔ Stocrin ✔ Rheumacin

100

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 December 2009 (continued)

110 NORTRIPTYLINE HYDROCHLORIDE Tab 25 mg .............................................................................. 20.06 Note: Norpress tab 25 mg 180 tablet pack size listed 1 May 2009 PILOCARPINE ❋ Eye drops 0.5% ......................................................................... 3.19 FLUOROMETHOLONE ❋ Eye drops 0.1% ........................................................................ 4.05 (4.30) 250 ✔ Norpress

156 158 176

15 ml OP 5 ml OP

✔ Pilopt

Flucon

ENTERAL FEED WITH FIBRE 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ........................................................................................ 1.24 250 ml OP ✔ Fibersource 5.29 1,000 ml OP ✔ Fibersource RTH

Effective 1 November 2009

61 HYDROCORTISONE ❋ Powder – Only in combination ................................................ 33.00 25 g (37.64) m-Hydrocortisone Up to 5% in a dermatological base (not proprietary Topical Corticosteriod – Plain) with or without other dermatological galenicals. PAEDIATRIC ORAL FEED 1.5KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid (strawberry) ................................................................... 1.60 200 ml OP ✔ Fortini Liquid (vanilla) .......................................................................... 1.60 200 ml OP ✔ Fortini PAEDIATRIC ORAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.60 200 ml OP ✔ Fortini Multifibre Liquid (strawberry) ................................................................... 1.60 200 ml OP ✔ Fortini Multifibre Liquid (vanilla) .......................................................................... 1.60 200 ml OP ✔ Fortini Multifibre

176

Effective 1 October 2009

48 TERAZOSIN HYDROCHLORIDE ❋ Tab 2 mg .................................................................................. 1.30 ❋ Tab 5 mg .................................................................................. 1.62 CILAZAPRIL Tab 2.5 mg ............................................................................... 4.39 Tab 5 mg .................................................................................. 6.44 INDOMETHACIN ❋ Cap 50 mg ................................................................................ 6.95 APOMORPHINE HYDROCHLORIDE ▲ Inj 10 mg per ml, 2 ml ............................................................. 50.43 ▲ Inj 10 mg per ml, 1 ml ............................................................. 50.53 AZATHIOPRINE – Retail pharmacy – Specialist ❋ Tab 50 mg .............................................................................. 25.00 28 28 30 30 100 5 5 100 ✔ Hytrin ✔ Hytrin ✔ Inhibace ✔ Inhibace ✔ Rheumacin ✔ APO-go S29 ✔ Mayne ✔ Thioprine

100 119 145

▲

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 October 2009 (continued)

170 CARBOHYDRATE SUPPLEMENT – Special Authority – Hospital pharmacy [HP3] Powder ..................................................................................... 1.14 350 g OP (7.85)

Polycose

176

PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.27 237 ml OP ✔ Pediasure Liquid (chocolate) ..................................................................... 1.27 237 ml OP ✔ Pediasure

Effective 1 September 2009

32 BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood glucose test strips ........................................................ 22.00 50 test OP ✔ Optium 10 second test 11.00 25 test OP ✔ Optium 10 second test GLYCEROL ❋ Suppos 2.55 g – Only on a prescription .................................... 3.12 LABETALOL ❋ Inj 5 mg per ml, 5 ml .............................................................. 14.77 (22.15) 12 ✔ Fleet Glycerin Suppositories

34 52 62

Trandate S29

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN Oint 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g – Only on a prescription............. 3.00 15 g OP ETHINYLOESTRADIOL WITH GESTODENE ❋ Tab 30 µg with gestodene 75 µg and 7 inert tab ....................... 6.62 84 (14.49) a) Higher subsidy of $14.49 per 84 with Special Authority see SA0500 above b) Up to 84 tab available on a PSO

✔ Kenacomb

Minulet 28

ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab ethinyloestradiol 30 µg with levonorgestrel 50 µg (6) and tab ethinyloestradiol 40 µg with levonorgestrel 75 µg (5), and tab ethinyloestradiol 30 µg with levonorgestrel 125 µg (10) and 7 inert tab ............................................................... 6.62 84 (14.49) Triphasil 28 a) Higher subsidy of up to $14.49 per 84 with Special Authority see SA0500 on the preceding page b) Up to 84 tab available on a PSO

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 September 2009 (continued)

76 85 TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 5 ml ............................................................ 10.31 DICLOXACILLIN Cap 250 mg ............................................................................. 2.47 (4.35) Cap 500 mg ............................................................................. 3.83 (8.65) ROPINIROLE HYDROCHLORIDE ▲ Tab 0.25 mg .......................................................................... 19.75 (31.50) ▲ Tab 0.25 mg × 42, 0.5 mg × 42 and 1 mg × 21 .................. 21.92 (35.70) ▲ Tab 0.5 mg × 42, 1 mg × 42 and 2 mg × 63 ....................... 73.60 (122.11) ▲ Tab 1 mg ............................................................................... 40.32 (67.20) ▲ Tab 2 mg ............................................................................... 60.72 (101.21) ▲ Tab 5 mg ............................................................................... 90.00 (150.00) 1 24 Diclocil 24 Diclocil 210 Requip 105 Requip Starter Pack 147 Requip Follow-on Pack 84 Requip 84 Requip 84 Requip ✔ Kenacort-A

120

174

DIABETIC ENTERAL FEED 1KCAL/ML – Special Authority see SA0594 – Hospital pharmacy [HP3] Liquid ........................................................................................ 7.50 1,000 ml OP ✔ Resource Diabetic TF RTH

▲

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

Items to be Delisted

Effective 1 January 2010

60 CALAMINE a) Only on a prescription b) Not in combination Crm, aqueous, BP .................................................................... 2.78 (3.02) Lotn, BP ................................................................................. 16.70 (19.44)

100 g ABM 2,000 ml ABM

Effective 1 February 2010

58 ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg ............................................................................. 26.93 Cap 20 mg ............................................................................. 38.72 100 100 ✔ Isotane 10 ✔ Isotane 20

Effective 1 March 2010

97 PEGYLATED INTERFERON ALPHA-2B WITH RIBAVIRIN – Special Authority see SA0953 – Hospital pharmacy [HP3] See prescribing guideline Inj 50 µg × 4 with ribavirin cap 200 mg × 112 ................. 1,080.40 1 OP ✔ Pegatron Combination Therapy Inj 50 µg × 4 with ribavirin cap 200 mg × 84 ...................... 976.80 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 140 ................. 1,583.60 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 168 ................. 1,687.20 1 OP ✔ Pegatron Combination Therapy Inj 80 µg × 4 with ribavirin cap 200 mg × 84 ................... 1,376.40 1 OP ✔ Pegatron Combination Therapy Inj 100 µg × 4 with ribavirin cap 200 mg × 112 ............... 1,746.40 1 OP ✔ Pegatron Combination Therapy Inj 100 µg × 4 with ribavirin cap 200 mg × 84 ................. 1,642.80 1 OP ✔ Pegatron Combination Therapy Inj 120 µg × 4 with ribavirin cap 200 mg × 140 ............... 2,116.40 1 OP ✔ Pegatron Combination Therapy Inj 120 µg × 4 with ribavirin cap 200 mg × 84 ................. 1,909.20 1 OP ✔ Pegatron Combination Therapy Inj 150 µg × 4 with ribavirin cap 200 mg × 140 ............... 2,516.00 1 OP ✔ Pegatron Combination Therapy continued...

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

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

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 2010 (continued)

continued... Inj 150 µg × 4 with ribavirin cap 200 mg × 168 ............... 2,619.60 Inj 150 µg × 4 with ribavirin cap 200 mg × 84 ................. 2,308.80 1 OP 1 OP ✔ Pegatron Combination Therapy ✔ Pegatron Combination Therapy

112 115 119 125

DICLOFENAC SODIUM ❋ Tab EC 25 mg ........................................................................... 3.26 (3.51) ❋ Tab EC 50 mg ......................................................................... 21.30 (25.88) TRIMIPRAMINE MALEATE Cap 25 mg ............................................................................... 6.20 LAMOTRIGINE ▲ ab dispersible 200 mg ........................................................ 101.80 T BROMOCRIPTINE MESYLATE ❋ Tab 10 mg ........................................................................... 120.86 DIAZEPAM Tab 5 mg – Month Restriction.................................................... 5.00 ‡ Safety cap for extemporaneously compounded oral liquid preparations. PACLITAXEL – PCT only – Specialist Inj 30 mg ............................................................................... 37.95 Note – Paclitaxel Ebewe inj 30 mg, 5 inj pack remains listed. LATANOPROST - Retail pharmacy – Specialist ▲ Eye drops 50 mcg per ml, 2.5 ml .............................................. 9.75 (19.50) PILOCARPINE ❋ Eye drops 1% ........................................................................... 3.24

100 Apo-Diclo 500 Apo-Diclo 100 56 100 250 ✔ Tripress ✔ Mogine ✔ Alpha-Bromocriptine ✔ Pro-Pam

140

✔ Paclitaxel Ebewe

159

2.5ml OP Xalatan 15 ml OP ✔ Pilopt

160 183

GLUTEN FREE PASTA – Special Authority see SA0722 – Hospital pharmacy [HP3] Corn and Spinach Rigatini.......................................................... 2.00 250 g OP (2.92) Garlic and Parsley Shells ........................................................... 2.00 250 g OP (2.92) Rice and Corn Garden Herb Pasta .............................................. 2.00 250 g OP (2.92)

Orgran Orgran Orgran

Effective 1 April 2010

40 42

▲

PHYTOMENADIONE Tab 10 mg ............................................................................... 5.60 HEPARINISED SALINE ❋ Inj 10 iu per ml, 5 ml .............................................................. 18.00 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

10 50

✔ Konakion ✔ AstraZeneca

❋ 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 April 2010 (continued)

125 DIAZEPAM Tab 10 mg – Month Restriction.................................................. 3.45 ‡ Safety cap for extemporaneously compounded oral liquid preparations. PILOCARPINE ❋ Eye drops 4% ............................................................................ 6.57 100 ✔ Pro-Pam

160 178

15 ml OP

✔ Pilopt

SEMI-ELEMENTAL ENTERAL FEED 1KCAL/ML - Special Authority – Hospital pharmacy [HP3] Liquid ........................................................................................ 6.02 500 ml OP ✔ Peptisorb

Effective 1 May 2010

64 WOOL FAT WITH MINERAL OIL – Only on a prescription ❋ Lotn hydrous 3% with mineral oil .............................................. 1.12 (5.00) 2.10 (9.38) 200 ml OP Alpha-Keri Lotion 375 ml OP Alpha-Keri Lotion

SUNSCREENS, PROPRIETARY – Subsidy by endorsement Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly. Lotn ......................................................................................... 3.19 125 ml OP (8.82) Aquasun Sensitive SPF 30+ LAMOTRIGINE ▲ Tab dispersible 200 mg ........................................................ 101.80 TENIPOSIDE – PCT only – Specialist Inj 10 mg per ml, 5 ml .......................................................... 845.11 Inj 50 mg for ECP ................................................................... 84.51 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab 2 mg ................................................................................. 1.26 (5.60) 2.52 (9.99) 56 ✔ Arrow-Lamotrigine

115 140

10 ✔ Vumon 50 mg OP ✔ Baxter 25 Polaramine 50 Polaramine

151

Effective 1 June 2010

27 28 ATROPINE SULPHATE ❋ Inj 1200 µg, 1 ml – Up to 5 inj available on a PSO.................... 32.00 OMEPRAZOLE ❋ Cap 10 mg ................................................................................ 2.00 ❋ Cap 40 mg ................................................................................ 3.35 50 28 28 ✔ AstraZeneca ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole

Note – Dr Reddy's Omeprazole cap 10 mg and 40 mg, 30 cap pack, remains listed.

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 June 2010 (continued)

43 51 70 POTASSIUM CHLORIDE ❋ Inj 150 mg per ml, 10 ml ......................................................... 26.00 ATENOLOL ❋ Tab 50 mg ............................................................................... 0.39 ETHINYLOESTRADIOL WITH GESTODENE ❋ Tab 30 µg with gestodene 75 µg and 7 inert tab ........................ 6.62 (16.50) a) Higher subsidy of $14.49 per 84 with Special Authority see SA0500 b) Up to 84 tab available on a PSO CLOMIPRAMINE HYDROCHLORIDE Tab 10 mg ............................................................................. 10.00 BROMOCRIPTINE MESYLATE ❋ Tab 2.5 mg ............................................................................. 32.08 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 15,000 iu .......................................................................... 680.00 MITOMYCIN C - PCT only – Specialist Inj 10 mg .............................................................................. 531.30 50 30 84 Femodene 28 ✔ AstraZeneca ✔ Noten S29

111 119 138 140

100 100 10 5

✔ Clopress ✔ Alpha-Bromocriptine ✔ Blenoxane ✔ Mitomycin-C 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 December 2009

AMOXYCILLIN Grans for oral liq 125 mg per 5 ml ..Ospamox Grans for oral liq 250 mg per 5 ml .Ospamox ATROPINE SULPHATE ( price and discontinuing HSS) Eye drops 1% ................................Atropt 1.55 1.10 100 ml 100 ml

Feb-10

Amoxil Ranbaxy Amoxicillin (B)

17.36

15 ml

Dec-08

ATROPINE SULPHATE Inj 1200 µg, 1 ml............................AstraZeneca 32.00 50 Note – AstraZeneca inj 1200 µg, 1 ml to be delisted 1 February 2010. BLEOMYCIN SULPHATE Inj 15,000 iu ...................................Blenoxane 680.00 Note – Blenoxane inj 15,000 iu to be delisted 1 February 2010. CALCITRIOL Cap 0.25 µg ..................................Airflow Cap 0.5 µg .....................................Airflow 3.03 5.62 10

30 30

1% 1%

Feb-10 Feb-10

Calcitriol-AFT Rocaltrol Caltriol-AFT Rocaltrol

Note – Calcitriol-AFT cap 0.25 µg and 0.5 µg to be delisted 1 February 2010. CEPHALEXIN MONOHYDRATE Grans for oral liq 125 mg per 5 ml ..Cefalexin Sandoz Grans for oral liq 250 mg per 5 ml ..Cefalexin Sandoz 8.50 11.50 100 ml 100 ml 1% 1% Feb-10 Feb-10 (B) (B)

DOCETAXEL Inj 20 mg........................................Docetaxel 325.00 1 Ebewe Inj 80 mg........................................Docetaxel 1,300.00 1 Ebewe Note – Taxotere inj 20 mg and 80 mg to be delisted 1 February 2010. ETHAMBUTOL HYDROCHLORIDE Tab 100 mg....................................Myambutol FUROSEMIDE Tab 500 mg....................................Urex Forte 57.81 50.00 56 50

1% 1%

Feb-10 Feb-10

Docetaxel Winthrop Taxotere Docetaxel Winthrop Taxotere

HYDROXYETHYL STARCH 200/0.5 PENTASTARCH (amended description) Inj Inf 10% per 500 ml bag ..............StarQuin 10% 216.00 16 LETROZOLE ( price) Tab 2.5 mg.....................................Femara 146.46 30

Sept-08

Pentaspan

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 changes to Part II - effective 1 December 2009 (continued)

MEGLUMINE DIATRIZOATE WITH SODIUM AMIDOTRIZOATE ( price) Oral soln 660 mg per ml with sodium amidotrizoate 100 mg per ml, 100 ml ...........................Gastrografin 210.00 10 MEGLUMINE GADOPENTETATE Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 10 ml prefilled Syringe ( price) ........................Magnevist 92.00 5 Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 20 ml ............Magnevist 33.85 1 Note – Magnevist inj 469 mg per ml, 20 ml to be delisted 1 February 2010. PERMETHRIN Lotn 5% .........................................A-Scabies Note – Lyderm crm 5% to be delisted 1 February 2010. 3.65 30 ml 1% Feb-10 Lyderm

POLYETHYLENE GLYCOL WITH SODIUM SULPHATE ( price) Powder, sachets .............................Klean-Prep 16.46 QUETIAPINE ( price) Tab 25 mg......................................Quetapel Tab 100 mg....................................Quetapel Tab 200 mg....................................Quetapel Tab 300 mg ...................................Quetapel 16.78 32.59 56.70 95.40

4 90 90 90 90

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 Accu-Chek Performa .......................................... 37 Actos ........................................................... 37, 42 Alendronate for osteoporosis .............................. 28 Alendronate sodium with cholecalciferol ............. 21 Alpha-Bromocriptine .................................... 47, 49 Alpha-Keri Lotion ......................................... 37, 48 Aminoacid formula with minerals without phenylalanine .................................................. 27 Aminoacid formula without phenylalanine ........... 21 Amoxycillin .................................................. 18, 50 Amoxycillin clavulanate ...................................... 19 Amsacrine ......................................................... 41 Amsidine ........................................................... 41 Amsidyl ............................................................. 41 Anastrozole ........................................................ 27 Anastrozole-DP .................................................. 33 Andriol Testocaps .............................................. 22 Antiretrovirals ..................................................... 24 Apo-Bromocriptine ....................................... 18, 22 Apo-Clomipramine ............................................. 18 Apo-Clopidogrel ................................................. 39 Apo-Diclo..................................................... 35, 47 APO-go .............................................................. 43 Apo-Moclobemide.............................................. 39 Apomorphine hydrochloride ............................... 43 Aprepitant .......................................................... 21 Aquasun 30+ .................................................... 36 Aquasun Oil Free Faces SPF30+ ........................ 36 Aquasun Sensitive SPF 30+ .............................. 48 Arrow-Azithromycin ........................................... 32 Arrow-Clopidogrel .............................................. 22 Arrow-Etidronate ................................................ 19 Arrow-Lamotrigine ............................................. 48 Arrow-Metformin................................................ 26 A-Scabies .............................................. 18, 23, 51 Atenolol ............................................................. 49 Atropine sulphate ....................... 26, 35, 36, 48, 50 Atropt .................................................... 26, 35, 50 Avanza............................................................... 19 Azamun ............................................................. 35 Azathioprine ................................................. 35, 43 Azithromycin ...................................................... 32 Azol ................................................................... 40 B B-D Micro-Fine................................................... 39 Baclofen ............................................................ 38 Bakels Gluten Free Health Bread Mix ................... 35 Baraclude .......................................................... 32 Betadine Skin Prep ............................................. 40 Betahistine dihydrochloride................................. 40 Betaloc CR ................................................... 31, 40 Betamethasone valerate ..................................... 38 Beta Scalp ......................................................... 38 Blenoxane .................................................... 49, 50 Bleomycin sulphate .......................... 18, 35, 49, 50 Blood glucose diagnostic test meter ................... 20 Blood glucose diagnostic test strip ......... 20, 37, 44 Bromocriptine mesylate.................... 18, 22, 47, 49 Budesonide ........................................................ 40 Butacort Aqueous .............................................. 40 C Calamine...................................................... 37, 46 Calcitriol ...................................................... 18, 50 Calcium carbonate with aminoacetic acid ........... 42 Carbohydrate supplement................................... 44 Carboplatin ........................................................ 39 Carboplatin Ebewe ............................................. 39 CareSens ........................................................... 20 CareSens II ........................................................ 20 CareSens POP ................................................... 20 Catapres ............................................................ 37 Catapres-TTS-1 ................................................. 37 Catapres-TTS-2 ................................................. 37 Catapres-TTS-3 ................................................. 37 Cefalexin Sandoz .......................................... 18, 50 Cephalexin monohydrate .............................. 18, 50 Cilazapril ............................................................ 43 Clarithromycin.............................................. 20, 28 Clobetasol propionate................................... 37, 38 Clomipramine hydrochloride ......................... 18, 49 Clonidine............................................................ 37 Clonidine hydrochloride ................................ 37, 39 Clopidogrel .................................................. 22, 39 Clopixol.............................................................. 22 Clopress ............................................................ 49 Codeine phosphate ............................................ 36 Colifoam ............................................................ 36 Cosopt ............................................................... 39 Curam ............................................................... 19 Cyclosporin A .................................................... 33 Cyproterone acetate with ethinyloestradiol .......... 19 D D-Zol ................................................................. 40 Danazol.............................................................. 40 Dermol......................................................... 37, 38 Dextrochlorpheniramine maleate ................... 19, 48 Diabetic enteral feed 1kcal/ml ............................. 45 Diazepam..................................................... 47, 48 Diclax SR ..................................................... 18, 21 Diclocil .............................................................. 45 Diclofenac sodium ........................... 18, 21, 35, 47 Diclohexal .......................................................... 21 Dicloxacillin........................................................ 45

Index

Pharmaceuticals and brands Dixarit ................................................................ 39 DM Ject ............................................................. 22 Docetaxel ..................................................... 18, 50 Docetaxel Ebewe .......................................... 18, 50 Dorzolamide hydrochloride with timolol maleate.. 39 DP-Anastrozole ............................................ 27, 33 Dr Reddy’s Omeprazole...................................... 48 E Efavirenz ............................................................ 42 Elemental formula .............................................. 21 Emend Tri-Pack ................................................. 21 Eligard ............................................................... 38 Entecavir ............................................................ 32 Enteral feed with fibre 1kcal/ml ........................... 43 Ethambutol hydrochloride ............................. 18, 50 Ethinyloestradiol with gestodene ................... 44, 49 Ethinyloestradiol with levonorgestrel ............. 42, 44 Etidronate disodium ........................................... 19 F Femara .................................................. 26, 35, 50 Femodene 28 ..................................................... 49 Fibersource ........................................................ 43 Fibersource RTH ................................................ 43 Fine-Ject ............................................................ 18 Fleet Glycerin Suppositories ............................... 44 Fluarix ................................................................ 27 Flucloxacillin sodium .......................................... 38 Flucon.......................................................... 40, 43 Fluorometholone .......................................... 40, 43 Flutamide ........................................................... 40 Flutamin ............................................................. 40 Fluvax ................................................................ 27 Foremount Child’s Silicone Mask ........................ 30 Fortimel ....................................................... 40, 41 Fortimel Regular ................................................. 41 Fortini ................................................................ 43 Fortini Multifibre ................................................. 43 Fosamax Plus .................................................... 21 Furosemide .................................................. 18, 50 G Gastrografin ....................................................... 51 GenRx Moclobemide .......................................... 20 Gentamicin sulphate ........................................... 38 Ginet 84 ............................................................. 19 Glucose oxidase................................................. 42 Gluten free bread mix ......................................... 35 Gluten free flour ................................................. 35 Gluten free pasta ................................................ 47 Glycerol ............................................................. 44 Goserelin acetate ............................................... 31 H Habitrol .............................................................. 31 Heparinised saline ........................................ 20, 47 Heparin sodium............................................ 20, 37 Horleys Bread Mix .............................................. 35 Horleys Flour...................................................... 35 Hydrocortisone ............................................ 38, 43 Hydrocortisone acetate ...................................... 36 Hydroxyethyl starch 200/0.5 .............................. 50 Hypnovel ........................................................... 25 Hysite ................................................................ 21 Hytrin................................................................. 43 I Idarubicin hydrochloride ..................................... 36 Indomethacin ............................................... 42, 43 Influenza vaccine................................................ 27 Inhibace ............................................................. 43 Insulin pen needles................................. 18, 22, 39 Insulin syringes, disposable with attached needle ............................................... 22 Isentress ............................................................ 21 Isotane 10.................................................... 36, 46 Isotane 20.................................................... 36, 46 Isotretinoin ............................................. 22, 36, 46 K Kenacomb ......................................................... 44 Kenacort-A......................................................... 45 Keto-Diabur 5000............................................... 42 Keto-Diastix ....................................................... 42 Ketone blood beta-ketone electrodes .................. 30 Ketostix.............................................................. 42 Ketovite ............................................................. 26 Ketovite Liquid ................................................... 26 Ketur-Test .......................................................... 42 Klacid ................................................................ 28 Klamycin...................................................... 20, 28 Klean-Prep ......................................................... 51 Konakion ........................................................... 47 Konakion MM..................................................... 28 L Labetalol ............................................................ 44 Lamotrigine.................................................. 47, 48 Lansoprazole ..................................................... 35 Latanoprost............................................ 21, 35, 47 Lemnis Fatty Cream ........................................... 42 Letrozole ................................................ 26, 35, 50 Leuprorelin......................................................... 38 Levodopa with carbidopa ............................. 29, 39 Lithium carbonate .............................................. 36 Lyderm .............................................................. 23 M m-Hydrocortisone .............................................. 43 m-Mometasone.................................................. 19 Magnevist .......................................................... 51

Index

Pharmaceuticals and brands Mask for spacer device ...................................... 30 Meglumine diatrizoate with sodium amidotrizoate 51 Meglumine gadopentetate................................... 51 Mesalazine ......................................................... 35 Metabolic Mineral Mixture................................... 27 Metformin hydrochloride .............................. 18, 26 Methylprednisolone sodium succinate ................ 38 Metoprolol succinate .................................... 30, 40 Midazolam ......................................................... 25 Minulet 28.......................................................... 44 Mirtazapine ........................................................ 19 Mitomycin C ...................................................... 49 Mitomycin-C ...................................................... 49 Moclobemide ............................................... 20, 39 Mogine .............................................................. 47 Mometasone furoate .......................................... 19 Morphine hydrochloride...................................... 39 Morphine sulphate.............................................. 39 Multivitamins ..................................................... 26 Myambutol................................................... 18, 50 N Naproxen ........................................................... 38 Neoral ................................................................ 33 Nicotine ............................................................. 31 Nicotinell ............................................................ 31 Nitrados ............................................................. 36 Nitrazepam......................................................... 36 Noflam 250 ........................................................ 38 Noflam 500 ........................................................ 38 Norpress ............................................................ 43 Nortriptyline hydrochloride.................................. 43 Noten ................................................................. 49 Nuvelle............................................................... 42 NZB Low Gluten Bread Mix ................................. 35 O Oestradiol with levonorgestrel ............................. 42 Oil in water emulsion .......................................... 42 Omeprazole........................................................ 48 Optium 10 second test ....................................... 44 Optium Blood Ketone Test Strips ........................ 30 Oral feed 1kcal/ml ........................................ 40, 41 Oratane .............................................................. 22 Orgran ............................................................... 47 Ospamox ..................................................... 18, 50 Oxaliplatin .......................................................... 19 Oxaliplatin Ebewe ............................................... 19 Oxazepam .......................................................... 36 Ox-Pam ............................................................. 36 Oxytocin ............................................................ 38 P Pacifen .............................................................. 38 Paclitaxel ........................................................... 47 Paclitaxel Ebewe ................................................ 47 Paediatric oral feed 1.5kcal/ml............................ 43 Paediatric oral feed 1kcal/ml............................... 44 Paediatric oral feed with fibre 1.5kcal/ml............. 43 Paediatric Seravit ............................................... 26 Parnate S29 ....................................................... 33 Pediasure........................................................... 44 Pegatron Combination Therapy ..................... 46, 47 Pegylated interferon alpha-2b with ribavirin ......... 46 Pentasa ............................................................. 35 Pentastarch........................................................ 50 Pepti Junior Gold................................................ 21 Peptisorb ........................................................... 48 Permethrin ............................................. 18, 23, 51 Phenobarbitone sodium...................................... 20 Phytomenadione .......................................... 28, 47 Pilocarpine ............................................. 43, 47, 48 Pilocarpine oral liquid ......................................... 34 Pilopt ..................................................... 43, 47, 48 Pioglitazone ................................................. 37, 42 PKU Anamix Infant ............................................. 21 PKU Lophlex LQ ................................................. 21 Plavix ................................................................. 39 Polaramine................................................... 19, 48 Polycose............................................................ 44 Polyethylene glycol with sodium sulphate ........... 51 Potassium chloride ...................................... 37, 49 Povidone iodine ................................................. 40 Pro-Pam ...................................................... 47, 48 Protein supplement ............................................ 41 Protifar............................................................... 41 Protifar 90.......................................................... 41 Q Q 300 ................................................................ 38 Quetapel ...................................................... 35, 51 Quetiapine.................................................... 35, 51 Quinine sulphate ................................................ 38 R Raltegravir potassium......................................... 21 RA-Morph .......................................................... 39 Requip ............................................................... 45 Requip Follow-on Pack....................................... 45 Requip Starter Pack............................................ 45 Resource Diabetic TF RTH.................................. 45 Rheumacin .................................................. 42, 43 Risperidone........................................................ 21 Risperon ............................................................ 21 Ropinirole hydrochloride..................................... 45 S SC Profi-Fine...................................................... 22 Semi-elemental enteral feed 1kcal/ml.................. 48 Sevredol ............................................................ 39

Index

Pharmaceuticals and brands Sinemet ............................................................. 39 Sinemet CR.................................................. 29, 39 Sodium cromoglycate ........................................ 39 Sodium nitroprusside ......................................... 42 Solox ................................................................. 35 Solu-Medrol ....................................................... 38 Space Chamber ................................................. 30 Spacer device .................................................... 30 Span-K .............................................................. 37 StarQuin 10% ..................................................... 50 Stocrin ............................................................... 42 Sunscreens, proprietary ............................... 36, 48 Syntocinon......................................................... 38 Syntometrine...................................................... 38 T Teniposide ......................................................... 48 Tenofovir disoproxil fumarate ............................. 23 Terazosin hydrochloride ..................................... 43 Testosterone undecanoate.................................. 22 Thioprine ........................................................... 43 Titralac .............................................................. 42 Trandate ............................................................ 44 Tranylcypromine sulphate .................................. 33 Triamcinolone acetonide .................................... 45 Triamcinolone acetonide with gramicidin, neomycin and nystatin .................................... 44 Trimipramine maleate ......................................... 47 Triphasil 28 ........................................................ 44 Tripress ............................................................. 47 Triquilar ED ........................................................ 42 U Urex Forte .................................................... 18, 50 V Vaxigrip ............................................................. 27 Vergo 16 ............................................................ 40 Vinorelbine ......................................................... 40 Viread ................................................................ 23 Vitadol C ............................................................ 37 Vitamin A with vitamins D and C ......................... 37 Voltaren SR ........................................................ 21 Volumatic .......................................................... 30 Vumon ............................................................... 48 W Wool fat with mineral oil ............................... 37, 48 X Xalatan......................................................... 35, 47 Z Zavedos ............................................................. 36 Zinc ................................................................... 36 Zoladex .............................................................. 31 Zuclopenthixol hydrochloride .............................. 22

Pharmaceutical Management Agency Level 9, 40 Mercer Street, PO Box 10-254, Wellington 6143, New Zealand Phone: 64 4 460 4990 - Fax: 64 4 460 4995 - www.pharmac.govt.nz Freephone Information line (9am-5pm weekdays) 0800 66 00 50 ISSN 1172-9376 (Print) ISSN 1179-3686 (Online)

PHARMAC is the Government agency responsible for deciding which medicines are subsidised for New Zealanders. It manages spending on pharmaceuticals for the District Health Boards, and ensures that a comprehensive list of medicines (the Pharmaceutical Schedule) is subsidised for New Zealanders, and that the list of medicines continues to grow to meet the needs of patients.

Metadata

Title

Schedule Update - effective 1 December 2009

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 December 2009 Cumulative for September, October, November and December 2009 Section H for December 2009 Contents Summary of PHARMAC decisions effective 1 Decembr 2009 …. 3 Access changes to tenofovir…

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