Schedule Update - effective 1 August 2010 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 August 2010 Cumulative for May, June, July and August 2010 Section H for August 2010

Contents

Summary of PHARMAC decisions effective 1 August 2010 ............................ 3 Changes to various dispensing restrictions .................................................... 5 Helicobacter Pylori eradication treatment ..................................................... 6 Levonorgestrel subdermal implant – new listing ........................................... 6 Insulin glargine – Special Authority removal ................................................. 7 Insulin glulisine – new listing ........................................................................ 7 Tamsulosin hydrochloride – new listing ......................................................... 7 Hydrocortisone with cinchocaine – new listing ............................................. 8 Amiloride with hydrochlorothiazide – new listing ......................................... 8 Amiloride with frusemide – subsidy increase ................................................. 8 Ketone Testing – endorsement removal ......................................................... 8 Dietitian prescribing ...................................................................................... 9 Adalimumab – Special Authority amendment ............................................... 9 Antiretrovirals – Special Authority amendment ............................................. 9 Triclosan 1% solution – new listing ............................................................... 9 Danthron with poloxamer – new listing ...................................................... 10 Tender News ................................................................................................ 11 Looking Forward ......................................................................................... 11 Sole Subsidised Supply products cumulative to August 2010 ..................... 14 New Listings ................................................................................................ 21 Changes to Restrictions ............................................................................... 25 Changes to Subsidy and Manufacturer’s Price............................................. 53 Changes to General Rules............................................................................ 60 Changes to Brand Name ............................................................................. 64 Changes to Sole Subsidised Supply ............................................................. 64 Delisted Items ............................................................................................. 65 Items to be Delisted .................................................................................... 70 Section H changes to Part II ........................................................................ 74 Section H changes to Part IV ....................................................................... 75 Index ........................................................................................................... 76

Summary of PharmaC decisions

effeCtive 1 auguSt 2010 New listings (pages 21-22) • Hydrocortisone with cinchocaine (Proctosedyl) oint and suppos • Insulin glulisine inj 100 u per ml, 10 ml (Apidra) and inj 100 u per ml, 3 ml disposable pen (Apidra SoloStar) • Danthron with poloxamer (Pinorax Forte) oral liq 75 mg with poloxamer 1 g per 5 ml – only on a prescription – only for the prevention or treatment of constipation in the terminally ill • Sodium citrate with sodium lauryl sulphoacetate (Micolette) enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml – only on a prescription • Ascorbic acid (Vitala-C) tab 100 mg – no more than 100 mg per dose, only on a prescription • Atorvastatin tab 10 mg (Lorstat 10), 20 mg (Lorstat 20), 40 mg (Lorstat 40), and 80 mg (Lorstat 80) • Terazosin hydrochloride (Arrow) tab 1 mg, 2 mg and 5 mg • Amiloride with hydrochlorothiazide (Moduretic) tab 5 mg with hydrochlorothiazide 50 mg – Section 29 • Indapamide (Dapa-Tabs) tab 2.5 mg • Triclosan (healthE) soln 1 % - maximum of 500 ml per prescription, subsidy by endorsment • Malathion (A-Lices) liq 0.5 % • Levonorgestrel (Jadelle) subdermal implant (2 x 75 mg rods) • Tamsulosin hydrochloride (Tamsulosin-Rex) cap 400 µg – Special Authority – Retail pharmacy • Ceftriaxone sodium (Aspen Ceftriaxone) inj 1 g – subsidy by endorsement • Quetiapine (Dr Reddy’s Quetiapine) tab 25 mg, 100 mg, 200 mg and 300 mg • Risperidone (Dr Reddy’s Risperidone) tab 0.5 mg • Azathioprine (Imuprine) tab 50 mg – Retail pharmacy–Specialist • Ipratropium bromide (Univent) nebuliser soln, 250 µg per ml, 1 ml and 2 ml – available on a PSO Changes to restrictions (pages 25-41) • Insulin glargine inj 100 u per ml, 10 ml and 3 ml (Lantus) and 3 ml disposable pen (Lantus Solostar) – removal of Special Authority criteria and addition of prescribing note • Ketone blood beta-ketone electrodes (Optium Blood Ketone Test Strips ) test strip – removal of endorsement criteria and addition of maximum rule • Sodium nitroprusside (Ketostix) test strip – addition of maximum rule • All Hospital pharmacy [HP1] medicines – removal of Hospital Pharmacy [HP1] restriction

Summary of PharmaC decisions – effective 1 august 2010 (continued) • Hospital pharmacy [HP1]-Specialist – replaced with Retail pharmacy-Specialist • Hospital pharmacy [HP3] medicines except Special Foods – Removal of Hospital pharmacy [HP3] restriction • Hospital pharmacy [HP3]-Specialist – replaced with Retail pharmacy-Specialist • WSO restriction – removal of WSO restriction and transfer to ‘Only on a PSO’ • Furosemide (Urex Forte) removal of Section 29 • Diaphragm (Ortho All-flex and Ortho Coil) amended presentation descriptions • Cabergoline (Dostinex and Arrow-Cabergoline) tab 0.5 mg – amended Special Authority criteria • Tenofovir disoproxil fumarate (Viread) tab 300 mg – amended subsidy restriction • Antiretrovirals – amended Special Authority criteria • Adalimumab inj 40 mg per 0.8 ml prefilled pen (Humira) and syringe (HumiraPen) – amended Special Authority criteria • Exemestane (Aromasin) tab 25 mg – removal of repeat rule Decreased subsidy (pages 53-54) • Ketone blood beta-ketone electrodes (Optium Blood Ketone Test Strips) test strip • Calcium carbonate tab 1.25 g (500 mg elemental) (Calci-Tab 500) and 1.5 g (600 mg elemental) (Calci-Tab 600) • Enalapril (m-Enalapril) tab 5 mg, 10 mg and 20 mg • Cilazapril with hydrochlorothiazide (Inhibace Plus) tab 5 mg with hydrochlorothiazide 12.5 mg • Furosemide (Urex Forte) tab 500 mg • Methadone hydrochloride (Methatabs) tab 5 mg • Interferon beta-1-beta (Betaferon) inj 8 million iu per 1 ml • Cytarabine (Baxter) inj 1 mg for ECP and inj 100 mg intrathecal syringe for ECP • Irinotecan (Camptosar) inj 20 mg per ml, 2 ml and 5 ml • Irinotecan (Baxter) inj 1 mg for ECP increased subsidy (pages 53-54) • Imiglucerase (Cerezyme) inj 40 iu per ml, 200 iu vial • Amiloride with frusemide (Frumil) tab 5 mg with frusemide 40 mg • Povidone iodine (Betadine) oint 10 % • Azathioprine (Imuran) inj 50 mg • Food Thickener (Karicare Food Thickener) powder 380 g OP

Pharmaceutical Schedule - Update News

Changes to various dispensing restrictions

Various dispensing restrictions in the Pharmaceutical Schedule will be removed from 1 August 2010. In summary these relate to Hospital pharmacy (HP1) and Hospital pharmacy (HP3) restrictions and the Wholesale Supply Order (WSO) mechanism. For detailed information, please review the ‘Changes to Restrictions’ section of this Update. The Hospital pharmacy [HP1] restriction will be removed All pharmaceuticals listed in the Pharmaceutical Schedule with the Hospital pharmacy [HP1] restriction will have this removed from 1 August 2010. This will result in all community pharmacies being able to claim a subsidy for dispensing products that currently have this restriction without requiring the Complex Medicines Variation to their pharmacy contract. Any pharmaceuticals that are currently listed with the Hospital pharmacy [HP1] – Specialist restriction will be changed to Retail pharmacy – Specialist from 1 August 2010. The Hospital pharmacy [HP3] restriction will be removed from Section B All pharmaceuticals listed in the Pharmaceutical Schedule with the Hospital pharmacy [HP3] restriction as listed in

Section B, will have this removed from 1 August 2010. The [HP3] restriction will remain on products in Section D of the Pharmaceutical Schedule (Special Foods). Any pharmaceuticals that are currently listed with the Hospital pharmacy [HP3] – Specialist restriction will be changed to Retail pharmacy – Specialist from 1 August 2010.

Pharmaceutical Schedule - Update News

The Wholesale Supply Order (WSO) mechanism will be removed Products with an ‘Only on a WSO’ restriction will instead have an ‘Only on a PSO’ restriction from 1 August 2010 with the following quantity limits per order:

Device Intra-uterine device Peak flow meter Peak flow meter Spacer device Spacer device Spacer device Mask for spacer device Presentation Quantity limit IUD 40 Low range 10 Normal range 10 230 ml (autoclavable) 20 230 ml (single patient) 20 800 ml 20 Size 2 20

This ordering mechanism change will result in prescribers obtaining these products directly from their pharmacy, along with their usual PSO items, and not from pharmaceutical suppliers.

Helicobacter Pylori eradication treatment

PHARMAC has had a number of enquiries regarding a substitute for the recently discontinued Losec HP7 OAC combination pack used for the treatment of H. Pylori eradication. Please note that the individual components for Losec HP7 OAC are fully funded without requiring doctor’s endorsement. Clarithromycin 500 mg tablets (Klamycin) are subsidised with endorsement criteria for helicobacter pylori eradication and a maximum quantity of 14 tablets per prescription. Please note that prescriptions are considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxicillin or metronidazole. Please note that the 250 mg clarithromycin tablet is not subsidised for this purpose.

Levonorgestrel subdermal implant – new listing

Levonorgestrel subdermal implant (2 X 75 mg rods) (Jadelle) will be subsidised without restriction from 1 August 2010. Jadelle will be the sole subsidised Hormonal Long Acting Reversible Contraceptive in the Pharmaceutical Schedule until 31 December 2013. Bayer NZ Ltd will provide training and insertion tools for clinicians, please contact Bayer for details.

Pharmaceutical Schedule - Update News

Insulin glargine – Special Authority removal

The Special Authority criteria for insulin glargine (Lantus and Lantus SoloStar) will be replaced with a prescriber note targeting access for certain type 1 and type 2 diabetes patients from 1 August 2010.

Insulin glulisine – new listing

Insulin glulisine injection 100 iu per ml, 10 ml (Apidra) and 100 iu per ml, 3 ml disposable pen (Apidra SoloStar) will be listed in the Pharmaceutical Schedule from 1 August 2010 without restriction. Insulin glulisine is an additional subsidised rapid-acting insulin. Insulin glulisine is indicated for the treatment of type 1 and type 2 diabetes mellitus in adults and children of 4 years or above who require insulin for the control of hyperglycaemia. In addition insulin glulisine 100 iu per ml, 3 ml cartridges will be listed in the Pharmaceutical Schedule from 1 September 2010.

Tamsulosin hydrochloride – new listing

The alpha-1A adrenoreceptor blocker tamsulosin hydrochloride cap 400 µg (Tamsulosin-Rex) will be subsidised under Special Authority criteria from 1 August 2010. Subsidy will be available for patients with symptomatic benign prostatic hyperplasia and who are intolerant to non-selective alpha blockers or these are contraindicated. Tamsulosin-Rex will be the sole subsidised brand of tamsulosin hydrochloride 400 µg caps from 1 November 2010 to 30 June 2013.

Pharmaceutical Schedule - Update News

Hydrocortisone with cinchocaine – new listing

Hydrocortisone with cinchocaine (Proctosedyl) will be subsidised without restriction in the Pharmaceutical Schedule from 1 August 2010. The product is available in both ointment and suppository form. The funding for fluocortolone caproate with fluocortolone pivalate and cinchocaine (UltraProct) remains available.

Amiloride with hydrochlorothiazide – new listing

The Moduretic brand of amiloride 5 mg with hydrochlorothiazide 50 mg tablet will be subsidised from 1 August 2010. Moduretic will be supplied under Section 29 of the Medicines Act 1981 as it is an unregistered medicine. This provides a replacement product for the Amizide brand. PHARMAC would like to thank pharmacists for their patience during the procurement of this alternative brand.

Amiloride with frusemide – subsidy increase

The Frumil brand of amiloride 5 mg with frusemide 40 mg tablet will be fully subsidised from 1 August 2010.

Ketone Testing – endorsement removal

The endorsement requirement for ketone blood betaketone electrodes will be removed from 1 August 2010. A maximum of 20 test strips per prescription will apply to both ketone blood beta-ketone electrodes and sodium nitroprusside test strips from 1 August 2010.

Pharmaceutical Schedule - Update News

Dietitian prescribing

From 1 August 2010, the definition of ‘Practitioner’ in the Pharmaceutical Schedule has been amended to include registered Dietitians. This will enable Dietitians to prescribe subsidised products that are within their scope of practice (special foods, vitamin products, mineral products and oral electrolyte replacement products). Please note that implementation of this change requires some technical changes to be made within the pharmacy payments system, and for the Dietitians Board to accredit Dietitians to prescribe these products; as such Dietitians’ prescriptions are not currently valid for subsidy. We will update the sector when these matters have been resolved.

Adalimumab – Special Authority amendment

The renewal criteria for adalimumab (Humira and HumiraPen) inj 40 mg per 0.8 ml prefilled pen and syringe will be amended from 1 August 2010. The changes specifically exclude 40 mg weekly dosing from the adalimumab Special Authority renewal criteria for all funded indications with the exception of patients with rheumatoid arthritis not taking concomitant methotrexate who have received inadequate benefit from fortnightly administration. The changes also specify a level of response that must be met for renewal applications for patients with Crohn’s disease.

Antiretrovirals – Special Authority amendment

The Special Authority criteria for antiretrovirals will be amended from 1 August 2010 to allow subsidies for up to four oral antiretrovirals per patient. Currently only three oral antiretrovirals are subsidised per patient. A combination of a protease inhibitor and low-dose ritonavir given as a booster will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals.

Triclosan 1% solution – new listing

Triclosan (healthE) 1% solution will be subsidised from 1 August 2010 for patients identified with Methicillin-resistant Staphylococcus aureus (MRSA) prior to elective surgery in hospital, and for patients with recurrent Staphylococcus aureus infection. Prescriptions must be endorsed ‘certified condition’ accordingly and no more than 500 ml per prescription will be subsidised.

10 Pharmaceutical Schedule - Update News

Danthron with poloxamer – new listing

Danthron with poloxamer oral liquid 75 mg with poloxamer 1 g per 5 ml (Pinorax Forte) will be listed and fully subsidised on the Pharmaceutical Schedule from 1 August 2010. The following prescribing note has been applied to the listing “Only for the prevention or treatment of constipation in the terminally ill”. This follows the listing from July 2010 of the lower strength Pinorax (danthron with poloxamer oral liquid 25 mg with poloxamer 200 mg per 5 ml).

tender News

Sole Subsidised Supply changes – effective 1 September 2010

Chemical Name Dexamethasone sodium phosphate Dexamethasone sodium phosphate Docusate sodium Docusate sodium Tramadol hydrochloride Presentation; Pack size Inj 4 mg per ml, 1 ml; 5 inj Inj 4 mg per ml, 2 ml; 5 inj Cap 50 mg; 100 tab Cap 120 mg; 100 tab Cap 50 mg; 100 cap Sole Subsidised Supply brand (and supplier) Hospira (Hospira) Hospira (Hospira) Laxofast 50 (Arrow) Laxofast 120 (Arrow) Arrow-Tramadol (Arrow)

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. Decision for implementation 1 September 2010 • Acarbose (Glucobay) tab 50 mg and 100 mg – removal of Special Authority • Alprazolam (Arrow-Alprazolam) tab 250 µg, 500 µg and 1 mg – removal of Month Restriction • Anti-inflammatory Non Steroidal Drugs (NSAIDS) – amend Special Authority to approvals without renewal and no new approvals to be given • Atorvastatin (Lipitor) tab 10 mg, 20 mg, 40 mg and 80 mg – removal of Special Authority for additional subsidy, subsidy decrease on Lipitor brand only • Azithromycin (Arrow-Azithromycin) tab 500 mg – increasing PSO quantity from 2 packs to 4 • Bupivacaine hydrochloride inj 0.5%, 4 ml (Marcain Isobaric) and inj 0.5% with 8% glucose, 4 ml (Marcain Heavy) – delisting from 1 September 2010 • Buspirone hydrochloride (Pacific Buspirone) tab 5 mg and 10 mg – removal of Month Restriction • Buserelin acetate (Suprefact) inj 1 mg per ml, 5.5 ml – cessation of subsidy from 1 December 2010 • Capecitabine (Xeloda) tab 150 mg and 500 mg – amended Special Authority criteria to allow applications from a medical practitioner on the recommendation of a relevant specialist • Clopidogrel (Apo-Clopidogrel, Arrow-Clopidogrel, Plavix) tab 75 mg – removal of Special Authority • Deferiprone (Ferriprox) tab 500 mg and oral soln 100 mg per ml – new listing – Special Authority – Retail pharmacy

Possible decisions for implementation 1 September 2010 (continued) • Diazepam (Arrow-Diazepam) tab 2 mg and 5 mg – removal of Month Restriction • Enoxaparin sodium (Clexane) inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg and 150 mg –addition of Retail pharmacy-Specialist which can be waived by Special Authority (no change in criteria) • Ibuprofen (Brufen Retard) tab long-acting 800 mg – increase subsidy to match manufacturer’s price • Insulin glulisine (Apidra) inj 100 iu per ml, 3 ml cartridge – new listing • Lignocaine hydrochloride (Xylocaine Viscous) viscous solution 2% – new listing and removal from DCS list • Lignocaine hydrochloride (Xylocaine) inj 2%, 5 ml and 20 ml – new listing and addition of “Up to 5 inj available on a PSO” • Lignocaine hydrochloride (Xylocaine) inj 0.5%, 5 ml and 1%, 5 ml and 20 ml – removal of current restriction “only if prescribed for a dialysis patient or child with rheumatic fever or on PSO for emergency use” while retaining “Up to 5 inj available on a PSO” • Lignocaine (Pfizer) gel 2%, 10 ml urethral syringes – addition of “Up to 5 syringes available on a PSO” • Lignocaine with chlorhexidine (Pfizer) gel 2% with chlorhexidine 0.05%, 10 ml urethral syringes – addition of “Up to 5 syringes available on a PSO” • Lorazepam (Ativan) tab 1 mg and 2.5 mg – removal of Month Restriction • Lormetazepam (Noctamid) tab 1 mg – removal of Month Restriction • Meloxicam (Arrow-Meloxicam) tab 7.5 mg – new listing – Special Authority – Retail pharmacy • Midazolam (Hypnovel) tab 7.5 mg – removal of Month Restriction • Nedocromil (Tilade) aerosol inhaler, 2 mg per dose CFC-free – increase subsidy to match manufacturer’s price • Nitrazepam (Nitrados) tab 5 mg – removal of Month Restriction • Ondansetron tab 4 mg and 8 mg (Zofran) and tab disp 4 mg and 8 mg (Zofran Zydis) – removal of Retail pharmacy-Specialist – prescription and dispensing maximums would still apply • Oxazepam (Ox-Pam) tab 10 mg and 15 mg – removal of Month Restriction • Pioglitazone (Pizaccord) tab 15 mg, 30 mg and 45 mg – amended Special Authority criteria • Sodium bicarbonate (Sodibic) cap 840 mg – new listing • Sodium cromoglycate (Vicrom) aerosol inhaler, 5 mg per dose CFC-free – increase subsidy to match manufacturer’s price

Possible decisions for implementation 1 September 2010 (continued) • Temazepam (Normison) tab 10 mg – removal of Month Restriction • Tenoxicam (AFT) inj 20 mg – new listing • Theophylline (Nuelin) oral liq 80 mg per 15 ml – increase subsidy to match manufacturer’s price • Triazolam (Hypam) tab 125 µg and 250 µg – removal of Month Restriction • Tropisetron (Navoban) cap 5 mg – removal of Retail pharmacy-Specialist – prescription and dispensing maximums would still apply • Zolendronic acid (Aclasta) inf 5 mg in 100 ml – new listing - Special Authority – Retail pharmacy • Zopiclone (Apo-Zopiclone) tab 7.5 mg – removal of Month Restriction

Sole Subsidised Supply Products – cumulative to August 2010

Generic Name

Acarbose Acetazolamide Allopurinol Amantadine hydrochloride Amoxycillin

Presentation

Tab 50 mg & 100 mg Tab 250 mg Tab 100 mg & 300 mg Cap 100 mg Grans for oral liq 250 mg per 5 ml Drops 125 mg per 1.25 ml Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml Tab amoxycillin 500 mg with potassium clavulanate 125 mg Crm 500 g Tab 50 mg & 100 mg Inj 600 µg, 1 ml Tab 500 mg Tab 10 mg Inj 1 mega u Scalp app 0.1% Tab 200 mg Tab 50 mg Eye drops 0.2% Crm, aqueous, BP Lotn, BP Inj 100 iu per ml, 1 ml Cap 0.25 µg & 0.5 µg Tab eff 1.7 g (1 g elemental) Inj 50 mg Inj 500 mg & 1 g Inj 750 mg & 1.5 g Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 10 mg Oral liq 1 mg per ml Eye oint 1%

Brand Name Expiry Date*

Glucobay Diamox Apo-Allopurinol Symmetrel Ospamox Ospamox Paediatric Drops Curam Curam Synermox AFT Atenolol Tablet USP AstraZeneca Arrow-Azithromycin Pacifen Sandoz Beta Scalp Fibalip Bicalox AFT healthE API Miacalcic Airflow Calsource Calcium Folinate Ebewe Hospira Zinacef Cefalexin Sandoz Cefalexin Sandoz Zetop Cetirizine-AFT Chlorsig 2011 2011 2012 2012 2012 2012 2011 2012 2011 2011 2011 2012 2011 2012 2011 2011 2011 2011 2012 2011 2012 2012 2011 2011 2011 2012 2011 2012

Amoxycillin clavulanate

Aqueous cream Atenolol Atropine sulphate Azithromycin Baclofen Benzylpenicillin sodium (Penicillin G) Betamethasone valerate Bezafibrate Bicalutamide Brimonidine tartrate Calamine Calcitonin Calcitriol Calcium carbonate Calcium folinate Cefazolin sodium Cefuroxime sodium Cephalexin monohydrate Cetirizine hydrochloride Chloramphenicol

*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 August 2010

Generic Name

Chlorhexidine gluconate Ciclopiroxolamine Ciprofloxacin Citalopram Clobetasol propionate

Presentation

Handrub 1% with ethanol 70% Soln 4% Nail soln 8% Tab 250 mg, 500 mg & 750 mg Tab 20 mg Crm 0.05% Oint 0.05% Scalp app 0.05% Tab 500 µg & 2 mg TDDS 2.5 mg, 100 µg per day TDDS 5 mg, 200 µg per day TDDS 7.5 mg, 300 µg per day Inj 150 µg per ml, 1 ml Tab 25 µg Tab 150 µg Crm 1% Crm 10% Tab 50 mg Tab 50 mg & 100 mg Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs Nasal spray 10 µg per dose Inj 50%, 10 ml Tab EC 25 mg & 50 mg Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab long-acting 60 mg Tab 30 mg & 60 mg Cap long-acting 120 mg, 180 mg & 240 mg Tab long-acting 150 mg Tab 50 mg with total sennosides 8 mg Oint BP Inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg & 150 mg Tab 200 mg

Brand Name Expiry Date*

healthE Orion Batrafen Rex Medical Arrow-Citalopram Dermol Dermol Dermol Paxam Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3 Catapres Dixarit Catapres Clomazol Itch-Soothe Nausicalm Siterone Ginet 84 Desmopressin-PH&T Biomed Diclofenac Sandoz Voltaren Ophtha Voltaren Voltaren DHC Continus Dilzem Cardizem CD Pytazen SR Laxsol AFT Clexane Comtan 2012 2011 2012 2011 2011 2012

Clonazepam Clonidine

2011 2012

Clonidine hydrochloride

2012

Clotrimazole Crotamiton Cyclizine hydrochloride Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dextrose Diclofenac sodium

2011 2012 2012 2012 2011 2011 2011 2012 2011

Dihydrocodeine tartrate Diltiazem hydrochloride

2013 31/12/11

Dipyridamole Docusate sodium with sennosides Emulsifying ointment Enoxaparin sodium (low molecular weight heparin) Entacapone

2011 2013 2011 2012 2012

Sole Subsidised Supply Products – cumulative to August 2010

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 200 mg Tab long-acting 5 mg Tab long-acting 10 mg Tab 5 mg Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Inj 250 mg, 500 mg & 1 g Cap 50 mg, 150 mg & 200 mg Inj 50 mg Tab 10 mg Eye drops 0.1% Metered aqueous nasal spray, 50 µg per dose Tab 40 mg Cap 100 mg, 300 mg & 400 mg Inj 40 mg per ml, 2 ml 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 Arrow-Etidronate Felo 5 ER Felo 10 ER Fintral AFT AFT AFT Flucloxin Pacific Fludara Fludara Oral FML Flixonase Hayfever & Allergy Diurin 40 Nupentin Pfizer Apo-Gliclazide Minidiab Lycinate Nitrolingual Pumpspray Nitroderm TTS Douglas ABM PSM Colifoam DP Lotn HC ABM Hydroxocobalamin Plaquenil Methopt Buscopan Gastrosoothe 2012 2011 2012 2012 2012 2011 2012 2011 2011 2011 2012 31/1/13 2012 31/7/12 2012 2011 2011 2011

Ethinyloestradiol Etidronate disodium Felodipine Finasteride Flucloxacillin sodium

Fluconazole Fludarabine phosphate Fluorometholone Fluticasone propionate Furosemide Gabapentin Gentamicin sulphate Gliclazide Glipizide Glyceryl trinitrate

Hydrocortisone

Tab 5 mg & 20 mg Powder Crm 1% Rectal foam 10%, CFC-free (14 applications) Lotn 1% with wool fat hydrous 3% and mineral oil Inj 1 mg per ml, 1 ml Tab 200 mg Eye drops 0.5% Inj 20 mg, 1 ml Tab 20 mg

2012 2011 2012 2011 2012 2012 2011 2011

Hydrocortisone acetate Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hypromellose Hysocine N-butylbromide

Sole Subsidised Supply Products – cumulative to August 2010

Generic Name

Ibuprofen Iron polymaltose Isotretinoin Ketoconazole Lamivudine Latanoprost Letrozole Levonorgestrel Lisinopril Malathion Mask for Spacer Device Mebendazole Mebeverine hydrochloride Megestrol acetate Mesalazine Metformin hydrochloride Methadone hydrochloride

Presentation

Tab 200 mg Inj 50 mg per ml, 2 ml Cap 10 mg & 20 mg Shampoo 2% Oral liq 10 mg per ml Tab 150 mg Eye drops 50 µg per ml Tab 2.5 mg Subdermal implant (2 x 75 mg rods) Tab 5 mg, 10 mg & 20 mg Shampoo 1% Device Tab 100 mg Tab 135 mg Tab 160 mg Enema 1 g per 100 ml Tab immediate-release 500 mg & 850 mg Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml 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 40 mg per ml, 1 ml Inj 62.5 mg per ml, 2 ml Inj 500 mg Inj 1 g Inj 5 mg per ml, 2 ml Crm 2% Crm 0.1% Oint 0.1%

Brand Name Expiry Date*

Ethics Ibuprofen Ferrum H Oratane Sebizole 3TC 3TC Hysite Letara Jadelle Arrow-Lisinopril A-Lices Foremount Child’s Silicone Mask De-Worm Colofac Apo-Megestrol Pentasa Apotex Biodone Biodone Forte Biodone Extra Forte Methoblastin Methotrexate Ebewe Methotrexate Ebewe Prodopa Medrol Depo-Medrol Depo-Medrol with Lidocaine Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Pfizer Multichem m-Mometasone m-Mometasone 2012 2011 2012 2011 2013 2012 2012 31/12/13 2012 2011 30/9/11 2011 2011 2012 2012 2012 2012

Methotrexate

2012 2011 2011 2012 2011 2011 2012

Methyldopa Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Methylprednisolone sodium succinate

Metoclopramide hydrochloride Miconazole nitrate Mometasone furoate

2011 2011 2012

Sole Subsidised Supply Products – cumulative to August 2010

Generic Name

Morphine hydrochloride

Presentation

Oral liq 1 mg per ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Tab immediate release 10 mg & 20 mg Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Tab 250 mg Tab 500 mg Oral suspension 10 mg per ml Tab 200 mg

Brand Name Expiry Date*

RA-Morph RA-Morph RA-Morph RA-Morph Sevredol Mayne Mayne Noflam 250 Noflam 500 Viramune Suspension Viramune Noriday 28 Primolut N Norpress Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Syntocinon Syntocinon Syntometrine Pamisol Pamisol Pamisol Pharmacare Paracare Junior Paracare Double Strength ParaCode Breath-Alert Pegasys Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Permax 2012

Morphine sulphate

2012 2011 2012 2012

Naproxen Nevirapine

Norethisterone Nortriptyline hydrochloride Nystatin Omeprazole

Tab 350 µg Tab 5 mg Tab 10 mg & 25 mg Oral liq 100,000 u per ml, 24 ml OP Cap 10 mg, 20 mg & 40 mg Inj 40 mg

2012 2011 2011 2011 2011

Oxytocin

Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml Tab 500 mg Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml Tab paracetamol 500 mg with codeine phosphate 8 mg Low range and Normal range Inj 135 µg prefilled syringe Inj 180 µg prefilled syringe Inj 135 µg prefilled syringe x 4 with ribavirin tab 200 mg x 112 Inj 135 µg prefilled syringe x 4 with ribavirin tab 200 mg x 168 Inj 180 µg prefilled syringe x 4 with ribavirin tab 200 mg x 112 Inj 180 µg prefilled syringe x 4 with ribavirin tab 200 mg x 168 Tab 0.25 mg & 1 mg

2012

Pamidronate disodium

2011

Paracetamol

2011

Paracetamol with codeine Peak Flow Meter Pegylated interferon alpha-2A

2011 30/9/11 31/12/12

Pergolide

2011

Sole Subsidised Supply Products – cumulative to August 2010

Generic Name

Permethrin Pindolol Pioglitazone Pizotifen Poloxamer Polyvinyl alcohol Potassium chloride Prednisone Prednisone sodium phosphate Pregnancy tests – hCG urine

Presentation

Lotn 5% Tab 5 mg, 10 mg & 15 mg Tab 15 mg, 30 mg & 45 mg Tab 500 µg Oral drops 10% Eye drops 1.4% Eye drops 3% Tab long-acting 600 mg Tab 1 mg, 2.5 mg, 5 mg & 20 mg Oral liq 5 mg per ml Cassette

Brand Name Expiry Date*

A-Scabies Apo-Pindolol Pizaccord Sandomigran Coloxyl Vistil Vistil Forte Span-K Apo-Prednisone Redipred Innovacon hCG One Step Pregnancy Test Cilicaine Promethazine Winthrop Elixir Allersoothe Accupril Accuretic 10 Accuretic 20 Q 300 ArrowRoxithromycin Asthalin Asthalin Duolin 2012 2012 2012 2012 2011 2012 2012 2012 2011 2011 2012 2011 2012 2012

Procaine penicillin Promethazine hydrochloride

Inj 1.5 mega u Oral liq 5 mg per 5 ml Tab 10 mg & 25 mg

2011 2012 2011 2011 2011

Quinapril Quinapril with hydroclorothiazide

Tab 5 mg, 10 mg & 20 mg Tab 10 mg with hydroclorothiazide 12.5 mg Tab 20 mg with hydroclorothiazide 12.5 mg Tab 300 mg Tab 150 mg & 300 mg Nebuliser soln, 1 mg per ml, 2.5 ml Nebuliser soln, 2 mg per ml, 2.5 ml Nebuliser soln, 2.5 mg with ipratopium bromide 0.5 mg per vial, 2.5 ml Tab 5 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Nasal spray, 4% Inj cartridge 16 iu (5.3 mg) Inj cartridge 36 iu (12 mg) Tab 80 mg & 160 mg 230 ml Tab 50 mg & 100 mg

Quinine sulphate Roxithromycin Salbutamol Salbutamol with ipratropium bromide Selegiline hydrochloride Simvastatin

Apo-Selegiline Arrow-Simva 10 mg Arrow-Simva 20 mg Arrow-Simva 40 mg Arrow-Simva 80 mg Rex Genotropin Genotropin Mylan Space Chamber Arrow-Sumatriptan

2012 2011

Sodium cromoglycate Somatropin Sotalol Spacer Device Sumatriptan

2012 31/12/12 2012 30/9/11 2013

Sole Subsidised Supply Products – cumulative to August 2010

Generic Name

Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terbinafine Testosterone cypionate Tetracosactrin Timolol maleate Tranexamic acid Triamcinolone acetonide

Presentation

Soln 2.3% Tab 10 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Inj 250 µg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.25% & 0.5% Tab 500 mg Crm 0.02% Oint 0.02% Inj 40 mg per ml, 1 ml 0.1% in Dental Paste USP Tab 300 mg Cap 5 mg Cap 300 mg Inj 50 mg per ml, 10 ml Cap 100 mg Oral liq 10 mg per ml Oint BP Cap 137.4 mg (50 mg elemental) Tab 7.5 mg

Brand Name Expiry Date*

Pinetarsol Normison Apo-Terbinafine Depo-Testosterone Synacthen Synacthen Depot Apo-Timol Apo-Timop Cycklokapron Aristocort Aristocort Kenacort-A40 Oracort TMP Navoban Actigall Pacific Retrovir Retrovir PSM Zincaps Apo-Zopiclone 2011 2011 2011 2011 2011 2012 2011 2013 2011

Trimethoprim Tropisetron Ursodeoxycholic acid Vancomycin hydrochloride Zidovudine [AZT] Zinc and castor oil Zinc sulphate Zopiclone August changes in bold

2011 2012 2011 2011 2013 2011 2011 2011

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 August 2010

26 HYDROCORTISONE WITH CINCHOCAINE Oint 5 mg with cinchocaine hydrochloride 5 mg per g .............. 15.00 Suppos 5 mg with cinchocaine hydrochloride 5 mg per g........... 9.90 INSULIN GLULISINE ▲ Inj 100 u per ml, 10 ml ............................................................ 27.03 ▲ Inj 100 u per ml, 3 ml disposable pen ...................................... 46.07 30 g OP 12 1 5 ✔ Proctosedyl ✔ Proctosedyl ✔ Apidra ✔ Apidra SoloStar ✔ Pinorax Forte

DANTHRON WITH POLOXAMER – Only on a prescription Oral liq 75 mg with poloxamer 1 g per 5 ml .............................. 13.95 300 ml Note: Only for the prevention or treatment of constipation in the terminally ill.

SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE – Only on a prescription Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml ............................................................... 25.00 50 ✔ Micolette ASCORBIC ACID a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg ............................................................................ 13.80 ATORVASTATIN ❋ Tab 10 mg ................................................................................ 1.77 ❋ Tab 20 mg ................................................................................ 2.60 ❋ Tab 40 mg ............................................................................... 4.38 ❋ Tab 80 mg ............................................................................... 7.73 TERAZOSIN HYDROCHLORIDE ❋ Tab 1 mg ................................................................................. 1.50 ❋ Tab 2 mg .................................................................................. 0.80 ❋ Tab 5 mg .................................................................................. 1.00 AMILORIDE WITH HYDROCHLOROTHIAZIDE ❋ Tab 5 mg with hydrochlorothiazide 50 mg................................ 17.50 INDAPAMIDE ❋ Tab 2.5 mg ............................................................................... 2.95

500 30 30 30 30 28 28 28 50 90

✔ Vitala-C ✔ Lorstat 10 ✔ Lorstat 20 ✔ Lorstat 40 ✔ Lorstat 80 ✔ Arrow ✔ Arrow ✔ Arrow ✔ Moduretic S29 ✔ Dapa-Tabs

55 56 63

TRICLOSAN – Subsidy by endorsement a) Maximum of 500 ml per prescription b) 1) Only if prescribed for a patient identified with Methicillin-resistant Staphylococcus aureus (MRSA) prior to elective surgery in hospital and the prescription is endorsed accordingly; or 2) Only if prescribed for a patient with recurrent Staphylococcus aureus infection and the prescription is endorsed accordingly. Soln 1 % ................................................................................... 5.90 500 ml ✔ healthE MALATHION Liq 0.5%.................................................................................... 3.79 200 ml ✔ A-Lices

▲

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 August 2010 (continued)

73 74 LEVONORGESTREL ❋ Subdermal implant (2 x 75 mg rods) ...................................... 133.65 1 ✔ Jadelle

TAMSULOSIN HYDROCHLORIDE – Special Authority see SA1032 – Retail pharmacy Cap 400 µg ............................................................................... 5.98 30 ✔ Tamsulosin-Rex ➽ SA1032 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1. Patient has symptomatic benign prostatic hyperplasia; and 2. The patient is intolerant of non-selective alpha blockers or these are contraindicated. CEFTRIAXONE SODIUM – Subsidy by endorsement a) Up to 5 inj available on a PSO b) Subsidised only if prescribed for a dialysis or cystic fibrosis patient, or the treatment of confirmed ciprofloxacin-resistant gonorrhoea, or the treatment of suspected meningitis in patients who have a known allergy to penicillin, and the prescription or PSO is endorsed accordingly. Inj 1 g ..................................................................................... 10.49 5 ✔ Aspen Ceftriaxone QUETIAPINE Tab 25 mg ............................................................................... 7.00 Tab 100 mg ............................................................................ 14.00 Tab 200 mg ............................................................................ 24.00 Tab 300 mg ............................................................................ 40.00 60 60 60 60 ✔ Dr Reddy’s Quetiapine ✔ Dr Reddy’s Quetiapine ✔ Dr Reddy’s Quetiapine ✔ Dr Reddy’s Quetiapine ✔ Dr Reddy’s Risperidone ✔ Imuprine

124

125

RISPERIDONE Tab 0.5 mg ............................................................................... 3.51 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg .............................................................................. 18.45 IPRATROPIUM BROMIDE Nebuliser soln, 250 µg per ml, 1 ml – Up to 40 neb available on a PSO ............................................................................... 3.79 Nebuliser soln, 250 µg per ml, 2 ml – Up to 40 neb available on a PSO ............................................................................... 4.06

147 154

100

20 20

✔ Univent ✔ Univent

Effective 1 July 2010

25 35 POTASSIUM IODATE Tab 268 µg (150 µg elemental) ................................................. 7.55 90 ✔ NeuroKare ✔ Pinorax

DANTHRON WITH POLOXAMER – Only on a prescription Oral liq 25 mg with poloxamer 200 mg per 5 ml ......................... 9.50 300 ml Note: Only for the prevention or treatment of constipation in the terminally ill.

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 July 2010 (continued)

37 38 54 MULTIVITAMINS – Special Authority see SA0963 – Retail pharmacy Powder ................................................................................... 72.00 VITAMINS ❋ Tab (BPC cap strength) ........................................................... 10.85 AMLODIPINE ❋ Tab 5 mg ................................................................................ 22.82 ❋ Tab 10 mg .............................................................................. 34.85 TRETINOIN Crm 0.5 mg per g .................................................................... 13.90 a) maximum of 50 g per prescription 200 g OP 1,000 30 30 50 g OP ✔ Paediatric Seravit ✔ MultiADE ✔ Norvasc ✔ Norvasc ✔ ReTrieve

COAL TAR Soln BP – Only in combination ................................................. 12.95 200 ml ✔ Midwest Up to 10 % Only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain, refer, page 163 With or without other dermatological galenicals. OESTRADIOL – See prescribing guideline ❋ TDDS 50 µg per day .................................................................. 4.12 8 (13.18) a) Higher subsidy of $13.18 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription CLOMIPHENE CITRATE Tab 50 mg ............................................................................. 29.84 10

Estradot 50 mcg

82 95 113 158

✔ Serophene

LOPINAVIR WITH RITONAVIR – Special Authority see SA1021 – Hospital pharmacy [HP1] Tab 100 mg with ritonavir 25 mg .......................................... 183.75 60 ✔ Kaletra FLUOXETINE HYDROCHLORIDE ❋ Cap 20 mg ................................................................................ 2.70 FLUMETASONE PIVALATE Ear drops 0.02% with clioquinol 1% ........................................... 4.46 GLYCEROL ❋ Liquid – Only in combination.................................................... 17.86 Only in extemporaneously compounded oral liquid preparations. 84 ✔ Fluox

7.5 ml OP ✔ Locacorten-Vioform ED's 2,000 ml ✔ healthE

167

172

PROTEIN SUPPLEMENT – Special Authority see SA0582 – Hospital pharmacy [HP3] Powder ..................................................................................... 8.95 227 g OP

✔ Resource Beneprotein

185

AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA0962 – Retail pharmacy See prescribing guideline Powder ................................................................................... 23.38 100 g OP ✔ Metabolic Mineral Mixture ❋ 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

New listings - effective 1 June 2010

49 ENALAPRIL ❋ Tab 5 mg ................................................................................. 1.98 ❋ Tab 10 mg ............................................................................... 2.44 ❋ Tab 20 mg ............................................................................... 3.24 NANDROLONE DECANOATE – Retail pharmacy-Specialist Inj 50 mg per ml, 1 ml ............................................................ 21.16 TRAMADOL HYDROCHLORIDE Cap 50 mg ................................................................................ 6.95 CYTARABINE Inj 500 mg – PCT – Retail pharmacy-Specialist ....................... 18.15 Inj 1 g – PCT – Retail pharmacy-Specialist .............................. 37.00 Inj 2 g – PCT only – Specialist ................................................. 31.00 IRINOTECAN – PCT only – Specialist – Special Authority see SA0878 Inj 20 mg per ml, 2 ml ............................................................ 41.00 Inj 20 mg per ml, 5 ml .......................................................... 100.00 MITOMYCIN C – PCT only – Specialist Inj 5 mg ................................................................................. 72.75 90 90 90 1 ✔ Arrow-Enalapril ✔ Arrow-Enalapril ✔ Arrow-Enalapril ✔ Deca-Durabolin Orgaject S29 ✔ Arrow-Tramadol ✔ Pfizer ✔ Pfizer ✔ Pfizer ✔ Irinotecan-Rex ✔ Irinotecan-Rex ✔ Arrow S29

109 138

100 1 1 1 1 1 1

139

142

Effective 28 May 2010

52 ATENOLOL ❋ Tab 50 mg ............................................................................. 12.36 ❋ Tab 100 mg ........................................................................... 21.46 1,000 1,000 ✔ Atenolol Tablet USP ✔ Atenolol Tablet USP

Effective 5 May 2010

Effective 1 May 2010

55 77 109 138 BENDROFLUAZIDE ❋ Tab 2.5 mg – Up to 150 tab available on a PSO ......................... 7.58 May be supplied on a PSO for reasons other than emergency. ❋ Tab 5 mg ............................................................................... 11.75 TESTOSTERONE UNDECANOATE – Retail pharmacy–Specialist Cap 40 mg .............................................................................. 79.92 LIGNOCAINE Gel 2%, 10 ml urethral syringe ................................................. 43.26 FLUOROURACIL SODIUM Inj 50 mg per ml, 10 ml – PCT only – Specialist ....................... 24.75

S29

500 500 100 10 5

✔ Arrow Bendrofluazide ✔ Arrow Bendrofluazide ✔ Arrow-Testosterone ✔ Pfizer ✔ Fluorouracil Ebewe

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

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 August 2010

29 INSULIN GLARGINE – Special Authority see SA0834 – Retail pharmacy ▲ Inj 100 u per ml, 10 ml ........................................................... 63.00 1 ✔ Lantus ▲ Inj 100 u per ml, 3 ml ............................................................. 94.50 5 ✔ Lantus ▲ Inj 100 u per ml, 3 ml disposable pen ..................................... 94.50 5 ✔ Lantus SoloStar Note: Only for patients meeting one of the following criteria: 1 Type 1 diabetes; or 2 Other condition related diabetes (e.g. Cystic Fibrosis, diabetes in pregnancy, pancreatectomy patients); or 3 Type 2 diabetes after there has been unacceptable hypoglycaemic events with a 3 month trial of an insulin regimen; or 4 Type 2 diabetes who require insulin therapy and who require assistance from a carer or healthcare professional to administer their insulin injections. ➽ SA0834 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Both: 1.1 Patient has type 1 diabetes and has received an intensive regimen (injections at least three times a day) of an intermediate acting insulin in combination with a rapid acting insulin analogue for at least three months; and 1.2 Either: 1.2.1 Patient has experienced more than one unexplained severe hypoglycaemic episode in the previous 12 months (severe defined as requiring the assistance of another person); or 1.2.2 Patient has experienced unexplained symptomatic nocturnal hypoglycaemia, biochemically documented at <3.0 mmol/L, more than once a month despite optimal management; or 2 Patient has documented severe, or continuing, systemic or local allergic reaction to existing insulins. Note this does not include hypoglycaemic episodes. Renewal only from a relevant specialist or general practitioner. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Patient is continuing to derive benefit due to reduced hypoglycaemic events whilst maintaining similar or better glycaemic control; or 2 Patient’s allergic reaction has significantly decreased, or resolved, following the change to long-acting insulin and patient is continuing to benefit from treatment. 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 .................................................................................. 7.07 10 strip OP ✔ Optium Blood Ketone Test Strips a) Maximum of 20 test strips per prescription b) Not on a BSO SODIUM NITROPRUSSIDE ❋ Test strip ................................................................................ 14.14 a) Maximum of 20 test strips per prescription b) Not on a BSO 20 strip OP ✔ Ketostix

▲

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 August 2010 (continued)

35 37 40 IMIGLUCERASE – Special Authority see SA0473 – Retail pharmacy Hospital pharmacy [HP1] Inj 40 iu per ml, 200 iu vial .................................................. CBS 1 ✔ Cerezyme ALPHA TOCOPHERYL ACETATE – Special Authority see SA0915 – Retail pharmacy Hospital pharmacy [HP3] Water solubilised soln 156 iu/ml, with calibrated dropper ......... 18.30 50 ml OP ✔ Micelle E ERYTHROPOIETIN ALPHA – Special Authority see SA0922 – Retail pharmacy Hospital pharmacy [HP3] Inj human recombinant 1,000 iu prefilled syringe .................... 48.68 6 ✔ Eprex Inj human recombinant 2,000 iu, prefilled syringe ................. 120.18 6 ✔ Eprex Inj human recombinant 3,000 iu, prefilled syringe ................. 166.87 6 ✔ Eprex Inj human recombinant 4,000 iu, prefilled syringe ................. 193.13 6 ✔ Eprex Inj human recombinant 5,000 iu, prefilled syringe ................. 243.26 6 ✔ Eprex Inj human recombinant 6,000 iu, prefilled syringe ................. 291.92 6 ✔ Eprex Inj human recombinant 10,000 iu, prefilled syringe ............... 395.18 6 ✔ Eprex ERYTHROPOIETIN BETA – Special Authority see SA0922 – Retail pharmacy Hospital pharmacy [HP3] Inj 2,000 iu, prefilled syringe ................................................. 120.18 6 ✔ NeoRecormon Inj 3,000 iu, prefilled syringe ................................................. 166.87 6 ✔ NeoRecormon Inj 4,000 iu, prefilled syringe ................................................. 193.13 6 ✔ NeoRecormon Inj 5,000 iu, prefilled syringe ................................................. 243.26 6 ✔ NeoRecormon Inj 6,000 iu, prefilled syringe ................................................. 291.29 6 ✔ NeoRecormon Inj 10,000 iu, prefilled syringe ............................................... 395.18 6 ✔ NeoRecormon TOTAL PARENTERAL NUTRITION (TPN) – Retail pharmacy Hospital pharmacy [HP1]-Specialist Infusion ............................................................................... CBS 1 OP ✔ TPN DESFERRIOXAMINE MESYLATE – Hospital pharmacy [HP3] ❋ Inj 500 mg ............................................................................. 99.00 10 ✔ Mayne

44 48 52

MIDODRINE – Special Authority see SA0934 – Retail pharmacy Hospital pharmacy [HP3] Tab 2.5 mg ............................................................................ 53.00 100 ✔ Gutron Tab 5 mg ............................................................................... 79.00 100 ✔ Gutron PERHEXILINE MALEATE – Special Authority see SA0256 – Retail pharmacy Hospital pharmacy [HP3] ❋ Tab 100 mg ........................................................................... 62.90 100 ✔ Pexsig FUROSEMIDE ❋ Tab 500 mg ........................................................................... 25.00 50 ✔ Urex Forte S29

54 55 57

AMBRISENTAN – Special Authority see SA0967 – Retail pharmacy Hospital pharmacy [HP1] Tab 5 mg .......................................................................... 4,585.00 30 ✔ Volibris Tab 10 mg ........................................................................ 4,585.00 30 ✔ Volibris OXYPENTIFYLLINE – Hospital pharmacy [HP3] Tab 400 mg ........................................................................... 36.94 (42.26) 50 Trental 400

BOSENTAN – Special Authority see SA0967 – Retail pharmacy Hospital pharmacy [HP1] Tab 62.5 mg ..................................................................... 4,585.00 60 ✔ Tracleer Tab 125 mg ...................................................................... 4,585.00 60 ✔ Tracleer

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 August 2010 (continued)

58 58 ILOPROST – Special Authority see SA0969 – Retail pharmacy Hospital pharmacy [HP1] Nebuliser soln 10 µg per ml, 2 ml ...................................... 1,185.00 30 ✔ Ventavis SILDENAFIL – Special Authority see SA0968 – Retail pharmacy Hospital pharmacy [HP1] Tab 25 mg ............................................................................. 52.00 4 ✔ Viagra Tab 50 mg ............................................................................. 59.50 4 ✔ Viagra Tab 100 mg ........................................................................... 68.00 4 ✔ Viagra INTRA-UTERINE DEVICE – Only on a WSO a) Up to 40 dev available on a PSO b) Only on a PSO ❋ IUD ........................................................................................ 39.50 Distributed by Pharmaco NZ Ltd, PO Box 4079, Auckland Ph 09 377 3336 70 DIAPHRAGM ❋ Diaphragm – Up to 1 dev available on a PSO............................ 42.90 One of each size is permitted on a PSO. ❋ Diaphragm, 55 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 60 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 65 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 70 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 75 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 80 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 85 mm – Up to 1 dev available on a PSO ............42.90 ❋ Diaphragm, 90 mm – Up to 1 dev available on a PSO ............42.90 Note - amended descriptions only. 77 CYPROTERONE ACETATE – Retail pharmacy Hospital pharmacy [HP3]-Specialist Tab 50 mg ............................................................................. 21.10 50 Tab 100 mg ........................................................................... 41.50 50 ✔ Siterone ✔ Siterone 1 1 1 1 1 1 1 1 1 ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil

✔ Multiload Cu 375 ✔ Multiload Cu 375 SL

BUSERELIN ACETATE – Special Authority see SA0835 – Retail pharmacy Hospital pharmacy [HP3] Inj 1 mg per ml, 5.5 ml ......................................................... 195.00 2 (272.53) Suprefact CABERGOLINE Tab 0.5 mg – Maximum of 2 tab per prescription; can be waived by Special Authority see SA1031 0175..................... 66.00 16.50 66.00 ➽ SA1031 0175 Special Authority for Waiver of Rule

8 2 8

✔ Dostinex ✔ Arrow-Cabergoline ✔ Arrow-Cabergoline

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

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 August 2010 (continued)

continued... Initial application only from an obstetrician, endocrinologist or gynaecologist. Approvals valid without further renewal, unless notified, for applications for 2 years where the patient has pathological hyperprolactinemia. Renewal only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years without further renewal, unless notified, for applications where the patient has previously held a valid Special Authority which has expired and the treatment remains appropriate and the patient is benefiting from treatment. 82 DESMOPRESSIN Inj 4 µg per ml, 1 ml – Special Authority see SA0090 – Retail pharmacy Hospital pharmacy [HP3] .......................... 67.18 GOSERELIN ACETATE – Hospital pharmacy [HP3] Inj 3.6 mg ............................................................................ 200.00 Inj 10.8 mg .......................................................................... 500.00 LEUPRORELIN – Hospital pharmacy [HP3] Inj 3.75 mg .......................................................................... 221.60 Inj 3.75 mg prefilled syringe .................................................. 221.60 Inj 7.5 mg ............................................................................ 166.20 Inj 11.25 mg ........................................................................ 591.68 Inj 11.25 mg prefilled syringe ................................................ 591.68 Inj 22.5 mg .......................................................................... 443.76 Inj 30 mg ............................................................................. 591.68 Inj 30 mg prefilled syringe .................................................. 1,109.40 Inj 45 mg ............................................................................. 832.05 METYRAPONE Cap 250 mg – Retail pharmacy Hospital pharmacy [HP3]-Specialist ................................... 238.00

10 1 1 1 1 1 1 1 1 1 1 1

✔ Minirin ✔ Zoladex ✔ Zoladex ✔ Lucrin Depot ✔ Lucrin Depot PDS ✔ Eligard ✔ Lucrin Depot ✔ Lucrin Depot PDS ✔ Eligard ✔ Eligard ✔ Lucrin Depot PDS ✔ Eligard

✔ Metopirone

CEFAZOLIN SODIUM – Hospital pharmacy [HP3] – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg ............................................................................... 5.00 5 ✔ Hospira Inj 1 g ...................................................................................... 8.00 5 ✔ Hospira CEFOXITIN SODIUM – Retail pharmacy Hospital pharmacy [HP3]-Specialist – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 1 g .................................................................................... 55.00 5 ✔ Mayne CEFTRIAXONE SODIUM – Hospital pharmacy [HP3] – Subsidy by endorsement a) Up to 5 inj available on a PSO b) Subsidised only if prescribed for a dialysis or cystic fibrosis patient, or the treatment of confirmed ciprofloxacin-resistant gonorrhoea, or the treatment of suspected meningitis in patients who have a known allergy to penicillin, and the prescription or PSO is endorsed accordingly. Inj 500 mg ............................................................................... 3.99 1 ✔ AFT Inj 1 g ...................................................................................... 5.40 1 ✔ AFT 10.49 5 ✔ Aspen Ceftriaxone

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 August 2010 (continued)

84 CEFUROXIME SODIUM – Hospital pharmacy [HP3] Inj 250 mg – Maximum of 3 inj per prescription; can be waived by endorsement ................................................................... 20.97 10 ✔ Mayne Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ................................................................... 10.71 5 ✔ Zinacef Inj 1.5 g – Retail pharmacy Hospital pharmacy [HP3] -Specialist – Subsidy by Endorsement ................................... 4.04 1 ✔ Zinacef Only if prescribed for a dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. 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 .......................................... 11.50 100 ml 100 ml ✔ Cefalexin Sandoz ✔ Cefalexin Sandoz

COLISTIN SULPHOMETHATE – Retail pharmacy Hospital pharmacy [HP3]-Specialist – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 150 mg ............................................................................. 65.00 1 ✔ Colistin-Link FLUCONAZOLE – Retail pharmacy Hospital pharmacy [HP3]-Specialist Cap 50 mg ............................................................................... 6.82 Cap 150 mg ............................................................................. 1.30 Cap 200 mg ........................................................................... 19.05 28 1 28 ✔ Pacific ✔ Pacific ✔ Pacific

FUSIDIC ACID Tab 250 mg – Retail pharmacy Hospital pharmacy [HP3]-Specialist ................................................................. 34.50 12 ✔ Fucidin Inj 500 mg sodium fusidate per 10 ml – Retail pharmacy Hospital pharmacy [HP3]-Specialist – Subsidy by endorsement ................................................. 12.87 1 (17.80) Fucidin Only if prescribed for a dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. GENTAMICIN SULPHATE Inj 10 mg per ml, 1 ml – Hospital pharmacy [HP3] – Subsidy by endorsement .......................................... 8.56 5 ✔ Mayne Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly. 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. ITRACONAZOLE – Retail pharmacy Hospital pharmacy [HP3]-Specialist Cap 100 mg ........................................................................... 23.70 15 ✔ Sporanox

88 88

VANCOMYCIN HYDROCHLORIDE – Hospital pharmacy [HP3] – Subsidy by endorsement Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudomembranous colitis or for prophylaxis of endocarditis and the prescription is endorsed accordingly. Inj 50 mg per ml, 10 ml ............................................................ 5.04 1 ✔ Pacific

▲

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 August 2010 (continued)

88 TOBRAMYCIN Inj 40 mg per ml, 2 ml – Hospital pharmacy [HP3] – Subsidy by endorsement ........................................ 34.50 5 ✔ Mayne Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. RIFABUTIN – Retail pharmacy Hospital pharmacy [HP3]-Specialist No patient co-payment payable ❋ Cap 150 mg ......................................................................... 213.19

✔ Mycobutin

TENOFOVIR DISOPROXIL FUMARATE – Subsidy by endorsement; can be waived by Special Authority see SA0997 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 SA0997 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 4 3 subsidised antiretrovirals for the purposes of Special Authority SA0997, • Subsidy for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. Tab 300 mg ......................................................................... 531.00 30 ✔ Viread Antiretrovirals ➽ SA1025 1021 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. Notes: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 3 subsidised antiretrovirals. Subsidies for a combination of up to four 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. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. 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. Renewal – (Second or subsequent 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. 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 August 2010 (continued)

continued... Notes: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 3 subsidised antiretrovirals. Subsidies for a combination of up to four 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. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. 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 4 3 subsidised antiretrovirals. Subsidies for a combination of up to four 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. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. 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. Initial application - (Post-exposure prophylaxis following non-occupational exposure to HIV) only from a named specialist. Approvals valid for 4 weeks for applications meeting the following criteria: Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. Notes: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 3 subsidised antiretrovirals. Subsidies for a combination of up to four three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including ritonavir plus indinavir or atazanavir will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals. Renewal - (Second or subsequent post-exposure prophylaxis) only from a named specialist. Approvals valid for 4 weeks for applications meeting the following criteria: Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. 94 EFAVIRENZ – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 50 mg ........................................................................... 158.33 30 ✔ Stocrin Tab 200 mg ......................................................................... 474.99 90 ✔ Stocrin Tab 600 mg ......................................................................... 474.99 30 ✔ Stocrin

▲

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 August 2010 (continued)

94 NEVIRAPINE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 200 mg ......................................................................... 319.80 60 ✔ Viramune Oral suspension 10 mg per ml .............................................. 134.55 240 ml ✔ Viramune Suspension ABACAVIR SULPHATE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 300 mg ......................................................................... 458.00 60 ✔ Ziagen Oral liq 20 mg per ml ............................................................ 100.00 240 ml OP ✔ Ziagen ABACAVIR SULPHATE WITH LAMIVUDINE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Note: Kivexa counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority. Tab 600 mg with lamivudine 300 mg .................................... 630.00 30 ✔ Kivexa DIDANOSINE [DDI] – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 125 mg ......................................................................... 115.05 30 ✔ Videx EC Cap 200 mg ......................................................................... 184.08 30 ✔ Videx EC Cap 250 mg ......................................................................... 230.10 30 ✔ Videx EC Cap 400 mg ......................................................................... 368.16 30 ✔ Videx EC EMTRICITABINE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 200 mg ......................................................................... 307.20 30 ✔ Emtriva ATAZANAVIR SULPHATE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 150 mg ......................................................................... 568.34 60 ✔ Reyataz Cap 200 mg ......................................................................... 757.79 60 ✔ Reyataz ENFUVIRTIDE – Special Authority see SA0845 – Retail pharmacy Hospital pharmacy [HP1] Powder for inj 90 mg per ml × 60 ..................................... 2,380.00 1 ✔ Fuzeon INDINAVIR – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 200 mg ......................................................................... 519.75 360 ✔ Crixivan Cap 400 mg ......................................................................... 519.75 180 ✔ Crixivan LAMIVUDINE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 150 mg ......................................................................... 153.60 60 ✔ 3TC Oral liq 10 mg per ml .............................................................. 50.00 240 ml OP ✔ 3TC LOPINAVIR WITH RITONAVIR – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 100 mg with ritonavir 25 mg ........................................... 183.75 60 ✔ Kaletra Tab 200 mg with ritonavir 50 mg .......................................... 735.00 120 ✔ Kaletra Oral liq 80 mg with ritonavir 20 mg per ml ............................. 735.00 300 ml OP ✔ Kaletra RALTEGRAVIR POTASSIUM – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Tab 400 mg ...................................................................... 1,350.00 60 ✔ Isentress RITONAVIR – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 100 mg ......................................................................... 121.27 84 ✔ Norvir Oral liq 80 mg per ml ............................................................ 103.98 90 ml OP ✔ Norvir

94 95

95 95

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 Restrictions - effective 1 August 2010 (continued)

95 STAVUDINE [D4T] – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 20 mg ........................................................................... 317.10 60 ✔ Zerit Cap 30 mg ........................................................................... 377.80 60 ✔ Zerit Cap 40 mg ........................................................................... 503.80 60 ✔ Zerit Powder for oral soln 1 mg per ml .......................................... 100.76 200 ml OP ✔ Zerit ZIDOVUDINE [AZT] – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Cap 100 mg ......................................................................... 145.00 100 ✔ Retrovir Oral liq 10 mg per ml .............................................................. 29.00 200 ml OP ✔ Retrovir ZIDOVUDINE [AZT] WITH LAMIVUDINE – Special Authority see SA1025 – Retail pharmacy Hospital pharmacy [HP1] Combivir counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority. Tab 300 mg with lamivudine 150 mg .................................... 667.20 60 ✔ Combivir INTERFERON ALPHA-2A – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist a) See prescribing guideline b) Only one multidose cartridge starter pack to be prescribed and dispensed per patient. Inj 3 m iu prefilled syringe ........................................................ 31.32 1 ✔ Roferon-A Inj 6 m iu prefilled syringe ........................................................ 62.64 1 ✔ Roferon-A Inj 9 m iu prefilled syringe ........................................................ 93.96 1 ✔ Roferon-A INTERFERON ALPHA-2B – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist See prescribing guideline Inj 18 m iu, 1.2 ml multidose pen .......................................... 187.92 1 ✔ Intron-A Inj 30 m iu, 1.2 ml multidose pen .......................................... 313.20 1 ✔ Intron-A Inj 60 m iu, 1.2 ml multidose pen .......................................... 626.40 1 ✔ Intron-A PEGYLATED INTERFERON ALPHA-2A – Special Authority see SA0952 – Retail pharmacy Hospital pharmacy [HP3] See prescribing guideline Inj 135 μg prefilled syringe ................................................... 362.00 1 ✔ Pegasys Inj 180 μg prefilled syringe ................................................... 450.00 1 ✔ Pegasys Inj 135 μg prefilled syringe × 4 with ribavirin tab 200 mg ×112 ............................................................... 1,799.68 1 OP ✔ Pegasys RBV Combination Pack Inj 135 μg prefilled syringe × 4 with ribavirin tab 200 mg × 168 .............................................................. 1,975.00 1 OP ✔ Pegasys RBV Combination Pack Inj 180 μg prefilled syringe × 4 with ribavirin tab 200 mg × 112 .............................................................. 2,059.84 1 OP ✔ Pegasys RBV Combination Pack Inj 180 μg prefilled syringe × 4 with ribavirin tab 200 mg × 168 .............................................................. 2,190.00 1 OP ✔ Pegasys RBV Combination Pack

▲

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 Restrictions - effective 1 August 2010 (continued)

102 ADALIMUMAB – Special Authority see SA1026 0974 – Retail pharmacy Inj 40 mg per 0.8 ml prefilled pen ...................................... 1,799.92 2 ✔ HumiraPen Inj 40 mg per 0.8 ml prefilled syringe ................................. 1,799.92 2 ✔ Humira ➽ SA1026 0974 Special Authority for Subsidy Initial application — (rheumatoid arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and 5 Either: 5.1 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of cyclosporin alone or in combination with another agent; or 5.2 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of leflunomide alone or in combination with another agent; and 6 Either: 6.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 6.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 7 Either: 7.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 7.2 C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months. Initial application — (Crohn’s disease) only from a gastroenterologist. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Patient has severe active Crohn’s disease; and 2 Any of the following: 2.1 Patient has a Crohn’s Disease Activity Index (CDAI) score of greater than or equal to 300; or 2.2 Patient has extensive small intestine disease affecting more than 50 cm of the small intestine; or 2.3 Patient has evidence of short gut syndrome or would be at risk of short gut syndrome with further bowel resection; or 2.4 Patient has an ileostomy or colostomy, and has intestinal inflammation; and 3 Patient has tried but had an inadequate response to, or has experienced intolerable side effects from, prior systemic therapy with immunomodulators at maximum tolerated doses (unless contraindicated) and corticosteroids; and 4 Surgery (or further surgery) is considered to be clinically inappropriate. Initial application — (severe chronic plaque psoriasis) only from a dermatologist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Patient has "whole body" severe chronic plaque psoriasis with a Psoriasis Area and Severity Index (PASI) score of greater than 15, where lesions have been present for at least 6 months from the time of initial diagnosis; or 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

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Changes to Restrictions - effective 1 August 2010 (continued)

continued... 1.2 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and 2 Patient has tried, but had an inadequate response (see Note) to, or has experienced intolerable side effects from, at least three of the following (at maximum tolerated doses unless contraindicated): phototherapy, methotrexate, cyclosporin, or acitretin; and 3 A PASI assessment has been completed for at least the most recent prior treatment course (but preferably all prior treatment courses), preferably while still on treatment but no longer than 1 month following cessation of each prior treatment course; and 4 The most recent PASI assessment is no more than 1 month old at the time of application. Note: "Inadequate response" is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment. Initial application — (ankylosing spondylitis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has a confirmed diagnosis of ankylosing spondylitis present for more than six months; and 2 Patient has low back pain and stiffness that is relieved by exercise but not by rest; and 3 Patient has bilateral sacroiliitis demonstrated by plain radiographs, CT or MRI scan; and 4 Patient’s ankylosing spondylitis has not responded adequately to treatment with two or more non-steroidal anti-inflammatory drugs (NSAIDs), in combination with anti-ulcer therapy if indicated, while patient was undergoing at least 3 months of an exercise regimen supervised by a physiotherapist; and 5 Either: 5.1 Patient has limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or 5.2 Patient has limitation of chest expansion by at least 2.5 cm below the average normal values corrected for age and gender (see Notes); and 6 A Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 6 on a 0-10 scale; and 7 Either: 7.1 An elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 7.2 A C-reactive protein (CRP) level greater than 15 mg per litre. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI, ESR and CRP measures must be no more than 1 month old at the time of initial application. Average normal chest expansion corrected for age and gender: 18-24 years - Male: 7.0 cm; Female: 5.5 cm 25-34 years - Male: 7.5 cm; Female: 5.5 cm 35-44 years - Male: 6.5 cm; Female: 4.5 cm 45-54 years - Male: 6.0 cm; Female: 5.0 cm 55-64 years - Male: 5.5 cm; Female: 4.0 cm 65-74 years - Male: 4.0 cm; Female: 4.0 cm 75+ years - Male: 3.0 cm; Female: 2.5 cm Initial application — (psoriatic arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Patient has had severe active psoriatic arthritis for six months duration or longer; and 2 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 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

Check your Schedule for full details Schedule page ref

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2010 (continued)

continued... 3 Patient has tried and not responded to at least three months of sulphasalazine at a dose of at least 2 g per day or leflunomide at a dose of up to 20 mg daily (or maximum tolerated doses); and 4 Either: 4.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 4.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 5 Any of the following: 5.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 5.2 Patient has an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 5.3 ESR and CRP not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months. Renewal — (rheumatoid arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Either: 3.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or 3.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician.; and 4 Either: 4.1 Adalimumab to be administered at doses no greater than 40 mg every 14 days; or 4.2 Patient cannot take concomitant methotrexate and requires doses of adalimumab higher than 40 mg every 14 days to maintain an adequate response. Renewal — (Crohn’s disease) only from a gastroenterologist or Practitioner on the recommendation of a gastroenterologist. Approvals valid for 6 months for applications meeting the following criteria: Both All of the following: 1 Either: 1.1 Applicant is a gastroenterologist; or 1.2 Applicant is a Practitioner and confirms that a gastroenterologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 The treatment remains appropriate and the patient is benefiting from treatment. Either: 2.1 Either: 2.1.1 CDAI score has reduced by 100 points from the CDAI score when the patient was initiated on adalimumab; or 2.1.2 CDAI score is 150 or less; or 2.2 Both: 2.2.1 The patient has demonstrated an adequate response to treatment but CDAI score cannot be assessed; and 2.2.2 Applicant to state the reason that CDAI score cannot be assessed; and 3 Adalimumab to be administered at doses no greater than 40 mg every 14 days. Renewal — (severe chronic plaque psoriasis) only from a dermatologist or Practitioner on the recommendation of a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2010 (continued)

continued... Both All of the following: 1 Either: 1.1 Applicant is a dermatologist; or 1.2 Applicant is a Practitioner and confirms that a dermatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Either: 2.1 Both: 2.1.1 Patient has "whole body" severe chronic plaque psoriasis; and 2.1.2 Following each prior adalimumab treatment course the patient has a PASI score which is reduced by 75% or more, or is sustained at this level, when compared with the pre-adalimumab treatment baseline value; or 2.2 Both: 2.2.1 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and 2.2.2 Either: 2.2.2.1 Following each prior adalimumab treatment course the patient has a reduction in the PASI symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the treatment course baseline values; or 2.2.2.2 Following each prior adalimumab treatment course the patient has a reduction of 75% or more in the skin area affected, or sustained at this level, as compared to the preadalimumab treatment baseline value.; and 3 Adalimumab to be administered at doses no greater than 40 mg every 14 days. Note: An adalimumab treatment course is defined as a minimum of 12 weeks of adalimumab treatment. Renewal — (ankylosing spondylitis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Following 12 weeks of adalimumab treatment, BASDAI has improved by 4 or more points from preadalimumab baseline on a 10 point scale, or by 50%, whichever is less; and 3 ESR or CRP is within the normal range; and 4 Physician considers that the patient has benefited from treatment and that continued treatment is appropriate.; and 5 Adalimumab to be administered at doses no greater than 40 mg every 14 days. Renewal —(psoriatic arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Both All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Either: 2.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the treating physician; or 2.2 The patient demonstrates at least a continuing 50% improvement in active joint count from baseline and a clinically significant response to prior adalimumab treatment in the opinion of the treating physician.; and 3 Adalimumab to be administered at doses no greater than 40 mg every 14 days.

▲

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 August 2010 (continued)

108 PAMIDRONATE DISODIUM – Hospital pharmacy [HP3] Inj 3 mg per ml, 5 ml .............................................................. 18.75 Inj 3 mg per ml, 10 ml ............................................................ 37.50 Inj 6 mg per ml, 10 ml ............................................................ 75.00 Inj 9 mg per ml, 10 ml .......................................................... 112.50 BUPIVACAINE HYDROCHLORIDE – Hospital pharmacy [HP3] Inj 0.5%, 4 ml ......................................................................... 29.35 Inj 0.5%, 8% glucose, 4 ml ..................................................... 24.50 1 1 1 1 5 5 ✔ Pamisol ✔ Pamisol ✔ Pamisol ✔ Pamisol ✔ Marcain Isobaric ✔ Marcain Heavy

109

LIGNOCAINE WITH PRILOCAINE – Special Authority see SA0906 – Retail pharmacy Hospital pharmacy [HP3] Crm 2.5% with prilocaine 2.5% ............................................... 41.00 30 g OP ✔ EMLA Crm 2.5% with prilocaine 2.5% (5 g tubes) ............................. 41.00 5 ✔ EMLA SUMATRIPTAN Inj 12 mg per ml, 0.5 ml – Retail pharmacy Hospital pharmacy [HP3]-Specialist .................................... 80.00 Maximum of 10 inj per prescription

119

2 OP

✔ Imigran

120 121

HYOSCINE (SCOPOLAMINE) – Special Authority see SA0939 – Retail pharmacy Hospital pharmacy [HP3] Patch 1.5 mg ......................................................................... 11.95 2 ✔ Scopoderm TTS TROPISETRON – Retail pharmacy Hospital pharmacy [HP3]-Specialist a) Maximum of 6 cap per prescription b) Maximum of 3 cap per dispensing c) Not more than one prescription per month. Cap 5 mg ............................................................................... 77.41 CALCIUM FOLINATE Tab 15 mg – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist ................................................. 63.89 Inj 3 mg per ml, 1 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................... 17.10 Inj 50 mg – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist ................................................. 24.50

✔ Navoban

137

10 5 5

✔ Mayne ✔ Mayne ✔ Calcium Folinate Ebewe

137

CAPECITABINE – Retail pharmacy Hospital pharmacy [HP1]-Specialist – Special Authority see SA0869 Tab 150 mg ......................................................................... 115.00 60 ✔ Xeloda Tab 500 mg ......................................................................... 705.00 120 ✔ Xeloda

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

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2010 (continued)

139 METHOTREXATE ❋ Tab 2.5 mg – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist ................................................... 5.22 ❋ Tab 10 mg – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist ................................................. 40.93 ❋ Inj 2.5 mg per ml, 2 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................... 23.65 ❋ Inj 25 mg per ml, 2 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................... 46.10 ❋ Inj 25 mg per ml, 20 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................... 80.25 ❋ Inj 100 mg per ml, 10 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................... 27.50 ❋ Inj 100 mg per ml, 50 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]-Specialist .................................. 135.00 30 50 5 5 1 1 1 ✔ Methoblastin ✔ Methoblastin ✔ Mayne ✔ Mayne ✔ Mayne ✔ Methotrexate Ebewe ✔ Methotrexate Ebewe ✔ Lanvis

140 141

THIOGUANINE – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist Tab 40 mg ............................................................................. 97.16 25 ETOPOSIDE Cap 50 mg – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist ............................................... 340.73 Cap 100 mg – PCT – Retail pharmacy Hospital pharmacy [HP3]-Specialist ............................................... 340.73 Inj 20 mg per ml, 5 ml – PCT – Retail pharmacy Hospital pharmacy [HP1]- Specialist ................................... 25.00 612.20

20 10 1 10

✔ Vepesid ✔ Vepesid ✔ Mayne ✔ Vepesid

142

TEMOZOLOMIDE – Special Authority see SA0831 – Retail pharmacy Hospital pharmacy [HP3] Cap 5 mg ............................................................................... 50.00 5 ✔ Temodal Cap 20 mg ........................................................................... 170.00 5 ✔ Temodal Cap 100 mg ......................................................................... 840.00 5 ✔ Temodal Cap 250 mg ...................................................................... 2,100.00 5 ✔ Temodal EXEMESTANE – Additional subsidy by Special Authority see SA1000 – Retail pharmacy Note: Repeat dispensings for Aromasin will be fully subsidised where the initial dispensing was before 1 February 2010 Tab 25 mg ............................................................................. 26.55 30 (175.00) Aromasin FLUTAMIDE – Retail pharmacy Hospital pharmacy [HP3]-Specialist Tab 250 mg ........................................................................... 48.30 100 ✔ Flutamin

146

146 146

OCTREOTIDE (SOMATOSTATIN ANALOGUE) – Special Authority see SA1016 – Retail pharmacy Hospital pharmacy [HP3] Inj 50 µg per ml, 1 ml ............................................................. 25.65 5 ✔ Hospira 43.50 ✔ Sandostatin Inj 100 µg per ml, 1 ml ........................................................... 48.50 5 ✔ Hospira 81.00 ✔ Sandostatin Inj 500 µg per ml, 1 ml ......................................................... 175.00 5 ✔ Hospira 399.00 ✔ Sandostatin Inj LAR 10 mg prefilled syringe .......................................... 1,772.50 1 ✔ Sandostatin LAR Inj LAR 20 mg prefilled syringe .......................................... 2,358.75 1 ✔ Sandostatin LAR Inj LAR 30 mg prefilled syringe .......................................... 2,951.25 1 ✔ Sandostatin LAR ❋ 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 August 2010 (continued)

147 MYCOPHENOLATE MOFETIL – Special Authority see SA0960 – Retail pharmacy Hospital pharmacy [HP3] Tab 500 mg ......................................................................... 206.66 50 ✔ Cellcept Cap 250 mg ......................................................................... 206.66 100 ✔ Cellcept Powder for oral liq 1 g per 5 ml – Subsidy by endorsement ... 285.00 165 ml OP ✔ Cellcept Mycophenolate powder for oral liquid is subsidised only for patients unable to swallow tablets and capsules, and when the prescription is endorsed accordingly CYCLOSPORIN – Hospital pharmacy [HP3] Cap 25 mg ............................................................................. 59.50 Cap 50 mg ........................................................................... 118.54 Cap 100 mg ......................................................................... 237.08 Oral liq 100 mg per ml .......................................................... 264.17 50 50 50 50 ml OP ✔ Neoral ✔ Neoral ✔ Neoral ✔ Neoral

149

SIROLIMUS – Special Authority see SA0866 – Retail pharmacy Hospital pharmacy [HP3] Tab 1 mg ............................................................................. 813.00 100 ✔ Rapamune Tab 2 mg .......................................................................... 1,626.00 100 ✔ Rapamune Oral liq 1 mg per ml .............................................................. 487.80 60 ml OP ✔ Rapamune TACROLIMUS – Special Authority see SA0669 – Retail pharmacy Hospital pharmacy [HP3] Cap 0.5 mg .......................................................................... 214.00 100 ✔ Prograf Cap 1 mg ............................................................................. 428.00 100 ✔ Prograf Cap 5 mg .......................................................................... 1,070.00 50 ✔ Prograf BEE VENOM ALLERGY TREATMENT – Special Authority see SA0053 – Retail pharmacy Hospital pharmacy [HP3] Maintenance kit - 6 vials 120 µg freeze dried venom, 6 diluent 1.8 ml ................................................................ 285.00 Treatment kit - 1 vial 550 µg freeze dried venom, 1 diluent 9 ml, 3 diluent 1.8 ml ........................................................ 285.00 WASP VENOM ALLERGY TREATMENT – Special Authority see SA0053 – Retail pharmacy Hospital pharmacy [HP3] Treatment kit (Paper wasp venom) - 1 vial 550 µg freeze dried polister venom, 1 diluent 9 ml, 1 diluent 1.8 ml ................. 285.00 Treatment kit (Yellow jacket venom) - 1 vial 550 µg freeze dried vespula venom, 1 diluent 9 ml, 1 diluent 1.8 ml ........ 285.00

150

151

1 OP 1 OP

✔ Albay ✔ Albay

151

1 OP 1 OP

✔ Albay ✔ Albay

156 156

DORNASE ALFA – Special Authority see SA0611 – Retail pharmacy Hospital pharmacy [HP1] Nebuliser soln, 2.5 mg per 2.5 ml ampoule ........................... 294.30 6 ✔ Pulmozyme MASK FOR SPACER DEVICE a) Up to 20 dev available on a PSO b) Only for children aged six years and under c) Only on a PSO a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) Only available for children aged six years and under. 2) 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. 3) 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

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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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 August 2010 (continued)

157 PEAK FLOW METER a) Up to 10 dev available on a PSO b) Only on a PSO a) Maximum of 10 dev per WSO b) Only on a WSO Low range .............................................................................. 13.75 Normal range ......................................................................... 13.75

1 1

✔ Breath-Alert ✔ Breath-Alert

157

SPACER DEVICE a) Up to 20 dev available on a PSO b) Only on a PSO a) Maximum of 20 dev per WSO b) Only on a WSO c) 1) 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 PSO WSO is endorsed accordingly. 800 ml ..................................................................................... 8.50 1 ✔ Volumatic 230 ml (single patient) .............................................................. 8.38 1 ✔ Space Chamber

161

PILOCARPINE ❋ Eye drops 2% single dose – Special Authority see SA0895 – Retail pharmacy Hospital pharmacy [HP3] .......................... 31.95 (32.72) ACETYLCYSTEINE – Retail pharmacy Hospital pharmacy [HP1]-Specialist Inj 200 mg per ml, 10 ml ...................................................... 137.06 (219.75) (255.35)

20 dose Minims 10 Martindale Acetylcysteine Hospira

167

Effective 1 July 2010

73 77 CLOTRIMAZOLE ❋ Vaginal crm 1% with applicator(s) ............................................. 1.30 35 g OP ✔ Clomazol

Hormone Replacement Therapy – Systemic ➽ SA10180312 Special Authority for Alternate Subsidy Initial application only from any relevant practitioner an obstetrician, gynaecologist, general practitioner or general physician. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 acute or significant liver disease – where oral oestrogens are contraindicated as determined by a gastroenterologist or general physician. The applicant must keep written confirmation from such a specialist with the patient’s record; or 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

▲

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 July 2010 (continued)

continued... 2 oestrogen induced hypertension requiring antihypertensive therapy - documented evidence must be kept on file that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens; or 3 hypertriglyceridaemia - documented evidence must be kept on file that triglyceride levels increased to at least 2 x normal triglyceride levels post oral oestrogens; or 4 Somatropin co-therapy – patient is being prescribed somatropin with subsidy provided under a valid approval issued under Special Authority Note: Prescriptions with a valid Special Authority (CHEM) number will be reimbursed at the level of the lowest priced TDDS product within the specified dose group. Renewal only from a relevant practitioner an obstetrician, gynaecologist, general practitioner or general physician. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment, or the patient remains on subsidised somatropin co-therapy. 82 CLOMIPHENE CITRATE – Retail pharmacy-Specialist Only a prescription for a female patient. Tab 50 mg ................................................................................ 2.50 29.84 DAPSONE – No patient co-payment payable Tab 25 mg .............................................................................. 95.00 Tab 100 mg .......................................................................... 110.00

5 10

✔ Phenate ✔ Serophene

100 100

✔ Dapsone S29 ✔ Dapsone S29

Antiretrovirals ➽ SA10210779 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. 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. 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. Renewal – (Second or subsequent 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.

Notes: Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to continued... 3 subsidised antiretrovirals. 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

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 July 2010 (continued)

continued... 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. Initial application - (Post-exposure prophylaxis following non-occupational exposure to HIV) only from a named specialist. Approvals valid for 4 weeks for applications meeting the following criteria: Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. Renewal - (Second or subsequent post-exposure prophylaxis) only from a named specialist. Approvals valid for 4 weeks for applications meeting the following criteria: Both: 1 Treatment course to be initiated within 72 hours post exposure; and 2 Either: 2.1 Patient has had unprotected receptive anal intercourse with a known HIV positive person; or 2.2 Patient has shared intravenous injecting equipment with a known HIV positive person. 99 INFLUENZA VACCINE – Hospital pharmacy [Xpharm] A) is available between 1 March and 30 June until vaccine supplies are exhausted 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: 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

▲

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 July 2010 (continued)

continued... 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. c) people under 65 years of age who are: i) pregnant; or ii) morbidly obsese d) children aged over 6 months and under 5 years who are from high deprivation backgrounds 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, B) Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule. C) 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. D) 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 90.00 10 ✔ Influvac ✔ Vaxigrip

120

DOMPERIDONE – Additional subsidy by Special Authority see SA0938 below – Retail pharmacy ❋ Tab 10 mg ................................................................................ 7.99 100 ✔ Motilium ➽ SA0938 Special Authority for Manufacturers Price Initial application from any relevant practitioner. Approvals valid for 6 months where the patient is terminally ill and requires control of nausea and vomiting. Renewal from any relevant practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. TOLCAPONE – Retail pharmacy-Specialist prescription Specialist must be a neurologist, geriatrician or general physician. ▲ Tab 100 mg .......................................................................... 128.75

122

100

✔ Tasmar

146

OCTREOTIDE (SOMATOSTATIN ANALOGUE) – Special Authority see SA10160563 – Hospital pharmacy [HP3] Inj 50 µg per ml, 1 ml .............................................................. 25.65 5 ✔ Hospira 43.50 ✔ Sandostatin Inj 100 µg per ml, 1 ml ............................................................ 48.50 5 ✔ Hospira 81.00 ✔ Sandostatin Inj 500 µg per ml, 1 ml .......................................................... 175.00 5 ✔ Hospira 399.00 ✔ Sandostatin Inj LAR 10 mg prefilled syringe ........................................... 1,772.50 1 ✔ Sandostatin LAR Inj LAR 20 mg prefilled syringe ........................................... 2,358.75 1 ✔ Sandostatin LAR Inj LAR 30 mg prefilled syringe ........................................... 2,951.25 1 ✔ Sandostatin LAR ➽ SA10160563 Special Authority for Subsidy Initial application – (Malignant Bowel Obstruction) from any relevant practitioner. Approvals valid for 2 months for applications meeting the following criteria: All of the following: continued...

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 July 2010 (continued)

continued... 1 The patient has nausea* and vomiting* due to malignant bowel obstruction*; and 2 Treatment with antiemetics, rehydration, antimuscarinic agents, corticosteroids and analgesics for at least 48 hours has failed; and 3 Octreotide to be given up to a maximum dose of 1,500 μg daily for up to 4 weeks. Renewal – (Malignant Bowel Obstruction) from any relevant practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. Note: indications marked with * are Unapproved Indications. Initial application – (Acromegaly) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 The patient has acromegaly; and 2 Any of the following 2.1 Treatment with surgery, radiotherapy and a dopamine agonist has failed; or 2.2 Treatment with octreotide is for an interim period while awaiting the effects of radiotherapy and a dopamine agonist has failed; or 2.3 The patient is unwilling, or unable, to undergo surgery and/or radiotherapy. Renewal – (Acromegaly) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1. IGF1 levels have decreased since starting octreotide; and 2. The treatment remains appropriate and the patient is benefiting from treatment. Note: In patients with acromegaly octreotide treatment should be discontinued if IGF1 levels have not decreased after 3 months treatment. In patients treated with radiotherapy octreotide treatment should be withdrawn every 2 years, for 1 month, for assessment of remission. Octreotide treatment should be stopped where there is biochemical evidence of remission (normal IGF1 levels) following octreotide treatment withdrawal for at least 4 weeks. Initial application – (Other Indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patient has failed surgery, radiotherapy, bromocriptine and other oral therapies; or 21 VIPomas and Glucagonomas - for patients who are seriously ill in order to improve their clinical state prior to definitive surgery; or 32 Both: 32.1 Gastrinoma; and 32.2 Either: 32.2.1 Patient has failed surgery; or 32.2.2 Patient in metastatic disease after H2 antagonists (or proton pump inhibitors) have failed; or 43 Both: 43.1 Insulinomas; and 43.2 Surgery is contraindicated or has failed; or 54 For pre-operative control of hypoglycaemia and for maintenance therapy; or 65 Both: 65.1 Carcinoid syndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis); and 65.2 Disabling symptoms not controlled by maximal medical therapy. Note: The use of octreotide in patients with fistulae, oesophageal varices, miscellaneous diarrhoea and hypotension will not be funded as a Special Authority item. 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

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 July 2010 (continued)

continued... Renewal – (Other Indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. 149 TRASTUZUMAB – PCT only – Specialist – Special Authority see SA10170885 Inj 150 mg vial .............................................................................1,350.00 1 Inj 440 mg vial .............................................................................3,875.00 1 Inj 1 mg for ECP .................................................................................9.36 1 mg ✔ Herceptin ✔ Herceptin ✔ Baxter

➽ SA10170885 Special Authority for Subsidy Initial application — (metastatic breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months where the patient has metastatic breast cancer expressing HER-2 IHC 3+ or FISH+. Renewal — (metastatic breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastatic breast cancer; and 2 The cancer has not progressed. Initial application — (early breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 3 15 months for applications meeting the following criteria: All of the following: 1 The patient has early breast cancer expressing HER 2 IHC 3+ or FISH + ISH + (including FISH or other current technology); and 2 Maximum cumulative dose of 20106 mg/kg (9 weeks 12 months’ treatment)*; and 3 Any of the following: 3.1 9 weeks’ concurrent treatment with adjuvant chemotherapy is planned; or 3.2 12 months’ concurrent treatment with adjuvant chemotherapy is planned; or 3.3 12 months’ sequential treatment following adjuvant chemotherapy is planned; or 3.4 Other treatment regimen, in association with adjuvant chemotherapy, is planned. 3 Trastuzumab is to be given concurrently with adjuvant taxane chemotherapy*; and 4 Trastuzumab is not to be given concurrently with anthracycline chemotherapy. Notes: indications marked with * are Unapproved Indications. It is recommended that for early breast cancer trastuzumab be administered concurrently with docetaxel prior to anthracyclines as per the FinHer regimen (Joensuu H, Kellokumpu-Lehtinen P, Bono P, et al. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med 2006;354(8):809-20). Note: For patients with previous Special Authority approvals for a maximum cumulative dose of 20 mg/kg (9 weeks treatment) granted after 1 April 2009 the approval period has been extended to allow claims for a maximum cumulative dose of 106 mg/kg (12 months treatment)

Effective 1 June 2010

33 PANCREATIC ENZYME Cap 8,000 USP u lipase, 30,000 USP u amylase, 30,000 USP u protease – Retail pharmacy-Specialist ........... 85.00 Cap EC 10,000 BP u lipase, 9,000 BP u amylase and 210 BP u protease – Retail pharmacy-Specialist................... 34.93 Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease – Retail pharmacy-Specialist................ 94.38 Cap EC 25,000 BP u lipase, 22,500 BP u amylase, 1,250 BP u protease – Retail pharmacy-Specialist................ 94.40 250 100 100 100 ✔ Cotazym ECS ✔ Creon 10000 ✔ Creon Forte ✔ Panzytrat

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 June 2010 (continued)

39 65 71 FERROUS SULPHATE ❋‡ Oral liq 30 mg per 1 ml 150 mg per 5 ml (6 mg elemental per 1 ml 30 mg elemental per 1 ml) .............. 10.30 MALATHION Liq 0.5% ................................................................................... 4.99

500 ml

✔ Ferodan

200 ml OP ✔ Derbac-M

COMBINED ORAL CONTRACEPTIVES ➽ SA0500 Special Authority for Alternate Subsidy Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Patient is on a Social Welfare benefit; or 1.2 Patient has an income no greater than the benefit; and 2 Has tried at least one of the fully funded options and has been unable to tolerate it. Renewal from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient is on a Social Welfare benefit; or 2 Patient has an income no greater than the benefit. Notes: The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon, and Marvelon, Minulet and Femodene. The additional subsidy will fund Mercilon, and Marvelon, Minulet and Femodene up to the manufacturer’s price for each of these products as identified on the Schedule at 1 November 1999. Special Authorities approved before 1 November 1999 remain valid until the expiry date and can be renewed providing that women are still either: • on a Social Welfare benefit; or • have an income no greater than the benefit. The approval numbers of Special Authorities approved before 1 November 1999 are interchangeable for products within the combined oral contraceptives and progestogen-only contraceptives groups, except Loette and Microgynon 20 ED

PROGESTOGEN-ONLY CONTRACEPTIVES ➽ SA0500 Special Authority for Alternate Subsidy Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Patient is on a Social Welfare benefit; or 1.2 Patient has an income no greater than the benefit; and 2 Has tried at least one of the fully funded options and has been unable to tolerate it. Renewal from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient is on a Social Welfare benefit; or 2 Patient has an income no greater than the benefit. Notes: The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon, and Marvelon, Minulet and Femodene. The additional subsidy will fund Mercilon, and Marvelon, Minulet and Femodene up to the manufacturer’s price for each of these products as identified on the Schedule at 1 November 1999. Special Authorities approved before 1 November 1999 remain valid until the expiry date and can be renewed providing that women are still either: • on a Social Welfare benefit; or • have an income no greater than the benefit. 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

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 June 2010 (continued)

continued... The approval numbers of Special Authorities approved before 1 November 1999 are interchangeable for products within the combined oral contraceptives and progestogen-only contraceptives groups, except Loette and Microgynon 20 ED 107 ALENDRONATE SODIUM – Special Authority see SA0990 – Retail pharmacy Tab 70 mg ............................................................................. 35.91 4 ✔ Fosamax

ALENDRONATE SODIUM WITH CHOLECALCIFEROL – Special Authority see SA0990 – Retail pharmacy Tab 70 mg with cholecalciferol 5,600 iu .................................. 35.91 4 ✔ Fosamax Plus Tab 70 mg with cholecalciferol 2,800 iu .................................. 35.91 4 ✔ Fosamax Plus ➽ SA0990 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 mineral density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note); 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 (see Note); 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 (see Note). 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) (see Note); 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 mineral density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note); 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 (see Note); 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 (see Note). Notes: 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 June 2010 (continued)

continued... a) BMD (including BMD used to derive T-Score) must be derived measured using dual-energy x-ray absorptiometry (DXA). Quantitative ultrasound and quantitative computed tomography (QCT) are not acceptable. b) 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. c) 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. d) 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. 135 NALTREXONE HYDROCHLORIDE – Special Authority see SA0909 – Retail pharmacy Tab 50 mg ........................................................................... 180.00 30 ✔ ReVia ➽ SA0909 Special Authority for Subsidy Initial application from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is currently enrolled in a recognised comprehensive treatment programme for alcohol dependence; and 2 Applicant works in or with a community Alcohol and Drug Service contracted to one of the 21 District Health Boards or accredited against the New Zealand Alcohol and Other Drug Sector Standard or the National Mental Health Sector Standard. Renewal from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Compliance with the medication (prescriber determined); and 2 Any of the following: 2.1 Patient is still unstable and requires further treatment; or 2.2 Patient achieved significant improvement but requires further treatment; or 2.3 Patient is well controlled but requires maintenance therapy. The patient may not have had more than 1 prior approval in the last 12 months. CYTARABINE Inj 500 mg 100 mg per ml, 5 ml – PCT – Retail pharmacy-Specialist ................................................... 18.15 95.36 Inj 1 g 100 mg per ml, 10 ml – PCT – Retail pharmacy-Specialist .................................................. 37.00 42.65 Inj 2 g 100 mg per ml, 20 ml – PCT only – Specialist ............... 31.00 34.47 CYTARABINE Inj 1 mg for ECP – PCT only – Specialist ................................... 0.30

138

1 5 1 1 1 1 10 1 mg

✔ Pfizer ✔ Mayne ✔ Pfizer ✔ Mayne ✔ Pfizer ✔ Mayne ✔ Baxter

138

▲

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 May 2010

34 DOCUSATE SODIUM – Only on a prescription ❋ Tab Cap 50 mg ......................................................................... 3.95 ❋ Tab Cap 120 mg ....................................................................... 5.49 CALCIUM CARBONATE ❋ Tab eff 1.75 g (1 g elemental) .................................................. 6.54 CALCIUM CARBONATE ❋ Tab 1.25 g (500 mg elemental) ................................................ 9.18 ❋ Tab 1.5 g (600 mg elemental) ................................................ 10.33 SODIUM FLUORIDE Tab 1.1 mg (0.5 mg elemental) ................................................ 4.00 FERROUS FUMARATE Tab 200 mg (65 mg elemental) ................................................ 4.35 FERROUS FUMARATE WITH FOLIC ACID Tab 310 mg (100 mg elemental) with folic acid 350 µg ............ 4.75 FERROUS GLUCONATE WITH ASCORBIC ACID ❋ Tab 170 mg (20 mg elemental) with ascorbic acid 40 mg ....... 12.04 FERROUS SULPHATE ❋ Tab long-acting 325 mg (105 mg elemental) ............................ 5.06 (15.58) ❋‡ Oral liq 150 mg per 5 ml (30 mg elemental per 1 ml) ........... 10.30 FERROUS SULPHATE WITH FOLIC ACID ❋ Tab long-acting 325 mg (105 mg elemental) with folic acid 350 µg .................................................................. 1.80 (3.73) MAGNESIUM SULPHATE Inj 49.3%, 5 ml ....................................................................... 26.60 ZINC SULPHATE ❋ Cap 220 137.4 mg (50 mg elemental) ................................... 10.00 100 100 30 250 250 100 100 60 500 ✔ Laxofast 50 ✔ Laxofast 120 ✔ Calsource ✔ Calci-Tab 500 ✔ Calci-Tab 600 ✔ PSM ✔ Ferro-tab ✔ Ferro-F-Tabs ✔ Healtheries Iron with Vitamin C

38 38

38 38 38 38

150 500 ml Ferro-Gradumet ✔ Ferodan

30 Ferrograd-Folic 10 100 ✔ Mayne ✔ Zincaps

39 39 138

GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA1012 0877 Inj 1 g ................................................................................... 245.00 1 ✔ Gemcitabine Ebewe 349.20 ✔ Gemzar Inj 200 mg .............................................................................. 49.00 1 ✔ Gemcitabine Ebewe 78.00 ✔ Gemzar Inj 1 mg for ECP ....................................................................... 0.26 1 mg ✔ Baxter ➽ SA1012 0877 Special Authority for Subsidy Initial application - (Hodgkin’s disease) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following continued...

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 May 2010 (continued)

continued... 1 The patient has Hodgkin’s disease*; and 2 Either 2.1 Disease has failed to respond to second-line salvage chemotherapy treatment; or 2.2 Disease has relapsed following transplant; or 2.3 The patient is unsuitable for, or intolerant to, second-line salvage chemotherapy or high dose chemotherapy and transplant. 3 Gemcitabine to be given for a maximum of 6 treatment cycles. Initial application - (T-cell Lymphoma) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following 1 The patient has T-cell lymphoma*; and 2 Gemcitabine to be given for a maximum of 6 treatment cycles. Initial application - (Other indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or 2 The patient has advanced malignant mesothelioma*; or 3 The patient has advanced pancreatic carcinoma; or 4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*; or 5 The patient has advanced transitional cell carcinoma of the urothelial tract (locally advanced or metastatic). Renewal - (Other Indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment. Note: Indications marked with a * are Unapproved Indications. 143 VINORELBINE – PCT only – Specialist – Special Authority see SA1013 0901 Inj 10 mg per ml, 1 ml ............................................................ 24.00 1 42.00 Inj 10 mg per ml, 5 ml ........................................................... 120.00 1 210.00 Inj 1 mg for ECP ........................................................................ 2.71 1 mg ✔ Navelbine ✔ Vinorelbine Ebewe ✔ Navelbine ✔ Vinorelbine Ebewe ✔ Baxter

➽ SA1013 0901 Special Authority for Subsidy Initial application - (Hodgkin’s disease) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: All of the following 1 The patient has Hodgkin’s disease*; and 2 Either 2.1 Disease has failed to respond to second-line salvage chemotherapy treatment; or 2.2 Disease has relapsed following transplant; or 2.3 The patient is unsuitable for, or intolerant to, second-line salvage chemotherapy or high dose chemotherapy and transplant. 3 Vinorelbine to be given for a maximum of 6 treatment cycles. Initial application - (T-cell Lymphoma) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 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

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 May 2010 (continued)

continued... All of the following 1 The patient has T-cell lymphoma*; and 2 Vinorelbine to be given for a maximum of 6 treatment cycles. Initial application – (Other indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has metastatic breast cancer; or 2 The patient has non-small cell lung cancer (stage IIIa, or above); or 3 All of the following: 3.1 The patient has stage IB-IIIA non-small cell lung cancer; and 3.2 Vinorelbine is to be given as adjuvant treatment in combination with cisplatin; and 3.3 The patient has good performance status (WHO/ECOG grade 0-1). Renewal – (Other Indications) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment. Note: Indications marked with a * are Unapproved Indications.

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 Subsidy and Manufacturer’s Price

Effective 1 August 2010

31 KETONE BLOOD BETA-KETONE ELECTRODES ( subsidy) Test strip ................................................................................... 7.07 a) Maximum of 20 test strips per prescription b) Not on a BSO 35 IMIGLUCERASE – Special Authority SA0473 – Retail pharmacy ( subsidy) Inj 40 iu per ml, 200 iu vial ........................................................CBS 1 ✔ Cerezyme Note: Due to supply issues, the listing of Cerezyme has been temporarily amended to Cost Brand Source CALCIUM CARBONATE ( subsidy) ❋ Tab 1.25 g (500 mg elemental).................................................. 9.08 ❋ Tab 1.5 g (600 mg elemental).................................................. 10.18 ENALAPRIL ( subsidy) ❋ Tab 5 mg ................................................................................. 1.98 ❋ Tab 10 mg ................................................................................ 2.44 (2.76) ❋ Tab 20 mg ................................................................................ 3.24 (3.68) CILAZAPRIL WITH HYDROCHLOROTHIAZIDE ( subsidy) Tab 5 mg with hydrochlorothiazide 12.5 mg............................... 5.36 AMILORIDE WITH FRUSEMIDE ( subsidy) ❋ Tab 5 mg with frusemide 40 mg ................................................ 8.63 FUROSEMIDE ( subsidy) ❋ Tab 500 mg .......................................................................... 25.00 POVIDONE IODINE ( subsidy) Oint 10% ................................................................................... 3.27 a) Maximum of 100 g per prescription b) Only on a prescription 250 250 90 90 90 m-Enalapril 28 28 50 25 g OP ✔ Inhibace Plus ✔ Frumil ✔ Urex Forte ✔ Betadine ✔ Calci-Tab 500 ✔ Calci-Tab 600 ✔ m-Enalapril m-Enalapril 10 strip OP ✔ Optium Blood Ketone Test Strips

50 55 55 65

OESTRADIOL – See prescribing guideline ( price) ❋ TDDS 3.9 mg (releases 50 µg of oestradiol per day) .................. 4.12 4 (13.18) a) Higher subsidy of $13.18 per 4 patch with Special Authority see SA0312 b) No more than 1 patch per week c) Only on a prescription ❋ TDDS 7.8 mg (releases 100 µg of oestradiol per day) ................ 7.05 4 (16.14) a) Higher subsidy of $16.14 per 4 patch with Special Authority see SA0312 b) No more than 1 patch per week c) Only on a prescription

Climara 50

Climara 100

▲

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 Manufacturers Price - effective 1 August 2010 (continued)

110 METHADONE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable c) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets). d) For methadone hydrochloride oral liquid refer to Pharmaceutical Schedule Tab 5 mg .................................................................................. 1.85 10 ✔ Methatabs INTERFERON BETA-1-BETA – Special Authority SA0855 ( subsidy) Inj 8 million iu per 1 ml ...................................................... 1,407.33 CYTARABINE ( subsidy) Inj 1 mg for ECP – PCT only – Specialist ................................... 0.27 Inj 100 mg intrathecal syringe for ECP – PCT only – Specialist . 15.20 15 ✔ Betaferon

129 138

10 mg ✔ Baxter 100 mg OP ✔ Baxter ✔ Camptosar ✔ Camptosar ✔ Baxter ✔ Imuran

139

IRINOTECAN – PCT only – Specialist – Special Authority SA0878 ( subsidy) Inj 20 mg per ml, 2 ml ............................................................. 41.00 1 Inj 20 mg per ml, 5 ml ........................................................... 100.00 1 Inj 1 mg for ECP ........................................................................ 1.04 1 mg AZATHIOPRINE – Retail pharmacy-Specialist ( subsidy) ❋ Inj 50 mg ................................................................................ 60.00 1

147 181

FOOD THICKENER – Special Authority SA0595 – Hospital pharmacy [HP3] ( subsidy) Powder .................................................................................... 7.25 380 g OP ✔ Karicare Food Thickener

Effective 1 July 2010

28 PANTOPRAZOLE ( subsidy) ❋ Tab 20 mg ................................................................................ 1.23 ❋ Tab 40 mg ................................................................................ 1.54 35 41 45 BISACODYL – Only on a prescription ( subsidy) ❋ Tab 5 mg .................................................................................. 4.99 ASPIRIN ( subsidy) ❋ Tab 100 mg ............................................................................ 14.00 DEXTROSE WITH ELECTROLYTES ( subsidy) Soln with electrolytes................................................................. 6.60 6.75 28 28 ✔ Dr Reddy’s Pantoprazole ✔ Dr Reddy’s Pantoprazole ✔ Lax-Tabs ✔ Ethics Aspirin EC

200 990

1,000 ml OP ✔ Pedialyte Bubblegum ✔ Pedialyte - Fruit ✔ Pedialyte - Plain

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 Manufacturers Price - effective 1 July 2010 (continued)

53 METOPROLOL SUCCINATE ( subsidy) ❋ Tab long-acting 23.75 mg ......................................................... 2.18 ❋ Tab long-acting 47.5 mg ........................................................... 2.74 ❋ Tab long-acting 95 mg .............................................................. 4.71 ❋ Tab long-acting 190 mg ............................................................ 8.51 55 BENDROFLUAZIDE ( subsidy) ❋ Tab 2.5 mg – Up to 150 tab available on a PSO ......................... 7.58 (13.50) May be supplied on a PSO for reasons other than emergency. ❋ Tab 5 mg ............................................................................... 11.75 (21.50) SPIRONOLACTONE ( subsidy) ❋ Tab 25 mg ................................................................................ 4.60 ❋ Tab 100 mg ............................................................................ 15.15 FUSIDIC ACID ( subsidy) Crm 2% ..................................................................................... 3.25 a) Maximum of 15 g per prescription b) Only on a prescription c) Not in combination Oint 2% ..................................................................................... 3.25 a) Maximum of 15 g per prescription b) Only on a prescription c) Not in combination 30 30 30 30 ✔ Betaloc CR ✔ Metoprolol - AFT CR ✔ Betaloc CR ✔ Metoprolol - AFT CR ✔ Betaloc CR ✔ Metoprolol - AFT CR ✔ Betaloc CR ✔ Metoprolol - AFT CR

500 Neo-Naclex 500 Neo-Naclex 100 100 15 g OP ✔ Spirotone ✔ Spirotone ✔ Foban

15 g OP

✔ Foban

63 64 66

HYDROCORTISONE WITH MICONAZOLE – Only on a prescription ( subsidy) ❋ Crm 1% with miconazole nitrate 2% ........................................... 2.10 15 g OP CETOMACROGOL ( subsidy) ❋ Crm BP ..................................................................................... 3.15 500 g

✔ Micreme H ✔ PSM

COAL TAR ( subsidy) Soln BP – Only in combination ................................................. 32.37 500 ml ✔ PSM Up to 10 % Only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain, refer, page 163 With or without other dermatological galenicals. CLOTRIMAZOLE ( subsidy) ❋ Vaginal crm 1% with applicators ................................................ 1.30 ❋ Vaginal crm 2% with applicators ................................................ 2.50 TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist ( subsidy) Cap 40 mg .............................................................................. 47.95 (60.71) 35 g OP 20 g OP 60 ✔ Clomazol ✔ Clomazol ✔ Andriol Testocaps Panteston

▲

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 Manufacturers Price - effective 1 July 2010 (continued)

82 CABERGOLINE ( subsidy) Tab 0.5 mg – Maximum of 2 tab per prescription; can be waived by Special Authority see SA0175 ................. 16.50 66.00 CEFACLOR MONOHYDRATE ( subsidy) Grans for oral liq 125 mg per 5 ml ............................................. 3.53 PHENOXYMETHYLPENICILLIN (PENICILLIN V) ( subsidy) Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 1.78 IBUPROFEN ( subsidy) ❋‡ Oral liq 100 mg per 5 ml.......................................................... 2.69 ASPIRIN ( subsidy) ❋ Tab EC 300 mg ......................................................................... 2.00 (8.10) ❋ Tab dispersible 300 mg – Up to 30 tab available on a PSO ......... 2.00

2 8 100 ml

✔ Arrow-Cabergoline ✔ Arrow-Cabergoline ✔ Ranbaxy-Cefaclor

84 87

100 ml 200 ml 100 100

✔ AFT ✔ Fenpaed

100 109

Aspec 300 ✔ Ethics Aspirin

113

FLUOXETINE HYDROCHLORIDE ( subsidy) ❋ Tab dispersible 20 mg, scored – Subsidy by endorsement ......... 2.50 30 ✔ Fluox Subsidised by endorsement 1) When prescribed for a patient who cannot swallow whole tablets or capsules and the prescription is endorsed accordingly; or 2) When prescribed in a daily dose that is not a multiple of 20 mg in which case the prescription is deemed to be endorsed. Note: Tablets should be combined with capsules to facilitate incremental 10 mg doses. ❋ Cap 20 mg ............................................................................... 2.89 90 ✔ Fluox PAROXETINE HYDROCHLORIDE ( subsidy) Tab 20 mg ............................................................................... 2.38 PHENYTOIN SODIUM ( subsidy) ❋ Tab 50 mg .............................................................................. 42.09 ❋ Cap 30 mg .............................................................................. 19.13 ❋ Cap 100 mg ............................................................................ 17.21 ❋‡ Oral liq 30 mg per 5 ml.......................................................... 19.16 DOMPERIDONE ( subsidy) ❋ Tab 10 mg ................................................................................ 7.99 ROPINIROLE HYDROCHLORIDE ( subsidy) ▲ Tab 0.25 mg ............................................................................. 6.20 ▲ Tab 1 mg ................................................................................ 15.95 ▲ Tab 2 mg ................................................................................ 24.95 ▲ Tab 5 mg ................................................................................ 38.00 CISPLATIN – PCT only – Specialist ( subsidy) Inj 1 mg for ECP ........................................................................ 0.27 30 200 200 200 500 ml 100 84 84 84 84 1 mg ✔ Loxamine ✔ Dilantin Infatab ✔ Dilantin ✔ Dilantin ✔ Dilantin ✔ Motilium ✔ Ropin ✔ Ropin ✔ Ropin ✔ Ropin ✔ Baxter

113 117

120 122

136

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 Manufacturers Price - effective 1 July 2010 (continued)

138 GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority SA0877 ( subsidy) Inj 1 g ..................................................................................... 62.50 1 ✔ Gemcitabine Ebewe Inj 200 mg .............................................................................. 12.50 1 ✔ Gemcitabine Ebewe Inj 1 mg for ECP ........................................................................ 0.07 1 mg ✔ Baxter DOCETAXEL – PCT only – Specialist – Special Authority see SA0880 ( subsidy) Inj 1 mg for ECP ..................................................................... 17.55 1 mg MITOZANTRONE – PCT only – Specialist ( subsidy) Inj 2 mg per ml, 10 ml ........................................................... 100.00 Inj 1 mg for ECP ........................................................................ 5.65 LORATADINE ( subsidy) ❋ Tab 10 mg ................................................................................ 2.09 ❋ Oral liq 1 mg per ml ................................................................... 3.10 154 167 SALBUTAMOL ( subsidy) ‡Oral liq 2 mg per 5 ml .................................................................. 1.99 GLYCEROL ( subsidy) ❋ Liquid – Only in combination.................................................... 17.86 Only in extemporaneously compounded oral liquid preparations. 1 1 mg 100 100 ml 150 ml 2,000 ml ✔ Baxter ✔ Mitozantrone Ebewe ✔ Baxter ✔ Loraclear Hayfever Relief ✔ Lorapaed ✔ Salapin ✔ PSM

140 142

152

172

ORAL SUPPLEMENT 1KCAL/ML – Special Authority – Hospital pharmacy [HP3] ( subsidy) Powder (chocolate) ................................................................. 10.22 900 g OP ✔ Sustagen Hospital Formula Powder (vanilla) ...................................................................... 10.22 900 g OP ✔ Sustagen Hospital Formula ORAL FEED 1KCAL/ML – Special Authority see SA0594 – Hospital pharmacy [HP3] ( price) Liquid (vanilla) .......................................................................... 1.78 237 ml OP (2.10) Resource Diabetic RENAL ORAL FEED 2KCAL/ML – Special Authority see SA0587 – Hospital pharmacy [HP3] ( price) Liquid ........................................................................................ 2.88 237 ml OP (3.31) NovaSource Renal ORAL ELEMENTAL FEED 1KCAL/ML – Special Authority see SA0592 – Hospital pharmacy [HP3] ( subsidy) Powder (unflavoured) ................................................................ 4.50 80.4 g OP ✔ Vivonex TEN

173

176

177

Effective 1 June 2010

34 DOCUSATE SODIUM – Only on a prescription ( subsidy) ❋ Tab 50 mg ............................................................................... 3.95 (4.89) ❋ Tab 120 mg .............................................................................. 5.49 (6.73) 100 Coloxyl 100 Coloxyl

▲

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 Manufacturers Price - effective 1 June 2010 (continued)

125 RISPERIDONE ( subsidy) Tab 0.5 mg ............................................................................... 1.17 3.51 Tab 1 mg .................................................................................. 6.00 Tab 2 mg ................................................................................ 11.00 Tab 3 mg ................................................................................ 15.00 Tab 4 mg ................................................................................ 20.00 20 60 60 60 60 60 ✔ Ridal ✔ Ridal ✔ Ridal ✔ Ridal ✔ Ridal ✔ Ridal

138

CYTARABINE Inj 100 mg – PCT – Retail pharmacy-Specialist ( subsidy) ..... 76.00 5 ✔ Pfizer Inj 1 mg for ECP – PCT only – Specialist ( subsidy) ................. 0.30 10 mg ✔ Baxter Note - Baxter inj 1 mg for ECP subsidy and price increase is pro rated to the new 10 mg pack size. VINCRISTINE SULPHATE Inj 1 mg per ml, 1 ml – PCT – Retail pharmacy-Specialist ( subsidy) .............................. 108.00 Inj 1 mg per ml, 2 ml – PCT – Retail pharmacy-Specialist ( subsidy) .............................. 116.00 Inj 1 mg for ECP – PCT only – Specialist ( subsidy) ............... 15.77

143

5 5 1 mg

✔ Hospira ✔ Hospira ✔ Baxter

156

BECLOMETHASONE DIPROPIONATE ( price) Metered aqueous nasal spray, 50 µg per dose ........................... 2.35 200 dose OP (4.00) Metered aqueous nasal spray, 100 µg per dose ......................... 2.46 200 dose OP (4.81)

Alanase Alanase

Effective 1 May 2010

61 CROTAMITON ( subsidy) a) Only on a prescription b) Not in combination Crm 10% .................................................................................. 3.79 (4.45)

20 g OP Eurax

CHLORHEXIDINE GLUCONATE – Subsidy by endorsement ( subsidy) a) No more than 500 ml per month b) Only if prescribed for a dialysis patient and the prescription is endorsed accordingly. ❋ Handrub 1% with ethanol 70% .................................................. 4.60 500 ml (5.40) PREGNANCY TESTS - HCG URINE ( subsidy) a) Up to 200 test available on a PSO b) Only on a PSO Cassette ................................................................................. 14.25

Orion

25 test OP ✔ MDS Quick Card

LAMIVUDINE – Special Authority see SA0779 – Hospital pharmacy [HP1] ( subsidy) Tab 150 mg ......................................................................... 153.60 60 ✔ 3TC Oral liq 10 mg per ml .............................................................. 50.00 240 ml OP ✔ 3TC CISPLATIN – PCT only – Specialist ( subsidy) Inj 1 mg per ml, 50 ml ............................................................ 15.00 Inj 1 mg per ml, 100 ml .......................................................... 21.00 1 1 ✔ Cisplatin Ebewe ✔ Cisplatin Ebewe

136

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 Manufacturers Price - effective 1 May 2010 (continued)

146 MEGESTROL ACETATE – Retail pharmacy-Specialist ( subsidy) Tab 160 mg ........................................................................... 57.92 (74.25) 30 Megace

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules

Effective 1 August 2010

5 Finding Information in the Pharmaceutical Schedule Community Pharmaceuticals For Community Pharmaceuticals, the Schedule is organised in a way to help the reader find Community Pharmaceuticals, which may be used to treat similar conditions. To do this, Community Pharmaceuticals are first classified anatomically, originally based on the Anatomical Therapeutic Chemical (ATC) system, and then further classified under section headings structured for the New Zealand medical system. • Section A lists the General Rules in relation to Community Pharmaceuticals and related products. • Section B lists Community Pharmaceuticals and related products by anatomical classification, which are further divided into one or more therapeutic headings. Community Pharmaceuticals used to treat similar conditions are grouped together. • Section C lists the rules in relation to Extemporaneously Compounded Products (ECPs) and Community Pharmaceuticals that will be subsidised when extemporaneously compounded. • Section D lists the rules in relation to Special Foods and the Special Foods that are subsidised. • Section E Part I lists the Community Pharmaceuticals that are subsidised on a Practitioner’s Supply Order (PSO) and Wholesale Supply Order (WSO). • Section E Part II lists rural areas for the purpose of PSOs. • Section F lists the Community Pharmaceuticals dispensing period exemptions. • Section G lists the Community Pharmaceuticals eligible for reimbursement of safety cap and related rules. GLOSSARY WSO Wholesale Supply Order. GLOSSARY Definitions Abbrev. [HP1] Pharmacy Services Agreement Subsidised when dispensed from pharmacies that have the Complex Medicines Variation of the Pharmacy Services Agreement Subsidised when dispensed from pharmacies that have the Pharmacy Services Agreement. A Special Food with [HP3] annotation is subsidised when dispensed by a pharmacy that has a Special Foods Service appended to their Pharmacy Services Agreement by their DHB. Subsidised when dispensed from pharmacies that have the Monitored Therapy Variation (for Clozapine Services) All other Pharmacy Agreements Available from selected pharmacies that have an exclusive contract to dispense ‘Hospital Pharmacy’ [HP1] pharmaceuticals. Available from selected pharmacies that have an exclusive contract to dispense Special Foods ‘Hospital Pharmacy’ [HP3] pharmaceuticals.

7 8

[HP3]

[HP4]

Avaliable from selected pharmacies that have an exclusive contract to dispense ‘Hospital Pharmacy’ [HP4] pharmaceuticals.

14 16

“Dietitian” means a person registered as a dietitian with the Dietitians Board, and who holds a current annual practicing certificate under the HPCA Act 2003. “Practitioner” means a Doctor, a Dentist, a Dietitian, a Midwife, a Nurse Prescriber or an Optometrist as those terms are defined in the Pharmaceutical Schedule.

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules - effective 1 August 2010 (continued)

16 16 16 17 17 19 “Prescription Medicine” means any Pharmaceutical listed in Part I of Schedule 1 of the Medicines Regulations 1984. “Restricted Medicine” means any Pharmaceutical listed in Part II of Schedule 1 of the Medicines Regulations 1984. “Section E Part I” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for Subsidies and available on a Practitioner’s Supply Order or a Wholesale Supply Order included in the Schedule. “Supply Order” means a Bulk Supply Order, or a Practitioner’s Supply Order or a Wholesale Supply Order. “Wholesale Supply Order” means a written order by a Practitioner, on a form supplied by the Ministry of Health for the supply of certain Community Pharmaceuticals as listed in Section B and Section E Part I of the Schedule. 3.1 Doctors’, Dietitians’, Midwives’, Nurse Prescribers’ and Optometrists’ Prescriptions (other than oral contraceptives) The following provisions apply to all Prescriptions, other than those for an oral contraceptive, written by a Doctor, Dietitian, Midwife, Nurse Prescriber or Optometrist: 3.1.1 For a Community Pharmaceutical other than a Class B Controlled Drug, only a quantity sufficient to provide treatment for a period not exceeding three Months will be subsidised. 3.1.2 For methylphenidate hydrochloride and dexamphetamine sulphate, only a quantity sufficient to provide treatment for a period not exceeding one Month will be subsidised. 3.1.3 For a Class B Controlled Drug other than methylphenidate hydrochloride and dexamphetamine sulphate, only a quantity: a) sufficient to provide treatment for a period not exceeding 10 days; and b) which has been dispensed pursuant to a Prescription sufficient to provide treatment for a period not exceeding one Month, will be subsidised. 3.1.4 Subject to clauses 3.1.3 and 3.1.7, for a Doctor, Dietitian, Midwife or Nurse Prescriber and 3.1.7 for an Optometrist, where a practitioner has prescribed a quantity of a Community Pharmaceutical sufficient to provide treatment for: a) one Month or less than one Month, but dispensed by the Contractor in quantities smaller than the quantity prescribed, the Community Pharmaceutical will only be subsidised as if that Community Pharmaceutical had been dispensed in a Monthly Lot; b) more than one Month, the Community Pharmaceutical will be subsidised only if it is dispensed: i) in a 90 Day Lot, where the Community Pharmaceutical is a Pharmaceutical covered by Section F Part I of the Pharmaceutical Schedule; or ii) if the Community Pharmaceutical is not a Pharmaceutical referred to in Section F Part I of the Pharmaceutical Schedule, in Monthly Lots, unless: A) the eligible person or his/her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criterion (Criteria) applies and signs that statement to this effect; or B) both: 1) the Practitioner endorses the Community Pharmaceutical on the Prescription with the words “certified exemption” written in the Practitioner’s own handwriting, or signed or initialled by the Practitioner; and 2) every Community Pharmaceutical endorsed as “certified exemption” is covered by Section F Part II of the Pharmaceutical Schedule. 3.1.5 A Community Pharmaceutical is only eligible for Subsidy if the Prescription under which it has been dispensed was presented to the Contractor: a) for a Class B Controlled Drug, within eight days of the date on which the Prescription was written; or 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 General Rules - effective 1 August 2010 (continued)

continued... b) for any other Community Pharmaceutical, within three Months of the date on which the Prescription was written. 3.1.6 No subsidy will be paid for any Prescription, or part thereof, that is not fulfilled within: a) in the case of a Prescription for a total supply of from one to three Months, three Months from the date the Community Pharmaceutical was first dispensed; or b) in any other case, one Month from the date the Community Pharmaceutical was first dispensed. Only that part of any Prescription that is dispensed within the time frames specified above is eligible for Subsidy. 3.1.7 If a Community Pharmaceutical: a) is stable for a limited period only, and the Doctor, Dietitian, Midwife, Nurse Prescriber or Optometrist has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that may be dispensed at any one time; or b) is stable for a limited period only, and the Contractor has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that should be dispensed at any one time in all the circumstances of the particular case; or c) is Close Control, The actual quantity dispensed will be subsidised in accordance with any such specification.

3.5 Dietitians’ Prescriptions The following provisions apply to every Prescription written by a Dietitian: 3.5.1 Prescriptions written by a Dietitian for a Community Pharmaceutical will only be subsidised where they are for either: a) special foods, as listed in Section D; or b) any other Pharmaceutical that has been identified in Section D of the Pharmaceutical Schedule as being able to be prescribed by a Dietitian, providing that the products being prescribed are not classified as Prescription Medicines or Restricted Medicines. 3.5.2 For the purposes of Dietitians prescribing pursuant to this clause 3.5, the prescribing and dispensing of these products is required to be in accordance with regulations 41 and 42 of the Medicines Regulations 1984. 4.3 Wholesale Supply Orders The following provisions apply to the supply of Community Pharmaceuticals to Practitioners under Wholesale Supply Orders: 4.3.1 Notwithstanding anything contained in the Schedule, but subject nevertheless to subclause 4.3.3 of this clause, a Practitioner may obtain from a wholesaler or distributor, pursuant to a Wholesale Supply Order made on a form supplied by the Ministry of Health, any Community Pharmaceutical specified in Section B and Section E Part I of the Schedule as being available on a Wholesale Supply Order. 4.3.2 Subject to clause 4.3.3, Community Pharmaceuticals supplied to Practitioners under Wholesale Supply Orders will be subsidised at a rate not exceeding the Manufacturer’s Price for each such Community Pharmaceutical as set out in Section B and Section E Part I of the Schedule. 4.3.3 No subsidy will be paid for any quantity of a Community Pharmaceutical supplied to a Practitioner under a Wholesale Supply Order in excess of what is a reasonable monthly allocation for that particular Practitioner, after taking into account stock on hand. 4.3.4 The Ministry of Health may, at any time, on the recommendation of an Advisory Committee appointed by the Ministry of Health for that purpose, by public notification, declare that a Practitioner specified in such a notice is not entitled to obtain supplies of Community Pharmaceuticals under Wholesale Supply Orders until such time as the Ministry of Health notifies otherwise.

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 General Rules - effective 1 August 2010 (continued)

169 Dietitian Prescribing Prescriptions from Dietitians will be only valid for subsidy where they are for special foods, as listed in this section, or where they are for the following products: Alpha tocopheryl acetate Water solubilised soln 156 iu/ml, with calibrated dropper Ascorbic acid Tab 100 mg Calcium carbonate Tab 1.25 g (500 mg elemental) Tab 1.5 g (600 mg elemental) Tab 1.75 g (1 g elemental) Compound electrolytes Powder for soln for oral use 5 g Dextrose with electrolytes Soln with electrolytes Ferrous fumarate Tab 200 mg (65 mg elemental) Ferrous fumarate with folic acid Tab 310 mg (100 mg elemental) with folic acid 350 μg Ferrous sulphate Tab long-acting 325 mg (105 mg elemental) Oral liq 30 mg per 1 ml (6 mg elemental per 1 ml) Ferrous sulphate with folic acid Tab long-acting 325 mg (105 mg elemental) with folic acid 350 μg Multivitamins Tab Powder Oral liq Potassium bicarbonate Tab eff 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg Potassium chloride Tab eff 584 mg (14 m eq) with chloride 385 mg (8 m eq) Tab long-acting 600 mg Pyridoxine hydrochloride Tab 25 mg Tab 50 mg Sodium fluoride Tab 1.1 mg (0.5 mg elemental) Thiamine hydrochloride Tab 50 mg Vitamin A with vitamins D and C Soln 1000 u with Vitamin D 400 u and ascorbic acid 30 mg per 10 drops Vitamin B complex Tab, strong, BPC Vitamins Tab (BPC cap strength) Cap (fat soluble vitamins A, D, E, K)

▲

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 Brand Name

Effective 1 July 2010

35 108 CHLORHEXIDINE GLUCONATE Mouthwash 0.2% ..................................................................... 3.06 PROBENECID ❋ Tab 500 mg ........................................................................... 55.00 200 ml OP ✔ Rivacol Orion 100 ✔ Probenecid-AFT AFT

Effective 1 June 2010

76 DEXAMETHASONE SODIUM PHOSPHATE ❋ Inj 4 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 21.50 ❋ Inj 4 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 31.00 CYTARABINE Inj 100 mg – PCT – Retail pharmacy-Specialist. ...................... 76.00 VINCRISTINE SULPHATE Inj 1 mg per ml, 1 ml – PCT – Retail pharmacy-Specialist ..... 108.00 Inj 1 mg per ml, 2 ml – PCT – Retail pharmacy-Specialist ..... 116.00 5 5 5 5 5 ✔ Hospira Mayne ✔ Hospira Mayne ✔ Pfizer Pharmacia ✔ Hospira Mayne ✔ Hospira Mayne

138 143

Changes to Sole Subsidised Supply

Effective 1 August 2010

For the list of new Sole Subsidised Supply products effective 1 August 2010 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 14-20.

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 August 2010

35 38 BISACODYL – Only on a prescription ❋ Suppos 10 mg........................................................................... 3.96 FERROUS GLUCONATE WITH ASCORBIC ACID ❋ Tab 170 mg with ascorbic acid 40 mg ..................................... 12.04 CROTAMITON a) Only on a prescription b) Not in combination Crm 10% ................................................................................... 3.79 (4.45) 12 500 ✔ Fleet ✔ Healtheries Iron with Vitamin C

20 g OP Eurax

CHLORHEXIDINE GLUCONATE – Subsidy by endorsement a) No more than 500 ml per month b) Only if prescribed for a dialysis patient and the prescription is endorsed accordingly. ❋ Handrub 1% with ethanol 70% ................................................... 4.60 500 ml (5.40) PREGNANCY TESTS - HCG URINE a) Up to 200 test available on a PSO b) Only on a PSO Cassette .................................................................................. 14.25

Orion

25 test OP ✔ MDS Quick Card

INTERFERON ALPHA-2A – PCT – Retail pharmacy-Specialist a) See prescribing guideline b) Only one multidose cartridge starter pack to be prescribed and dispensed per patient. Inj 4.5 m iu prefilled syringe ..................................................... 46.98 1 ✔ Roferon-A Inj 18 m iu multidose cartridge .............................................. 187.92 1 ✔ Roferon-A Inj 18 m iu multidose cartridge × 2 starter pack .................... 375.84 1 ✔ Roferon-A INTERFERON ALPHA-2A WITH RIBAVIRIN – Special Authority see SA0784 – Retail pharmacy-Specialist See prescribing guideline Inj 18 m iu multidose cartridge × 2 with ribavirin tab 200 mg × 168 .............................. 1,375.84 1 OP ✔ Roferon RBV Combination Pack Inj 18 m iu multidose cartridge × 2 with pen and needles with ribavirin tab 200 mg × 168 ............................................ 1,375.84 1 OP ✔ Roferon RBV Combination Pack Starter Kit DICLOFENAC SODIUM ❋ Tab long-acting 75 mg .............................................................. 3.10 Note – Diclax SR tab long-acting 75 mg, 500 tab pack, remains listed. 30 ✔ Diclax SR

100

▲

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 August 2010 (continued)

110 DEXTROPROPOXYPHENE WITH PARACETAMOL Tab napsylate 50 mg with paracetamol 325 mg ....................... 14.50 (22.50) Cap hydrochloride 32.5 mg with paracetamol 325 mg................ 3.98 (4.90) 19.91 (33.14) TRIMIPRAMINE MALEATE Cap 50 mg .............................................................................. 11.20 MEGESTROL ACETATE – Retail pharmacy-Specialist Tab 160 mg ........................................................................... 57.92 (74.25) DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab long-acting 6 mg ................................................................ 5.40 (12.56) 2.70 (7.73) 500 Paradex 100 Capadex 500 Capadex 100 30 Megace 40 Polaramine ColourFree Repetab 20 Polaramine ColourFree Repetab ✔ Tripress

113 146

151

Effective 1 July 2010

36 HYDROXOCOBALAMIN ❋ Inj 1 mg per ml, 1 ml – Up to 6 inj available on a PSO ................ 6.15 (10.84) SILVER SULPHADIAZINE Crm 1% with chlorhexidine digluconate 0.2% .......................... 15.04 a) Up to 500 g available on a PSO b) Not in combination HYDROCORTISONE BUTYRATE Milky emul 0.1% ....................................................................... 5.00 DITHRANOL Crm 1% ................................................................................... 27.50 SOMATROPIN – Special Authority see SA0755 ❋ Inj 5 mg ............................................................................... 300.00 ❋ Inj 10 mg ............................................................................. 600.00 ❋ Inj 15 mg ............................................................................. 900.00 138 FLUDARABINE PHOSPHATE – PCT only – Specialist Tab 10 mg ........................................................................... 650.25 Note – Fludara Oral tab 10 mg, 20 tab pack size remains listed. 3 Neo-B12 100 g OP ✔ Silvazine

62 67 81

30 ml OP 50 g OP 1 1 1

✔ Locoid Crelo ✔ Micanol ✔ Norditropin SimpleXx 5mg ✔ Norditropin SimpleXx 10mg ✔ Norditropin SimpleXx 15mg ✔ Fludara

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 July 2010 (continued)

146 LETROZOLE Tab 2.5 mg ............................................................................ 26.55 (146.46) PROMETHAZINE HYDROCHLORIDE ❋‡ Oral liq 5 mg per 5 ml ............................................................. 3.10 (8.51) 30 Femara 100 ml Phenergan

152

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, remain listed. 44 52 POTASSIUM CHLORIDE ❋ Inj 150 mg per ml, 10 ml ......................................................... 26.00 ATENOLOL ❋ Tab 50 mg ................................................................................ 0.39 PINDOLOL ❋ Tab 5 mg .................................................................................. 4.50 ❋ Tab 10 mg ................................................................................ 8.35 ❋ Tab 15 mg .............................................................................. 12.00 50 ✔ AstraZeneca

30 100 100 100

✔ Noten S29 ✔ Pindol ✔ Pindol ✔ Pindol

ETHINYLOESTRADIOL WITH GESTODENE ❋ Tab 30 µg with gestodene 75 µg and 7 inert tab ........................ 6.62 84 (16.50) a) Higher subsidy of $14.49 per 84 tab with Special Authority see SA0500 above b) Up to 84 tab available on a PSO FLUCLOXACILLIN SODIUM Cap 250 mg – Up to 30 cap available on a PSO ....................... 18.50 Cap 500 mg ............................................................................ 57.90 DICLOFENAC SODIUM ❋ Tab long-acting 75 mg ............................................................ 19.60 CLOMIPRAMINE HYDROCHLORIDE Tab 10 mg .............................................................................. 10.00 PARACETAMOL WITH CODEINE ❋ Tab paracetamol 500 mg with codeine phosphate 8 mg ............ 2.45 (3.24) 250 500 100 100 100

Femodene 28

✔ Staphlex ✔ Staphlex ✔ Voltaren SR ✔ Clopress

100 112 112

Codalgin

▲

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 June 2010 (continued)

121 BROMOCRIPTINE MESYLATE ❋ Tab 2.5 mg ............................................................................ 32.08 BLEOMYCIN SULPHATE – PCT only – Specialist Inj 15,000 iu .......................................................................... 680.00 100 ✔ AlphaBromocriptine ✔ Blenoxane

140

Effective 1 May 2010

30 METFORMIN HYDROCHLORIDE ❋ Tab immediate-release 500 mg ................................................. 8.09 ❋ Tab immediate-release 850 mg ................................................. 6.67 CALCITRIOL ❋ Cap 0.25 µg ........................................................................... 10.10 ❋ Cap 0.5 µg ............................................................................. 18.73 PERMETHRIN Crm 5% .................................................................................... 3.65 (4.20) WOOL FAT WITH MINERAL OIL – Only on a prescription ❋ Lotn hydrous 3% with mineral oil .............................................. 1.12 (5.00) 2.10 (9.38) 500 250 100 100 30 g OP Lyderm 200 ml OP Alpha-Keri Lotion 375 ml OP Alpha-Keri Lotion ✔ Arrow-Metformin ✔ Arrow-Metformin ✔ Calcitriol-AFT ✔ Calcitriol-AFT

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+ AMOXYCILLIN Grans for oral liq 250 mg per 5 ml – Up to 200 ml available on a PSO ............................................................................... 1.27 LAMOTRIGINE ▲ Tab dispersible 200 mg ........................................................ 101.80 SUMATRIPTAN Tab 50 mg ............................................................................... 1.55 (12.00) (22.00) Tab 100 mg ............................................................................. 1.55 (12.00) (22.00) TENIPOSIDE – PCT only – Specialist Inj 10 mg per ml, 5 ml .......................................................... 845.11 Inj 50 mg for ECP ................................................................... 84.51

100 ml 56 4

✔ Ranbaxy Amoxicillin ✔ Arrow-Lamotrigine

117 119

Sumagran Imigran 2 Sumagran Imigran 10 ✔ Vumon 50 mg OP ✔ Baxter

143

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 May 2010 (continued)

151 DEXTROCHLORPHENIRAMINE MALEATE ❋ Tab 2 mg ................................................................................. 1.26 (5.60) 2.52 (9.99) 25 Polaramine 50 Polaramine

▲

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 September 2010

34 DOCUSATE SODIUM – Only on a prescription ❋ Tab 50 mg ................................................................................ 3.95 (4.89) ❋ Tab 120 mg .............................................................................. 5.49 (6.73) 100 Coloxyl 100 Coloxyl

Effective 1 October 2010

55 BENDROFLUAZIDE ❋ Tab 2.5 mg – Up to 150 tab available on a PSO ......................... 7.58 (13.50) May be supplied on a PSO for reasons other than emergency. ❋ Tab 5 mg ............................................................................... 11.75 (21.50) TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist Cap 40 mg ............................................................................. 47.95 (60.71) 500 Neo-Naclex 500 Neo-Naclex 60 ✔ Andriol Testocaps Panteston

Effective 1 November 2010

49 ENALAPRIL ❋ Tab 5 mg ................................................................................. 1.98 ❋ Tab 10 mg ................................................................................ 2.44 (2.76) ❋ Tab 20 mg ................................................................................ 3.24 (3.68) FUROSEMIDE ❋ Tab 500 mg ........................................................................... 12.00 HYDROCORTISONE ❋ Crm 1% – Only on a prescription .............................................. 2.44 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 – Up to 84 tab available on a PSO................ 6.62 DYDROGESTERONE Tab 10 mg ............................................................................. 27.50 (29.90) Note – Duphaston tab 10 mg, 28 tab pack remains listed. DANAZOL – Retail pharmacy-Specialist Cap 200 mg ........................................................................... 29.35 90 90 90 m-Enalapril 100 100 g ✔ Diurin 500 ✔ Lemnis Fatty Cream HC ✔ m-Enalapril m-Enalapril

55 62

84 50

✔ Trifeme

Duphaston

✔ D-Zol

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 November 2010 (continued)

100 DICLOFENAC SODIUM ❋ Tab EC 25 mg ........................................................................... 1.63 ❋ Tab EC 50 mg ........................................................................... 2.13 ❋ Tab long-acting 75 mg ........................................................... 22.78 ❋ Tab long-acting 100 mg ......................................................... 34.32 CLOMIPRAMINE HYDROCHLORIDE Tab 25 mg ............................................................................. 26.00 50 50 500 500 500 ✔ Diclohexal ✔ Diclohexal ✔ Apo-Diclo SR ✔ Apo-Diclo SR ✔ Clopress

112 113

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 FLUOROURACIL SODIUM Inj 50 mg per ml, 10 ml – PCT only – Specialist ......................... 4.95 1 ✔ Fluorouracil Ebewe Note – Fluorouracil Ebewe inj 50 mg per ml, 10 ml, 5 injection pack listed 1 May 2010.

138

Effective 1 December 2010

27 OMEPRAZOLE, AMOXYCILLIN AND CLARITHROMYCIN Omeprazole cap 20 mg × 14, amoxycillin cap 500 mg × 28 and clarithromycin tab 500 mg × 14 .................................. 55.00 HEPARIN SODIUM Inj 5,000 iu per ml, 5 ml .......................................................... 43.67 KETOCONAZOLE Crm 2% ..................................................................................... 1.00 (9.50) a) Only on a prescription b) Not in combination

1 OP 10 15 g OP

✔ Losec Hp7 OAC ✔ Multiparin

43 60

Nizoral

179

ENTERAL FEED 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ........................................................................................ 1.24 250 ml OP ✔ Isosource HN 5.29 1,000 ml OP ✔ Isosource HN RTH ENTERAL FEED WITH FIBRE 1 KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid .................................................................................... 1.24 250 ml OP ✔ Fibersource HN 5.29 1,000 ml OP ✔ Fibersource HN RTH ENTERAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ........................................................................................ 7.00 1,000 ml OP ✔ Isosource 1.5 ORAL FEED 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid (vanilla) .......................................................................... 1.33 237 ml OP ✔ Resource Plus FOOD THICKENER – Special Authority see SA0595 – Hospital pharmacy [HP3] Powder ..................................................................................... 3.80 250 g OP ✔ Resource Thicken Up

179

179 180 181

▲

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 2011

25 SODIUM ALGINATE ❋ Oral liq 500 mg with sodium bicarbonate 267 mg per 10 ml (aniseed) .................................................................. 1.50 (8.64) ZINC OXIDE Oint zinc oxide with balsam peru ............................................... 4.50 (6.67) Suppos zinc oxide with balsam peru ......................................... 4.47 (6.49) MULTIVITAMINS – Special Authority see SA0963 – Retail pharmacy Powder .................................................................................. 36.00 Note – Paediatric Seravit powder 200 g OP subsidised from 1 July 2010.

500 ml Gaviscon 50 g OP Anusol 12 Anusol 100 g OP ✔ Paediatric Seravit

CICLOPIROXOLAMINE a) Only on a prescription b) Not in combination Crm 1% ..................................................................................... 1.00 20 g OP (12.82) SODIUM HYPOCHLORITE – Subsidy by endorsement Only if prescribed for a dialysis patient and the prescription is endorsed accordingly. ❋ Soln ......................................................................................... 2.71 2,500 ml

Batrafen ✔ Janola

DIPHEMANIL METHYLSULPHATE – Subsidy by endorsement Only if prescribed for an amputee with an artificial limb, or for a paraplegic patient and the prescription endorsed accordingly. Powder 2% ............................................................................... 6.81 50 g OP (13.54) Prantal GLYCEROL WITH PARAFFIN AND CETYL ALCOHOL – Only on a prescription ❋ Lotn 5% with paraffin liq 5% and cetyl alcohol 2% ..................... 1.40 250 ml (8.10) OILY CREAM ❋ Crm BP .................................................................................... 2.80 (13.60) (15.40) ZINC Crm BP .................................................................................... 6.55 (12.00) TAR WITH CADE OIL Bath emul 7.5% coal tar, 2.5% cade oil, 7.5% compound ........... 9.70 (29.60) HYDROGEN PEROXIDE ❋ Soln 20 vol – Maximum of 500 ml per prescription .................... 3.13 (7.00) 500 g David Craig PSM 500 g PSM 350 ml Polytar Emollient 500 ml PSM

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 January 2011 (continued)

70 APPLICATOR When ordered with a spermicide. ❋ Applicator – Up to 1 dev available on a PSO ............................... 4.34 DIAPHRAGM – Up to 1 dev available on a PSO ❋ Diaphragm, 55 mm ................................................................. 42.90 ❋ Diaphragm, 60 mm ................................................................. 42.90 ❋ Diaphragm, 65 mm ................................................................. 42.90 ❋ Diaphragm, 70 mm ................................................................. 42.90 ❋ Diaphragm, 75 mm ................................................................. 42.90 ❋ Diaphragm, 80 mm ................................................................. 42.90 ❋ Diaphragm, 85 mm ................................................................. 42.90 ❋ Diaphragm, 90 mm ................................................................. 42.90 One of each size is permitted on a PSO. 70 175 176 179 180 185 NONOXYNOL-9 Jelly 2% – Up to 108 g available on a PSO ............................... 10.95 108 g OP 1 1 1 1 1 1 1 1 1 ✔ Ortho ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho Coil ✔ Ortho Coil ✔ Ortho Coil ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil ✔ Ortho All-flex ✔ Ortho Coil

✔ Gynol II

PAEDIATRIC ENTERAL FEED 1.5KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.60 200 ml OP ✔ Nutrini Energy RTH PAEDIATRIC ENTERAL FEED 1KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.07 200 ml OP ✔ Nutrini RTH ENTERAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ........................................................................................ 1.75 250 ml OP ✔ Isosource 1.5 ORAL FEED 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.33 237 ml OP ✔ Resource Plus AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA0962 – Retail pharmacy See prescribing guideline Powder .................................................................................. 58.44 250 g OP ✔ Metabolic Mineral Mixture Note – Metabolic Mineral Mixture powder 100 g OP subsidised from 1 July 2010.

Effective 1 February 2011

82 101 173 180

▲

CLOMIPHENE CITRATE Tab 50 mg ................................................................................ 2.50 INDOMETHACIN ❋ Cap long-acting 75 mg ........................................................... 13.30

5 100

✔ Phenate ✔ Rheumacin SR

ORAL FEED 1KCAL/ML – Special Authority see SA0594 – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.78 237 ml OP ✔ Resource Diabetic ORAL FEED 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid (strawberry) .................................................................... 1.33 237 ml OP ✔ Resource Plus ❋ 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.

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 August 2010

18 18 ASCORBIC ACID Tab 100 mg – 1% DV Oct-10 to 2013 ..................................... 13.80 ATORVASTATIN Tab 10 mg – 1 % DV Dec-2010 - 31/7/12................................. 1.77 Tab 20 mg – 1 % DV Dec-2010 - 31/7/12................................. 2.60 Tab 40 mg – 1 % DV Dec-2010 - 31/7/12................................. 4.38 Tab 80 mg – 1 % DV Dec-2010 - 31/7/12................................. 7.73 AZATHIOPRINE Tab 50 mg – 1% DV Oct-10 to 2013 ....................................... 18.45 Inj 50 mg – 1% DV Oct-10 to 2013 ......................................... 60.00 CEFTRIAXONE SODIUM Inj 1 g – 1% DV Oct-10 to 2013 .............................................. 10.49 Note – AFT ceftriaxone sodium inj 1 g to be delisted 1 October 2010 CLOMIPHENE CITRATE Tab 50 mg ............................................................................... 2.50 Note – Phenate tab 50 mg to be delisted 1 October 2010 DANTHRON WITH POLOXAMER Oral liq 75 mg with poloxamer 1 g per 5 ml .............................. 13.95 FUROSEMIDE ( price) Tab 500 mg ........................................................................... 25.00 HYDROCORTISONE WITH CINCHOCAINE Oint 5 mg with cinchocaine hydrochloride 5 mg per g .............. 15.00 Suppos 5 mg with cinchocaine hydrochloride 5 mg per g........... 9.90 INDAPAMIDE Tab 2.5 mg – 1% DV Oct-10 to 2013 ........................................ 2.95 Note – Napamide tab 2.5 mg to be delisted 1 October 2010 INSULIN GLULISINE Inj 100 iu per ml, 10 ml ........................................................... 27.03 Inj 100 iu per ml, 3 ml disposable pen ..................................... 46.07 500 30 30 30 30 100 1 5 Vitala-C Lorstat 10 Lorstat 20 Lorstat 40 Lorstat 80 Imuprine Imuran Aspen Ceftriaxone

Phenate

26 32 34

300 ml 50 30 g 12 90

Pinorax Forte Urex Forte Proctosedyl Proctosedyl Dapa-Tabs

1 5

Apidra Apidra SoloStar

IPRATROPIUM BROMIDE Nebuliser soln, 250 µg per ml, 1 ml – 1% DV Oct-10 to 2013 .... 3.79 20 Univent Nebuliser soln, 250 µg per ml, 2 ml – 1% DV Oct-10 to 2013 .... 4.06 20 Univent Note – Ipratropium Steri-Neb nebuliser soln, 250 µg per ml, 1 ml and 2 ml to be delisted 1 October 2010 KETONE BLOOD BETA-KETONE ELECTRODES ( price) Test strips ................................................................................ 7.07 LEVONORGESTREL Subdermal implant (2 x 75 mg rods) ...................................... 133.65 Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated 10 strip Optium Blood Ketone Test Strips Jadelle

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 August 2010 (continued)

40 49 METHADONE HYDROCHLORIDE ( price and addition of HSS) Tab 5 mg – 1% DV Oct-10 to 2013 ........................................... 1.85 QUETIAPINE Tab 25 mg ............................................................................... 7.00 Tab 100 mg ........................................................................... 14.00 Tab 200 mg ........................................................................... 24.00 Tab 300 mg ........................................................................... 40.00 RISPERIDONE Tab 0.5 mg ............................................................................... 3.51 SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml – 1% DV Oct-10 to 2013 ......................... 25.00 Note – Microlex enema to be delisted 1 October 2010 TAMSULOSIN HYDROCHLORIDE Cap 400 µg – 1% DV Oct-10 to 2013........................................ 5.98 10 60 60 60 60 60 Methatabs Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Risperidone

Micolette

Tamsulosin-Rex

Section H changes to Part IV

Effective 1 August 2010

INDOMETHACIN Cap long-acting 75 mg S29 For any indication approved by the hospital service

Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Index

Pharmaceuticals and brands Symbols 3TC ............................................................. 32, 58 A A-Lices .............................................................. 21 Abacavir sulphate............................................... 32 Abacavir sulphate with lamivudine ...................... 32 Acetylcysteine.................................................... 41 Adalimumab....................................................... 34 Alanase.............................................................. 58 Albay ................................................................. 40 Alendronate sodium ........................................... 48 Alendronate sodium with cholecalciferol ............. 48 Alpha-Bromocriptine .......................................... 68 Alpha-Keri Lotion ............................................... 68 Alpha tocopheryl acetate .................................... 26 Ambrisentan ...................................................... 26 Amiloride with frusemide .................................... 53 Amiloride with hydrochlorothiazide ..................... 21 Aminoacid formula with minerals without phenylalanine ................................ 23, 73 Amlodipine......................................................... 23 Amoxycillin ........................................................ 68 Andriol Testocaps ........................................ 55, 70 Antiretrovirals ............................................... 30, 42 Anusol ............................................................... 72 Apidra .......................................................... 21, 74 Apidra SoloStar ............................................ 21, 74 Apo-Diclo SR ..................................................... 71 Applicator .......................................................... 73 Aquasun Sensitive SPF 30+ .............................. 68 Aromasin ........................................................... 39 Arrow-Bendrofluazide ......................................... 24 Arrow-Cabergoline ....................................... 27, 56 Arrow-Enalapril .................................................. 24 Arrow-Lamotrigine ............................................. 68 Arrow-Metformin................................................ 68 Arrow-Testosterone ........................................... 24 Arrow-Tramadol ................................................. 24 Ascorbic acid ............................................... 21, 74 Aspec 300 ......................................................... 56 Aspen Ceftriaxone .................................. 22, 28, 74 Aspirin ......................................................... 54, 56 Atazanavir sulphate ............................................ 32 Atenolol ....................................................... 24, 67 Atenolol Tablet USP............................................ 24 Atorvastatin.................................................. 21, 74 Atropine sulphate ............................................... 67 Azathioprine ........................................... 22, 54, 74 B Batrafen ............................................................. 72 Beclomethasone dipropionate............................. 58 Bee venom allergy treatment .............................. 40 Bendrofluazide ....................................... 24, 55, 70 Betadine............................................................. 53 Betaferon ........................................................... 54 Betaloc CR ......................................................... 55 Bisacodyl ..................................................... 54, 65 Blenoxane .......................................................... 68 Bleomycin sulphate ............................................ 68 Bosentan ........................................................... 26 Breath-Alert........................................................ 41 Bromocriptine mesylate...................................... 68 Bupivacaine hydrochloride.................................. 38 Buserelin acetate ................................................ 27 C Cabergoline.................................................. 27, 56 Calci-Tab 500 .............................................. 50, 53 Calci-Tab 600 .............................................. 50, 53 Calcitriol ............................................................ 68 Calcitriol-AFT ..................................................... 68 Calcium carbonate ....................................... 50, 53 Calcium folinate ................................................. 38 Calcium Folinate Ebewe...................................... 38 Calsource .......................................................... 50 Camptosar ......................................................... 54 Capadex............................................................. 66 Capecitabine ...................................................... 38 Cefaclor monohydrate ........................................ 56 Cefalexin Sandoz ................................................ 29 Cefazolin sodium ............................................... 28 Cefoxitin sodium ................................................ 28 Ceftriaxone sodium ................................ 22, 28, 74 Cefuroxime sodium ............................................ 29 Cellcept ............................................................. 40 Cephalexin monohydrate .................................... 29 Cerezyme..................................................... 26, 53 Cetomacrogol .................................................... 55 Chlorhexidine gluconate ......................... 58, 64, 65 Ciclopiroxolamine............................................... 72 Cilazapril with hydrochlorothiazide ...................... 53 Cisplatin....................................................... 56, 58 Cisplatin Ebewe.................................................. 58 Climara 50 ......................................................... 53 Climara 100 ....................................................... 53 Clomazol...................................................... 41, 55 Clomiphene citrate ........................... 23, 42, 73, 74 Clomipramine hydrochloride ......................... 67, 71 Clopress ...................................................... 67, 71 Clotrimazole ................................................. 41, 55 Coal tar ........................................................ 23, 55 Codalgin ............................................................ 67 Colistin-Link ....................................................... 29 Colistin sulphomethate ....................................... 29 Coloxyl ........................................................ 57, 70

Index

Pharmaceuticals and brands Combined oral contraceptives ............................ 47 Combivir ............................................................ 33 Cotazym ECS ..................................................... 46 Creon 10000...................................................... 46 Creon Forte ........................................................ 46 Crixivan.............................................................. 32 Crotamiton ................................................... 58, 65 Cyclosporin........................................................ 40 Cyproterone acetate ........................................... 27 Cytarabine ................................. 24, 49, 54, 58, 64 D D-Zol ................................................................. 70 Danazol.............................................................. 70 Danthron with poloxamer........................ 21, 22, 74 Dapa-Tabs ................................................... 21, 74 Dapsone ............................................................ 42 Deca-Durabolin Orgaject .................................... 24 Derbac-M .......................................................... 47 Desferrioxamine mesylate .................................. 26 Desmopressin .................................................... 28 Dexamethasone sodium phosphate .................... 64 Dextrochlorpheniramine maleate ................... 66, 69 Dextropropoxyphene with paracetamol ............... 66 Dextrose with electrolytes................................... 54 Diaphragm ................................................... 27, 73 Diclax SR ........................................................... 65 Diclofenac Sandoz ............................................. 24 Diclofenac sodium ........................... 24, 65, 67, 71 Diclohexal .......................................................... 71 Didanosine [DDI]................................................ 32 Dilantin .............................................................. 56 Dilantin Infatab ................................................... 56 Diphemanil methylsulphate ................................. 72 Dithranol ............................................................ 66 Diurin 500 .......................................................... 70 Docetaxel ........................................................... 57 Docusate sodium ................................... 50, 57, 70 Domperidone ............................................... 44, 56 Dornase alfa....................................................... 40 Dostinex ............................................................ 27 Dr Reddy’s Omeprazole...................................... 67 Dr Reddy’s Pantoprazole .................................... 54 Dr Reddy’s Quetiapine .................................. 22, 75 Dr Reddy’s Risperidone................................ 22, 75 Duphaston ......................................................... 70 Dydrogesterone.................................................. 70 E Efavirenz ............................................................ 31 Eligard ............................................................... 28 EMLA................................................................. 38 Emtricitabine ...................................................... 32 Emtriva .............................................................. 32 Enalapril ................................................. 24, 53, 70 Enfuvirtide .......................................................... 32 Enteral feed 1kcal/ml .......................................... 71 Enteral feed with fibre 1.5kcal/ml .................. 71, 73 Enteral feed with fibre 1 kcal/ml .......................... 71 Eprex ................................................................. 26 Erythropoietin alpha............................................ 26 Erythropoietin beta ............................................. 26 Estradot 50 mcg ................................................ 23 Ethics Aspirin ..................................................... 56 Ethics Aspirin EC................................................ 54 Ethinyloestradiol with gestodene ......................... 67 Ethinyloestradiol with levonorgestrel ................... 70 Etoposide........................................................... 39 Eurax ........................................................... 58, 65 Exemestane ....................................................... 39 F Femara .............................................................. 67 Femodene 28 ..................................................... 67 Fenpaed ............................................................. 56 Ferodan ....................................................... 47, 50 Ferro-F-Tabs ...................................................... 50 Ferro-Gradumet.................................................. 50 Ferro-tab ............................................................ 50 Ferrograd-Folic................................................... 50 Ferrous fumarate ................................................ 50 Ferrous fumarate with folic acid .......................... 50 Ferrous gluconate with ascorbic acid ............ 50, 65 Ferrous sulphate .......................................... 47, 50 Ferrous sulphate with folic acid .......................... 50 Fibersource HN .................................................. 71 Fibersource HN RTH........................................... 71 Fleet................................................................... 65 Flucloxacillin sodium .......................................... 67 Fluconazole ........................................................ 29 Fludara............................................................... 66 Fludarabine phosphate ....................................... 66 Flumetasone pivalate .......................................... 23 Fluorouracil Ebewe ....................................... 24, 71 Fluorouracil sodium...................................... 24, 71 Fluox............................................................ 23, 56 Fluoxetine hydrochloride ............................... 23, 56 Flutamide ........................................................... 39 Flutamin ............................................................. 39 Fluvax ................................................................ 44 Foban ................................................................ 55 Food thickener ............................................. 54, 71 Foremount Child’s Silicone Mask ........................ 40 Fosamax ............................................................ 48 Fosamax Plus .................................................... 48 Frumil ................................................................ 53 Fucidin ............................................................... 29

Index

Pharmaceuticals and brands Furosemide ...................................... 26, 53, 70, 74 Fusidic acid.................................................. 29, 55 Fuzeon ............................................................... 32 G Gaviscon ........................................................... 72 Gemcitabine Ebewe...................................... 50, 57 Gemcitabine hydrochloride ........................... 50, 57 Gemzar .............................................................. 50 GenRx Moclobemide .......................................... 71 Gentamicin sulphate ........................................... 29 Glycerol ....................................................... 23, 57 Glycerol with paraffin and cetyl alcohol ............... 72 Goserelin acetate ............................................... 28 Gutron ............................................................... 26 Gynol II .............................................................. 73 H Healtheries Iron with Vitamin C ..................... 50, 65 Heparin sodium.................................................. 71 Herceptin ........................................................... 46 Hormone Replacement Therapy – Systemic........ 41 Humira............................................................... 34 HumiraPen ......................................................... 34 Hydrocortisone .................................................. 70 Hydrocortisone butyrate ..................................... 66 Hydrocortisone with cinchocaine .................. 21, 74 Hydrocortisone with miconazole ......................... 55 Hydrogen peroxide ............................................. 72 Hydroxocobalamin ............................................. 66 Hyoscine (scopolamine)..................................... 38 I Ibuprofen ........................................................... 56 Iloprost .............................................................. 27 Imiglucerase ................................................ 26, 53 Imigran ........................................................ 38, 68 Imuprine ...................................................... 22, 74 Imuran ......................................................... 54, 74 Indapamide .................................................. 21, 74 Indinavir ............................................................. 32 Indomethacin ............................................... 73, 75 Influenza vaccine................................................ 43 Influvac .............................................................. 44 Inhibace Plus ..................................................... 53 Insulin glargine ................................................... 25 Insulin glulisine ............................................ 21, 74 Interferon alpha-2a ....................................... 33, 65 Interferon alpha-2a with ribavirin......................... 65 Interferon alpha-2b ............................................. 33 Interferon beta-1-beta......................................... 54 Intra-uterine device............................................. 27 Intron-A ............................................................. 33 Ipratropium bromide ..................................... 22, 74 Irinotecan..................................................... 24, 54 Irinotecan-Rex.................................................... 24 Isentress ............................................................ 32 Isosource 1.5............................................... 71, 73 Isosource HN ..................................................... 71 Isosource HN RTH ............................................. 71 Itraconazole ....................................................... 29 J Jadelle ......................................................... 22, 74 Janola ................................................................ 72 K Kaletra ......................................................... 23, 32 Karicare Food Thickener ..................................... 54 Ketoconazole ..................................................... 71 Ketone blood beta-ketone electrodes ...... 25, 53, 74 Ketostix.............................................................. 25 Kivexa ................................................................ 32 L Lamivudine .................................................. 32, 58 Lamotrigine........................................................ 68 Lantus ............................................................... 25 Lantus SoloStar ................................................. 25 Lanvis ................................................................ 39 Laxofast 50 ........................................................ 50 Laxofast 120 ...................................................... 50 Lax-Tabs............................................................ 54 Lemnis Fatty Cream HC...................................... 70 Letrozole ............................................................ 67 Leuprorelin......................................................... 28 Levonorgestrel ............................................. 22, 74 Lignocaine ......................................................... 24 Lignocaine with prilocaine .................................. 38 Locacorten-Vioform ED’s ................................... 23 Locoid Crelo ...................................................... 66 Lopinavir with ritonavir ................................. 23, 32 Loraclear Hayfever Relief.................................... 57 Lorapaed ........................................................... 57 Loratadine.......................................................... 57 Lorstat 10 .................................................... 21, 74 Lorstat 20 .................................................... 21, 74 Lorstat 40 .................................................... 21, 74 Lorstat 80 .................................................... 21, 74 Losec Hp7 OAC ................................................. 71 Loxamine ........................................................... 56 Lucrin Depot ...................................................... 28 Lucrin Depot PDS............................................... 28 Lyderm .............................................................. 68 M m-Enalapril .................................................. 53, 70 Magnesium sulphate .......................................... 50 Malathion ..................................................... 21, 47 Marcain Heavy ................................................... 38 Marcain Isobaric ................................................ 38

Index

Pharmaceuticals and brands Martindale Acetylcysteine ................................... 41 Mask for spacer device ...................................... 40 MDS Quick Card .......................................... 58, 65 Megace........................................................ 59, 66 Megestrol acetate......................................... 59, 66 Metabolic Mineral Mixture............................. 23, 73 Metformin hydrochloride .................................... 68 Methadone hydrochloride ............................. 54, 75 Metoprolol - AFT CR........................................... 55 Methatabs .................................................... 54, 75 Methoblastin ...................................................... 39 Methotrexate ...................................................... 39 Methotrexate Ebewe ........................................... 39 Metopirone ........................................................ 28 Metoprolol succinate .......................................... 55 Metyrapone........................................................ 28 Micanol.............................................................. 66 Micelle E ............................................................ 26 Micolette ...................................................... 21, 75 Micreme H ......................................................... 55 Midodrine .......................................................... 26 Minims .............................................................. 41 Minirin ............................................................... 28 Mitomycin C ...................................................... 24 Mitozantrone ...................................................... 57 Mitozantrone Ebewe ........................................... 57 Moclobemide ..................................................... 71 Moduretic .......................................................... 21 Motilium ...................................................... 44, 56 MultiADE............................................................ 23 Multiload Cu 375................................................ 27 Multiload Cu 375 SL........................................... 27 Multiparin........................................................... 71 Multivitamins ............................................... 23, 72 Mycobutin.......................................................... 30 Mycophenolate mofetil ....................................... 40 N Naltrexone hydrochloride .................................... 49 Nandrolone decanoate........................................ 24 Navelbine ........................................................... 51 Navoban ............................................................ 38 Neo-B12 ............................................................ 66 Neo-Naclex .................................................. 55, 70 Neoral ................................................................ 40 NeoRecormon .................................................... 26 NeuroKare.......................................................... 22 Nevirapine .......................................................... 32 Nizoral ............................................................... 71 Nonoxynol-9 ...................................................... 73 Norditropin SimpleXx 10mg ................................ 66 Norditropin SimpleXx 15mg ................................ 66 Norditropin SimpleXx 5mg .................................. 66 Norvasc ............................................................. 23 Norvir ................................................................ 32 Noten ................................................................. 67 NovaSource Renal.............................................. 57 Nutrini Energy RTH ............................................. 73 Nutrini RTH ........................................................ 73 O Octreotide (somatostatin analogue) .............. 39, 44 Oestradiol .................................................... 23, 53 Oily cream ......................................................... 72 Omeprazole........................................................ 67 Omeprazole, amoxycillin and clarithromycin ....... 71 Optium Blood Ketone Test Strips ............ 25, 53, 74 Oral elemental feed 1kcal/ml............................... 57 Oral feed 1.5kcal/ml ..................................... 71, 73 Oral feed 1kcal/ml ........................................ 57, 73 Oral supplement 1kcal/ml ................................... 57 Ortho ................................................................. 73 Ortho All-flex ................................................ 27, 73 Ortho Coil .................................................... 27, 73 Oxypentifylline .................................................... 26 P Paediatric enteral feed 1.5kcal/ml ....................... 73 Paediatric enteral feed 1kcal/ml .......................... 73 Paediatric Seravit ......................................... 23, 72 Pamidronate disodium ....................................... 38 Pamisol ............................................................. 38 Pancreatic enzyme ............................................. 46 Panteston .................................................... 55, 70 Pantoprazole ...................................................... 54 Panzytrat............................................................ 46 Paracetamol with codeine .................................. 67 Paradex ............................................................. 66 Paroxetine hydrochloride .................................... 56 Peak flow meter ................................................. 41 Pedialyte - Bubblegum ....................................... 54 Pedialyte - Fruit .................................................. 54 Pedialyte - Plain ................................................. 54 Pegasys............................................................. 33 Pegasys RBV Combination Pack ........................ 33 Pegylated interferon alpha-2a ............................. 33 Perhexiline maleate ............................................ 26 Permethrin ......................................................... 68 Pexsig................................................................ 26 Phenate ................................................. 42, 73, 74 Phenergan ......................................................... 67 Phenoxymethylpenicillin (penicillin v) .................. 56 Phenytoin sodium .............................................. 56 Pilocarpine ......................................................... 41 Pindol ................................................................ 67 Pindolol ............................................................. 67 Pinorax .............................................................. 22 79

Index

Pharmaceuticals and brands Pinorax Forte ................................................ 21, 74 Polaramine......................................................... 69 Polaramine Colour-Free Repetab ........................ 66 Polytar Emollient ................................................ 72 Potassium chloride ............................................ 67 Potassium iodate ............................................... 22 Povidone iodine ................................................. 53 Prantal ............................................................... 72 Pregnancy tests - hcg urine .......................... 58, 65 Probenecid ........................................................ 64 Probenecid-AFT ................................................. 64 Proctosedyl.................................................. 21, 74 Progestogen-only contraceptives........................ 47 Prograf .............................................................. 40 Promethazine hydrochloride ............................... 67 Protein supplement ............................................ 23 Pulmozyme ........................................................ 40 Q Quetiapine.................................................... 22, 75 QV ..................................................................... 72 R Raltegravir potassium......................................... 32 Ranbaxy-Cefaclor............................................... 56 Ranbaxy Amoxicillin ........................................... 68 Rapamune ......................................................... 40 Renal oral feed 2kcal/ml ..................................... 57 Resource Beneprotein ........................................ 23 Resource Diabetic ........................................ 57, 73 Resource Plus.............................................. 71, 73 Resource Thicken Up ......................................... 71 ReTrieve ............................................................ 23 Retrovir .............................................................. 33 ReVia ................................................................. 49 Reyataz.............................................................. 32 Rheumacin SR ................................................... 73 Ridal .................................................................. 58 Rifabutin ............................................................ 30 Risperidone............................................ 22, 58, 75 Ritonavir ............................................................ 32 Rivacol .............................................................. 64 Roferon-A .................................................... 33, 65 Roferon RBV Combination Pack ......................... 65 Roferon RBV Combination Pack Starter Kit ......... 65 Ropin ................................................................. 56 Ropinirole hydrochloride..................................... 56 S Salapin .............................................................. 57 Salbutamol......................................................... 57 Sandostatin .................................................. 39, 44 Sandostatin LAR .......................................... 39, 44 Scopoderm TTS ................................................. 38 Serophene ................................................... 23, 42 Sildenafil ............................................................ 27 Silvazine ............................................................ 66 Silver sulphadiazine ............................................ 66 Sirolimus ........................................................... 40 Siterone ............................................................. 27 Sodium alginate ................................................. 72 Sodium citrate with sodium lauryl sulphoacetate .................................. 21, 75 Sodium fluoride .................................................. 50 Sodium hypochlorite .......................................... 72 Sodium nitroprusside ......................................... 25 Somatropin ........................................................ 66 Space Chamber ................................................. 41 Spacer device .................................................... 41 Spironolactone ................................................... 55 Spirotone ........................................................... 55 Sporanox ........................................................... 29 Staphlex ............................................................. 67 Stavudine [D4T] ................................................. 33 Stocrin ............................................................... 31 Sumagran .......................................................... 68 Sumatriptan ................................................. 38, 68 Sunscreens, proprietary ..................................... 68 Suprefact ........................................................... 27 Sustagen Hospital Formula ................................. 57 T Tacrolimus......................................................... 40 Tamsulosin hydrochloride ............................ 22, 75 Tamsulosin-Rex ........................................... 22, 75 Tar with cade oil................................................. 72 Tasmar .............................................................. 44 Temodal ............................................................ 39 Temozolomide ................................................... 39 Teniposide ......................................................... 68 Tenofovir disoproxil fumarate ............................. 30 Terazosin hydrochloride ..................................... 21 Testosterone undecanoate...................... 24, 55, 70 Thioguanine ....................................................... 39 Tobramycin........................................................ 30 Tolcapone .......................................................... 44 Total parenteral nutrition (TPN) ........................... 26 TPN ................................................................... 26 Tracleer ............................................................. 26 Tramadol hydrochloride...................................... 24 Trastuzumab ...................................................... 46 Trental 400 ........................................................ 26 Tretinoin ............................................................ 23 Triclosan............................................................ 21 Trifeme .............................................................. 70 Trimipramine maleate ......................................... 66 Tripress ............................................................. 66 Tropisetron ........................................................ 38

Index

Pharmaceuticals and brands U Univent ........................................................ 22, 74 Urex Forte .............................................. 26, 53, 74 V Vancomycin hydrochloride ................................. 29 Vaxigrip ............................................................. 44 Ventavis ............................................................. 27 Vepesid.............................................................. 39 Viagra ................................................................ 27 Videx EC ............................................................ 32 Vincristine sulphate ...................................... 58, 64 Vinorelbine ......................................................... 51 Vinorelbine Ebewe .............................................. 51 Viramune ........................................................... 32 Viramune Suspension ........................................ 32 Viread ................................................................ 30 Vitala-C ........................................................ 21, 74 Vitamins ............................................................ 23 Vivonex TEN....................................................... 57 Volibris .............................................................. 26 Voltaren SR ........................................................ Volumatic .......................................................... Vumon ............................................................... W Wasp venom allergy treatment ........................... Wool fat with mineral oil ..................................... X Xeloda ............................................................... Z Zerit ................................................................... Ziagen................................................................ Zidovudine [AZT] ................................................ Zidovudine [AZT] with lamivudine ....................... Zinacef ............................................................... Zinc ................................................................... Zincaps .............................................................. Zinc oxide .......................................................... Zinc sulphate...................................................... Zoladex .............................................................. 67 41 68 40 68 38 33 32 33 33 29 72 50 72 50 28

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)

While care has been taken in compiling this Update, Pharmaceutical Management Agency takes no responsibility for any errors or omissions and shall not be liable to any person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Update.

Metadata

Title

Schedule Update - effective 1 August 2010

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 August 2010 Cumulative for May, June, July and August 2010 Section H for August 2010 Contents Summary of PHARMAC decisions effective 1 August 2010 …. 3 Changes to various dispensing…

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