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5 January 2010

Proposal for funding a new multivitamin

PHARMAC is seeking feedback on a proposal to fund a multivitamin containing the fatsoluble vitamins A, D, E and K for patients with cystic fibrosis with pancreatic insufficiency and infants or children with liver disease or short gut syndrome with effect from 1 March 2010. Further details of the proposal can be found below and on the following page.

Feedback sought PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by 5 pm on Monday 26 January 2010 to: Mike Bignall Therapeutic Group Manager PHARMAC Email: mike.bignall@pharmac.govt.nz Fax: 04 460 4995 Post: PO Box 10 254, Wellington 6143

All feedback received before the closing date will be considered by PHARMAC’s Board (or Chief Executive acting under delegated authority) prior to making a decision on this proposal.

Details of the proposal We have entered into a provisional agreement with Pharmaco (NZ) Limited to list a multivitamin in Section B of the Pharmaceutical Schedule under Special Authority restrictions from 1 March 2010 at the following price and subsidy (ex-manufacturer, excluding GST):

Proposed price and subsidy

Chemical

Formulation

Brand

Strength

Pack Size

Multivitamin (A, D, E, K)

Capsule

Vitabdeck

Vitamin A (2500 IU); Folic acid (0.2 mg); Beta Carotene (3 mg); Ascorbic acid (100 mg); Thiamin (1.5mg); Pantothenic acid (12 mg); Riboflavin (1.7 mg); Cholecalciferol (11 µg); Niacin (20 mg) Alpha Tocopherol (150 IU); Pyridoxine HCl (1.9 mg); Phytonadione (150 µg); Cyanocobalamine (3 µg); Zinc (7.5 mg); Biotin (100 µg)

60

$23.40

Vitabdeck would be subject to the following Special Authority criteria:

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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. Patient has cystic fibrosis with pancreatic insufficiency; or 2. Both: 2.1 Infant or child with liver disease or short gut syndrome; and 2.2 Requires vitamin A, D, E and K vitamin supplementation.

Vitabdeck would have protection from delisting from the Pharmaceutical Schedule until 1 March 2013. Background to the Proposal At its October 2009 meeting, the Cystic Fibrosis Advisory Panel considered that there were several issues with access to fat-soluble vitamins in New Zealand for patients with cystic fibrosis. The Panel discussed the availability of Vitabdeck, a multivitamin supplement currently available for private purchase in New Zealand and noted anecdotal evidence from Australia suggesting that problems with vitamin deficiencies had decreased significantly with the introduction of Vitabdeck. Vitabdeck contains the fat soluble vitamins A, D, E and K in water miscible/soluble forms as well as a number of other vitamins and zinc. Infants or children with liver disease or short gut syndrome who require vitamin supplementation may also benefit from treatment with Vitabdeck so we are proposing access to this patient group in addition to patients with cystic fibrosis in the same way as funding is provided for vitamin E. Currently, patients requiring fat-soluble vitamin supplementation are prescribed a number of different fully subsidised vitamin products. Because Vitabdeck contains the fat-soluble vitamins A, D, E and K in one product, this proposal is intended to reduce costs to DHBs from multiple dispensing fees and costs to patients from multiple co-payments. Vitabdeck is not registered by Medsafe, however, based on the quantities of active ingredients it contains, this product is permitted to be classified as a dietary supplement in New Zealand.

A272320

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