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12 March 2010

Approval of reference pricing of the prostaglandin analogue travoprost

PHARMAC is pleased to announce the approval of a proposal to reference price the subsidy for the prostaglandin analogue travoprost to the subsidy of latanoprost. This was the subject of a consultation letter dated 10 December 2009. The decision will result in savings to the community pharmaceutical budget of approximately $1.2 million over 5 years; these savings can be used to fund other medicines. We note that PHARMAC has recently also notified of the acceptance of an agreement with the supplier of bimatoprost, Allergan. As a result of these decisions, latanoprost and bimatoprost will be fully funded and travoprost will be reference priced, but will have additional subsidy available via an endorsement until 30 September 2010. Details of the change From 1 April 2010, reference pricing of travoprost will be applied as follows:

Chemical Travoprost Presentation Eye drop 0.004% Brand Travatan Pack size 2.5 ml OP Current price and subsidy $19.50 New subsidy $9.75

Higher subsidy of $19.50 per 2.5 ml OP will be available for patients until 30 September 2010 under the following endorsement criteria:

Additional subsidy by endorsement is available for patients who were being prescribed travoprost prior to 1 April 2010. Note additional subsidy valid until 30 September 2010. Pharmacists may annotate prescriptions for patients who were being prescribed travoprost prior to 1 April 2010 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.

Clinical feedback to consultation suggested this product was exclusively initiated by ophthalmologists. The six month transition period will allow patients sufficient time to return to their ophthalmologist for a review of their medication. PHARMAC included the ability for pharmacists to annotate the prescription to reduce pharmacist workload as they would not require a clinician to endorse the prescription.

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Feedback received We appreciate all of the feedback that we received and acknowledge the time people took to respond. All consultation responses received by 15 January 2010 were considered in their entirety in making a decision on the proposed changes. Most responses were supportive of the proposal, and the following issues were raised in relation to specific aspects of the proposal:

Theme Comment

Travoprost exhibits superior Intra-ocular pressure reduction (IOP) compared to latanoprost at and beyond 24 hours. Most responders accepted that, in general, all the prostaglandin analogues demonstrate the same or similar effect. Most noted, however, that New Zealand clinicians prefer to switch between prostaglandin analogues prior to instigating poly-therapy as sometimes this resulted in a lowering of IOP. More information

All prostaglandin analogues are indicated for once daily dosing. PHARMAC has received clinical advice that the products have the same or similar therapeutic effect. We appreciate the clinical view that patients may respond to one prostaglandin analogue and not another. We note that a proposal to fully fund bimatoprost was accepted and two prostaglandin analogues remain fully funded without restriction.

If you have any questions about this decision, you can call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.

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