Schedule Update - effective 1 October 2010 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 October 2010

Section H cumulative for August, September and October 2010

Contents

Summary of PHARMAC decisions effective 1 October 2010 .......................... 3 Pharmaceutical co-payments remain unchanged .......................................... 6 Further topical anti-acne treatment fully subsidised ...................................... 6 New funded treatment for lung cancer ......................................................... 7 Oral iron chelator subsidised ......................................................................... 7 Mycophenolate mofetil – new listing and Special Authority amendment...... 7 Travoprost eye drops now fully subsidised .................................................... 8 Ezetimibe – greater subsidised access ........................................................... 8 Mianserin hydrochloride – widened access ................................................... 8 Tenofovir disoproxil fumarate – widened access ............................................ 9 Rituximab – widened access .......................................................................... 9 Budesonide and anastrozole – further brands subsidised ............................ 10 Urea cream – fully subsidised ...................................................................... 10 Capecitabine – widened access ................................................................... 10 Phenobarbitone sodium paediatric oral liquid – new standard formulae .... 11 Tender News ................................................................................................ 12 Looking Forward ......................................................................................... 12 Sole Subsidised Supply products cumulative to October 2010 .................... 14 New Listings ................................................................................................ 22 Changes to Restrictions ............................................................................... 28 Changes to Subsidy and Manufacturer’s Price............................................. 44 Changes to General Rules............................................................................ 49 Changes to Brand Name ............................................................................. 49 Changes to Section E Part I ......................................................................... 49 Changes to Sole Subsidised Supply ............................................................. 50 Delisted Items ............................................................................................. 51 Items to be Delisted .................................................................................... 53 Section H changes to Part II ........................................................................ 56 Section H changes to Part III........................................................................ 63 Index ........................................................................................................... 64

Summary of Pharmac decisions

effective 1 OctOBer 2010 New listings (pages 22-24) • Loperamide hydrochloride (Diamide Relief) cap 2 mg – up to 30 cap available on a PSO • Imiglucerase (Cerezyme) inj 40 iu per ml, 400 iu vial – Special Authority – Retail pharmacy, section 29 • Sodium chloride (Pfizer) inj 0.9%, 5 ml and 10 ml – Up to 5 inj available on a PSO • Deferiprone (Ferriprox) tab 500 mg and oral liq 100 mg per 1 ml, 250 ml OP – Special Authority – Retail pharmacy • Cilazapril (Zapril) tab 0.5 mg, 2.5 mg and 5 mg • Adapalene (Differin) crm 0.1%, 30 g OP, and gel 0.1%, 30 g OP – Only on a prescription and maximum of 30 g per prescription • Amoxycillin (Alphamox) cap 250 mg – Up to 30 cap available on a PSO • Amoxycillin (Alphamox) cap 500 mg • Ondansetron (Dr Reddy’s Ondansetron) tab 4 mg and 8 mg – Maximum of 12 tab per prescription and maximum of 6 tab per dispensing – not more than one prescription per month – restrictions can be waived by Special Authority • Erlotinib hydrochloride (Tarceva) tab 100 mg and 150 mg – Retail pharmacySpecialist – Special Authority • Anastrozole (Aremed) tab 1 mg • Mycophenolate mofetil (Myaccord) tab 500 mg and cap 250 mg – Special Authority – Retail pharmacy • Budesonide (Budenocort) powder for inhalation 200 µg and 400 µg per dose, 200 dose OP • Chloramphenicol (Chlorafast) eye drops 0.5% • Standard formulae – phenobarbitone sodium paediatric oral liquid (10 mg per ml) • Oral supplement 1kcal/ml (Ensure) powder (chocolate and vanilla) 900 g OP – Special Authority – Hospital pharmacy [HP3] • Paediatric oral feed 1kcal/ml (Pediasure) liquid (vanilla) 200 ml OP – Special Authority – Hospital pharmacy [HP3] • Renal oral feed 2kcal/ml (Nepro (strawberry)) liquid 200 ml OP – Special Authority – Hospital pharmacy [HP3] • Enteral feed with fibre 1kcal/ml (Jevity) liquid 237 ml OP and (Jevity RTH) liquid 500 ml OP – Special Authority – Hospital pharmacy [HP3] • Enteral feed 1kcal/ml (Osmolite) liquid 250 ml OP and (Osmolite RTH) liquid 500 ml OP – Special Authority – Hospital pharmacy [HP3]

Summary of Pharmac decisions – effective 1 October 2010 (continued) • Enteral feed with fibre 1.5kcal/ml (Ensure Plus HN) liquid 250 ml OP – Special Authority – Hospital pharmacy [HP3] • Elemental formula (Elecare) powder (vanilla and unflavoured) 400 g OP and (Elecare LCP) powder (unflavoured) 400 g OP – Special Authority – Hospital pharmacy [HP3] changes to restrictions (pages 28-35) • Sodium chloride (Pharmacia and Multichem) inj 0.9%, 20 ml – addition of Up to 5 inj available on a PSO • Ezetimibe (Ezetrol) tab 10 mg – amended Special Authority criteria • Ezetimibe with simvastatin (Vytorin) tab 10 mg with simvastatin 10 mg, 20 mg, 40 mg and 80 mg – amended Special Authority criteria • Tenofovir disoproxil fumarate (Viread) tab 300 mg – amended Special Authority criteria • Mianserin hydrochloride (Tolvon) tab 30 mg – amended Special Authority criteria • Capecitabine (Xeloda) tab 150 mg and 500 mg – amended Special Authority criteria • Mycophenolate mofetil (Cellcept and Myaccord) tab 500 mg and cap 250 mg – amended Special Authority criteria • Rituximab inj 100 mg per 10 ml vial and inj 500 mg per 50 ml vial (Mabthera), and inj 1 mg for ECP (Baxter) – amended Special Authority criteria • Travoprost (Travatan) eye drops 0.004%, 2.5 ml OP – removal of additional subsidy by endorsement Decreased subsidy (pages 44-46) • Sodium citrate with sodium lauryl sulphoacetate (Microlax) enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml • Ascorbic acid (Apo-Ascorbic Acid) tab 100 mg • Water (Multichem) purified for inj, 5 ml, 10 ml and 20 ml • Terazosin hydrochloride (Apo-Terazosin) tab 1 mg, 2 mg and 5 mg • Indapamide (Napamide) tab 2.5 mg • Malathion (Derbac-M) liq 0.5%, 200 ml OP • Oestriol (Ovestin) crm 1 mg per g with applicator and pessaries 500 µg • Ceftriaxone sodium (AFT) inj 1 g • Mianserin hydrochloride (Tolvon) tab 30 mg • Quetiapine (Seroquel) tab 25 mg, 100 mg, 200 mg and 300 mg • Azathioprine (Azamun and Imuran) tab 50 mg • Mycophenolate mofetil (Cellcept) tab 500 mg and cap 250 mg

Summary of Pharmac decisions – effective 1 October 2010 (continued) • Ipratropium bromide (Ipratropium Steri-Neb) nebuliser soln 250 µg per ml, 1 ml and 2 ml • Oral supplement 1kcal/ml (Ensure) powder (chocolate, strawberry, vanilla) 400 g OP increased subsidy (pages 44-46) • Sodium chloride (Multichem) inj 0.9%, 20 ml • Urea (Nutraplus) crm 10%, 100 g OP • Nitrofurantoin (Nifuran) tab 50 mg and 100 mg • Travoprost (Travatan) eye drops 0.004%, 2.5 ml OP

6 Pharmaceutical Schedule - Update News

Pharmaceutical copayments remain unchanged

As you will be aware, the Government has announced an increase in Goods and Services Tax (GST) from 12.5% to 15% to take effect from 1 October 2010. Existing patient co-payments for pharmaceuticals are to be maintained at their current level after 1 October 2010, as they are GST inclusive in most cases. The impact of the GST increase will be absorbed by District Health Boards.

The GST component of service fee payments to pharmacies will increase, as required by the current Pharmacy Services contract.

Further topical anti-acne treatment fully subsidised

From 1 October 2010 the topical anti-acne treatment adapalene will be listed fully subsidised. Adapalene, brand name Differin, will be fully subsidised in 0.1% cream and gel formulations when dispensed on a prescription. A maximum of 30 g per prescription will be subsidised. Adapalene is a once daily topical retinoid indicated for the topical treatment of comedo, papular and pustular acne (acne vulgaris) of the face, chest or back.

Pharmaceutical Schedule - Update News

New funded treatment for lung cancer

Erlotinib hydrochloride (Tarceva) will be fully subsidised for people with advanced lung cancer from 1 October 2010. Tarceva 100 mg and 150 mg tablets will be fully subsidised under Special Authority criteria for treatment of patients with advanced Non Small Cell Lung Cancer following failure of previous chemotherapy.

Oral iron chelator subsidised

The oral iron chelator deferiprone (Ferriprox) 500 mg tablet and 100 mg per ml, 250 ml oral liquid will be fully subsidised from 1 October 2010. Subsidy, via Special Authority application, will be available to patients diagnosed with chronic transfusional iron overload due to congenital inherited anaemia.

Mycophenolate mofetil – new listing and Special Authority amendment

Douglas Pharmaceutical’s brand of mycophenolate mofetil 250 mg capsules and 500 mg tablets (Myaccord) will be listed fully subsidised, under Special Authority criteria, from 1 October 2010. Myaccord will have protection from subsidy reduction and delisting until 30 June 2012. Roche’s brand of mycophenolate mofetil, Cellcept, will remain fully subsidised, with a price and subsidy decrease also effective from 1 October 2010. The Special Authority criteria applying to both brands of mycophenolate mofetil (Cellcept and Myaccord 250 mg capsules, 500 mg tablets and Cellcept oral liquid) will be amended from 1 October 2010. The amendment widens funded access to include all transplant recipients and patients with autoimmune diseases that have not responded to other standard immunosuppressant treatments. The following dispensing note has also been added to the listing of mycophenolate mofetil – “the dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically”. The reason for this note is that dispensing Myaccord would result in a brand switch for current patients stabilised on Cellcept. While PHARMAC does not anticipate any problems with switching brands in most patients, we consider that the prescriber should be actively involved in such a decision.

Pharmaceutical Schedule - Update News

Travoprost eye drops now fully subsidised

Travoprost (Travatan) eye drops 0.004%, 2.5 ml OP, will be fully subsidised from 1 October 2010. The subsidy will increase from 1 October 2010 to match the manufacturer’s price. In addition, the requirement for an endorsement for additional subsidy for travoprost eye drops 0.004% will be removed from 1 October 2010, resulting in Travatan being fully subsidised without restriction.

Ezetimibe – greater subsidised access

Subsidised access for ezetimibe (Ezetrol) tablets 10 mg and ezetimibe with simvastatin (Vytorin) tablets will be widened from 1 October 2010. The Special Authority criteria will be amended to include patients whose LDL-cholesterol treatment goals are not achieved with the use of maximally tolerated dose of atorvastatin. The current specialist application and renewal restrictions will be removed, enabling prescribers acting within their scope of practice to apply for Special Authority approvals.

Mianserin hydrochloride – widened access

From 1 October 2010 subsidised access to mianserin hydrochloride (Tolvon) 30 mg tablets will be expanded. The Special Authority criteria will be amended to include patients who have not responded to other antidepressants. Please refer to page 31 for further details.

Pharmaceutical Schedule - Update News

Tenofovir disoproxil fumarate – widened access

Funded access to tenofovir disoproxil fumarate (Viread) 300 mg tablets will be amended from 1 October 2010. Liver transplant recipients will have subsidised access to tenofovir, in combination with lamivudine, for the treatment of Hepatitis B infection under amended Special Authority criteria. Pregnant Hepatitis B positive patients will also have funded access to tenofovir for prevention of mother to child vertical transmission of Hepatitis B. The current requirement for an increase in ALT or > Metavir stage 3 for tenofovir funding will be removed. The current requirement for renewal of Special Authority approvals every 2 years will

be removed from 1 October 2010 so that approvals for Chronic Hepatitis B (new and existing) will be valid without further renewal unless notified.

Rituximab – widened access

The Special Authority criteria for the in-hospital cancer treatment rituximab (Mabthera) will be widened from 1 October 2010. This will mean greater numbers of people with lymphoma, will be able to have that treatment funded. The changes for subsidised access to rituximab (Mabthera) 100 mg and 500 mg injections and (Baxter) 1 mg for ECP injection include widening of funding for this inhospital cancer drug to include more patients with relapsed/refractory aggressive CD20positive Non-Hodgkins lymphoma (NHL). The duration of funded treatment for patients with relapsed indolent NHL has also been increased.

10 Pharmaceutical Schedule - Update News

Budesonide and anastrozole – further brands subsidised

From 1 October 2010 AFT Pharmaceuticals Ltd’s brand of budesonide powder for inhalation 200 µg and 400 µg per dose (Budenocort) will be fully subsidised without restriction. Also from 1 October 2010 AFT’s brand of anastrozole 1 mg tablets, (Aremed), will be fully subsidised without restriction.

Urea cream – fully subsidised

The subsidy for urea 10% cream (Nutraplus) will increase to match the manufacturer’s price from 1 October 2010 resulting in urea 10% cream being fully subsidised.

Capecitabine – widened access

The Special Authority criteria for the oral cancer treatment capecitabine (Xeloda) will be widened from 1 October 2010. This will mean that new patients with colon and rectal cancer will be funded. The widening of subsidised access to capecitabine (Xeloda) 150 mg and 500 mg tablets, includes adjuvant treatment of patients with high risk stage II (Duke’s B) colorectal cancer, and neoadjuvant treatment of patients with locally advanced rectal cancer when given concurrently with radiation.

Pharmaceutical Schedule - Update News

Phenobarbitone sodium paediatric oral liquid – new standard formulae

An additional standard formula for phenobarbitone sodium oral liquid will be listed from 1 October 2010. The new formula is suitable for paediatric patients where the existing one is now not recommended for paediatric use. Please see page 23 for the new formula. PHARMAC has received guidance from the Paediatric Society of NZ that the paediatric oral liquid would have an expiry date of 28 days when stored in a fridge.

tender News

Sole Subsidised Supply changes – effective 1 November 2010

Chemical Name Azathioprine Calcium carbonate Calcium carbonate Cilazapril with hydrochorothiazide Donepezil hydrochloride Donepezil hydrochloride Enalapril Enalapril Enalapril Methadone hydrochloride Moclobemide Moclobemide Tamsulosin hydrochloride Presentation; Pack size Inj 50 mg; 1 inj Tab 1.25 g (500 mg elemental); 250 tab Tab 1.5 g (600 mg elemental); 250 tab Tab 5 mg with hydrochlorothiazide 12.5 mg; 28 tab Tab 5 mg; 90 tab Tab 10 mg; 90 tab Tab 5 mg; 90 tab Tab 10 mg; 90 tab Tab 20 mg; 90 tab Tab 5 mg; 10 tab Tab 150 mg; 500 tab Tab 300 mg; 500 tab Cap 400 µg; 30 cap Sole Subsidised Supply brand (and supplier) Imuran (Aspen) Calci-Tab 500 (AFT) Calci-Tab 600 (AFT) Inhibace Plus (Roche) Donepezil-Rex (Rex Medical) Donepezil-Rex (Rex Medical) Arrow-Enalapril (Arrow) Arrow-Enalapril (Arrow) Arrow-Enalapril (Arrow) Methatabs (API) Apo-Moclobemide (Apotex) Apo-Moclobemide (Apotex) Tamsulosin-Rex (Rex Medical)

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for implementation 1 November 2010 • Adalimumab (Humira and HumiraPen) inj 40 mg per 0.8 ml prefilled pen and syringe – amended Special Authority criteria • Darunavir (Prezista) tab 300 mg and 400 mg – new listing under current antiretroviral Special Authority criteria • Daunorubicin (Pfizer) inj 2 mg per ml, 10 ml – price and subsidy increase • Donepezil hydrochloride (Donepezil-Rex) tab 5 mg and 10 mg – new listing – listed as stat (dispense all-at-once) from date of listing • Etanercept (Enbrel) 50 mg autoinjector – new listing under Special Authority criteria • Etanercept (Enbrel) inj 25 mg and 50 mg autoinjector – widened access via amended Special Authority criteria • Etravirine (Intelence) tab 100 mg – new listing under current antiretroviral Special Authority criteria

Possible decisions for implementation 1 November 2010 (continued) • Insulin pen needles (B-D Micro-Fine) 32 g x 4 mm – new listing under existing restrictions • Levetiracetam (Levetiracetam-Rex) tab 250 mg, 500 mg and 750 mg – new listing – not subject to Special Authority • Levetiracetam (Keppra) tab – no new approvals (new or initial) will be granted under Levetiracetam Special Access – Keppra will be delisted from 1 November 2010 • Mucilaginous laxatives (Mucilax) sugar free, 275 g OP – subsidy decrease • Mucilaginous laxatives with stimulants (Normacol Plus) dry, 200 g OP and 500 g OP – subsidy decrease • Sunitinib (Sutent) cap 12.5 mg, 25 mg and 50 mg – new listing under Special Authority criteria • Varenicline (Champix) tab 1 mg and starter pack (11 x 0.5 mg and 14 x 1 mg tab) – new listing under Special Authority criteria

Sole Subsidised Supply Products – cumulative to October 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 100 mg Tab dispersible 300 mg Tab 50 mg & 100 mg Inj 600 µg, 1 ml Tab 500 mg Tab 10 mg Tab 2.5 mg & 5 mg Inj 1 mega u Scalp app 0.1% Tab 200 mg Tab 50 mg Tab 5 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 Grans for oral liq 125 mg per 5 ml Inj 500 mg & 1 g

Brand Name Expiry Date*

Glucobay Diamox Apo-Allopurinol Symmetrel Ospamox Ospamox Paediatric Drops Curam Curam Synermox AFT Ethics Aspirin EC Ethics Aspirin Atenolol Tablet USP AstraZeneca Arrow-Azithromycin Pacifen ArrowBendrofluazide Sandoz Beta Scalp Fibalip Bicalox Lax-Tab AFT healthE API Miacalcic Airflow Calsource Calcium Folinate Ebewe Ranbaxy-Cefaclor Hospira 2011 2011 2013 2012 2012 2012 2012 2011 2011 2012 2011 2011 2013 2011 2012 2011 2012 2011 2011 2013 2011 2012 2011 2011 2011 2012 2011 2012

Amoxycillin clavulanate

Aqueous cream Aspirin Atenolol Atropine sulphate Azithromycin Baclofen Bendrofluazide Benzylpenicillin sodium (Penicillin G) Betamethasone valerate Bezafibrate Bicalutamide Bisacodyl Brimonidine tartrate Calamine Calcitonin Calcitriol Calcium carbonate Calcium folinate Cefaclor monohydrate Cefazolin sodium

*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 October 2010

Generic Name

Cefuroxime sodium Cephalexin monohydrate Cetirizine hydrochloride Cetomacrogol Chloramphenicol Chlorhexidine gluconate Ciclopiroxolamine Ciprofloxacin Citalopram Clobetasol propionate

Presentation

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 Crm BP Eye oint 1% 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 Vaginal crm 1% with applicator Vaginal crm 2% with applicator Crm 1% Tab 500 µg Crm 10% Tab 50 mg 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 Eye drops 0.1% Inj 4 mg per ml, 1 ml & 2 ml Inj 50%, 10 ml Soln with electrolytes

Brand Name Expiry Date*

Zinacef Cefalexin Sandoz Cefalexin Sandoz Zetop Cetirizine-AFT PSM Chlorsig healthE Orion Batrafen Rex Medical Arrow-Citalopram Dermol Dermol Dermol Paxam Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3 Catapres Dixarit Catapres Clomazol Clomazol Clomazol Colgout Itch-Soothe Nausicalm Cycloblastin Siterone Ginet 84 Desmopressin-PH&T Maxidex Hospira Biomed Pedialyte – Fruit Pedialyte – Bubblegum Pedialyte – Plain 2011 2012 2011 2013 2012 2012 2011 2012 2011 2011 2012

Clonazepam Clonidine

2011 2012

Clonidine hydrochloride

2012

Clotrimazole

2013 2011 2013 2012 2012 2013 2012 2011 2011 2013 2013 2011 2013

Colchicine Crotamiton Cyclizine hydrochloride Cyclophosphamide Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone Dexamethasone sodium phosphate Dextrose Dextrose with electrolytes

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Diclofenac sodium

Presentation

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 Cap 50 mg Cap 120 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 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 Oral liq 30 mg per 1 ml (6 mg elemental per 1 ml) 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% Tab dispersible 20 mg, scored Metered aqueous nasal spray, 50 µg per dose Tab 40 mg

Brand Name Expiry Date*

Diclofenac Sandoz Voltaren Ophtha Voltaren Voltaren DHC Continus Dilzem Cardizem CD Pytazen SR Laxofast 50 Laxofast 120 Laxsol AFT Clexane Comtan E-Mycin E-Mycin E-Mycin NZ Medical and Scientific Arrow-Etidronate Felo 5 ER Felo 10 ER Ferodan Fintral AFT AFT AFT Flucloxin Pacific Fludara Fludara Oral FML Fluox Flixonase Hayfever & Allergy Diurin 40 2012 2011

Dihydrocodeine tartrate Diltiazem hydrochloride

2013 31/12/11

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

2011 2011 2013 2011 2012 2012 2012 2011 2012 2012 2012 2013 2011 2012 2011 2011 2011 2012 2013 31/1/13 2012

Ethinyloestradiol Etidronate disodium Felodipine Ferrous sulphate Finasteride Flucloxacillin sodium

Fluconazole Fludarabine phosphate Fluorometholone Fluoxetine hydrochloride Fluticasone propionate Furosemide

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Fusidic acid Gabapentin Gentamicin sulphate Gliclazide Glipizide Glyceryl trinitrate

Presentation

Crm 2% Oint 2% 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*

Foban Foban Nupentin Pfizer Apo-Gliclazide Minidiab Lycinate Nitrolingual Pumpspray Nitroderm TTS Douglas ABM PSM Colifoam Micreme H DP Lotn HC ABM Hydroxocobalamin Plaquenil Methopt Buscopan Gastrosoothe Fenpaed Ethics Ibuprofen Ferrum H Oratane Sebizole 3TC 3TC Hysite Letara Jadelle Arrow-Lisinopril Lorapaed Loraclear Hayfever Relief A-Lices 2013 31/7/12 2012 2011 2011 2011

Hydrocortisone

Tab 5 mg & 20 mg Powder Crm 1% Rectal foam 10%, CFC-free (14 applications) Crm 1% with miconazole nitrate 2% 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 Oral liq 100 mg per 5 ml 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 Oral liq 1 mg per ml Tab 10 mg Shampoo 1%

2012 2011 2012 2013 2011 2012 2012 2011 2011 2013 2012 2011 2012 2011 2013 2012 2012 31/12/13 2012 2013

Hydrocortisone acetate Hydrocortisone with miconazole Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hypromellose Hysocine N-butylbromide Ibuprofen Iron polymaltose Isotretinoin Ketoconazole Lamivudine Latanoprost Letrozole Levonorgestrel Lisinopril Loratadine

Malathion

2013

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Mask for Spacer Device Mebendazole Mebeverine hydrochloride Megestrol acetate Mesalazine Metformin hydrochloride Methadone hydrochloride

Presentation

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% 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*

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 RA-Morph RA-Morph RA-Morph RA-Morph Sevredol Mayne Mayne Noflam 250 Noflam 500 Viramune Suspension Viramune Noriday 28 Primolut N 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 Morphine hydrochloride

2011 2011 2012 2012

Morphine sulphate

2012 2011 2012 2012

Naproxen Nevirapine

Norethisterone

Tab 350 µg Tab 5 mg

2012 2011

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Nortriptyline hydrochloride Nystatin Omeprazole

Presentation

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

Brand Name Expiry Date*

Norpress Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Syntocinon Syntocinon Syntometrine Pamisol Pamisol Pamisol Dr Reddy’s Pantoprazole Pharmacare Paracare Junior Paracare Double Strength ParaCode Lacri-Lube Loxamine Breath-Alert Pegasys Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Permax A-Scabies AFT AFT Apo-Pindolol Pizaccord Sandomigran Coloxyl 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 20 mg & 40 mg 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 Eye oint with soft white paraffin Tab 20 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 Lotn 5% Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 5 mg, 10 mg & 15 mg Tab 15 mg, 30 mg & 45 mg Tab 500 µg Oral drops 10%

2012

Pamidronate disodium

2011

Pantoprazole Paracetamol

2013 2011

Paracetamol with codeine Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak Flow Meter Pegylated interferon alpha-2A

2011 2013 2013 30/9/11 31/12/12

Pergolide Permethrin Phenoxymethylpenicillin (Pencillin V) Pindolol Pioglitazone Pizotifen Poloxamer

2011 2011 2013 2012 2012 2012 2011

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Polyvinyl alcohol Potassium chloride Prednisone Prednisone sodium phosphate Pregnancy tests – hCG urine Procaine penicillin Promethazine hydrochloride

Presentation

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

Brand Name Expiry Date*

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 Mycobutin Ropin ArrowRoxithromycin Salapin Asthalin Asthalin Duolin 2012 2013 2013 2012 2013 2012 2012 2011 2012 2011 2012 2012 2011 2012 2011 2011 2011

Quinapril Quinapril with hydrochlorothiazide

Tab 5 mg, 10 mg & 20 mg Tab 10 mg with hydrochlorothiazide 12.5 mg Tab 20 mg with hydrochlorothiazide 12.5 mg Tab 300 mg Cap 150 mg Tab 0.25 mg, 1 mg, 2 mg & 5 mg Tab 150 mg & 300 mg Oral liq 2 mg per 5 ml 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 25 mg & 100 mg Tab 50 mg & 100 mg Soln 2.3%

Quinine sulphate Rifabutin Ropinirole hydrochloride 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 Spirotone Arrow-Sumatriptan Pinetarsol

2012 2011

Sodium cromoglycate Somatropin Sotalol Spacer Device Spironolactone Sumatriptan Tar with triethanolamine lauryl sulphate and fluorescein

2012 31/12/12 2012 30/9/11 2013 2013 2011

Sole Subsidised Supply Products – cumulative to October 2010

Generic Name

Temazepam Terbinafine Testosterone cypionate Testosterone undecanoate Tetracosactrin Timolol maleate Tramadol hydrochloride Tranexamic acid Triamcinolone acetonide

Presentation

Tab 10 mg Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Cap 40 mg Inj 250 µg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.25% & 0.5% Cap 50 mg 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*

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

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

2011 2012 2011 2011 2013 2011 2011 2011

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 October 2010

25 35 44 LOPERAMIDE HYDROCHLORIDE – Up to 30 cap available on a PSO ❋ Cap 2 mg .................................................................................. 8.95 IMIGLUCERASE – Special Authority see SA0473 – Retail pharmacy Inj 40 iu per ml, 400 iu vial ................................................ 2,144.00 SODIUM CHLORIDE Inj 0.9%, 5 ml – Up to 5 inj available on a PSO ......................... 15.50 Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 15.50 400 1 50 50 ✔ Diamide Relief ✔ Cerezyme S29 ✔ Pfizer ✔ Pfizer

DEFERIPRONE – Special Authority see SA1042 – Retail pharmacy Tab 500 mg .......................................................................... 533.17 100 ✔ Ferriprox Oral liq 100 mg per 1 ml ........................................................ 266.59 250 ml OP ✔ Ferriprox ➽ SA1042 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where the patient has been diagnosed with chronic transfusional iron overload due to congenital inherited anaemia. Note: For the purposes of this Special Authority, a relevant specialist is defined as a haematologist. CILAZAPRIL ❋ Tab 0.5 mg .............................................................................. 0.95 ❋ Tab 2.5 mg ............................................................................... 2.06 ❋ Tab 5 mg ................................................................................. 3.28 ADAPALENE a) Maximum of 30 g per prescription b) Only on a prescription Crm 0.1% ................................................................................ 22.89 Gel 0.1% ................................................................................. 22.89 AMOXYCILLIN Cap 250 mg – Up to 30 cap available on a PSO ....................... 16.18 Cap 500 mg ........................................................................... 26.50 30 30 30 ✔ Zapril ✔ Zapril ✔ Zapril

30 g OP 30 g OP 500 500

✔ Differin ✔ Differin ✔ Alphamox ✔ Alphamox

122

ONDANSETRON a) Maximum of 12 tab per prescription; can be waived by Special Authority see SA0887 b) Maximum of 6 tab per dispensing; can be waived by Special Authority see SA0887 c) Not more than one prescription per month; can be waived by Special Authority see SA0887 d) The maximum of 6 tab per dispensing cannot be waived via Access Exemption Criteria. Tab 4 mg .................................................................................. 5.10 30 ✔ Dr Reddy’s Ondansetron Tab 8 mg .................................................................................. 1.70 10 ✔ Dr Reddy’s Ondansetron

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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148 ERLOTINIB HYDROCHLORIDE – Retail pharmacy–Specialist – Special Authority see SA1044 Tab 100 mg ....................................................................... 3,100.00 30 ✔ Tarceva Tab 150 mg ....................................................................... 3,950.00 30 ✔ Tarceva ➽ SA1044 Special Authority for Subsidy Initial application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1. Patient has advanced, unresectable, Non Small Cell Lung Cancer (NSCLC); and 2. Patient has documented disease progression following treatment with first line platinum based chemotherapy; and 3. Erlotinib is to be given for a maximum of 3 months. Renewal application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 6 months where radiological assessment (preferably including CT scan) indicates NSCLC has not progressed. ANASTROZOLE Tab 1 mg ................................................................................ 26.55 30 ✔ Aremed ✔ Myaccord ✔ Myaccord

150 151

MYCOPHENOLATE MOFETIL – Special Authority see SA1041 – Retail pharmacy Tab 500 mg ............................................................................ 85.00 50 Cap 250 mg ............................................................................ 85.00 100 BUDESONIDE Powder for inhalation, 200 µg per dose ................................... 19.00 Powder for inhalation, 400 µg per dose ................................... 32.00 CHLORAMPHENICOL Eye drops 0.5% ......................................................................... 1.28 STANDARD FORMULAE Phenobarbitone Sodium Paediatric Oral Liquid (10 mg per ml) Phenobarbitone sodium powder 400 mg Glycerol BP 4 ml Water to 40 ml

156

200 dose OP ✔ Budenocort 200 dose OP ✔ Budenocort 10 ml OP ✔ Chlorafast

162 170

178

ORAL SUPPLEMENT 1KCAL/ML – Special Authority see SA0583 – Hospital pharmacy [HP3] Powder (chocolate) ................................................................... 9.50 900 g OP ✔ Ensure Powder (vanilla) ........................................................................ 9.50 900 g OP ✔ Ensure PAEDIATRIC ORAL FEED 1KCAL/ML – Special Authority see SA0896 – Hospital pharmacy [HP3] Liquid (vanilla) .......................................................................... 1.07 200 ml OP ✔ Pediasure RENAL ORAL FEED 2KCAL/ML – Special Authority see SA0587– Hospital pharmacy [HP3] Liquid ....................................................................................... 2.43 200 ml OP ✔ Nepro (strawberry) ENTERAL FEED WITH FIBRE 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.32 237 ml OP ✔ Jevity 2.65 500 ml OP ✔ Jevity RTH ENTERAL FEED 1KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.24 250 ml OP ✔ Osmolite 2.65 500 ml OP ✔ Osmolite RTH ❋ Three months or six months, as applicable, dispensed all-at-once

181 182 184

184

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

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New listings - effective 1 October 2010 (continued)

185 191 ENTERAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.75 250 ml OP ✔ Ensure Plus HN ELEMENTAL FORMULA – Special Authority see SA0603 – Hospital pharmacy [HP3] Powder (vanilla) ...................................................................... 52.90 400 g OP (56.00) Powder (unflavoured) .............................................................. 52.90 400 g OP (56.00)

Elecare Elecare Elecare LCP

Effective 1 September 2010

29 33 36 41 45 55 85 INSULIN GLULISINE ▲ Inj 100 u per ml, 3 ml .............................................................. 46.07 MUCILAGINOUS LAXATIVES – Only on a prescription ❋ Dry ........................................................................................... 6.02 VITAMIN B COMPLEX ❋ Tab, strong, BPC ...................................................................... 4.70 CLOPIDOGREL Tab 75 mg ............................................................................. 16.25 SODIUM BICARBONATE Cap 840 mg .............................................................................. 8.52 FUROSEMIDE ❋ Inj 10 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 1.30 5 500 g OP 500 90 100 5 ✔ Apidra ✔ Konsyl-D ✔ B-PlexADE ✔ Apo-Clopidogrel ✔ Sodibic ✔ Frusemide-Claris

85 102

MELOXICAM – Special Authority see SA1034 – Retail pharmacy Tab 7.5 mg ............................................................................. 11.50 30 ✔ Arrow-Meloxicam ➽ SA1034 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient has moderate to severe haemophilia with less than or equal to 5% of normal circulating functional clotting factor; and 2 The patient has haemophilic arthropathy; and 3 Pain and inflammation associated with haemophilic arthropathy is inadequately controlled by alternative funded treatment options, or alternative funded treatment options are contraindicated.

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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New listings - effective 1 September 2010 (continued)

102 109 TENOXICAM ❋ Inj 20 mg .................................................................................. 9.95 1 ✔ AFT

ZOLEDRONIC ACID – Special Authority see SA1035 – Retail pharmacy Soln for infusion 5 mg in 100 ml ............................................ 600.00 100 ml ✔ Aclasta ➽ SA1035 Special Authority for Subsidy Initial application – (Paget’s disease) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Paget’s disease; and 2 Any of the following: 2.1 Bone or articular pain; or 2.2 Bone deformity; or 2.3 Bone, articular or neurological complications; or 2.4 Asymptomatic disease, but risk of complications; or 2.5 Preparation for orthopaedic surgery; and 3 The patient will not be prescribed more than one infusion in the 12-month approval period. Initial application – (Underlying cause - Osteoporosis) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Any of the following: 1.1 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 1.2 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 1.3 History of two significant osteoporotic fractures demonstrated radiologically; or 1.4 Documented T-Score ≤ -3.0 (see Note); or 1.5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Garvan) which incorporates BMD measurements (see Note); or 1.6 Patient has had a Special Authority approval for alendronate (Underlying cause – Osteoporosis); and 2 The patient will not be prescribed more than one infusion in a 12-month period. Initial application – (Underlying cause - glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 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 Any of the following: 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; or 2.3 The patient has had a Special Authority approval for alendronate (Underlying cause – glucocorticosteroid therapy); and 3 The patient will not be prescribed more than one infusion in the 12-month approval period. Renewal – (Paget’s disease) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 The patient has relapsed (based on increases in serum alkaline phosphatase); or continued...

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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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New listings - effective 1 September 2010 (continued)

continued... 1.2 The patient’s serum alkaline phosphatase has not normalised following previous treatment with zoledronic acid; or 1.3 Symptomatic disease (prescriber determined); and 2 The patient will not be prescribed more than one infusion in the 12-month approval period. The patient may not have had a prior approval for Paget’s disease within the last 12 months. Renewal – (Underlying cause was, and remains, glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is continuing systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents); and 2 The patient will not be prescribed more than one infusion in the 12-month approval period. The patient may not have had a prior approval for 'Underlying cause glucocorticosteroid therapy' within the last 12 months. 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: Both: 1 Any of the following: 1.1 History of one significant osteoporotic fracture demonstrated radiologically and documented BMD ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note); or 1.2 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 1.3 History of two significant osteoporotic fractures demonstrated radiologically; or 1.4 Documented T-Score ≤ -3.0 (see Note); or 1.5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Garvan) which incorporates BMD measurements (see Note); or 1.6 Patient has had a Special Authority approval for alendronate (Underlying cause was glucocorticosteroid therapy but patient now meets the ‘Underlying cause – Osteoporosis’ criteria); and 2 The patient will not be prescribed more than one infusion in a 12-month period. Notes: a) BMD (including BMD used to derive T-Score) must be 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 has quantified this as forces equivalent to a fall from a standing height or less. d) 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. 111 LIGNOCAINE HYDROCHLORIDE Inj 2%, 5 ml – Up to 5 inj available on a PSO ............................ 23.00 Inj 2%, 20 ml – Up to 5 inj available on a PSO .......................... 15.00 Viscous solution 2% ................................................................ 55.00 50 5 200 ml ✔ Xylocaine ✔ Xylocaine ✔ Xylocaine Viscous

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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121 141 145 163 CYCLIZINE LACTATE Inj 50 mg per ml, 1 ml ............................................................. 14.95 FLUOROURACIL SODIUM Inj 1 mg for ECP – PCT only – Specialist .................................... 0.77 MESNA – PCT only – Specialist Inj 1 mg for ECP ........................................................................ 2.29 SODIUM CROMOGLYCATE Eye drops 2% ............................................................................ 1.18 5 100 mg 100 mg 5 ml OP ✔ Nausicalm ✔ Baxter ✔ Baxter ✔ Rexacrom

▲

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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Changes to Restrictions

Effective 1 October 2010

44 SODIUM CHLORIDE Inj 0.9%, 20 ml – Up to 5 inj available on a PSO ...................... 4.72 11.79 8.41 6 30 20 ✔ Pharmacia ✔ Pharmacia ✔ Multichem

EZETIMIBE – Special Authority see SA1045 0796 – Retail pharmacy Tab 10 mg ............................................................................. 57.60 30 ✔ Ezetrol ➽ SA1045 0796 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Patient’s LDL cholesterol is 2.0 mmol/litre or greater; and 3 Any of the following: 3.1 The patient has rhabdomyolysis (defined as muscle aches and creatine kinase more than 10 x normal) when treated with one statin; or 3.2 The patient is intolerant to both simvastatin and atorvastatin; or 3.3 The patient has not reduced their LDL cholesterol to less than 2.0 mmol/litre with the use of the maximal tolerated dose of atorvastatin. Note: A patient who has failed to reduce their LDL cholesterol to < 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapies. Other treatment options including fibrates, resins and nicotinic acid should be considered after failure of statin therapy. If a patient’s LDL cholesterol cannot be calculated because the triglyceride level is too high then a repeat test should be performed and if the LDL cholesterol again cannot be calculated then it can be considered that the LDL cholesterol is greater than 2.0 mmol/litre. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 ezetimibe is to be used in combination with simvastatin; or 1.2 ezetimibe is to be used without a statin; and 2 Either: 2.1 All of the following: 2.1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 2.1.2 Patient cannot tolerate statin therapy at a dose of ≥ 40 mg per day; and 2.1.3 Either: 2.1.3.1 All of the following: 2.1.3.1.1 Patient has venous CABG; and 2.1.3.1.2 LDL cholesterol ≥ 2.0 mmol/litre (see note); and 2.1.3.1.3 LDL cholesterol ≥ 2.0 mmol/litre (at least 1 week after test 1 – see note); or 2.1.3.2 All of the following: 2.1.3.2.1 Patient does not have venous CABG; and 2.1.3.2.2 LDL cholesterol ≥ 2.5 mmol/litre (see note); and 2.1.3.2.3 LDL cholesterol ≥ 2.5 mmol/litre (at least 1 week after test 1 – see note); or continued...

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Changes to Restrictions - effective 1 October 2010 (continued)

continued... 2.2 All of the following: 2.2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholesterolemia; and 2.2.2 Patient has been compliant for at least two months with maximum dose statin therapy; and 2.2.3 LDL cholesterol ≥ 5 mmol/litre (see note); and 2.2.4 LDL cholesterol ≥ 5 mmol/litre (at least 1 week after test 1 – see note). Note: Two lipid tests are required to assess LDL cholesterol levels, the tests must be at least one week apart, and be carried out in a fasted state (other than for patients with IDDM). The results for LDL cholesterol levels in both tests must be above those specified. Renewal only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 ezetimibe is to be used in combination with simvastatin; or 2.2 ezetimibe is to be used without a statin.

EZETIMIBE WITH SIMVASTATIN – Special Authority see SA1046 0826 – Retail pharmacy Tab 10 mg with simvastatin 10 mg ......................................... 69.00 30 ✔ Vytorin Tab 10 mg with simvastatin 20 mg ......................................... 75.00 30 ✔ Vytorin Tab 10 mg with simvastatin 40 mg ....................................... 103.50 30 ✔ Vytorin Tab 10 mg with simvastatin 80 mg ....................................... 123.00 30 ✔ Vytorin ➽ SA1046 0826 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for two years for applications meeting the following criteria: All of the following: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Patient’s LDL cholesterol is 2.0 mmol/litre or greater; and 3 The patient has not reduced their LDL cholesterol to less than 2.0 mmol/litre with the use of the maximal tolerated dose of atorvastatin. Note: A patient who has failed to reduce their LDL cholesterol to < 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapies. Other treatment options including fibrates, resins and nicotinic acid should be considered after failure of statin therapy. If a patient’s LDL cholesterol cannot be calculated because the triglyceride level is too high then a repeat test should be performed and if the LDL cholesterol again cannot be calculated then it can be considered that the LDL cholesterol is greater than 2.0 mmol/litre. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 1.2 Patient cannot tolerate statin therapy at a dose of ≥ 40 mg per day; and 1.3 Either: 1.3.1 All of the following: 1.3.1.1 Patient has venous CABG; and 1.3.1.2 LDL cholesterol ≥ 2.0 mmol/litre (see note); and 1.3.1.3 LDL cholesterol ≥ 2.0 mmol/litre (at least 1 week after test 1 – see note); or 1.3.2 All of the following: continued...

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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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Changes to Restrictions - effective 1 October 2010 (continued)

continued... 1.3.2.1 Patient does not have venous CABG; and 1.3.2.2 LDL cholesterol ≥ 2.5 mmol/litre (see note); and 1.3.2.3 LDL cholesterol ≥ 2.5 mmol/litre (at least 1 week after test 1 – see note); or 2 All of the following: 2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholesterolemia; and 2.2 Patient has been compliant for at least two months with maximum dose statin therapy; and 2.3 LDL cholesterol ≥ 5 mmol/litre (see note); and 2.4 LDL cholesterol ≥ 5 mmol/litre (at least 1 week after test 1 – see note). Note: Two lipid tests are required to assess LDL cholesterol levels, the tests must be at least one week apart, and be carried out in a fasted state (other than for patients with IDDM). The results for LDL cholesterol levels in both tests must be above those specified. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.

TENOFOVIR DISOPROXIL FUMARATE – Subsidy by endorsement; can be waived by Special Authority see SA1047 0997 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 SA1025 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 subsidised antiretrovirals for the purposes of Special Authority SA1025. Tab 300 mg ......................................................................... 531.00 30 ✔ Viread ➽ SA1047 0997 Special Authority for Waiver of Rule Initial application — (Drug-Resistant Chronic Hepatitis B) Only only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid without further renewal, unless notified, for applications meeting the following criteria Approvals valid for 1 year for applications meeting the following criteria: Any All of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 All of the following 2.1 Patient has had previous lamivudine, adefovir or entecavir therapy; and 3 All of the following: Documented drug resistance, defined as both: 3.1 ALT greater than upper limit of normal; or ≥ Metavir Stage F3; and 2.2 3.2 HBV DNA greater than 20,000 IU/mL or increased ≥ 10 fold over nadir; and 2.3 4 Any of the following: 2.3.1 4.1 Hepatitis B virus resistant to lamivudine with detection of M204I/V mutation; or 2.3.2 4.2 Hepatitis B virus resistant to adefovir with detection of A181T/V or N236T mutation; or 2.3.3 4.3 Hepatitis B virus resistant to entecavir with detection of I169T, L180M T184S/A/I/L/GC/M, S202C/G/I, M204V or M250I/V mutation; or. 3 Patient is either listed or has undergone liver transplantation for HBV; Initial application - (Pregnant) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 4 months for applications meeting the following criteria: Both: 1 Patient is HBsAg positive and pregnant; and 2 Either: 2.1 HBV DNA > 20,000 IU/ml and ALT > ULN; or 2.2 HBV DNA > 100 million IU/ml and ALT normal. Renewal - (Confirmed Hepatitis B following funded tenofovir treatment for pregnancy within the previous two years) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: continued...

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

continued... Any of the following: 1 Patient has confirmed Hepatitis B infection (HBsAg positive for more than 6 months); and 2 All of the following: 2.1 Patient has had previous lamivudine, adefovir or entecavir therapy; and 2.2 HBV DNA greater than 20,000 IU/mL or increased ≥ 10 fold over nadir; and 2.3 Any of the following: 2.3.1 Lamivudine resistance - detection of M204I/V mutation; or 2.3.2 Adefovir resistance - detection of A181T/V or N236T mutation; or 2.3.3 Entecavir resistance - detection of relevant mutations including I169T, L180M T184S/A/I/L/GC/M, S202C/G/I, M204V or M250I/V mutation; or 3 Patient is either listed or has undergone liver transplantation for HBV. Renewal - (Subsequent pregnancy) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 4 months for applications meeting the following criteria: Both: 1 Patient is HBsAg positive and pregnant; and 2 Either: 2.1 HBV DNA > 20,000 IU/mL and ALT > ULN; or 2.2 HBV DNA > 100 million IU/mL and ALT normal. Renewal — (Drug-Resistant Chronic Hepatitis B) only from a gastroenterologist, infectious disease specialist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Notes: • Tenofovir disoproxil fumarate should be stopped 6 months following HBeAg seroconversion for patients who were HBeAg positive prior to commencing Tenofovir disoproxil fumarate this agent and 6 months following HBsAg seroconversion for patients who were HBeAg negative prior to commencing this agent. • The recommended dose of Tenofovir disoproxil fumarate for the treatment of hepatitis B is 300 mg once daily. • In patients with renal insufficiency (calculated creatinine clearance less than 50ml/min), Tenofovir disoproxil fumarate dose should be reduced in accordance with the approved Medsafe datasheet guidelines. • Tenofovir disoproxil fumarate is not approved for use in children. 115 MIANSERIN HYDROCHLORIDE – Special Authority see SA1048 0864 – Retail pharmacy Tab 30 mg ............................................................................. 24.86 30 ✔ Tolvon ➽ SA1048 0864 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either 1 Both: 1.1 Depression; and 1.2 Either: 1.2.1 Co-existent bladder neck obstruction; or 1.2.2 Cardiovascular disease.; or 2 Both: 2.1 The patient has a severe major depressive episode; and 2.2 Either: 2.2.1 The patient must have had a trial of two different antidepressants and was unable to tolerate the treatments or failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2.2 Both: 2.2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and continued... ❋ Three months or six months, as applicable, dispensed all-at-once

▲

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

continued... The patient must have had a trial of one other antidepressant and either could not tolerate it or failed to respond to an adequate dose over an adequate period of time. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. 2.2.2.2

140

CAPECITABINE – Retail pharmacy-Specialist – Special Authority see SA1049 1040 Tab 150 mg ......................................................................... 115.00 60 ✔ Xeloda Tab 500 mg ......................................................................... 705.00 120 ✔ Xeloda ➽ SA1049 1040 Special Authority for Subsidy Initial application 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 advanced gastrointestinal malignancy; or 2 The patient has metastatic breast cancer; or 3 The patient has stage III (Dukes’ stage C) colorectal*# cancer and has undergone surgery; or 4 All of the following: 4.1 The patient has stage II (Dukes' stage B) colorectal* cancer and has undergone surgery; and 4.2 Any of the following: 4.2.1 the patient has stage T4 disease; or 4.2.2 the patient has vascular invasion; or 4.2.3 Fewer than 10 lymph nodes were examined at resection; or 5 All of the following: 5.1 The patient has locally advanced (clinically or radiologically staged T3/T4: N0,1,2) rectal cancer; and 5.2 Surgery is planned; and 5.3 Capecitabine to be given prior to surgery (neoadjuvant); and 5.4 Capecitabine to be given at a maximum dose of 825 mg/m2 twice daily in combination with radiation therapy for a maximum of 6 weeks; or 6 Both: 6.1 The patient has poor venous access or needle phobia*; and 6.2 The patient requires a substitute for single agent fluoropyrimidine*. Renewal 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 * are Unapproved Indications, #capecitabine is approved for stage III (Dukes' stage C) colon cancer. Initial application 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 advanced gastrointestinal malignancy; or 2 The patient has metastatic breast cancer*; or 3 The patient has stage III (Duke’s stage C) colorectal*# cancer and undergone surgery; or 4 Both: 4.1 The patient has poor venous access or needle phobia*; and 4.2 The patient requires a substitute for single agent fluoropyrimidine*. Renewal 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 * are Unapproved Indications, # capecitabine is approved for stage III (Duke’s stage C) colon cancer.

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 October 2010 (continued)

151 MYCOPHENOLATE MOFETIL – Special Authority see SA1041 0960 – Retail pharmacy Note: Dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically. Tab 500 mg ........................................................................... 70.00 50 ✔ Cellcept 85.00 ✔ Myaccord Cap 250 mg ........................................................................... 70.00 100 ✔ Cellcept 85.00 ✔ Myaccord 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. ➽ SA1041 0960 Special Authority for Subsidy Initial application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Transplant recipient; or 2 Both: Patients with diseases where 2.1 Steroids and azathioprine have been trialled and discontinued because of unacceptable side effects or inadequate clinical response; and 2.2 Either: Patients with diseases where 2.2.1 Cyclophosphamide has been trialled and discontinued because of unacceptable side effects or inadequate clinical response; or 2.2.2 Cyclophosphamide treatment is contraindicated. Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Renal transplant recipient; or 2 Heart transplant recipient; or 3 Liver transplant recipient; or 4 Patient has an organ transplant and has severe tophaceous gout making azathioprine unsuitable. 151 RITUXIMAB – PCT only – Specialist – Special Authority see SA1050 0961 Inj 100 mg per 10 ml vial ................................................... 1,195.00 2 ✔ Mabthera Inj 500 mg per 50 ml vial ................................................... 2,987.00 1 ✔ Mabthera Inj 1 mg for ECP ....................................................................... 6.27 1 mg ✔ Baxter ➽ SA1050 0961 Special Authority for Subsidy Initial application — (Post-transplant) 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 B-cell post-transplant lymphoproliferative disorder*; and 2 To be used for a maximum of 8 treatment cycles. Initial application — (Indolent, Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has indolent low grade NHL with relapsed disease following prior chemotherapy; and 1.2 To be used for a maximum of 6 treatment cycles; or 2 Both: continued... ❋ Three months or six months, as applicable, dispensed all-at-once

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

continued... 2.1 The patient has indolent, low grade lymphoma requiring first-line systemic chemotherapy; and 2.2 To be used for a maximum of 6 treatment cycles. Note: ’Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for chronic lymphocytic leukaemia/small lymphocytic lymphoma. Initial application — (Aggressive CD20 positive NHL) 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 All of the following: 1.1 The patient has treatment-naive aggressive CD20 positive NHL; and 1.2 To be used with a multi-agent chemotherapy regimen given with curative intent; and 1.3 To be used for a maximum of 8 treatment cycles; or 2 Both: 2.1 The patient has aggressive CD20 positive NHL with relapsed disease following prior chemotherapy; and 2.2 To be used for a maximum of 6 treatment cycles. Note: ’Aggressive CD20 positive NHL’ includes large B-cell lymphoma and Burkitt’s lymphoma/leukaemia Renewal — (Post-transplant) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has B-cell post-transplant lymphoproliferative disorder*; and 3 To be used for no more than 6 treatment cycles. Renewal — (Indolent, Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has indolent, low-grade NHL with relapsed disease following prior chemotherapy; and 3 To be used for no more than 6 treatment cycles. Note: ’Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for chronic lymphocytic leukaemia/small lymphocytic lymphoma. Renewal — (Aggressive CD20 positive NHL) 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 had a rituximab treatment-free interval of 12 months or more; and 2 The patient has relapsed refractory/aggressive CD20 positive NHL; and 3 To be used with a multi-agent chemotherapy regimen given with curative intent; and 4 To be used for a maximum of 4 treatment cycles. Note: ’Aggressive CD20 positive NHL’ includes large B-cell lymphoma and Burkitt’s lymphoma/leukaemia Note: Indications marked with * are Unapproved Indications.

Initial application —(Post-transplant) 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 B-cell post-transplant lymphoproliferative disorder*; and 2 To be used for a maximum of 8 treatment cycles. 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 October 2010 (continued)

continued... Initial application —(Indolent, Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has indolent low grade NHL with relapsed disease following prior chemotherapy; and 1.2 To be used for a maximum of 4 treatment cycles; or 2 Both: 2.1 The patient has indolent, low grade lymphoma requiring first-line systemic chemotherapy; and 2.2 To be used for a maximum of 6 treatment cycles. Note: ’Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for Chronic lymphocytic leukaemia/small lymphocytic lymphoma. Initial application — (Aggressive CD20 positive NHL) 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 treatment-naive aggressive CD20 positive NHL; and 2 To be used with a multi-agent chemotherapy regimen given with curative intent; and 3 To be used for a maximum of 8 treatment cycles. Note: ’Aggressive CD20 positive NHL’ includes large B-cell lymphoma and Burkitt’s lymphoma/leukaemia Renewal — (Indolent, Low-grade lymphomas) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has indolent, low-grade NHL with relapsed disease following prior chemotherapy; and 3 To be used for no more than 4 treatment cycles. Note: ’Indolent, low-grade lymphomas’ includes follicular, mantle, marginal zone and lymphoplasmacytic/ Waldenstrom macroglobulinaemia. Rituximab is not funded for Chronic lymphocytic leukaemia/small lymphocytic lymphoma. Renewal —(Post-transplant) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 9 months for applications meeting the following criteria: All of the following: 1 The patient has had a rituximab treatment-free interval of 12 months or more; and 2 The patient has B-cell post-transplant lymphoproliferative disorder*; and 3 To be used for no more than 6 treatment cycles. Note: Indications marked with * are Unapproved Indications. 164 TRAVOPROST – Retail pharmacy-Specialist a) See prescribing guideline above b) Additional subsidy by endorsement is available for patients who were being prescribed travoprost prior to 1 April 2010. Note additional subsidy valid until 30 September 2010. Pharmacists may annotate prescriptions for patients who were being prescribed travoprost prior to 1 April 2010 in which case the prescription is deemed to be endorsed. The pharmacist must be able to show a clear documented dispensing history for the patient. The prescription must be endorsed accordingly. ▲ Eye drops 0.004% – Higher subsidy of $19.50 per 2.5 ml with Endorsement .............................................. 19.50 2.5 ml OP ✔ Travatan

▲

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010

29 ACARBOSE – Special Authority see SA0925 on the next page – Retail pharmacy ❋ Tab 50 mg ............................................................................. 16.50 90 ✔ Glucobay ❋ Tab 100 mg ........................................................................... 26.70 90 ✔ Glucobay ➽ SA0925 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 The patient has type 2 diabetes; and 2 Either: 2.1 Metformin is not tolerated, or is contraindicated; or 2.2 The patient has not responded to the maximum appropriate dose of metformin. PIOGLITAZONE – Special Authority see SA0959 below – Retail pharmacy Tab 15 mg ............................................................................... 2.61 28 ✔ Pizaccord Tab 30 mg ............................................................................... 5.23 28 ✔ Pizaccord Tab 45 mg ............................................................................... 7.80 28 ✔ Pizaccord ➽ SA0959 Special Authority for Subsidy Initial application — (Patients with type 2 diabetes) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patient has not achieved glycaemic control on maximum doses of metformin and/or a sulphonylurea or where either or both are contraindicated or not tolerated; or 2 Patient is on insulin. MULTIVITAMINS – Special Authority see SA1036 0963 – Retail pharmacy Powder .................................................................................. 72.00 200 g OP ✔ Paediatric Seravit ➽ SA1036 0963 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: where the patient has inborn errors of metabolism. Either: 1 The patient has inborn errors of metabolism; or 2 For use as a supplement to a ketogenic diet in patients diagnosed with epilepsy. Renewal from any relevant practitioner. Approvals valid without further renewal unless notified where patient has had a previous approval for multivitamins. Note: Use of Paediatric Seravit is not recommended as a supplement to a ketogenic diet. CLOPIDOGREL – Special Authority see SA0867 below – Retail pharmacy Tab 75 mg ............................................................................. 16.25 90 ✔ Apo-Clopidogrel 5.05 28 ✔ Apo-Clopidogrel 25.00 28 ✔ Arrow-Clopidogrel (73.38) Plavix ➽ SA0867 Special Authority for Subsidy Initial application — (aspirin allergic patients) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 The patient is allergic to aspirin (see definition below); and 2 Any of the following: The patient has: 2.1 suffered from a stroke, or transient ischaemic attack; or 2.2 experienced an acute myocardial infarction; or 2.3 experienced an episode of pain at rest of greater than 20 minutes duration due to coronary disease that required admission to hospital for at least 24 hours; 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

continued... 2.4 had a troponin T or troponin I test result greater than the upper limit of the reference range; or 2.5 had a revascularisation procedure; or 2.6 experienced symptomatic peripheral vascular disease of a severity that has required specialistconsultation. Note: Aspirin allergy is defined as a history of anaphylaxis, urticaria or asthma within 4 hours of ingestion of aspirin, other salicylates or NSAIDs. Initial application — (aspirin tolerant patients and aspirin naive patients) from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: Any of the following: The patient has: 1 experienced an acute myocardial infarction; or 2 had an episode of pain at rest of greater than 20 minutes duration due to coronary disease that required admission to hospital for at least 24 hours; or 3 had a troponin T or troponin I test result greater than the upper limit of the reference range; or 4 had a revascularisation procedure. Initial application —(patients awaiting revascularisation) from any relevant practitioner. Approvals valid for 6 months where the patient is on a waiting list or active review list for stenting, coronary artery bypass grafting, or percutaneous coronary angioplasty following acute coronary syndrome. Initial application — (post stenting) from any relevant practitioner. Approvals valid for 6 months where the patient has had a stent inserted in the previous 4 weeks. Initial application — (documented stent thrombosis) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has, while on treatment with aspirin or clopidogrel, experienced documented stent thrombosis.. Renewal — (aspirin tolerant patients) from any relevant practitioner. Approvals valid without further renewal unless notified where while on treatment with aspirin the patient has experienced an additional vascular event following the recent cessation of clopidogrel. Renewal — (acute coronary syndrome - aspirin tolerant patients and aspirin naive patients) from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: Any of the following: The patient has: 1 experienced an acute myocardial infarction; or 2 had an episode of pain at rest of greater than 20 minutes duration due to coronary disease that required admission to hospital for at least 24 hours; or 3 had a troponin T or troponin I test result greater than the upper limit of the reference range; or 4 had a revascularisation procedure. Renewal — (patients awaiting revascularisation) from any relevant practitioner. Approvals valid for 6 months where the patient is on a waiting list or active review list for stenting, coronary artery bypass grafting or percutaneous coronary angioplasty following acute coronary syndrome. Renewal —(post stenting) from any relevant practitioner. Approvals valid for 6 months where the patient has had a stent inserted in the previous 4 weeks. Renewal —(documented stent thrombosis) from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has, while on treatment with aspirin or clopidogrel, experienced documented stent thrombosis. ATORVASTATIN – Additional subsidy by Special Authority see SA0788 – Retail pharmacy See prescribing guideline ❋ Tab 10 mg ............................................................................. 18.32 30 ✔ Lipitor ❋ Tab 20 mg ............................................................................. 26.70 30 ✔ Lipitor ❋ Tab 40 mg ............................................................................. 37.02 30 ✔ Lipitor ❋ Tab 80 mg ........................................................................... 110.50 30 ✔ Lipitor ➽ SA0788 Special Authority for Manufacturers Price 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 September 2010 (continued)

continued... Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin (blood tests are not required); or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 ≥ 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 ≥ 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 ≥ 2.5 mmol/litre; and 2.2.2.2.3 LDL cholesterol test 2 ≥ 2.5 mmol/litre (at least 1 week after test 1). Notes: To confirm that cholesterol levels are not still improving, two lipid tests must be carried out during treatment with simvastatin 80 mg, and have results for LDL cholesterol that have reduced by <10% in the second test. The tests must be carried out while the patient is in a fasted state (with the exception of patients with IDDM). The following indications of intolerance to simvastatin, are known as class effects for all statins, and hence are likely to mean that the patient may also be intolerant of atorvastatin: • Constipation, flatulence (may occur in >1% of patients) • Asthenia, abdominal pain, headache (may occur in >1% of patients) • Myopathy, rhabdomyolysis (may occur in <3% of patients) • Elevated serum transaminase levels (may occur in <1% of patients) Statins have been shown to be generally well tolerated in clinical studies, with the rate of discontinuation due to adverse reactions being less than 5%, and similar to the discontinuation rate for patients taking a placebo. AMILORIDE WITH HYDROCHLOROTHIAZIDE ❋ Tab 5 mg with hydrochlorothiazide 50 mg ................................. 5.00 50 ✔ Moduretic S29

56 59

ISOTRETINOIN – Special Authority see SA0955 – Retail pharmacy Cap 10 mg ............................................................................. 48.48 180 ✔ Oratane Cap 20 mg ............................................................................. 69.70 180 ✔ Oratane ➽ SA0955 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Patient has had an adequate trial on other available treatments and has failed received an inadequate response from these treatments or these are contraindicated; and 2 Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice; and 3 Applicant has an up to date knowledge of the treatment options for acne and is aware of the safety issues around isotretinoin and is competent to prescribe isotretinoin; and 4 Either: 4.1 Patient is female and has been counselled and understands the risk of teratogenicity if isotretinoin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that she must not become pregnant during treatment and for a period of one month after the completion of the treatment; or continued... Patients pay a manufacturer’s surcharge when S29 Unapproved medicine supplied under Section 29 the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supply

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

continued... 4.2 Patient is male. Note: Applicants are recommended to either have used or be familiar with using a decision support tool accredited by their professional body. Renewal from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Patient has had an adequate trial on other available treatments and has failed received an inadequate response from these treatments or these are contraindicated; and 2 Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice; and 3 Applicant has an up to date knowledge of the treatment options for acne and is aware of the safety issues around isotretinoin and is competent to prescribe isotretinoin; and 4 Either: 4.1 Patient is female and has been counselled and understands the risk of teratogenicity if isotretinoin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that she must not become pregnant during treatment and for a period of one month after the completion of the treatment; or 4.2 Patient is male. Note: Applicants are recommended to either have used or be familiar with using a decision support tool accredited by their professional body. TRICLOSAN – Subsidy by endorsement a) Maximum of 500 ml per prescription b) a) 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 b) Only if prescribed for a patient with recurrent Staphylococcus aureus infection and the prescription is endorsed accordingly Soln 1% ................................................................................... 5.90 500 ml OP ✔ healthE MALATHION Liq 0.5% ................................................................................... 3.79 200 ml OP ✔ A-Lices

66 86

AZITHROMYCIN – Subsidy by endorsement; can be waived by Special Authority see SA0964 a) Maximum of 2 tab per prescription; can be waived by Special Authority see SA0964 b) Up to 8 4 tab available on a PSO c) Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly; can be waived by Special Authority see SA0964. Tab 500 mg ............................................................................. 5.95 2 OP ✔ Arrow-Azithromycin ETHAMBUTOL HYDROCHLORIDE – No patient co-payment payable Tab 100 mg ........................................................................... 48.01 Tab 400 mg ........................................................................... 49.34 56 56 ✔ Myambutol S29 ✔ Myambutol S29

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 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 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. ❋ Three months or six months, as applicable, dispensed all-at-once

▲

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

101 ANTI-INFLAMMATORY NON STEROIDAL DRUGS (NSAIDS) ➽ SA1038 0291 Special Authority for Manufacturers Price Notes: Subsidy for patients with existing approvals prior to 1 September 2010. Approvals valid without further renewal unless notified. No new approvals will be granted from 1 September 2010. Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Inflammatory arthritis (including osteoarthritis with an inflammatory component); and 2 Stabilised and are well controlled on the particular NSAID medication. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. ALENDRONATE SODIUM – Special Authority see SA1039 0990 – Retail pharmacy Tab 70 mg ............................................................................. 35.91 4 ✔ Fosamax

108

ALENDRONATE SODIUM WITH CHOLECALCIFEROL – Special Authority see SA1039 0990 – Retail pharmacy Tab 70 mg with cholecalciferol 5,600 iu .................................. 35.91 4 ✔ Fosamax Plus ➽ SA1039 0990 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 Garvan) which incorporates BMD measurements (see Note); or 6 Patient has had a Special Authority approval for zoledronic acid (Underlying cause – Osteoporosis). 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 Any of the following: 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; or 2.3 The patient has had a Special Authority approval for zoledronic acid (Underlying cause – glucocorticosteroid therapy). 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: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

S29

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

continued... 1 History of one significant osteoporotic fracture demonstrated radiologically and documented 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 Garvan) which incorporates BMD measurements (see Note); or 6 Patient has had a Special Authority approval for zoledronic acid (Underlying cause was glucocorticosteroid therapy but patient now meets the ‘Underlying cause – Osteoporosis’ criteria). Notes: a) BMD (including BMD used to derive T-Score) must be 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. LIGNOCAINE Gel 2%, 10 ml urethral syringe – Up to 5 each available on a PSO .................................... 43.26

111

✔ Pfizer

111

LIGNOCAINE HYDROCHLORIDE Inj 0.5%, 5 ml – Up to 5 inj available on a PSO ......................... 44.10 50 ✔ Xylocaine Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use. Inj 1%, 5 ml – Up to 5 inj available on a PSO ............................ 35.00 50 ✔ Xylocaine Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use. Inj 1%, 20 ml – Up to 5 inj available on a PSO .......................... 20.00 5 ✔ Xylocaine Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use. LIGNOCAINE WITH CHLORHEXIDINE Gel 2% with chlorhexidine 0.05%, 10 ml urethral syringes – Up to 5 each available on a PSO ..................................... 43.26

111

✔ Pfizer

▲

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

122 ONDANSETRON – Retail pharmacy-Specialist a) Maximum of 12 tab per prescription; can be waived by Special Authority see SA0887 b) Maximum of 6 tab per dispensing; can be waived by Special Authority see SA0887 c) Not more than one prescription per month; can be waived by Special Authority see SA0887. d) The maximum of 6 tab per dispensing cannot be waived via Access Exemption Criteria. Tab 4 mg ............................................................................... 17.18 10 ✔ Zofran Tab disp 4 mg ........................................................................ 17.18 10 ✔ Zofran Zydis Tab 8 mg ............................................................................... 33.89 20 ✔ Zofran Tab disp 8 mg ........................................................................ 20.43 10 ✔ Zofran Zydis TROPISETRON – Retail pharmacy-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 ALPRAZOLAM – Month Restriction Tab 250 µg .............................................................................. 3.15 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 500 µg .............................................................................. 4.10 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 1 mg ................................................................................. 7.25 ‡ Safety cap for extemporaneously compounded oral liquid preparations.

122

5 50 50 50

✔ Navoban ✔ Arrow-Alprazolam ✔ Arrow-Alprazolam ✔ Arrow-Alprazolam

129

BUSPIRONE HYDROCHLORIDE – Special Authority see SA0863 – Retail pharmacy Month Restriction Tab 5 mg ............................................................................... 28.00 100 Tab 10 mg ............................................................................. 17.00 100 DIAZEPAM Tab 2 mg – Month Restriction.................................................. 11.44 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 5 mg – Month Restriction.................................................. 13.71 ‡ Safety cap for extemporaneously compounded oral liquid preparations. LORAZEPAM – Month Restriction Tab 1 mg ............................................................................... 16.42 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 2.5 mg ............................................................................ 11.17 ‡ Safety cap for extemporaneously compounded oral liquid preparations. OXAZEPAM – Month Restriction Tab 10 mg ............................................................................... 1.98 (5.89) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 15 mg ............................................................................... 2.45 (8.13) ‡ Safety cap for extemporaneously compounded oral liquid preparations. 500 500

✔ Pacific Buspirone ✔ Pacific Buspirone ✔ Arrow-Diazepam ✔ Arrow-Diazepam

130

250 100

✔ Ativan ✔ Ativan

130

100 Ox-Pam 100 Ox-Pam

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 September 2010 (continued)

132 LORMETAZEPAM – Month Restriction Tab 1 mg ................................................................................. 3.11 (23.50) ‡ Safety cap for extemporaneously compounded oral liquid preparations. MIDAZOLAM Tab 7.5 mg – Month Restriction............................................... 10.38 (25.00) ‡ Safety cap for extemporaneously compounded oral liquid preparations. NITRAZEPAM – Month Restriction Tab 5 mg ................................................................................. 2.00 (4.98) ‡ Safety cap for extemporaneously compounded oral liquid preparations. TEMAZEPAM – Month Restriction Tab 10 mg ............................................................................... 0.83 ‡ Safety cap for extemporaneously compounded oral liquid preparations. TRIAZOLAM – Month Restriction Tab 125 µg .............................................................................. 5.10 (6.50) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 250 µg .............................................................................. 4.10 (7.20) ‡ Safety cap for extemporaneously compounded oral liquid preparations. ZOPICLONE – Month Restriction Tab 7.5 mg ............................................................................ 21.02 30 Noctamid

132

100 Hypnovel

132

100 Nitrados

132

✔ Normison

132

100 Hypam 100 Hypam

132 140

500

✔ Apo-Zopiclone

CAPECITABINE – Retail pharmacy-Specialist – Special Authority see SA1040 0869 Tab 150 mg ......................................................................... 115.00 60 ✔ Xeloda Tab 500 mg ......................................................................... 705.00 120 ✔ Xeloda ➽ SA1040 0869 Special Authority for Subsidy Initial application 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 advanced gastrointestinal malignancy; or 2 The patient has metastatic breast cancer*; or 3 The patient has stage III (Duke’s stage C) colorectal*# cancer and undergone surgery; or 4 Both: 4.1 The patient has poor venous access or needle phobia*; and 4.2 The patient requires a substitute for single agent fluoropyrimidine*. Renewal 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 * are Unapproved Indications, # capecitabine is approved for stage III (Duke’s stage C) colon cancer.

▲

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 October 2010

34 SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE – Only on a prescription ( subsidy) Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml ................................................................. 6.00 12 (7.30) Microlax IMIGLUCERASE – Special Authority see SA0473 – Retail pharmacy (removal of CBS) Inj 40 iu per ml, 200 iu vial ................................................. 1072.00 1 ASCORBIC ACID ( subsidy) a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg ........................................................................... 13.80 (17.25) SODIUM CHLORIDE ( subsidy) Inj 0.9%, 20 ml – Up to 5 inj available on a PSO ......................... 8.41 ✔ Cerezyme

35 37

44 44

500 Apo-Ascorbic Acid 20 ✔ Multichem

WATER ( subsidy) 1) On a prescription or Practitioner’s Supply Order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent; or 2) On a bulk supply order; or 3) When used in the extemporaneous compounding of eye drops. Purified for inj, 5 ml – Up to 5 inj available on a PSO .................. 9.20 50 ✔ Multichem Purified for inj, 10 ml – Up to 5 inj available on a PSO .............. 10.20 50 ✔ Multichem Purified for inj, 20 ml – Up to 5 inj available on a PSO ................ 5.00 20 ✔ Multichem CHOLESTYRAMINE WITH ASPARTAME ( price) Sachets 4 g with aspartame .................................................... 19.25 (52.68) TERAZOSIN HYDROCHLORIDE ( subsidy) ❋ Tab 1 mg ................................................................................. 1.50 (2.50) ❋ Tab 2 mg ............................................................................... 14.29 (23.30) ❋ Tab 5 mg ............................................................................... 17.86 (29.00) INDAPAMIDE ( subsidy) ❋ Tab 2.5 mg .............................................................................. 3.25 NYSTATIN ( price) Crm 100,000 u per g ................................................................ 1.00 (7.90) a) Only on a prescription b) Not in combination UREA ( subsidy) ❋ Crm 10% .................................................................................. 3.07 50 Questran-Lite 28 Apo-Terazosin 500 Apo-Terazosin 500 Apo-Terazosin 100 15 g OP Mycostatin ✔ Napamide

49 56 61

100 g OP

✔ Nutraplus

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 October 2010 (continued)

66 MALATHION ( subsidy) Liq 0.5% ................................................................................... 3.79 (4.99) OESTRIOL ( subsidy) ❋ Crm 1 mg per g with applicator ................................................. 6.30 ❋ Pessaries 500 µg ..................................................................... 6.53 200 ml OP Derbac-M 15 g OP 15 ✔ Ovestin ✔ Ovestin

74 85

CEFTRIAXONE SODIUM – Subsidy by endorsement ( subsidy) 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 ...................................................................................... 2.10 1 (5.40) AFT NITROFURANTOIN ( subsidy) ❋ Tab 50 mg ............................................................................. 22.20 ❋ Tab 100 mg ........................................................................... 37.50 100 100 ✔ Nifuran ✔ Nifuran

99 115 126

MIANSERIN HYDROCHLORIDE – Special Authority see SA1048 – Retail pharmacy ( subsidy) Tab 30 mg ............................................................................. 24.86 30 ✔ Tolvon QUETIAPINE ( subsidy) Tab 25 mg ............................................................................... 7.00 Tab 100 mg ........................................................................... 14.00 Tab 200 mg ........................................................................... 24.00 Tab 300 mg ........................................................................... 40.00 AZATHIOPRINE – Retail pharmacy-Specialist ( subsidy) ❋ Tab 50 mg ............................................................................. 18.45 (34.90) 60 60 60 60 100 ✔ Seroquel ✔ Seroquel ✔ Seroquel ✔ Seroquel ✔ Azamun Imuran

151 151

MYCOPHENOLATE MOFETIL – Special Authority see SA1041– Retail pharmacy ( subsidy) Note: Dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically. Tab 500 mg ........................................................................... 70.00 50 ✔ Cellcept Cap 250 mg ........................................................................... 70.00 100 ✔ Cellcept IPRATROPIUM BROMIDE ( subsidy) 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

159

20 20

✔ Ipratropium Steri-Neb ✔ Ipratropium Steri-Neb

164

TRAVOPROST – Retail pharmacy-Specialist ( subsidy) See prescribing guideline ▲ Eye drops 0.004% ................................................................... 19.50

2.5 ml OP ✔ Travatan

▲

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 October 2010 (continued)

178 ORAL SUPPLEMENT 1KCAL/ML – Special Authority see SA0583 – Hospital pharmacy [HP3] ( subsidy) Powder (chocolate) .................................................................. 4.22 400 g OP ✔ Ensure Powder (strawberry) ................................................................. 4.22 400 g OP ✔ Ensure Powder (vanilla) ....................................................................... 4.22 400 g OP ✔ Ensure

Effective 1 September 2010

35 41 44 46 49 56 67 CHOLINE SALICYLATE WITH CETALKONIUM CHLORIDE ( price) ❋ Adhesive gel 8.7% with cetalkonium chloride 0.01% ................. 2.06 (5.62) CLOPIDOGREL ( subsidy) Tab 75 mg ............................................................................... 5.05 SODIUM CHLORIDE ( subsidy) Inj 23.4%, 20 ml ..................................................................... 31.25 ATORVASTATIN ( subsidy) See prescribing guideline ❋ Tab 10 mg ............................................................................. 18.32 ❋ Tab 20 mg ............................................................................. 26.70 ❋ Tab 40 mg ............................................................................. 37.02 ❋ Tab 80 mg ........................................................................... 110.50 CAPTOPRIL ( subsidy) ❋‡ Oral liq 5 mg per ml .............................................................. 94.99 Oral liquid restricted to children under 12 years of age. AMILORIDE WITH HYDROCHLOROTHIAZIDE ( subsidy) ❋ Tab 5 mg with hydrochlorothiazide 50 mg ................................. 5.00 15 g OP Bonjela 28 5 ✔ Apo-Clopidogrel ✔ Biomed

30 30 30 30 95 ml OP

✔ Lipitor ✔ Lipitor ✔ Lipitor ✔ Lipitor ✔ Capoten

✔ Moduretic

COAL TAR ( subsidy) Soln BP – Only in combination ................................................ 12.95 200 ml ✔ David Craig Up to 10 % Only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain With or without other dermatological galenicals. SODIUM CITRO-TARTRATE ( subsidy) ❋ Grans eff 4 g sachets ............................................................... 2.71 HYDROCORTISONE ( subsidy) ❋ Inj 50 mg per ml, 2 ml .............................................................. 3.99 a) Up to 5 inj available on a PSO b) Only on a PSO PHENOXYMETHYLPENICILLIN (PENICILLIN V) ( subsidy) Cap potassium salt 250 mg – Up to 30 cap available on a PSO ................................................................. 9.71 Cap potassium salt 500 mg .................................................... 11.70 NYSTATIN ( subsidy) Tab 500,000 u ....................................................................... 14.16 Cap 500,000 u ....................................................................... 12.81 28 1 ✔ Ural ✔ Solu-Cortef

75 77

50 50 50 50

✔ Cilicaine VK ✔ Cilicaine VK ✔ Nilstat ✔ Nilstat

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 September 2010 (continued)

90 ETHAMBUTOL HYDROCHLORIDE – No patient co-payment payable ( subsidy) Tab 100 mg ........................................................................... 48.01 56 Tab 400 mg ........................................................................... 49.34 56 IBUPROFEN ( subsidy) ❋ Tab long-acting 800 mg ........................................................... 9.12 LIGNOCAINE HYDROCHLORIDE ( subsidy) Inj 1%, 5 ml – Up to 5 inj available on a PSO ............................ 35.00 Inj 1%, 20 ml – Up to 5 inj available on a PSO .......................... 20.00 30 50 5 ✔ Myambutol ✔ Myambutol ✔ Brufen Retard ✔ Xylocaine ✔ Xylocaine

101 111

111

LIGNOCAINE WITH PRILOCAINE – Special Authority see SA0906 – Retail pharmacy ( subsidy) Crm 2.5% with prilocaine 2.5% ............................................... 45.00 30 g OP ✔ EMLA Crm 2.5% with prilocaine 2.5% (5 g tubes) ............................. 45.00 5 ✔ EMLA MORPHINE SULPHATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Cap long-acting 10 mg ............................................................. 2.22 Cap long-acting 30 mg ............................................................. 3.20 Cap long-acting 100 mg ........................................................... 8.05 MORPHINE SULPHATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Cap long-acting 60 mg ............................................................. 6.90 MORPHINE TARTRATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Inj 80 mg per ml, 1.5 ml ......................................................... 30.00 Inj 80 mg per ml, 5 ml ............................................................ 75.00

113

10 10 10

✔ m-Eslon ✔ m-Eslon ✔m-Eslon

113

✔ m-Eslon

113

5 5

✔ Hospira ✔ Hospira

118 125

GABAPENTIN (NEURONTIN) – Special Authority see SA0973 – Retail pharmacy ( subsidy) ▲ Tab 600 mg ........................................................................... 67.50 100 ✔ Neurontin ▲ Cap 100 mg ........................................................................... 13.26 100 ✔ Neurontin ▲ Cap 300 mg ........................................................................... 39.76 100 ✔ Neurontin ▲ Cap 400 mg ........................................................................... 53.01 100 ✔ Neurontin HALOPERIDOL ( subsidy) Tab 500 µg – Up to 30 tab available on a PSO ........................... 5.42 Tab 1.5 mg – Up to 30 tab available on a PSO ........................... 8.20 Tab 5 mg – Up to 30 tab available on a PSO ............................ 25.84 Oral liq 2 mg per ml – Up to 200 ml available on a PSO ............ 19.87 Inj 5 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 18.74 FLUOROURACIL SODIUM ( subsidy) Inj 50 mg per ml, 10 ml – PCT only – Specialist ....................... 26.25 100 100 100 100 ml 10 5 ✔ Serenace ✔ Serenace ✔ Serenace ✔ Serenace ✔ Serenace ✔ Fluorouracil Ebewe

141

▲

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 September 2010 (continued)

141 FLUOROURACIL SODIUM ( subsidy) Inj 50 mg per ml, 20 ml – PCT only – Specialist ......................... 7.50 Inj 50 mg per ml, 50 ml – PCT only – Specialist ....................... 18.00 Inj 50 mg per ml, 100 ml – PCT only – Specialist ..................... 34.50 METHOTREXATE ( subsidy) ❋ Inj 25 mg per ml, 2 ml – PCT – Retail pharmacy-Specialist ..... 48.00 ❋ Inj 25 mg per ml, 20 ml – PCT – Retail pharmacy-Specialist ... 90.00 ❋ Inj 1 mg for ECP – PCT only – Specialist ................................... 0.10 DACARBAZINE – PCT only – Specialist ( subsidy) Inj 200 mg ............................................................................. 48.00 Inj 200 mg for ECP ................................................................. 48.00 MESNA – PCT only – Specialist ( subsidy) Tab 400 mg ......................................................................... 210.65 Tab 600 mg ......................................................................... 314.40 Inj 100 mg per ml, 4 ml ........................................................ 137.04 Inj 100 mg per ml, 10 ml ...................................................... 314.66 FLUTAMIDE – Retail pharmacy-Specialist ( subsidy) Tab 250 mg ........................................................................... 55.00 NEDOCROMIL ( subsidy) Aerosol inhaler, 2 mg per dose CFC-free ................................. 28.07 SODIUM CROMOGLYCATE ( subsidy) Powder for inhalation, 20 mg per dose .................................... 17.94 Aerosol inhaler, 5 mg per dose CFC-free ................................. 28.07 THEOPHYLLINE ( subsidy) ❋‡ Oral liq 80 mg per 15 ml ....................................................... 15.50 GLYCEROL ( subsidy) ❋ Liquid – Only in combination ................................................... 17.86 (19.80) (24.75) 0.89 (3.00) 1.79 (4.90) 4.47 (10.00) Only in extemporaneously compounded oral liquid preparations. 1 1 1 5 1 1 mg ✔ Fluorouracil Ebewe ✔ Fluorouracil Ebewe ✔ Fluorouracil Ebewe ✔ Hospira ✔ Hospira ✔ Baxter

142 143

1 ✔ Hospira 200 mg OP ✔ Baxter 50 50 15 15 100 ✔ Uromitexan ✔ Uromitexan ✔ Uromitexan ✔ Uromitexan ✔ Flutamin

145

149 160 160

112 dose OP ✔ Tilade 50 dose ✔ Intal Spincaps 112 dose OP ✔ Vicrom 500 ml 2,000 ml ABM MidWest 100 ml PSM 200 ml PSM 500 ml PSM ✔ Nuelin

160 171

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 September 2010

15 “Month restriction” means that no Subsidy is available: a) unless the Community Pharmaceutical is dispensed on the Prescription of a Practitioner; and b) for any quantity of that Community Pharmaceutical dispensed on the Prescription (whether or not dispensed as a repeat) in excess of a Monthly Lot.

Changes to Brand Name

Effective 1 October 2010

35 BISACODYL – Only on a prescription ❋ Tab 5 mg ................................................................................. 4.99 200 ✔ Lax-Tab Lax-Tabs

Effective 1 September 2010

113 MORPHINE TARTRATE a) Only on a controlled drug form b) No patient co-payment payable Inj 80 mg per ml, 1.5 ml ......................................................... 30.00 Inj 80 mg per ml, 5 ml ............................................................ 75.00 METHOTREXATE ❋ Inj 25 mg per ml, 2 ml – PCT – Retail pharmacy-Specialist ..... 48.00 ❋ Inj 25 mg per ml, 20 ml – PCT – Retail pharmacy-Specialist ... 90.00 DACARBAZINE – PCT only – Specialist Inj 200 mg ............................................................................. 48.00

5 5 5 1 1

✔ Hospira Mayne ✔ Hospira Mayne ✔ Hospira Mayne ✔ Hospira Mayne ✔ Hospira Mayne

142 143

Changes to Section E Part I

Effective 1 October 2010

196 SODIUM CHLORIDE ✔ Inj 0.9%, 20 ml ........................................................................5

Effective 1 September 2010

193 AZITHROMYCIN ✔ Tab 500 mg – Subsidy by endorsement – See note on page 86 ........................................................... 8 4 LIGNOCAINE ✔ Gel 2%, 10 ml urethral syringe.................................................5 LIGNOCAINE WITH CHLORHEXIDINE ✔ Gel 2% with chlorhexidine 0.05%, 10 ml urethral syringes ..................................................................5 ❋ Three months or six months, as applicable, dispensed all-at-once

195 195

▲

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Sole Subsidised Supply

Effective 1 October 2010

For the list of new Sole Subsidised Supply products effective 1 October 2010 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 14-21.

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

Delisted Items

Effective 1 October 2010

28 OMEPRAZOLE ❋ Cap 20 mg ................................................................................ 2.85 Note: Dr Reddy's Omeprazole cap 20 mg, 30 capsule pack, remains listed 49 53 ACEBUTOLOL ❋ Cap 200 mg ............................................................................ 15.94 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) 100 500 Neo-Naclex 500 Neo-Naclex ✔ ACB 28 ✔ Dr Reddy’s Omeprazole

AMLODIPINE 30 ✔ Norvasc ❋ Tab 5 mg ............................................................................... 22.82 ❋ Tab 10 mg ............................................................................. 34.85 30 ✔ Norvasc Note – Norvasc tab 5 mg and 10 mg was a temporary listing to cover the out-of-stock of Apo-Amlodipine which is now back in stock. TESTOSTERONE UNDECANOATE – Retail pharmacy-Specialist Cap 40 mg .............................................................................. 47.95 (60.71) 60 ✔ Andriol Testocaps Panteston

Effective 1 September 2010

30 COPPER ❋ Tab, diagnostic – Not on a BSO ................................................. 5.02 (31.80) GLUCOSE OXIDASE Urine diagnostic test – Not on a BSO ......................................... 4.11 (7.00) Urine diagnostic test with peroxidase – Not on a BSO ................. 4.11 (6.26) 4.13 (8.65) DOCUSATE SODIUM – Only on a prescription ❋ Tab 50 mg ................................................................................ 3.95 (4.89) ❋ Tab 120 mg .............................................................................. 5.49 (6.73) MULTIVITAMINS – Special Authority see SA0963 – Retail pharmacy Tab ......................................................................................... 19.65 Oral liq .................................................................................... 13.50 36 OP Clinitest 50 strip OP Diabur 5000 50 strip OP Diastix Clinistix 100 Coloxyl 100 Coloxyl 100 ✔ Ketovite 150 ml OP ✔ Ketovite Liquid

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Delisted Items - effective 1 September 2010 (continued)

46 82 ATORVASTATIN ❋ Tab 10 mg ............................................................................... 1.77 ❋ Tab 20 mg ............................................................................... 2.60 ❋ Tab 40 mg ............................................................................... 4.38 ❋ Tab 80 mg ............................................................................... 7.73 BUSERELIN ACETATE Inj 1 mg per ml, 5.5 ml .......................................................... 195.00 (272.53) AMOXYCILLIN Grans for oral liq 125 mg per 5 ml – Up to 200 ml available on a PSO ................................................................. 1.00 30 30 30 30 2 Suprefact ✔ Lorstat 10 ✔ Lorstat 20 ✔ Lorstat 40 ✔ Lorstat 80

100 ml

✔ Ranbaxy Amoxicillin

109 111

ALENDRONATE SODIUM WITH CHOLECALCIFEROL – Special Authority see SA1039 – Retail pharmacy Tab 70 mg with cholecalciferol 2,800 iu................................... 35.91 4 ✔ Fosamax Plus BUPIVACAINE HYDROCHLORIDE Inj 0.5%, 4 ml ......................................................................... 29.35 Inj 0.5%, 8% glucose, 4 ml ..................................................... 24.50 5 5 ✔ Marcain Isobaric ✔ Marcain Heavy

141

FLUOROURACIL SODIUM Inj 1 mg for ECP – PCT only – Specialist ................................... 0.01 1 mg ✔ Baxter Note – This product has been replaced with a 100 mg pack size listed 1 September 2010. MESNA – PCT only – Specialist Inj 1 mg for ECP ....................................................................... 0.02 1 mg ✔ Baxter Note – This product has been replaced with a 100 mg pack size listed 1 September 2010. CYPROHEPTADINE HYDROCHLORIDE ❋ Tab 4 mg ................................................................................. 6.27 PHENYLEPHRINE HYDROCHLORIDE WITH ZINC SULPHATE ❋ Eye drops 0.12% with zinc sulphate 0.25% ................................ 4.51 100 15 ml OP ✔ Periactin ✔ Zincfrin

145

155 166

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

119 LEVETIRACETAM – Special Authority see SA0921 – Retail pharmacy Tab ..................................................................................... CBS 60 ✔ Keppra

Effective 1 December 2010

67 COAL TAR Soln BP – Only in combination ................................................ 32.37 500 ml ✔ PSM 12.95 200 ml ✔ David Craig Up to 10 % Only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain With or without other dermatological galenicals. FLUOXETINE HYDROCHLORIDE ❋ Cap 20 mg ............................................................................... 2.89 Note – Fluox cap 20 mg 84 cap pack remains listed. GLYCEROL ❋ Liquid – Only in combination ................................................... 17.86 (19.80) (24.75) 0.89 (3.00) 1.79 (4.90) 4.47 (10.00) Only in extemporaneously compounded oral liquid preparations. 90 ✔ Fluox

116 171

2,000 ml 100 ml

✔ PSM ABM MidWest PSM

200 ml PSM 500 ml PSM

Effective 1 January 2011

34 SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE – Only on a prescription Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml ..................................................................................... 6.00 12 (7.30) ASCORBIC ACID a) No more than 100 mg per dose b) Only on a prescription ❋ Tab 100 mg ........................................................................... 13.80 (17.25) TERAZOSIN HYDROCHLORIDE ❋ Tab 1 mg ................................................................................. 1.50 (2.50) ❋ Tab 7 × 1 mg and 7 × 2 mg ................................................... 0.74 ❋ Tab 2 mg ............................................................................... 14.29 (23.30) ❋ Tab 5 mg ............................................................................... 17.86 (29.00)

Microlax

500 Apo-Ascorbic Acid 28 14 OP 500 500 Apo-Terazosin Apo-Terazosin ✔ Hytrin Starter Pack Apo-Terazosin

▲

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 (continued)

56 66 INDAPAMIDE ❋ Tab 2.5 mg .............................................................................. 3.25 MALATHION Liq 0.5% ................................................................................... 3.79 (4.99) 100 200 ml OP Derbac-M ✔ Napamide

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 ...................................................................................... 2.10 1 (5.40) AFT INFLUENZA VACCINE – Hospital pharmacy [Xpharm] Inj ............................................................................................ 9.00 90.00 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg ............................................................................. 18.45 (34.90) 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 1 10 100 ✔ Fluvax ✔ Influvac ✔ Vaxigrip ✔ Azamun Imuran

100

151 159

20 20

✔ Ipratropium Steri-Neb ✔ Ipratropium Steri-Neb

Effective 1 March 2011

63 74 121 HYDROCORTISONE BUTYRATE WITH CHLORQUINALDOL – Only on a prescription Crm 0.1% with chlorquinaldol 3% ............................................. 3.49 15 g OP METHYLERGOMETRINE Inj 200 µg per ml, 1 ml – Up to 10 inj available on a PSO ........... 9.28 CYCLIZINE LACTATE Inj 50 mg per ml, 1 ml ............................................................. 14.95 10 5 ✔ Locoid C ✔ Hospira S29 ✔ Valoid (AFT)

Effective 1 April 2011

44 SODIUM CHLORIDE Inj 0.9%, 5 ml – Up to 5 inj available on a PSO ......................... 11.50 Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 11.50 50 50 ✔ AstraZeneca ✔ AstraZeneca

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted - effective 1 April 2011 (continued)

44 WATER 1) On a prescription or Practitioner’s Supply Order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent; or 2) On a bulk supply order; or 3) When used in the extemporaneous compounding of eye drops. Purified for inj, 5 ml – Up to 5 inj available on a PSO ................ 10.51 50 ✔ AstraZeneca Purified for inj, 10 ml – Up to 5 inj available on a PSO ............. 11.32 50 ✔ AstraZeneca AMILORIDE WITH HYDROCHLOROTHIAZIDE ❋ Tab 5 mg with hydrochlorothiazide 50 mg ............................... 13.00 PIROXICAM ❋ Tab dispersible 10 mg .............................................................. 3.25 ❋ Tab dispersible 20 mg .............................................................. 5.50 500 50 100 ✔ Amizide ✔ Piram-D ✔ Piram-D

56 102

▲

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 October 2010

16 ACICLOVIR (addition of HSS) Tab dispersible 200 mg - 1% DV Dec-10 to 2013 ...................... 1.98 Tab dispersible 400 mg - 1% DV Dec-10 to 2013 ...................... 6.64 Tab dispersible 800 mg - 1% DV Dec-10 to 2013 ...................... 7.38 AMILORIDE WITH HYDROCHLOROTHIAZIDE (delisting) Tab 5 mg with hydrochlorothiazide 50 mg................................ 13.00 Note – Amizide to be delisted 1 December 2010 25 56 35 500 Lovir Lovir Lovir Amizide

AMLODIPINE Note: HSS for Apo-Amlodipine tab 5 mg and tab 10 mg has been suspended due to an out-of-stock. Tab 5 mg – 1% DV Oct-10 to 2011 ........................................... 7.33 100 Apo-Amlodipine Tab 10 mg – 1% DV Oct-10 to 2011 ....................................... 11.79 100 Apo-Amlodipine Note – Norvasc tab 5 mg and 10 mg to be delisted 1 October 2010 HSS for Apo-Amlodipine reinstated from 1 October 2010 AMOXYCILLIN Cap 250 mg - 1% DV Dec-10 to 2013 ..................................... 16.18 500 Cap 500 mg - 1% DV Dec-10 to 2013 ..................................... 26.50 500 Note – Apo-Amoxi cap 250 mg and 500 mg to be delisted 1 December 2010 ANASTROZOLE Tab 1 mg ............................................................................... 26.55 BUDESONIDE Powder for inhalation, 200 µg per dose ................................... 19.00 Powder for inhalation, 400 µg per dose ................................... 32.00 CHLORAMPHENICOL Eye drops 0.5% - 1% DV Dec-10 to 2012.................................. 1.28 Note – Chlorsig eye drops 10 ml to be delisted 1 December 2010 DEFERIPRONE Tab 500 mg .......................................................................... 533.17 Oral liq 100 mg per ml ........................................................... 266.59 ERLOTINIB HYDROCHLORIDE Tab 100 mg ....................................................................... 3,100.00 Tab 150 mg ....................................................................... 3,950.00 FLUCONAZOLE Inj 2 mg per ml, 50 ml - 1% DV Dec-10 to 2012 ........................ 5.68 Note – m-Fluconazole to be delisted 1 December 2010 LOPERAMIDE HYDROCHLORIDE Cap 2 mg - 1% DV Dec-10 to 2013 ........................................... 8.95 LORAZEPAM (addition of HSS) Tab 1 mg - 1% DV Dec-10 to 2013 ......................................... 16.42 Tab 2.5 mg - 1% DV Dec-10 to 2013 ...................................... 11.17 Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated 30 200 dose 200 dose 10 ml Alphamox Alphamox

18 20

Aremed Budenocort Budenocort Chlorafast

100 250 ml 30 30 1

Ferriprox Ferriprox Tarceva Tarceva Fluconazole-Claris

39 39

400 250 100

Diamide Relief Ativan Ativan

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

40 43 MERCAPTOPURINE Tab 50 mg - 1% DV Dec-10 to 2013 ....................................... 47.06 MYCOPHENOLATE MOFETIL (new listing) Tab 500 mg ............................................................................ 85.00 Cap 250 mg ............................................................................ 85.00 MYCOPHENOLATE MOFETIL ( price) Tab 500 mg ............................................................................ 70.00 Cap 250 mg ............................................................................ 70.00 ONDANSETRON HYDROCHLORIDE (Amended chemical name) Tab 4 mg - 1% DV Feb-11 to 2013 ........................................... 5.10 Tab 8 mg - 1% DV Feb-11 to 2013 ........................................... 1.70 Note – Zofran tab 4 mg and 8 mg to be delisted 1 February 2011 47 PIROXICAM Tab dispersible 10 mg .............................................................. 3.25 50 Tab dispersible 20 mg ............................................................... 5.50 100 Note – Piram-D tab dispersible 10 mg & 20 mg to be delisted 1 December 2010. QUETIAPINE ( price) Tab 25 mg ................................................................................ 7.00 Tab 100 mg ............................................................................ 14.00 Tab 200 mg ............................................................................ 24.00 Tab 300 mg ............................................................................ 40.00 60 60 60 60 Piram-D Piram-D 25 50 100 50 100 30 10 Purinethol Myaccord Myaccord CellCept CellCept Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron

Seroquel Seroquel Seroquel Seroquel Pfizer Pfizer Multichem

SODIUM CHLORIDE Inj 0.9%, 5 ml (new listing) ...................................................... 15.50 50 Inj 0.9%, 10 ml (new listing) .................................................... 15.50 50 Inj 0.9%, 20 ml ( price) ............................................................ 8.41 20 Note – Astra Zeneca Inj 0.9 %, 5 ml and 10 ml to be delisted 1 December 2010 SPECIAL FOOD SUPPLEMENT Cord oral feed 1.5 kcal/ml, liquid (vanilla) .................................. 1.66 Diabetic enteral feed 1 kcal/ml, liquid (vanilla) ............................ 7.50 Elemental formula 1 kcal/ml, powder (unflavoured) .................. 56.00 56.00 Elemental formula 1 kcal/ml, powder (vanilla) .......................... 56.00 Enteral feed with fibre 1 kcal/ml, liquid ....................................... 1.32 2.65 5.29 Enteral feed with fibre 1.5 kcal/ml, liquid .................................... 1.75 7.00 Enteral feed 1 kcal/ml, liquid ...................................................... 1.24 2.65 5.29 Enteral/oral elemental feed 1 kcal/ml, powder............................. 7.50 4.40 237 ml 1,000 ml 400 g 400 g 400 g 237 ml 500 ml 1,000 ml 250 ml 1,000 ml 250 ml 500 ml 1,000 ml 76 g 79 g

Pulmocare Glucerna Select RTH Elecare Elecare LCP Elecare Jevity Jevity RTH Jevity RTH Ensure Plus HN Ensure Plus RTH Osmolite Osmolite RTH Osmolite RTH Alitraq Vital HN continued...

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

continued... Oral feed 1 kcal/ml, liquid (vanilla) ............................................. 1.88 Oral feed 1.5 kcal/ml, liquid (vanilla) .......................................... 1.45 1.33 Oral feed 1.5 kcal/ml, liquid (chocolate) ..................................... 1.45 1.33 Oral feed 1.5 kcal/ml, liquid (strawberry).................................... 1.33 Oral feed 1.5 kcal/ml, liquid (banana) ........................................ 1.45 Oral feed 1.5 kcal/ml, liquid (fruit of the forest) .......................... 1.45 Oral feed 1.5 kcal/ml, liquid (coffee latte) ................................... 1.33 Oral feed 2 kcal/ml, liquid (vanilla) ............................................. 2.25 Oral supplement 1 kcal/ml, powder (vanilla) ............................... 4.22 9.50 Oral supplement 1 kcal/ml, powder (chocolate).......................... 4.22 9.50 Oral supplement 1 kcal/ml, powder (strawberry) ........................ 4.22 Paediatric oral feed 1 kcal/ml, liquid (vanilla) .............................. 1.07 1.27 Paediatric oral feed 1 kcal/ml, liquid (chocolate)......................... 1.07 Paediatric oral feed 1 kcal/ml, liquid (strawberry) ....................... 1.07 Paediatric enteral feed 1 kcal/ml, liquid ..................................... 2.68 Renal oral feed 2 kcal/ml, liquid (strawberry).............................. 2.43 Renal oral feed 2 kcal/ml, liquid (vanilla) .................................... 2.43 57 250 ml 200 ml 237 ml 200 ml 237 ml 237 ml 200 ml 200 ml 237 ml 237 ml 400 g 900 g 400 g 900 g 400 g 200 ml 237 ml 200 ml 200 ml 500 ml 200 ml 200 ml 50 50 20 Glucerna Select Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus Two Cal HN Ensure Ensure Ensure Ensure Ensure Pediasure Pediasure Pediasure Pediasure Pediasure RTH Nepro Nepro Multichem Multichem Multichem

WATER ( price) Purified for inj 5 ml .................................................................... 9.20 Purified for inj 10 ml ............................................................... 10.20 Purified for inj 20 ml ................................................................. 5.00 Note – Astra Zeneca 5 ml and 10 ml to be delisted from 1 December 2010

Effective 1 September 2010

18 ATORVASTATIN Tab 10 mg .............................................................................. 18.32 30 Tab 20 mg .............................................................................. 26.70 30 Tab 40 mg .............................................................................. 37.02 30 Tab 80 mg ............................................................................ 110.50 30 Note – Lorstat tab 10 mg, 20 mg, 40 mg and 80 mg to be delisted 1 September 2010. BARIUM SULPHATE Oral suspension 2.2%, 250 ml ............................................... 175.00 Oral suspension 2.2%, 450 ml ............................................... 220.00 CALCIUM GLUCONATE Gel, 2.5%, 50 g ..................................................................... 420.00 CAPTOPRIL Oral liq 5 mg per ml ................................................................. 94.99 24 24 20 95 ml Lipitor Lipitor Lipitor Lipitor

CT Plus+ CT Plus+ healthE Capoten

21 21

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

22 CEFTRIAXONE SODIUM Inj 500 mg – 1% DV Nov-10 to 2013 ........................................ 2.70 1 Inf 2 g – 1% DV Nov-10 to 2013 ............................................... 5.20 1 Note – AFT ceftriaxone sodium inj 500 mg and inf 2 g to be delisted 1 November 2010. CEPHALEXIN MONOHYDRATE Cap 500 mg ............................................................................. 8.90 CETOMACROGOL Crm BP, 100 g ........................................................................ 33.00 CHLORHEXIDINE Foaming liquid 4%, 50 ml ........................................................ 37.20 CHLORHEXIDINE IN ALCOHOL Soln 0.5% with 70% alcohol, 25 ml (tinted pink) .................... 232.50 20 20 20 150 Veracol Veracol

22 23 23 23 24

Cephalexin ABM healthE healthE healthE

CLOPIDOGREL Tab 75 mg – 1% DV Nov-10 to 2013 ...................................... 16.25 90 Apo-Clopidogrel Note – Arrow-Clopidogrel, Plavix and Apo-Clopidogrel 28 tab packs to be delisted 1 November 2010. CYCLIZINE LACTATE (brand name change) Inj 50 mg per ml, 1 ml ............................................................. 14.95 Note – Valoid (AFT) to be delisted 1 November 2010. DACARBAZINE ( price, brand name change and addition of HSS) Inj 200 mg – 1% DV Nov-10 to 2013 ...................................... 48.00 ETHAMBUTOL HYDROCHLORIDE ( price) Tab 100 mg ............................................................................ 48.01 Tab 400 mg ............................................................................ 49.34 FLUOROURACIL SODIUM (Addition of HSS) Inj 50 mg per ml, 10 ml – 1% DV Nov-10 to 2013 ( price) ..... 26.25 Inj 50 mg per ml, 20 ml – 1% DV Nov-10 to 2013 ( price) ....... 7.50 Inj 50 mg per ml, 50 ml – 1% DV Nov-10 to 2013 ( price) ..... 18.00 Inj 50 mg per ml, 100 ml – 1% DV Nov-10 to 2013 ( price) ... 34.50 FLUTAMIDE ( price and addition of HSS) Tab 250 mg – 1% DV Nov-10 to 2013 .................................... 55.00 5 Nausicalm

26 29

1 56 56 5 1 1 1 100

Mayne Hospira Myambutol Myambutol Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Flutamin Frusemide-Claris

31 32

FUROSEMIDE Inj 10 mg per ml, 2 ml – 1% DV Nov-10 to 2013 ....................... 1.30 5 Note – Mayne furosemide inj 10 mg per ml, 2 ml to be delisted 1 November 2010. HALOPERIDOL ( price and addition of HSS) Tab 500 µg – 1% DV Nov-10 to 2013 ....................................... 5.42 Tab 1.5 mg – 1% DV Nov-10 to 2013 ....................................... 8.20 Tab 5 mg – 1% DV Nov-10 to 2013 ........................................ 25.84 Oral liq 2 mg per ml – 1% DV Nov-10 to 2013 ......................... 19.87 Inj 5 mg per ml, 1 ml – 1% DV Nov-10 to 2013 ....................... 18.74 100 100 100 100 ml 10

Serenace Serenace Serenace Serenace Serenace

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

34 35 38 39 HYDROCORTISONE Inj 50 mg per ml, 2 ml – 1% DV Nov-10 to 2013 ....................... 3.99 INSULIN GLULISINE Inj 100 iu per ml, 3 ml ............................................................. 46.07 LIGNOCAINE HYDROCHLORIDE ( price and addition of HSS) Pump spray 10%, 50 ml CFC-free – 1% DV Nov-10 to 2013 .... 75.00 1 5 50 ml Solu-Cortef Apidra Xylocaine

LIGNOCAINE HYDROCHLORIDE WITH ADRENALINE ( price and addition of HSS) Inj 1% with 1:100,000 of adrenaline 5 ml – 1% DV Nov-10 to 2013 .................................................... 27.00 10 Inj 1% with 1:200,000 of adrenaline 20 ml – 1% DV Nov-10 to 2013 .................................................... 50.00 5 Inj 2% with 1:200,000 of adrenaline 20 ml – 1% DV Nov-10 to 2013 .................................................... 60.00 5 LIGNOCAINE WITH PRILOCAINE ( price and addition of HSS) Crm 2.5% with prilocaine 2.5%, 30 g – 1% DV 1 Nov-10 to 2013 ................................................. 45.00 Patch 2.5% with prilocaine 2.5% – 1% DV 1 Nov-10 to 2013 ............................................... 115.00 Crm 2.5% with prilocaine 2.5%, 5 g – 1% DV 1 Nov-10 to 2013 ................................................. 45.00 MESNA ( price and addition of HSS) Tab 400 mg – 1% DV 1 Nov-10 to 2013 ............................... 210.65 Tab 600 mg – 1% DV 1 Nov-10 to 2013 ............................... 314.40 Inj 100 mg per ml, 4 ml – 1% DV 1 Nov-10 to 2013 .............. 137.04 Inj 100 mg per ml, 10 ml – 1% DV 1 Nov-10 to 2013 ............ 314.66 METHOTREXATE Inj 25 mg per ml, 2 ml – 1% DV Nov-10 to 2013 ..................... 48.00 Inj 25 mg per ml, 20 ml – 1% DV Nov-10 to 2013 ................... 90.00 MITOMYCIN C Inj 5 mg .................................................................................. 72.75 MORPHINE SULPHATE (Addition of HSS) Cap long-acting 10 mg – 1% DV Nov-10 to 2013 ( price) ........ 2.22 Cap long-acting 30 mg – 1% DV Nov-10 to 2013 ( price) ........ 3.20 Cap long-acting 60 mg – 1% DV Nov-10 to 2013 ( price) ........ 6.90 Cap long-acting 100 mg – 1% DV Nov-10 to 2013 ( price) ...... 8.05 MORPHINE TARTRATE ( price, amended brand name and addition of HSS) Inj 80 mg per ml, 1.5 ml – 1% DV Nov-10 to 2013 .................. 30.00 Inj 80 mg per ml, 5 ml– 1% DV Nov-10 to 2013 ...................... 75.00 MUCILAGINOUS LAXATIVES Dry – 1% DV Nov-10 to 2013.................................................... 6.02 Note – Konsyl-D 325g pack to be delisted 1 November 2010

Xylocaine Xylocaine Xylocaine

30 g 20 5 50 50 15 15 5 1 1 10 10 10 10 5 5 500 g

EMLA EMLA EMLA Uromitexan Uromitexan Uromitexan Uromitexan Hospira Hospira Arrow m-Eslon m-Eslon m-Eslon m-Eslon Mayne Hospira Mayne Hospira Konsyl-D

42 43

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

44 NYSTATIN ( price and addition of HSS) Tab 500,000 u – 1% DV Nov-10 to 2013 ................................ 14.16 Cap 500,000 u – 1% DV Nov-10 to 2013 ................................ 12.81 OIL IN WATER EMULSION Crm 100 g............................................................................... 32.00 PHENOXYMETHYLPENICILLIN (PENICILLIN V) ( price and addition of HSS) Cap potassium salt 250 mg – 1% DV Nov-10 to 2013 ............... 9.71 Cap potassium salt 500 mg – 1% DV Nov-10 to 2013 ............. 11.70 PHENTOLAMINE MESYLATE ( price) Inj 10 mg per ml, 1 ml ............................................................ 31.65 PRILOCAINE HYDROCHLORIDE ( price and addition of HSS) Inj 0.5%, 50 ml – 1% DV Nov-10 to 2013 .............................. 100.00 Inj 2%, 5 ml – 1% DV Nov-10 to 2013 ..................................... 55.00 RETINOL PALMITATE Oint 50 g ................................................................................. 57.20 50 50 20 50 50 5 5 10 20 Nilstat Nilstat healthE Cilicaine VK Cilicaine VK Regitine Citanest Citanest healthE

44 47

47 48

50 51

ROPIVACAINE HYDROCHLORIDE WITH FENTANYL ( price and addition of HSS) Inf 2 mg per ml with 2 µg of fentanyl per ml, 100 ml – 1% DV Nov-10 to 2013 .................................................. 198.50 5 Inf 2 mg per ml with 2 µg of fentanyl per ml, 200 ml – 1% DV Nov-10 to 2013 .................................................. 270.00 5 SODIUM BICARBONATE Cap 840 mg .............................................................................. 8.52 SODIUM CHLORIDE ( price and addition of HSS) Inj 23.4%, 20 ml – 1% DV Nov-10 to 2013 .............................. 31.25 SODIUM DIOTRIZOATE ( price) Powder for oral soln 3.705 g, 10 ml sachet ........................... 156.12 SODIUM FLUORESCEIN Inj 100 mg per ml, 5 ml – 1% DV Nov-10 to 2013 ................. 125.00 SOFT WHITE PARAFFIN WITH PARAFFIN LIQUID Oint 50% with 50% paraffin liquid, 100 g .................................. 62.00 100 5 50 12 20

Naropin Naropin Sodibic Biomed Ioscan Fluorescite healthE

52 52 53 53 57

Effective 1 August 2010

18 ASCORBIC ACID Tab 100 mg – 1% DV Oct-10 to 2013 ..................................... 13.80 500 Vitala-C

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

18 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 30 30 30 30 100 1 5 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 METHADONE HYDROCHLORIDE ( price and addition of HSS) Tab 5 mg – 1% DV Oct-10 to 2013 ........................................... 1.85 10 strip Optium Blood Ketone Test Strips Jadelle Methatabs

38 40

1 10

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

49 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 60 60 60 60 60 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 III

Effective 1 September 2010

LIGNOCAINE Viscous solution 2% For patients with head, neck and oesophageal cancer for up to 9 weeks following radiation therapy.

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 A A-Lices .............................................................. 39 Acarbose ........................................................... 36 Acebutolol.......................................................... 51 Aciclovir ............................................................ 56 Aclasta .............................................................. 25 Adapalene .......................................................... 22 Alendronate sodium ........................................... 40 Alendronate sodium with cholecalciferol ....... 40, 52 Alitraq ................................................................ 57 Alphamox .................................................... 22, 56 Alprazolam ......................................................... 42 Amiloride with hydrochlorothiazide ... 38, 46, 55, 56 Amizide........................................................ 55, 56 Amlodipine................................................... 51, 56 Amoxycillin ............................................ 22, 52, 56 Anastrozole .................................................. 23, 56 Andriol Testocaps .............................................. 51 Apidra .................................................... 24, 60, 62 Apidra SoloStar .................................................. 62 Apo-Amlodipine ................................................. 56 Apo-Ascorbic Acid ....................................... 44, 53 Apo-Clopidogrel ............................... 24, 36, 46, 59 Apo-Terazosin.............................................. 44, 53 Apo-Zopiclone.................................................... 43 Aremed ........................................................ 23, 56 Arrow-Alprazolam .............................................. 42 Arrow-Azithromycin ........................................... 39 Arrow-Clopidogrel .............................................. 36 Arrow-Diazepam ................................................ 42 Arrow-Meloxicam............................................... 24 Ascorbic acid ......................................... 44, 53, 61 Aspen Ceftriaxone .............................................. 62 Ativan .......................................................... 42, 56 Atorvastatin................................ 37, 46, 52, 58, 62 Azamun ....................................................... 45, 54 Azathioprine ........................................... 45, 54, 62 Azithromycin ................................................ 39, 49 B B-PlexADE ......................................................... 24 Barium sulphate ................................................. 58 Bendrofluazide ................................................... 51 Bisacodyl ........................................................... 49 Bonjela .............................................................. 46 Brufen Retard ..................................................... 47 Budenocort .................................................. 23, 56 Budesonide .................................................. 23, 56 Bupivacaine hydrochloride.................................. 52 Buserelin acetate ................................................ 52 Buspirone hydrochloride..................................... 42 C Calcium gluconate ............................................. 58 Capecitabine ................................................ 32, 43 Capoten ....................................................... 46, 58 Captopril ...................................................... 46, 58 Ceftriaxone sodium .................... 24, 45, 54, 59, 62 CellCept ............................................................. 57 Cellcept ....................................................... 33, 45 Cephalexin ABM ........................................... 24, 59 Cephalexin monohydrate .............................. 24, 59 Cerezyme..................................................... 22, 44 Cetomacrogol .................................................... 59 Chlorafast .................................................... 23, 56 Chloramphenicol .......................................... 23, 56 Chlorhexidine ..................................................... 59 Chlorhexidine in alcohol...................................... 59 Cholestyramine with aspartame .......................... 44 Choline salicylate with cetalkonium chloride........ 46 Cilazapril ............................................................ 22 Cilicaine VK.................................................. 46, 61 Citanest ............................................................. 61 Clinistix .............................................................. 51 Clinitest.............................................................. 51 Clomiphene citrate ............................................. 62 Clopidogrel ...................................... 24, 36, 46, 59 Coal tar ........................................................ 46, 53 Coloxyl .............................................................. 51 Copper............................................................... 51 CT Plus+ .......................................................... 58 Cyclizine lactate ........................................... 54, 59 Cyproheptadine hydrochloride ............................ 52 D Dacarbazine ................................................. 48, 59 Danthron with poloxamer.................................... 62 Dapa-Tabs ......................................................... 62 Deferiprone .................................................. 22, 56 Derbac-M .................................................... 45, 54 Diabur 5000 ....................................................... 51 Diamide Relief .............................................. 22, 56 Diastix ............................................................... 51 Diazepam........................................................... 42 Differin ............................................................... 22 Docusate sodium ............................................... 51 Dr Reddy’s Omeprazole...................................... 51 Dr Reddy’s Ondansetron .............................. 22, 57 Dr Reddy’s Quetiapine ........................................ 63 Dr Reddy’s Risperidone...................................... 63 E Elecare ........................................................ 24, 57 Elecare LCP ................................................. 24, 57 Elemental formula .............................................. 24 EMLA........................................................... 47, 60 Ensure ................................................... 23, 46, 58 Ensure Plus........................................................ 58

Index

Pharmaceuticals and brands Ensure Plus HN ............................................ 24, 57 Ensure Plus RTH ................................................ 57 Enteral feed 1kcal/ml .......................................... 23 Enteral feed with fibre 1.5kcal/ml ........................ 24 Enteral feed with fibre 1 kcal/ml .......................... 23 Erlotinib hydrochloride.................................. 23, 56 Ethambutol hydrochloride ....................... 39, 47, 59 Ezetimibe ........................................................... 28 Ezetimibe with simvastatin ................................. 29 Ezetrol ............................................................... 28 F Ferriprox ...................................................... 22, 56 Fluconazole ........................................................ 56 Fluconazole-Claris .............................................. 56 Fluorescite ......................................................... 61 Fluorouracil Ebewe ................................. 47, 48, 59 Fluorouracil sodium.................... 27, 47, 48, 52, 59 Fluox.................................................................. 53 Fluoxetine hydrochloride ..................................... 53 Flutamide ..................................................... 48, 59 Flutamin ....................................................... 48, 59 Fluvax ................................................................ 54 Fosamax ............................................................ 40 Fosamax Plus .............................................. 40, 52 Frusemide-Claris .......................................... 24, 59 Furosemide ............................................ 24, 59, 62 G Gabapentin (neurontin) ....................................... 47 Glucerna Select .................................................. 58 Glucerna Select RTH .......................................... 57 Glucobay ........................................................... 36 Glucose oxidase................................................. 51 Glycerol ....................................................... 48, 53 H Haloperidol .................................................. 47, 59 Hydrocortisone ............................................ 46, 60 Hydrocortisone butyrate with chlorquinaldol........ 54 Hydrocortisone with cinchocaine ........................ 62 Hypam ............................................................... 43 Hypnovel ........................................................... 43 Hytrin Starter Pack ............................................. 53 I Ibuprofen ........................................................... 47 Imuprine ............................................................ 62 Imuran ................................................... 45, 54, 62 Indomethacin ..................................................... 63 Influenza vaccine................................................ 54 Influvac .............................................................. 54 Insulin glulisine ...................................... 24, 60, 62 Intal Spincaps .................................................... 48 Interferon alpha-2a ............................................. 39 Imiglucerase ................................................ 22, 44 Indapamide ............................................ 44, 54, 62 Ioscan ............................................................... 61 Ipratropium bromide ............................... 45, 54, 62 Ipratropium Steri-Neb ................................... 45, 54 Isotretinoin ......................................................... 38 J Jadelle ............................................................... 62 Jevity ........................................................... 23, 57 Jevity RTH ................................................... 23, 57 K Keppra ............................................................... 53 Ketone blood beta-ketone electrodes .................. 62 Ketovite ............................................................. 51 Ketovite Liquid ................................................... 51 Konsyl-D...................................................... 24, 60 L Lax-Tab ............................................................. 49 Lax-Tabs............................................................ 49 Levetiracetam .................................................... 53 Levonorgestrel ................................................... 62 Lignocaine ............................................. 41, 49, 63 Lignocaine hydrochloride ................. 26, 41, 47, 60 Lignocaine hydrochloride with adrenaline............ 60 Lignocaine with chlorhexidine ....................... 41, 49 Lignocaine with prilocaine ............................ 47, 60 Lipitor .................................................... 37, 46, 58 Locoid C ............................................................ 54 Loperamide hydrochloride ............................ 22, 56 Lorazepam ................................................... 42, 56 Lormetazepam ................................................... 43 Lorstat 10 .................................................... 52, 62 Lorstat 20 .................................................... 52, 62 Lorstat 40 .................................................... 52, 62 Lorstat 80 .................................................... 52, 62 Lovir .................................................................. 56 M m-Eslon ....................................................... 47, 60 Malathion ............................................... 39, 45, 54 Marcain Heavy ................................................... 52 Marcain Isobaric ................................................ 52 Meloxicam ......................................................... 24 Mesna ............................................. 27, 48, 52, 60 Methadone hydrochloride ................................... 62 Methatabs .......................................................... 62 Methotrexate ................................................ 48, 60 Methylergometrine ............................................. 54 Mercaptopurine .................................................. 57 Mianserin hydrochloride ............................... 31, 45 Micolette ............................................................ 63 Microlax ....................................................... 44, 53 Midazolam ......................................................... 43 Mitomycin C ...................................................... 60

Index

Pharmaceuticals and brands Moduretic .................................................... 38, 46 Morphine sulphate........................................ 47, 60 Morphine tartrate .................................... 47, 49, 60 Mucilaginous laxatives ................................. 24, 60 Multivitamins ............................................... 36, 51 Myaccord .............................................. 23, 33, 57 Myambutol............................................. 39, 47, 59 Mycophenolate mofetil ..................... 23, 33, 45, 57 Mycostatin ......................................................... 44 N Napamide .................................................... 44, 54 Naropin .............................................................. 61 Nausicalm.................................................... 27, 59 Navoban ............................................................ 42 Nedocromil ........................................................ 48 Neo-Naclex ........................................................ 51 Nepro ................................................................ 58 Nepro (strawberry) ............................................. 23 Neurontin ........................................................... 47 Nifuran ............................................................... 45 Nilstat .......................................................... 46, 61 Nitrados ............................................................. 43 Nitrazepam......................................................... 43 Nitrofurantoin ..................................................... 45 Noctamid ........................................................... 43 Normison ........................................................... 43 Norvasc ............................................................. 51 Nuelin ................................................................ 48 Nutraplus ........................................................... 44 Nystatin ................................................. 44, 46, 61 O Oestriol .............................................................. 45 Oil in water emulsion .......................................... 61 Omeprazole........................................................ 51 Ondansetron .......................................... 22, 42, 57 Optium Blood Ketone Test Strips ........................ 62 Oral supplement 1kcal/ml ............................. 23, 46 Oratane .............................................................. 38 Osmolite ...................................................... 23, 57 Osmolite RTH............................................... 23, 57 Ovestin .............................................................. 45 Ox-Pam ............................................................. 42 Oxazepam .......................................................... 42 P Pacific Buspirone ............................................... 42 Paediatric oral feed 1kcal/ml............................... 23 Paediatric Seravit ............................................... 36 Panteston .......................................................... 51 Pediasure..................................................... 23, 58 Pediasure RTH ................................................... 58 Periactin ............................................................ 52 Phenate ............................................................. 62 Phenobarbitone Sodium Paediatric Oral Liquid .... 23 Phenoxymethylpenicillin (penicillin v) ............ 46, 61 Phentolamine mesylate ...................................... 61 Phenylephrine hydrochloride with zinc sulphate .. 52 Pinorax Forte ...................................................... 62 Pioglitazone ....................................................... 36 Piram-D ....................................................... 55, 57 Piroxicam..................................................... 55, 57 Pizaccord........................................................... 36 Plavix ................................................................. 36 Prilocaine hydrochloride ..................................... 61 Proctosedyl........................................................ 62 Pulmocare ......................................................... 57 Purinethol .......................................................... 57 Q Questran-Lite ..................................................... 44 Quetiapine.............................................. 45, 57, 63 R Ranbaxy Amoxicillin ........................................... 52 Regitine ............................................................. 61 Renal oral feed 2kcal/ml ..................................... 23 Retinol palmitate ................................................ 61 Rexacrom .......................................................... 27 Risperidone........................................................ 63 Rituximab .......................................................... 33 Roferon-A .......................................................... 39 Ropivacaine hydrochloride with fentanyl ............. 61 S Serenace ..................................................... 47, 59 Seroquel ...................................................... 45, 57 Sodibic ........................................................ 24, 61 Sodium bicarbonate ..................................... 24, 61 Sodium chloride ....... 22, 28, 44, 46, 49, 54, 57, 61 Sodium citrate with sodium lauryl sulphoacetate ............................ 44, 53, 63 Sodium citro-tartrate .......................................... 46 Sodium cromoglycate .................................. 27, 48 Sodium diotrizoate ............................................. 61 Sodium fluorescein ............................................ 61 Soft white paraffin with paraffin liquid ................. 61 Solu-Cortef .................................................. 46, 60 Special food supplement .................................... 57 Standard formulae .............................................. 23 Suprefact ........................................................... 52 T Tamsulosin hydrochloride .................................. 63 Tamsulosin-Rex ................................................. 63 Tarceva........................................................ 23, 56 Temazepam ....................................................... 43 Tenofovir disoproxil fumarate ............................. 30 Tenoxicam ......................................................... 25 Terazosin hydrochloride ............................... 44, 53

Index

Pharmaceuticals and brands Testosterone undecanoate.................................. 51 Theophylline ...................................................... 48 Tilade................................................................. 48 Tolvon ......................................................... 31, 45 Travatan....................................................... 35, 45 Travoprost ................................................... 35, 45 Triazolam ........................................................... 43 Triclosan............................................................ 39 Tropisetron ........................................................ 42 Two Cal HN........................................................ 58 U Univent .............................................................. 62 Ural.................................................................... 46 Urea................................................................... 44 Urex Forte .......................................................... 62 Uromitexan .................................................. 48, 60 V Valoid (AFT) ....................................................... 54 Vaxigrip ............................................................. 54 Veracol ........................................................ 24, 59 Vicrom ............................................................... 48 Viread ................................................................ 30 Vitala-C .............................................................. 61 Vital HN ............................................................. 57 Vitamin b complex.............................................. 24 Vytorin ............................................................... 29 W Water ........................................................... 55, 58 X Xeloda ......................................................... 32, 43 Xylocaine ......................................... 26, 41, 47, 60 Xylocaine Viscous .............................................. 26 Z Zapril ................................................................. 22 Zincfrin .............................................................. 52 Zofran ................................................................ 42 Zofran Zydis ....................................................... 42 Zoledronic acid .................................................. 25 Zopiclone ........................................................... 43

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 October 2010

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 October 2010 Section H cumulative for August, September and October 2010 Contents Summary of PHARMAC decisions effective 1 October 2010 ….. 3 Pharmaceutical co-payments remain unchanged … 6 Further topical…

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