Schedule Update - effective 1 November 2010 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 November 2010

Cumulative for September, October and November 2010 Section H cumulative for August, September, October and November 2010

Contents

Summary of PHARMAC decisions effective 1 November 2010 ....................... 3 Pharmacy Brand Switch Payments begin 1 November ................................... 5 Donepezil – fully subsidised .......................................................................... 5 Levetiracetam – fully subsidised .................................................................... 6 Varenicline (Champix) – fully subsidised with Special Authority .................... 6 Sunitinib (Sutent) – fully subsidised with Special Authority ........................... 7 Etanercept (Enbrel) – fully subsidised with Special Authority ........................ 7 Adalimumab (Humira and HumiraPen) – Special Authority criteria amendement .................................................................................. 7 Etravirine (Intelence) – fully subsidised with Special Authority ...................... 7 Darunavir (Prezista) – fully subsidised with Special Authority ........................ 8 Insulin pen needles – new presentation fully subsidised ............................... 8 Temporary Apo-Selegiline listing ................................................................... 8 Isopto Carpine eye drops now registered ...................................................... 8 Tender News .................................................................................................. 9 Looking Forward ......................................................................................... 10 Sole Subsidised Supply products cumulative to November 2010 ................ 12 New Listings ................................................................................................ 20 Changes to Restrictions ............................................................................... 28 Changes to Subsidy and Manufacturer’s Price............................................. 56 Changes to General Rules............................................................................ 62 Changes to Brand Name ............................................................................. 62 Changes to Section E Part I ......................................................................... 63 Changes to Sole Subsidised Supply ............................................................. 63 Delisted Items ............................................................................................. 64 Items to be Delisted .................................................................................... 67 Section H changes to Part II ........................................................................ 71 Section H changes to Part III........................................................................ 80 Index ........................................................................................................... 81

Summary of PharmaC decisions

effeCtive 1 NOvemBer 2010 New listings (pages 20-21) • Insulin pen needles (B-D Micro-Fine) 32 g x 4 mm – maximum of 100 dev per prescription • Captopril (m-Captopril) tab 12.5 mg, 25 mg and 50 mg • Etravirine (Intelence) tab 100 mg – Special Authority – Retail pharmacy • Darunavir (Prezista) tab 300 mg and 400 mg – Special Authority – Retail pharmacy • Etanercept (Enbrel) inj 50 mg autoinjector – Special Authority – Retail pharmacy • Levetiracetam (Levetiracetam-Rex) tab 250 mg, 500 mg and 750 mg • Selegiline hydrochloride (Apo-Selegiline) tab 5 mg – Section 29 • Donepezil hydrochloride (Donepezil-Rex) tab 5 mg and 10 mg • Varenicline tartrate (Champix) tab 0.5 mg x 11 and 1 mg x 14, 1 OP; tab 1 mg, 28 tab and 56 tab packs – Special Authority – Retail pharmacy • Sunitinib (Sutent) cap 12.5 mg, 25 mg and 50 mg – Special Authority – Retail pharmacy • Bacillus calmette-guerin (BCG) vaccine inj 2-8 x 100 million CFU – PCT only – Specialist – Subsidised only for bladder cancer • Pharmacy Services (BSF Arrow-Enalapril) brand switch fee – no patient copayment payable • Acetylcysteine (Acetadote) inj 200 mg per ml, 30 ml – Retail pharmacySpecialist Changes to restrictions (pages 28-39) • Sodium chloride (Pharmacia and Multichem) inj 0.9%, 20 ml – removal of Up to 5 inj available on a PSO • Enalapril (Arrow-Enalapril) tab 5 mg, 10 mg and 20 mg – a brand switch fee may be dispensed from 1 November 2010 until 31 January 2011 • Adalimumab (HumiraPen and Humira) inj 40 mg per 0.8 ml prefilled pen and syringe – amended Special Authority criteria • Etanercept (Enbrel) inj 25 mg and 50 mg autoinjector – removal of Retail pharmacy-Specialist prescription – amended Special Authority criteria • Venlafaxine (Efexor XR) cap 37.5 mg, 75 mg and 150 mg – amended Special Authority criteria • Levetiracetam tab 250 mg, 500 mg and 750 mg – removal of Special Authority • Pilocarpine (Isopto Carpine) eye drops 1%, 2% and 4% - removal of Section 29 Decreased subsidy (pages 56-57) • Mucilaginous laxatives dry 325 g OP (Konsyl-D), 380 g OP (Mucilax), 450 g OP (Isogel), 500 g OP (Normacol)

Summary of PharmaC decisions – effective 1 November 2010 (continued) • Mucilaginous laxatives (Metamucil) dry-original flavour, regular texture only, 336 g OP • Mucilaginous laxatives (Mucilax) sugar free, 275 g OP • Mucilaginous laxatives with stimulants (Normacol Plus) dry, 200 g OP and 500 g OP • Vitamin b complex (Apo-B-Complex) tab, strong, BPC • Vitamins (MultiADE) tab (BPC cap strength) • Clopidogrel (Arrow-Clopidogrel and Plavix) tab 75 mg • Furosemide (Mayne) inj 10 mg per ml, 2 ml • Ceftriaxone sodium (AFT) inj 500 mg • Sodium cromoglycate (Cromolux) eye drops 2%, 10 ml OP increased subsidy (pages 56-57) • Daunorubicin inj 2 mg per ml, 10 ml (Pfizer), and inj 20 mg for ECP (Baxter) • Terbutaline sulphate (Bricanyl Turbuhaler) powder for inhalation, 250 μg per dose, breath activated

Pharmaceutical Schedule - Update News

Pharmacy Brand Switch Payments begin 1 November

Brand switch payments for pharmacy will occur on certain pharmaceuticals from 1 November 2010. Detailed information on claiming these payments will be sent to community pharmacies with the November 2010 Update. Information is also available on the PHARMAC website. The first medicine to be eligible for a brand switch payment is enalapril. Pharmacy software vendors will also be supplying detailed information on how

to claim these payments. Brand switch payments can only be dispensed during the first three months of the Sole Supply period.

Donepezil – fully subsidised

As previously notified, the PHARMAC Board approved the funding of the DonepezilRex brand of donepezil for the treatment of Alzheimer’s disease and other types of dementia as soon as possible following Medsafe registration. Donepezil-Rex 5 mg and 10 mg tablets are now registered and funding will start on 1 November 2010. Prescriptions for donepezil hydrochloride 5 mg and 10 mg tablets must be dispensed ‘stat’ (all-at-once) unless prescribed under Close Control restrictions.

Pharmaceutical Schedule - Update News

Levetiracetam – fully subsidised

The Levetiracetam-Rex brand of levetiracetam 250 mg, 500 mg and 750 mg tablets will be fully subsidised without the requirement for Special Authority approval from 1 November 2010. Funding for the Keppra brand of levetiracetam was previously available via Levetiracetam Special Access (LSA); this has now changed as follows: • No new approvals (initial or renewal) for Keppra will be granted under LSA from 1 November 2010; • All existing LSA approvals (both initials and renewals) for Keppra with expiry dates beyond 1 November 2010 will remain valid until expiry or until 30 • • • April 2011, whichever is sooner; All LSA approvals (initial or renewal) for Keppra granted between 1 August 2010 and 1 November 2010 will have a 6-month expiry date; From 1 November 2010, patients with expired LSA approvals will need to be dispensed the Levetiracetam-Rex brand in order to receive a subsidised brand; and The Keppra brand will be delisted from the Pharmaceutical Schedule from 1 November 2010. Any subsequent claims will be processed via the Exceptional Circumstances claiming system.

Varenicline (Champix) – fully subsidised with Special Authority

Champix tablets will be subsidised, subject to Special Authority criteria, as a smoking cessation treatment from 1 November 2010. The criteria allow subsidy for patients who have previously had two trials of nicotine replacement therapy or a trial of buproprion or nortriptyline. Please refer to page 20 for further details.

Pharmaceutical Schedule - Update News

Sunitinib (Sutent) – fully subsidised with Special Authority

Sutent 12.5 mg, 25 mg and 50 mg capsules will be subsidised from 1 November 2010, subject to Special Authority criteria, for patients with advanced renal cell carcinoma. Please refer to page 21 for further details.

Etanercept (Enbrel) – fully subsidised with Special Authority

Funded access to etanercept will be widened from 1 November 2010. Funding will include, in addition to juvenile idiopathic arthritis, last-line use in psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis and psoriasis. Funded access will be subject to Special Authority criteria substantially the same as those that apply to adalimumab (Humira and HumiraPen) for these indications. Eligible patients will be able to access adalimumab or etanercept (in any order). Please refer to page 33 for further details.

Adalimumab (Humira and HumiraPen) – Special Authority criteria amendement

The Special Authority criteria for adalimumab for ankylosing spondylitis will be amended to remove the criteria relating to ESR and CRP from 1 November 2010.

Etravirine (Intelence) – fully subsidised with Special Authority

Etravirine (Intelence) 100 mg tablets will be fully subsidised, subject to Special Authority criteria, from 1 November 2010. Etravirine will be subject to the same Special Authority criteria that currently apply to all oral antiretrovirals for HIV treatment.

Pharmaceutical Schedule - Update News

Darunavir (Prezista) – fully subsidised with Special Authority

Darunavir (Prezista) 300 mg and 400 mg tablets will be fully subsidised, subject to Special Authority criteria, from 1 November 2010. Darunavir will be subject to the same Special Authority criteria that currently apply to all oral antiretrovirals for HIV treatment.

Insulin pen needles – new presentation fully subsidised

A new presentation (32 g x 4 mm) of insulin pen needles, B-D Micro-Fine brand, will be listed in the Pharmaceutical Schedule from 1 November 2010. The restrictions that currently apply to insulin pen needles and disposable insulin syringes will remain and will be applied to the new listing.

Temporary Apo-Selegiline listing

A new selegiline hydrochloride (Apo-Selegiline) 5 mg tablet pack will be subsidised from 1 November 2010. This pack is unregistered and will be supplied by Apotex in accordance with Section 29 of the Medicines Act 1981. This is a temporary listing to cover a potential out-ofstock.

Isopto Carpine eye drops now registered

Pilocarpine (Isopto Carpine) eye drops 1%, 2% and 4% have been approved by Medsafe for distribution within New Zealand. Isopto Carpine has been supplied by Alcon in accordance with Section 29 of the Medicine Act 1981 since August 2009; however, this restriction no longer applies.

tender News

Sole Subsidised Supply changes – effective 1 December 2010

Chemical Name Captopril Coal tar Fluoxetine hydrochloride Flutamide Glycerol Haloperidol Haloperidol Haloperidol Haloperidol Haloperidol Hydrocortisone Lignocaine hydrochloride Lignocaine hydrochloride Lignocaine with prilocaine Lignocaine with prilocaine Methotrexate Methotrexate Morphine sulphate Morphine sulphate Morphine sulphate Morphine sulphate Morphine tartrate Morphine tartrate Nystatin Nystatin Phenoxymethylpenicillin (Penicillin V) Phenoxymethylpenicillin (Penicillin V) Sodium chloride Sodium citro-tartrate Presentation; Pack size Oral liq 5 mg per ml; 95 ml OP Soln BP; 200 ml Cap 20 mg; 84 cap Tab 250 mg; 100 tab Liquid; 2,000 ml Inj 5 mg per ml, 1 ml; 10 inj Oral liq 2 mg per ml; 100 ml Tab 500 µg; 100 tab Tab 1.5 mg; 100 tab Tab 5 mg; 100 tab Inj 50 mg per ml, 2 ml; 1 inj Inj 1%, 5 ml; 50 inj Inj 1%, 20 ml; 5 inj Crm 2.5% with prilocaine 2.5%; 30 g OP Crm 2.5% with prilocaine 2.5% (5 g tubes); 5 tubes Inj 25 mg per ml, 2 ml; 5 inj Inj 25 mg per ml, 20 ml; 1 inj Cap long-acting 10 mg; 10 cap Cap long-acting 30 mg; 10 cap Cap long-acting 60 mg; 10 cap Cap long-acting 100 mg; 10 cap Inj 80 mg per ml, 1.5 ml; 5 inj Inj 80 mg per ml, 5 ml; 5 inj Cap 500,000 u; 50 cap Tab 500,000 u; 50 tab Cap potassium salt 250 mg; 50 cap Cap potassium salt 500 mg; 50 cap Inj 23.4%, 20 ml; 5 inj Grans effervescent 4 g sachets, 28 sachets Sole Subsidised Supply brand (and supplier) Capoten (Sigma) Midwest (Midwest) Fluox (Mylan) Flutamin (Mylan) healthE (Jaychem) Serenace (Sigma) Serenace (Sigma) Serenace (Sigma) Serenace (Sigma) Serenace (Sigma) Solu-Cortef (Pfizer) Xylocaine (AstraZeneca) Xylocaine (AstraZeneca) EMLA (AstraZeneca) EMLA (AstraZeneca) Hospira (Hospira) Hospira (Hospira) m-Elson (Multichem) m-Elson (Multichem) m-Elson (Multichem) m-Elson (Multichem) Hospira (Hospira) Hospira (Hospira) Nilstat (Sigma) Nilstat (Sigma) Cilicaine VK (Sigma) Cilicaine VK (Sigma) Biomed (Biomed) Ural (Arrow)

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for implementation 1 December 2010 • Calcium folinate (Calcium Folinate Ebewe) inj 1 g – price and subsidy decrease • Carboplatin (Carboplatin Ebewe) inj 10 mg per ml, 45 ml and 100 ml – price and subsidy decrease • Epirubicin (Epirubicin Ebewe) inj 2 mg per ml, 50 ml and 100 ml, and (Baxter) inj 1 mg for ECP – price and subsidy decrease • Escitalopram (Loxalate) tab 10 mg and 20 mg – new listing • Gemfibrozil (Lipazil) tab 600 mg – new listing • Glycerin with sodium saccharin (Ora-Sweet SF) suspension, 473 ml OP – new listing – Only in extemporaneously compounded oral formulations – Only in combination – Only in combination with Ora-Plus • Glycerin with sucrose (Ora-Sweet) suspension, 473 ml OP – new listing – Only in extemporaneously compounded oral formulations – Only in combination – Only in combination with Ora-Plus • Interferon beta-1-beta (Betaferon) inj 8 million iu per 1 ml – price and subsidy decrease • Isosorbide mononitrate (Duride) tab long-acting 60 mg – price and subsidy decrease • Labetalol (Hybloc) tab 50 mg, 100 mg and 200 mg – price and subsidy decrease • Menthol (Midwest) crystals, 25 g – new listing – Only in combination – Only in combination with aqueous cream, 10% urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion • Menthol crystals – added to the list of dermatological galenicals • Methotrexate (Methotrexate Ebewe) inj 100 mg per ml, 10 ml and 50 ml and (Baxter) inj 1 mg for ECP – price and subsidy decrease • Methylcellulose (Ora-Plus) suspension, 473 ml OP – new listing – Only in extemporaneously compounded oral formulations – Only in combination • Methylcellulose with glycerin and sodium saccharin (Ora-Blend SF) suspension, 473 ml OP – new listing – Only in extemporaneously compounded oral formulations – Only in combination • Methylcellulose with glycerin and sucrose (Ora-Blend) suspension, 473 ml OP – new listing – Only in extemporaneously compounded oral formulations – Only in combination

Possible decisions for implementation 1 December 2010 (continued) • Methyl hydroxybenzoate (Midwest) powder, 25 g – new listing • Moxifloxacin (Avelox) tab 400 mg - new listing with Special Authority criteria for treatment resistant mycobacterium tuberculosis and mycobacterium avium-intracellular complex • Multiple sclerosis treatments – amendment to Stopping Criteria • Naproxen sodium (Sonaflam) tab 275 mg and (Synflex) tab 550 mg – subsidy decrease • Nifedipine (Adefin XL) tab long-acting 30 mg and 60 mg – price and subsidy decrease • Oxaliplatin (Oxaliplatin Ebewe) inj 50 mg and 100 mg, and (Baxter) inj 1 mg for ECP – price and subsidy decrease • Paclitaxel (Paclitaxel Ebewe) inj 30 mg, 100 mg, 150 mg, 300 mg and 600 mg, and (Baxter) inj 1 mg for ECP – price and subsidy decrease • Propranolol (Cardinol LA) cap long-acting 160 mg – price and subsidy decrease • Propylene glycol (Midwest) liquid, 500 ml – new listing – Only in extemporaneously compounded methyl hydroxybenzoate 10% solution. • Rivaroxaban (Xarelto) tab 10 mg – new listing with Special Authority criteria for the prophylaxis of venous thromboembolism following orthopaedic surgery • Sertraline (Arrow-Sertraline) tab 50 mg and 100 mg – new listing • Sodium bicarbonate (Midwest) powder BP, 500 g – new listing – Only in combination – Only in extemporaneously compounded omeprazole suspension. • Sulphur (Midwest) precipitated, 100 g – new listing – Only in combination – Only in combination with a dermatological base or proprietary Topical Corticosteroid-Plain – with or without other dermatological galenicals

Sole Subsidised Supply Products – cumulative to November 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 Inj 50 mg 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 1.25 g (500 mg elemental) Tab 1.5 g (600 mg elemental) Tab eff 1.7 g (1 g elemental) Inj 50 mg

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 Imuran Arrow-Azithromycin Pacifen ArrowBendrofluazide Sandoz Beta Scalp Fibalip Bicalox Lax-Tab AFT healthE API Miacalcic Airflow Calci-Tab 500 Calci-Tab 600 Calsource Calcium Folinate Ebewe 2011 2011 2013 2012 2012 2013 2012 2012 2011 2011 2012 2011 2011 2013 2011 2012 2011 2012 2011 2012 2011 2011 2011 2012 2011 2012

Amoxycillin clavulanate

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

Calcium folinate

2011

*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 November 2010

Generic Name

Cefaclor monohydrate Cefazolin sodium Cefuroxime sodium Cephalexin monohydrate Cetirizine hydrochloride Cetomacrogol Chloramphenicol Chlorhexidine gluconate Ciclopiroxolamine Cilazapril with hydrochlorothiazide Ciprofloxacin Citalopram Clobetasol propionate

Presentation

Grans for oral liq 125 mg per 5 ml Inj 500 mg & 1 g Inj 750 mg & 1.5 g Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Tab 10 mg Oral liq 1 mg per ml Crm BP Eye oint 1% Handrub 1% with ethanol 70% Soln 4% Nail soln 8% Tab 5 mg with hydrochlorothiazide 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

Brand Name Expiry Date*

Ranbaxy-Cefaclor Hospira Zinacef Cefalexin Sandoz Cefalexin Sandoz Zetop Cetirizine-AFT PSM Chlorsig healthE Orion Batrafen Inhibace Plus 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 2013 2011 2011 2012 2011 2013 2012 2012 2011 2012 2013 2011 2011 2012

Clonazepam Clonidine

2011 2012

Clonidine hydrochloride

2012

Clotrimazole

2013 2011 2013 2012 2012 2013 2012 2011 2011 2013 2013

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

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Dextrose Dextrose with electrolytes

Presentation

Inj 50%, 10 ml Soln with electrolytes

Brand Name Expiry Date*

Biomed Pedialyte – Fruit Pedialyte – Bubblegum Pedialyte – Plain Diclofenac Sandoz Voltaren Ophtha Voltaren Voltaren DHC Continus Dilzem Cardizem CD Pytazen SR Laxofast 50 Laxofast 120 Laxsol Donepezil-Rex AFT Arrow-Enalapril 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 2011 2013

Diclofenac sodium

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 Tab 5 mg & 10 mg Oint BP Tab 5 mg, 10 mg & 20 mg 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

2012 2011

Dihydrocodeine tartrate Diltiazem hydrochloride

2013 31/12/11

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

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

Ethinyloestradiol Etidronate disodium Felodipine Ferrous sulphate Finasteride Flucloxacillin sodium

Fluconazole Fludarabine phosphate

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Fluorometholone Fluoxetine hydrochloride Fluticasone propionate Furosemide Fusidic acid Gabapentin Gentamicin sulphate Gliclazide Glipizide Glyceryl trinitrate

Presentation

Eye drops 0.1% Tab dispersible 20 mg, scored Metered aqueous nasal spray, 50 µg per dose Tab 40 mg 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*

FML Fluox Flixonase Hayfever & Allergy Diurin 40 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 2012 2013 31/1/13 2012 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)

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

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

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Lisinopril Loratadine

Presentation

Tab 5 mg, 10 mg & 20 mg Oral liq 1 mg per ml Tab 10 mg Shampoo 1% Device Tab 100 mg Tab 135 mg Tab 160 mg Enema 1 g per 100 ml Tab immediate-release 500 mg & 850 mg Tab 5 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% Tab 150 mg & 300 mg 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

Brand Name Expiry Date*

Arrow-Lisinopril Lorapaed Loraclear Hayfever Relief A-Lices Foremount Child’s Silicone Mask De-Worm Colofac Apo-Megestrol Pentasa Apotex Methatabs 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 Apo-Moclobemide m-Mometasone m-Mometasone RA-Morph RA-Morph RA-Morph RA-Morph Sevredol Mayne Mayne 2012 2013

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

2013 30/9/11 2011 2011 2012 2012 2012 2013 2012

Methotrexate

2012 2011 2011 2012 2011 2011 2012

Methyldopa Methylprednisolone Methylprednisolone acetate Methylprednisolone acetate with lignocaine Methylprednisolone sodium succinate

Metoclopramide hydrochloride Miconazole nitrate Moclobemide Mometasone furoate Morphine hydrochloride

2011 2011 2012 2012 2012

Morphine sulphate

2012 2011

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Naproxen Nevirapine

Presentation

Tab 250 mg Tab 500 mg Oral suspension 10 mg per ml Tab 200 mg

Brand Name Expiry Date*

Noflam 250 Noflam 500 Viramune Suspension Viramune Noriday 28 Primolut N Norpress Nilstat Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Syntocinon Syntocinon Syntometrine Pamisol Pamisol Pamisol 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 2012 2012

Norethisterone Nortriptyline hydrochloride Nystatin Omeprazole

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

2012 2011 2011 2011 2011

Oxytocin

Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml Inj 3 mg per ml, 5 ml Inj 3 mg per ml, 10 ml Inj 6 mg per ml, 10 ml Tab 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%

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

2011 2011

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Phenoxymethylpenicillin (Pencillin V) Pindolol Pioglitazone Pizotifen Poloxamer Polyvinyl alcohol Potassium chloride Prednisone Prednisone sodium phosphate Pregnancy tests – hCG urine Procaine penicillin Promethazine hydrochloride

Presentation

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% 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*

AFT AFT Apo-Pindolol Pizaccord Sandomigran Coloxyl Vistil Vistil Forte Span-K Apo-Prednisone Redipred Innovacon hCG One Step Pregnancy Test Cilicaine Promethazine Winthrop Elixir Allersoothe Accupril Accuretic 10 Accuretic 20 Q 300 Mycobutin Ropin ArrowRoxithromycin Salapin Asthalin Asthalin Duolin 2012 2013 2013 2012 2013 2012 2012 2013 2012 2012 2012 2011 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)

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

2012 2011

Sodium cromoglycate Somatropin

2012 31/12/12

Sole Subsidised Supply Products – cumulative to November 2010

Generic Name

Sotalol Spacer Device Spironolactone Sumatriptan Tamsulosin hydrochloride Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terbinafine Testosterone cypionate Testosterone undecanoate Tetracosactrin Timolol maleate Tramadol hydrochloride Tranexamic acid Triamcinolone acetonide

Presentation

Tab 80 mg & 160 mg 230 ml Tab 25 mg & 100 mg Tab 50 mg & 100 mg Cap 400 µg Soln 2.3% 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*

Mylan Space Chamber Spirotone Arrow-Sumatriptan Tamsulosin-Rex Pinetarsol 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 2012 30/9/11 2013 2013 2013 2011 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 November 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 November 2010

32 49 95 96 INSULIN PEN NEEDLES – Maximum of 100 dev per prescription ❋ 32 g × 4 mm ......................................................................... 10.50 CAPTOPRIL ❋ Tab 12.5 mg ............................................................................ 2.00 ❋ Tab 25 mg ............................................................................... 2.40 ❋ Tab 50 mg ............................................................................... 3.50 ETRAVIRINE – Special Authority see SA1025 – Retail pharmacy Tab 100 mg ......................................................................... 770.00 DARUNAVIR – Special Authority see SA1025 – Retail pharmacy Tab 300 mg ...................................................................... 1,190.00 Tab 400 mg ......................................................................... 837.50 ETANERCEPT – Special Authority see SA1060 – Retail pharmacy Inj 50 mg autoinjector ........................................................ 1,899.92 LEVETIRACETAM Tab 250 mg ........................................................................... 24.03 Tab 500 mg ........................................................................... 28.71 Tab 750 mg ........................................................................... 45.23 100 100 100 100 120 120 60 4 60 60 60 ✔ B-D Micro-Fine ✔ m-Captopril ✔ m-Captopril ✔ m-Captopril ✔ Intelence ✔ Prezista ✔ Prezista ✔ Enbrel ✔ Levetiracetam-Rex ✔ Levetiracetam-Rex ✔ Levetiracetam-Rex

107 119

123 136 137

SELEGILINE HYDROCHLORIDE ❋ Tab 5 mg ............................................................................... 16.06 100 ✔Apo-Selegiline S29 S29 Note – This unregistered pack of Apo-Selegiline tab 5 mg is a temporary listing to cover a potential out-of-stock. DONEPEZIL HYDROCHLORIDE ❋ Tab 5 mg .................................................................................. 7.71 ❋ Tab 10 mg .............................................................................. 14.06 90 90 ✔ Donepezil-Rex ✔ Donepezil-Rex

VARENICLINE TARTRATE – Special Authority see SA1054 – Retail pharmacy Tab 0.5 mg x 11 and 1 mg x 14 ............................................... 60.48 1 OP ✔ Champix Tab 1 mg ................................................................................ 67.74 28 ✔ Champix Tab 1 mg .............................................................................. 135.48 56 ✔ Champix ➽ SA1054 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Short-term therapy as an aid to achieving abstinence in a patient who has indicated that they are ready to cease smoking; and 2 The patient is part of, or is about to enrol in, a comprehensive support and counselling smoking cessation programme, which includes prescriber or nurse monitoring; and 3 Either: 3.1 The patient has tried but failed to quit smoking after at least two separate trials of nicotine replacement therapy, at least one of which included the patient receiving comprehensive advice on the optimal use of nicotine replacement therapy; or 3.2 The patient has tried but failed to quit smoking using bupropion or nortriptyline; and 4 The patient has not used varenicline in the last 12 months; and 5 Varenicline is not to be used in combination with other pharmacological smoking cessation treatments and the patient has agreed to this; and continued...

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

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

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New listings - effective 1 November 2010 (continued)

continued... 6 The patient is not pregnant. Renewal from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Short-term therapy as an aid to achieving abstinence in a patient who has indicated that they are ready to cease smoking; and 2 The patient is part of, or is about to enrol in, a comprehensive support and counselling smoking cessation programme, which includes prescriber or nurse monitoring; and 3 The patient has not used varenicline in the last 12 months; and 4 Varenicline is not to be used in combination with other pharmacological smoking cessation treatments and the patient has agreed to this; and 5 The patient is not pregnant. The patient may not have had more than 1 prior approval in the past 12 months. 149 SUNITINIB – Special Authority see SA1055 – Retail pharmacy Cap 12.5 mg ...................................................................... 2,315.38 Cap 25 mg ......................................................................... 4,630.77 Cap 50 mg ......................................................................... 9,261.54 28 28 28 ✔ Sutent ✔ Sutent ✔ Sutent

➽ SA1055 Special Authority for Subsidy Initial application only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 The patient has metastatic renal cell carcinoma; and 2 Either 2.1 The patient is sunitinib treatment naive; or 2.2 The patient received sunitinib prior to 1 November 2010 and disease has not progressed; and 3 The patient has good performance status (WHO/ECOG grade 0-1); and 4 The disease is of predominant clear cell histology; and 5 The patient has intermediate or poor prognosis based on the NCCN clinical practice guidelines for kidney cancer; and 6 Sunitinib to be used for a maximum of 2 cycles. Renewal only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 No evidence of disease progression; and 2 The treatment remains appropriate and the patient is benefiting from treatment. Notes: Sunitinib treatment should be stopped if disease progresses. NCCN clinical practice guidelines for kidney cancer are available at http://www.nccn.org/professionals/ physician_gls/f_guidelines.asp 151 BACILLUS CALMETTE-GUERIN (BCG) VACCINE – PCT only – Specialist Subsidised only for bladder cancer Inj 2-8 x 100 million CFU ....................................................... 187.37 PHARMACY SERVICES – No patient co-payment payable ❋ Brand switch fee........................................................................ 0.01 (BSF Arrow-Enalapril to be delisted 1 February 2011) ACETYLCYSTEINE – Retail pharmacy-Specialist Inj 200 mg per ml, 30 ml ...................................................... 219.00

1 1 fee

✔ OncoTICE ✔ BSF Arrow-Enalapril

167

171

▲

✔ Acetadote

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

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

86 122

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA0988 Tab 250 mg ............................................................................. 5.53 10 ✔ Klacid 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 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: continued...

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

148

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

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continued... 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. 150 151 ANASTROZOLE Tab 1 mg ................................................................................ 26.55 30 ✔ Aremed ✔ Myaccord ✔ Myaccord

New listings - effective 1 October 2010 (continued)

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 ENTERAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA0702 – Hospital pharmacy [HP3] Liquid ....................................................................................... 1.75 250 ml OP ✔ Ensure Plus HN

181 182 184

184

185

▲

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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Brand or Generic Mnfr ✔ fully subsidised

New listings - effective 1 October 2010 (continued)

191 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. TENOXICAM ❋ Inj 20 mg .................................................................................. 9.95 1 ✔ AFT

102

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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New listings - effective 1 September 2010 (continued)

109 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 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 continued...

▲

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

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

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Brand or Generic Mnfr ✔ fully subsidised

New listings - effective 1 September 2010 (continued)

continued... 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 CYCLIZINE LACTATE Inj 50 mg per ml, 1 ml ............................................................. 14.95 50 5 200 ml 5 ✔ Xylocaine ✔ Xylocaine ✔ Xylocaine Viscous ✔ Nausicalm

121

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

New listings - effective 1 September 2010 (continued)

141 145 163 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% ............................................................................ 1.18 100 mg 100 mg 5 ml OP ✔ 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions

Effective 1 November 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

50 103

ENALAPRIL A Brand Switch Fee may be claimed from 1 November 2010 until 31 January 2011. ❋ Tab 5 mg ................................................................................. 1.98 90 ✔ Arrow-Enalapril ❋ Tab 10 mg ............................................................................... 2.44 90 ✔ Arrow-Enalapril ❋ Tab 20 mg ............................................................................... 3.24 90 ✔ Arrow-Enalapril ADALIMUMAB – Special Authority see SA1059 1026 – Retail pharmacy Inj 40 mg per 0.8 ml prefilled pen ...................................... 1,799.92 Inj 40 mg per 0.8 ml prefilled syringe ................................. 1,799.92 2 2 ✔ HumiraPen ✔ Humira

➽ SA1059 1026 Special Authority for Subsidy Initial application — (rheumatoid arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for etanercept for rheumatoid arthritis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from etanercept; or 1.2.2 The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for rheumatoid arthritis; or 2 All of the following: 2.1 Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer; and 2.2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2.3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 2.4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and 2.5 Either: 2.5.1 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of cyclosporine alone or in combination with another agent; or 2.5.2 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of leflunomide alone or in combination with another agent; and 2.6 Either: 2.6.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 2.6.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 2.7 Either:

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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Changes to Restrictions - effective 1 November 2010 (continued)

continued... 2.7.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 2.7.2 C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months.

Initial application — (Crohn’s disease) only from a gastroenterologist. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Patient has severe active Crohn’s disease; and 2 Any of the following: 2.1 Patient has a Crohn’s Disease Activity Index (CDAI) score of greater than or equal to 300; or 2.2 Patient has extensive small intestine disease affecting more than 50 cm of the small intestine; or 2.3 Patient has evidence of short gut syndrome or would be at risk of short gut syndrome with further bowel resection; or 2.4 Patient has an ileostomy or colostomy, and has intestinal inflammation; and 3 Patient has tried but had an inadequate response to, or has experienced intolerable side effects from, prior systemic therapy with immunomodulators at maximum tolerated doses (unless contraindicated) and corticosteroids; and 4 Surgery (or further surgery) is considered to be clinically inappropriate. Initial application — (severe chronic plaque psoriasis) only from a dermatologist. Approvals valid for 4 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for etanercept for severe chronic plaque psoriasis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from etanercept; or 1.2.2 The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for severe chronic plaque psoriasis; or 2 All of the following: 2.1 Either: 2.1.1 Patient has "whole body" severe chronic plaque psoriasis with a Psoriasis Area and Severity Index (PASI) score of greater than 15, where lesions have been present for at least 6 months from the time of initial diagnosis; or 2.1.2 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and 2.2 Patient has tried, but had an inadequate response (see Note) to, or has experienced intolerable side effects from, at least three of the following (at maximum tolerated doses unless contraindicated): phototherapy, methotrexate, cyclosporin, or acitretin; and 2.3 A PASI assessment has been completed for at least the most recent prior treatment course (but preferably all prior treatment courses), preferably while still on treatment but no longer than 1 month following cessation of each prior treatment course; and 2.4 The most recent PASI assessment is no more than 1 month old at the time of application. Note: "Inadequate response" is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment.

continued...

▲

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

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

Check your Schedule for full details Schedule page ref

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

continued... Initial application — (ankylosing spondylitis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for etanercept for ankylosing spondylitis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from etanercept; or 1.2.2 The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for ankylosing spondylitis; or 2 All of the following: 2.1 Patient has a confirmed diagnosis of ankylosing spondylitis for more than six months; and 2.2 Patient has low back pain and stiffness that is relieved by exercise but not by rest; and 2.3 Patient has bilateral sacroiliitis demonstrated by plain radiographs, CT or MRI scan; and 2.4 Patient’s ankylosing spondylitis has not responded adequately to treatment with two or more nonsteroidal anti-inflammatory drugs (NSAIDs), in combination with anti-ulcer therapy if indicated, while patient was undergoing at least 3 months of an exercise regime supervised by a physiotherapist; and 2.5 Either: 2.5.1 Patient has limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or 2.5.2 Patient has limitation of chest expansion by at least 2.5 cm below the following average normal values corrected for age and gender (see Notes); and 2.6 A Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 6 on a 0-10 scale;. and 7 Either: 7.1 An elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 7.2 A C-reactive protein (CRP) level greater than 15 mg per litre. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI, ESR and CRP measures must be no more than 1 month old at the time of initial application. Average normal chest expansion corrected for age and gender: 18-24 years - Male: 7.0 cm; Female: 5.5 cm 25-34 years - Male: 7.5 cm; Female: 5.5 cm 35-44 years - Male: 6.5 cm; Female: 4.5 cm 45-54 years - Male: 6.0 cm; Female: 5.0 cm 55-64 years - Male: 5.5 cm; Female: 4.0 cm 65-74 years - Male: 4.0 cm; Female: 4.0 cm 75+ years - Male: 3.0 cm; Female: 2.5 cm Initial application — (psoriatic arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for etanercept for psoriatic arthritis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from etanercept; or 1.2.2 The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for psoriatic arthritis; or 2 All of the following: 2.1 Patient has had severe active psoriatic arthritis for six months duration or longer; and 2.2 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and continued... 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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Changes to Restrictions - effective 1 November 2010 (continued)

continued... 2.3 Patient has tried and not responded to at least three months of sulphasalazine at a dose of at least 2 g per day or leflunomide at a dose of up to 20 mg daily (or maximum tolerated doses); and 2.4 Either: 2.4.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 2.4.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 2.5 Any of the following: 2.5.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 2.5.2 Patient has an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 2.5.3 ESR and CRP not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months.

Renewal — (rheumatoid arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Either: 3.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or 3.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; and 4 Either: 4.1 Adalimumab to be administered at doses no greater than 40 mg every 14 days; or 4.2 Patient cannot take concomitant methotrexate and requires doses of adalimumab higher than 40 mg every 14 days to maintain an adequate response. Renewal — (Crohn’s disease) only from a gastroenterologist or Practitioner on the recommendation of a gastroenterologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a gastroenterologist; or 1.2 Applicant is a Practitioner and confirms that a gastroenterologist has provided a letter, email or fax recommending that the patient continues with adalimumab treatment; and 2 Either: 2.1 Either: 2.1.1 CDAI score has reduced by 100 points from the CDAI score when the patient was initiated on adalimumab; or 2.1.2 CDAI score is 150 or less; or 2.2 Both: 2.2.1 The patient has demonstrated an adequate response to treatment but CDAI score cannot be assessed; and 2.2.2 Applicant to indicate the reason that CDAI score cannot be assessed; and 3 Adalimumab to be administered at doses no greater than 40 mg every 14 days. Renewal — (severe chronic plaque psoriasis) only from a dermatologist or Practitioner on the recommendation of a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: continued...

▲

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

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

Check your Schedule for full details Schedule page ref

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

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

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 November 2010 (continued)

107 ETANERCEPT – Retail pharmacy-Specialist prescription – Special Authority see SA1060 0868 – Retail pharmacy Inj 25 mg ............................................................................. 949.96 4 ✔ Enbrel Inj 50 mg autoinjector ........................................................ 1,899.92 4 ✔ Enbrel ➽ SA1060 0868 Special Authority for Subsidy Initial application – (juvenile idiopathic arthritis) only from a named specialist or rheumatologist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 To be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Patient diagnosed with juvenile idiopathic arthritis (JIA); and 3 Patient has had severe active polyarticular course JIA for 6 months duration or longer; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-20 mg/m2 weekly or at the maximum tolerated dose) in combination with oral corticosteroids (prednisone 0.25 mg/kg or at maximum tolerated dose); and 5 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-15 mg/m2 weekly or at the maximum tolerated dose) in combination with one other diseasemodifying agent; and 6 Both: 6.1 Either: 6.1.1 Patient has persistent symptoms of poorly-controlled and active disease in at least 20 active, swollen, tender joints; or 6.1.2 Patient has persistent symptoms of poorly-controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, shoulder, cervical spine, hip; and 6.2 Physician's global assessment indicating severe disease. Initial application - (rheumatoid arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for adalimumab for rheumatoid arthritis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from adalimumab; or 1.2.2 The patient has received insufficient benefit from adalimumab to meet the renewal criteria for adalimumab for rheumatoid arthritis; or 2 All of the following: 2.1 Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer; and 2.2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2.3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 2.4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and 2.5 Either: 2.5.1 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of cyclosporin alone or in combination with another agent; or 2.5.2 Patient has tried and not responded to at least three months therapy at the maximum tolerated dose of leflunomide alone or in combination with another agent; and 2.6 Either: 2.6.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or continued...

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

continued... 2.6.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 2.7 Either: 2.7.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 2.7.2 C-reactive protein levels not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months.

Initial application - (severe chronic plaque psoriasis) only from a dermatologist. Approvals valid for 4 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for adalimumab for severe chronic plaque psoriasis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from adalimumab; or 1.2.2 The patient has received insufficient benefit from adalimumab to meet the renewal criteria for adalimumab for severe chronic plaque psoriasis; or 2 All of the following: 2.1 Either: 2.1.1 Patient has "whole body" severe chronic plaque psoriasis with a Psoriasis Area and Severity Index (PASI) score of greater than 15, where lesions have been present for at least 6 months from the time of initial diagnosis; or 2.1.2 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and 2.2 Patient has tried, but had an inadequate response (see Note) to, or has experienced intolerable side effects from, at least three of the following (at maximum tolerated doses unless contraindicated): phototherapy, methotrexate, cyclosporin, or acitretin; and 2.3 A PASI assessment has been completed for at least the most recent prior treatment course (but preferably all prior treatment courses), preferably while still on treatment but no longer than 1 month following cessation of each prior treatment course; and 2.4 The most recent PASI assessment is no more than 1 month old at the time of application. Note: "Inadequate response" is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment. Initial application - (ankylosing spondylitis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for adalimumab for ankylosing spondylitis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from adalimumab; or 1.2.2 The patient has received insufficient benefit from adalimumab to meet the renewal criteria for adalimumab for ankylosing spondylitis; or 2 All of the following: 2.1 Patient has a confirmed diagnosis of ankylosing spondylitis present for more than six months; and continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

continued... 2.2 Patient has low back pain and stiffness that is relieved by exercise but not by rest; and 2.3 Patient has bilateral sacroiliitis demonstrated by plain radiographs, CT or MRI scan; and 2.4 Patient's ankylosing spondylitis has not responded adequately to treatment with two or more non steroidal anti-inflammatory drugs (NSAIDs), in combination with anti-ulcer therapy if indicated, while patient was undergoing at least 3 months of an exercise regimen supervised by a physiotherapist; and 2.5 Either: 2.5.1 Patient has limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or 2.5.2 Patient has limitation of chest expansion by at least 2.5 cm below the average normal values corrected for age and gender (see Notes); and 2.6 A Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 6 on a 0-10 scale. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI measures must be no more than 1 month old at the time of initial application. Average normal chest expansion corrected for age and gender: 18-24 years - Male: 7.0 cm; Female: 5.5 cm 25-34 years - Male: 7.5 cm; Female: 5.5 cm 35-44 years - Male: 6.5 cm; Female: 4.5 cm 45-54 years - Male: 6.0 cm; Female: 5.0 cm 55-64 years - Male: 5.5 cm; Female: 4.0 cm 65-74 years - Male: 4.0 cm; Female: 4.0 cm 75+ years - Male: 3.0 cm; Female: 2.5 cm Initial application - (psoriatic arthritis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Both: 1.1 The patient has had an initial Special Authority approval for adalimumab for psoriatic arthritis; and 1.2 Either: 1.2.1 The patient has experienced intolerable side effects from adalimumab; or 1.2.2 The patient has received insufficient benefit from adalimumab to meet the renewal criteria for adalimumab for psoriatic arthritis; or 2 All of the following: 2.1 Patient has had severe active psoriatic arthritis for six months duration or longer; and 2.2 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and 2.3 Patient has tried and not responded to at least three months of sulphasalazine at a dose of at least 2 g per day or leflunomide at a dose of up to 20 mg daily (or maximum tolerated doses); and 2.4 Either: 2.4.1 Patient has persistent symptoms of poorly controlled and active disease in at least 20 active, swollen, tender joints; or 2.4.2 Patient has persistent symptoms of poorly controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, and either shoulder or hip; and 2.5 Any of the following: 2.5.1 Patient has a C-reactive protein level greater than 15 mg/L measured no more than one month prior to the date of this application; or 2.5.2 Patient has an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour; or 2.5.3 ESR and CRP not measured as patient is currently receiving prednisone therapy at a dose of greater than 5 mg per day and has done so for more than three months. 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 November 2010 (continued)

continued... Renewal - (juvenile idiopathic arthritis) only from a named specialist or rheumatologist or Practitioner on the recommendation of a named specialist or rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a named specialist or rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a named specialist or rheumatologist has provided a letter, email or fax recommending that the patient continues with etanercept treatment; and 2 Subsidised as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Either: 3.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count and an improvement in physician's global assessment from baseline; or 3.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count and continued improvement in physician's global assessment from baseline. Renewal - (rheumatoid arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with etanercept treatment; and 2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 3 Either: 3.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; or 3.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count from baseline and a clinically significant response to treatment in the opinion of the physician; and 4 Etanercept to be administered at doses no greater than 50 mg every 7 days. Renewal - (severe chronic plaque psoriasis) only from a dermatologist or Practitioner on the recommendation of a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a dermatologist; or 1.2 Applicant is a Practitioner and confirms that a dermatologist has provided a letter, email or fax recommending that the patient continues with etanercept treatment; and 2 Either: 2.1 Both: 2.1.1 Patient has "whole body" severe chronic plaque psoriasis; and 2.1.2 Following each prior etanercept treatment course the patient has a PASI score which is reduced by 75% or more, or is sustained at this level, when compared with the pre-treatment baseline value; or 2.2 Both: 2.2.1 Patient has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and 2.2.2 Either:

S29

Check your Schedule for full details Schedule page ref

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

continued... Following each prior etanercept treatment course the patient has a reduction in the PASI symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the treatment course baseline values; or 2.2.2.2 Following each prior etanercept treatment course the patient has a reduction of 75% or more in the skin area affected, or sustained at this level, as compared to the pre-treatment baseline value; and 3 Etanercept to be administered at doses no greater than 50 mg every 7 days. Note: An etanercept treatment course is defined as a minimum of 12 weeks of etanercept treatment. Renewal - (ankylosing spondylitis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with etanercept treatment; and 2 Following 12 weeks of etanercept treatment, BASDAI has improved by 4 or more points from pretreatment baseline on a 10 point scale, or by 50%, whichever is less; and 3 Physician considers that the patient has benefited from treatment and that continued treatment is appropriate; and 4 Etanercept to be administered at doses no greater than 50 mg every 7 days. Renewal - (psoriatic arthritis) only from a rheumatologist or Practitioner on the recommendation of a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 Applicant is a rheumatologist; or 1.2 Applicant is a Practitioner and confirms that a rheumatologist has provided a letter, email or fax recommending that the patient continues with etanercept treatment; and 2 Either: 2.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count from baseline and a clinically significant response to treatment in the opinion of the treating physician; or 2.2 The patient demonstrates at least a continuing 50% improvement in active joint count from baseline and a clinically significant response to prior etanercept treatment in the opinion of the treating physician; and 3 Etanercept to be administered at doses no greater than 50 mg every 7 days. Initial application only from a named specialist or rheumatologist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 To be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Patient diagnosed with Juvenile Idiopathic Arthritis (JIA); and 3 Patient has had severe active polyarticular course JIA for 6 months duration or longer; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-20mg/m2 weekly or at the maximum tolerated dose) in combination with oral corticosteroids (prednisone 0.25 mg/kg or at the maximum tolerated dose); and 5 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-15mg/m2 weekly or at the maximum tolerated dose) in combination with one other disease-modifying agent; and 6 Both: 6.1 Either:

▲

2.2.2.1

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

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

Check your Schedule for full details Schedule page ref

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

continued... 6.1.1 Patient has persistent symptoms of poorly-controlled and active disease in at least 20 active, swollen, tender joints; or 6.1.2 Patient has persistent symptoms of poorly-controlled and active disease in at least four active joints from the following: wrist, elbow, knee, ankle, shoulder, cervical spine, hip; and 6.2 Physician’s global assessment indicating severe disease; and 7 The patient or their legal guardian consents to details of their treatment being held on a central registry and has signed a consent form outlining conditions of ongoing treatment. Note: A patient declaration form http://www.pharmac.govt.nz/special_authority_forms/SA0667-declaration.pdf must be signed by the legal guardian of the patient and the prescriber in the presence of a witness (over 18 years of age) Renewal only from a named specialist or rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Subsidised as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Either: 2.1 Following 4 months initial treatment, the patient has at least a 50% decrease in active joint count and an improvement in physician’s global assessment from baseline; or 2.2 On subsequent reapplications, the patient demonstrates at least a continuing 30% improvement in active joint count and continued improvement in physician’s global assessment from baseline. 116 VENLAFAXINE – Special Authority see SA1061 0789 – Retail pharmacy Cap 37.5 mg .......................................................................... 18.64 Cap 75 mg ............................................................................. 37.27 Cap 150 mg ........................................................................... 45.68 28 28 28 ✔ Efexor XR ✔ Efexor XR ✔ Efexor XR

➽ SA1061 0789 Special Authority for Subsidy Initial application only from a relevant specialist or vocationally registered general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has ’treatment-resistant’ depression; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and failed to respond to have had an inadequate response from an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and failed to respond to have had an inadequate response from an adequate dose over an adequate period of time. Renewal from any medical practitioner. Approvals valid for 2 years where the patient has a high risk of relapse (prescriber determined). 119 LEVETIRACETAM – Special Authority see SA0921 – Retail pharmacy Tab 250 mg ........................................................................... 24.03 60 ✔ Levetiracetam-Rex Tab 500 mg ........................................................................... 28.71 60 ✔ Levetiracetam-Rex Tab 750 mg ........................................................................... 45.23 60 ✔ Levetiracetam-Rex ➽ SA0921 Special Authority for Subsidy Subsidy by application to the Levetiracetam Special Access Panel Notes: Application details may be obtained from PHARMAC’s website http://www.pharmac.govt.nz or: The Coordinator, Levetiracetam Special Access Panel Phone: (04) 916-7553 PHARMAC, PO Box 10 254 Facsimile: (09) 929-3226 Wellington Email: lsacoordinator@pharmac.govt.nz Note – Keppra tablets to be delisted 1 November 2010.

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 November 2010 (continued)

165 PILOCARPINE ❋ Eye drops 1% ........................................................................... 4.26 ❋ Eye drops 2% ........................................................................... 5.35 ❋ Eye drops 4% ........................................................................... 7.99 15 ml OP 15 ml OP 15 ml OP ✔ Isopto Carpine

S29

✔ Isopto Carpine

S29

✔ Isopto Carpine

S29

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: 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 October 2010 (continued)

continued... 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 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. 2.1.3.1

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: continued... Either: Patients pay a manufacturer’s surcharge when S29 Unapproved medicine supplied under Section 29 the Manufacturer’s Price is greater than the Subsidy ‡ safety cap reimbursed Sole Subsidised Supply

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

continued... 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: 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. 93 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: 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 October 2010 (continued)

continued... 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: 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: continued...

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

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

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 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 October 2010 (continued)

continued... 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. 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 continued...

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

continued... 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: 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. 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 October 2010 (continued)

continued... 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. 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.

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2010 (continued)

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

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.

▲

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)

41 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 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. 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... 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. 46 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 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

▲

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)

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 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

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

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 97 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 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

101

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 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... 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: 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. 111 LIGNOCAINE Gel 2%, 10 ml urethral syringe – Up to 5 each available on a PSO .................................... 43.26

✔ Pfizer

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

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

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. 500 500

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

130

▲

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)

130 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. 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 ............................................................................ 21.02 250 100 ✔ Ativan ✔ Ativan

130

100 Ox-Pam 100 Ox-Pam

132

30 Noctamid

132

100 Hypnovel

132

100 Nitrados

132

✔ Normison

132

100 Hypam 100 Hypam

132

500

✔ Apo-Zopiclone

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2010 (continued)

140 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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer’s Price

Effective 1 November 2010

33 MUCILAGINOUS LAXATIVES – Only on a prescription ( subsidy) ❋ Dry ........................................................................................... 3.91 (5.72) 4.58 (6.69) 5.42 (12.71) 6.02 (16.49) ❋ Dry-original flavour, regular texture only .................................... 4.05 (12.38) ❋ Sugar Free ................................................................................ 3.31 (10.60) MUCILAGINOUS LAXATIVES WITH STIMULANTS ( subsidy) ❋ Dry ........................................................................................... 2.41 (7.69) 6.02 (16.49) VITAMIN B COMPLEX ( subsidy) ❋ Tab, strong, BPC ...................................................................... 4.70 (12.10) VITAMINS ( subsidy) ❋ Tab (BPC cap strength) ............................................................ 8.00 CLOPIDOGREL ( subsidy) Tab 75 mg ............................................................................... 5.06 (73.38) FUROSEMIDE ( subsidy) ❋ Inj 10 mg per ml, 2 ml – Up to 5 inj available on a PSO ............................................................... 13.00 (29.50) 325 g OP Konsyl-D 380 g OP Mucilax 450 g OP Isogel 500 g OP Normacol 336 g OP Metamucil 275 g OP Mucilax 200 g OP Normacol Plus 500 g OP Normacol Plus 500 Apo-B-Complex 1,000 28 ✔ MultiADE ✔ Arrow-Clopidogrel Plavix

36 38 41

50 Mayne

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 500 mg ............................................................................... 2.57 1 (3.99) AFT DAUNORUBICIN – PCT only – Specialist ( subsidy) Inj 2 mg per ml, 10 ml .......................................................... 118.72 Inj 20 mg for ECP ................................................................. 118.72 TERBUTALINE SULPHATE ( subsidy) Powder for inhalation, 250 µg per dose, breath activated ......... 22.00 1 ✔ Pfizer S29 20 mg OP ✔ Baxter 200 dose OP ✔ Bricanyl Turbuhaler

143

158

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 November 2010 (continued)

163 SODIUM CROMOGLYCATE ( subsidy) Eye drops 2% ........................................................................... 2.36 (3.95) 10 ml OP Cromolux

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 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 50 Questran-Lite 28 Apo-Terazosin 500 Apo-Terazosin 500 Apo-Terazosin 100 15 g OP Mycostatin ✔ Napamide

49 56 61

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

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

65 66 UREA ( subsidy) ❋ Crm 10% .................................................................................. 3.07 MALATHION ( subsidy) Liq 0.5% ................................................................................... 3.79 (4.99) OESTRIOL ( subsidy) ❋ Crm 1 mg per g with applicator ................................................. 6.30 ❋ Pessaries 500 µg ..................................................................... 6.53 100 g OP 200 ml OP Derbac-M 15 g OP 15 ✔ Ovestin ✔ Ovestin ✔ Nutraplus

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

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

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

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 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 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 28 1 ✔ Ural ✔ Solu-Cortef

75 77

50 50 50 50

✔ Cilicaine VK ✔ Cilicaine VK ✔ Nilstat ✔ Nilstat

▲

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 September 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

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Subsidy and Manufacturer's Price - effective 1 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

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules

Effective 1 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

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Section E Part I

Effective 1 November 2010

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

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

195 195

Changes to Sole Subsidised Supply

Effective 1 November 2010

For the list of new Sole Subsidised Supply products effective 1 November 2010 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 12-19.

▲

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 November 2010

50 55 62 72 ENALAPRIL ❋ Tab 5 mg ................................................................................. 1.98 ❋ Tab 10 mg ............................................................................... 2.44 (2.76) ❋ Tab 20 mg ............................................................................... 3.24 (3.68) FUROSEMIDE ❋ Tab 500 mg ........................................................................... 12.00 HYDROCORTISONE ❋ Crm 1% – Only on a prescription .............................................. 2.44 ETHINYLOESTRADIOL WITH LEVONORGESTREL ❋ Tab ethinyloestradiol 30 µg with levonorgestrel 50 µg (6) and tab ethinyloestradiol 40 µg with levonorgestrel 75 µg (5), and tab ethinyloestradiol 30 µg with levonorgestrel 125 µg (10) and 7 inert tab – Up to 84 tab available on a PSO ............ 6.62 DYDROGESTERONE Tab 10 mg ............................................................................. 27.50 (29.90) Note – Duphaston tab 10 mg, 28 tab pack remains listed DANAZOL – Retail pharmacy-Specialist Cap 200 mg ........................................................................... 29.35 DICLOFENAC SODIUM ❋ Tab EC 25 mg .......................................................................... 1.63 ❋ Tab EC 50 mg .......................................................................... 2.13 ❋ Tab long-acting 75 mg ........................................................... 22.78 ❋ Tab long-acting 100 mg ......................................................... 34.32 CLOMIPRAMINE HYDROCHLORIDE Tab 25 mg ............................................................................. 26.00 90 90 90 m-Enalapril 100 100 g ✔ Diurin 500 ✔ Lemnis Fatty Cream HC ✔ m-Enalapril m-Enalapril

84 50

✔ Trifeme

Duphaston

83 101 114 115

30 50 50 500 500 500

✔ D-Zol ✔ Diclohexal ✔ Diclohexal ✔ Apo-Diclo SR ✔ Apo-Diclo SR ✔ Clopress

MOCLOBEMIDE Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide. Tab 150 mg ............................................................................. 8.31 60 ✔ GenRx Moclobemide Tab 300 mg ........................................................................... 18.80 60 ✔ GenRx Moclobemide LEVETIRACETAM – Special Authority see SA0921 – Retail pharmacy Tab ..................................................................................... CBS 60 ✔ Keppra ✔ Fluorouracil Ebewe

119 141

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

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

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 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 February 2011

33 MUCILAGINOUS LAXATIVES – Only on a prescription ❋ Dry ........................................................................................... 3.91 (5.72) 4.58 (6.69) 5.42 (12.71) 6.02 (16.49) ❋ Dry-original flavour, regular texture only .................................... 4.05 (12.38) Note – Konsyl-D 500 g pack remains fully subsidised VITAMIN B COMPLEX ❋ Tab, strong, BPC ...................................................................... 4.70 (12.10) 325 g OP Konsyl-D 380 g OP Mucilax 450 g OP Isogel 500 g OP Normacol 336 g OP Metamucil

500 Apo-B-Complex

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 February 2011 (continued)

41 CLOPIDOGREL Tab 75 mg ................................................................................ 5.06 (73.38) Note – Apo-Clopidogrel tab 75 mg, 90 tab pack, remains fully subsidised. 55 FUROSEMIDE ❋ Inj 10 mg per ml, 2 ml – Up to 5 inj available on a PSO ............ 13.00 (29.50) 50 Mayne 28 ✔ Apo-Clopidogrel ✔ Arrow-Clopidogrel Plavix

163

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

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 ............................... 13.00 500 ✔ Amizide

▲

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 April 2011 (continued)

102 PIROXICAM ❋ Tab dispersible 10 mg .............................................................. 3.25 ❋ Tab dispersible 20 mg .............................................................. 5.50 50 100 ✔ Piram-D ✔ Piram-D

Effective 1 May 2011

33 PANCREATIC ENZYME Cap 8,000 USP u lipase, 30,000 USP u amylase, 30,000 USP u protease ........................................................ 85.00 RISPERIDONE Tab 0.5 mg ............................................................................... 1.17 Note – Ridal tab 0.5 mg, 60 tab pack, remains subsidised.

250 20

✔ Cotazym ECS ✔ Ridal

127

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 November 2010

16 19 ACETYLCYSTEINE Inj 200 mg per ml, 30 ml ...................................................... 219.00 BACILLUS CALMETTE-GUERIN (BCG) VACCINE Subsidised only for bladder cancer Inj 2-8 x 100 million CFU – 1% Jan-11 to 2013 ..................... 187.37 4 Acetadote

OncoTICE m-Captopril m-Captopril m-Captopril

CAPTOPRIL Tab 12.5 mg - 1% DV Jan-11 to 2013....................................... 2.00 100 Tab 25 mg - 1% DV Jan-11 to 2013.......................................... 2.40 100 Tab 50 mg - 1% DV Jan-11 to 2013.......................................... 3.50 100 Note – Apo-Captopril tab 12.5 mg, 25 mg and 50 mg to be delisted 1 January 2011. CETOMACROGOL Crm, BP, 500 g ....................................................................... 42.00 DARUNAVIR Tab 300 mg ....................................................................... 1,190.00 Tab 400 mg .......................................................................... 837.50 DAUNORUBICIN ( price) Inj 2 mg per ml, 10 ml .......................................................... 118.72 DONEPEZIL HYDROCHLORIDE Tab 5 mg – 1% DV Nov-10 to 2012 .......................................... 7.71 Tab 10 mg – 1% DV Nov-10 to 2012 ...................................... 14.06 DORIPENEM Vial for infusion 500 mg ........................................................ 454.50 ETANERCEPT Inj 50 mg autoinjector ......................................................... 1,899.92 ETRAVIRINE Tab 100 mg .......................................................................... 770.00 INSULIN PEN NEEDLES 29 g x 12.7 mm ...................................................................... 10.50 31 g x 5 mm ........................................................................... 11.75 31 g x 8 mm ........................................................................... 10.50 32 g x 4 mm ........................................................................... 10.50 INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE Syringe 0.3 ml with 29 g × 12.7 mm needle .......................... 13.00 Syringe 0.3 ml with 31 g × 8 mm needle ............................... 13.00 Syringe 0.5 ml with 29 g × 12.7 mm needle .......................... 13.00 Syringe 0.5 ml with 31 g × 8 mm needle ............................... 13.00 Syringe 1 ml with 29 g × 12.7 mm needle ............................. 13.00 Syringe 1 ml with 31 g × 8 mm needle .................................. 13.00 12 120 60 1 90 90 10 4 120 100 100 100 100 100 100 100 100 100 100

23 26

Pharmacy Health Prezista Prezista Pfizer Donepezil-Rex Donepezil-Rex Doribax Enbrel Intelence B-D Micro-Fine B-D Micro-Fine B-D Micro-Fine B-D Micro-Fine B-D Ultra Fine B-D Ultra Fine II B-D Ultra Fine B-D Ultra Fine II B-D Ultra Fine B-D Ultra Fine II

26 28

28 29 29 35

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)

37 38 ISOPROPYL ALCOHOL Soln 70%, 500 ml ................................................................... 60.00 LEVETIRACETAM Tab 250 mg ........................................................................... 24.03 Tab 500 mg ........................................................................... 28.71 Tab 750 mg ........................................................................... 45.23 12 60 60 60 PSM Levetiracetam-Rex Levetiracetam-Rex Levetiracetam-Rex Provive MCT-LCT 1% Provive MCT-LCT 1% Provive MCT-LCT 1%

PROPOFOL Inj 1%, 20 ml .......................................................................... 10.21 5 Inj 1%, 50 ml ............................................................................ 5.56 1 Inj 1%, 100 ml .......................................................................... 9.28 1 Note - Provive 1% inj 1% 20 ml, 50 ml and 100 ml to be delisted 1 May 2011. RETINOL PALMITATE Oint, 25 g .............................................................................. 160.00 80

50 50

PSM

RISPERIDONE Tab 0.5 mg .............................................................................. 1.17 20 Ridal Note – Ridal tab 0.5 mg, 20 tab pack to be delisted 1 January 2011. Ridal tab 0.5 mg 60 tab pack remains available. SORBOLENE WITH GLYCERIN Crm with 10% glycerine, 100 g ............................................... 64.00 50.40 120.00 Crm with 10% glycerine, 500 ml .............................................. 54.00 Crm with 10% glycerine, 1,000 ml ........................................... 39.00 SUNITINIB Cap 12.5 mg ...................................................................... 2,315.38 Cap 25 mg ......................................................................... 4,630.77 Cap 50 mg ......................................................................... 9,261.54 VARENICLINE TARTRATE Tab 0.5 mg x 11 and 1 mg x 14 ............................................... 60.48 Tab 1 mg ................................................................................ 67.74 135.48 20 24 60 12 6 28 28 28 1 28 56 healthE Pharmacy Health Pharmacy Health Pharmacy Health Pharmacy Health Sutent Sutent Sutent Champix Champix Champix

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 25 56 35 Lovir Lovir Lovir

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)

17 AMILORIDE WITH HYDROCHLOROTHIAZIDE (delisting) Tab 5 mg with hydrochlorothiazide 50 mg................................ 13.00 Note – Amizide to be delisted 1 December 2010 500 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 MERCAPTOPURINE Tab 50 mg - 1% DV Dec-10 to 2013 ....................................... 47.06 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 25 50 100

Diamide Relief Ativan Ativan Purinethol Myaccord Myaccord

40 43

MYCOPHENOLATE MOFETIL (new listing) Tab 500 mg ............................................................................ 85.00 Cap 250 mg ............................................................................ 85.00 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)

43 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 50 100 30 10 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 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) ........................................ 1.45 237 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 250 ml 200 ml 237 ml 200 ml 237 ml 237 ml 200 ml

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 Glucerna Select Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus Ensure Plus 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 1.5 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 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 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 Ensure Plus Ensure Plus Two Cal HN Ensure Ensure Ensure Ensure Ensure Pediasure Pediasure Pediasure Pediasure Pediasure RTH Nepro Nepro Multichem Multichem Multichem

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 Veracol Veracol

21 21 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 20 20

22 23

Cephalexin ABM healthE

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)

23 23 24 CHLORHEXIDINE Foaming liquid 4%, 50 ml ........................................................ 37.20 CHLORHEXIDINE IN ALCOHOL Soln 0.5% with 70% alcohol, 25 ml (tinted pink) .................... 232.50 20 150 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 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 .... 75.00 100 100 100 100 ml 10 1 5 50 ml

Serenace Serenace Serenace Serenace Serenace Solu-Cortef Apidra Xylocaine

34 35 38

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)

39 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 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

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

50 50 20

Nilstat Nilstat healthE

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)

47 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 5 5 10 20 Cilicaine VK Cilicaine VK Regitine Citanest Citanest healthE

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 18 ASCORBIC ACID Tab 100 mg – 1% DV Oct-10 to 2013 ..................................... 13.80 ATORVASTATIN Tab 10 mg – 1 % DV Dec-2010 - 31/7/12................................. 1.77 Tab 20 mg – 1 % DV Dec-2010 - 31/7/12................................. 2.60 Tab 40 mg – 1 % DV Dec-2010 - 31/7/12................................. 4.38 Tab 80 mg – 1 % DV Dec-2010 - 31/7/12................................. 7.73 AZATHIOPRINE Tab 50 mg – 1% DV Oct-10 to 2013 ....................................... 18.45 Inj 50 mg – 1% DV Oct-10 to 2013 ......................................... 60.00 500 30 30 30 30 100 1 Vitala-C Lorstat 10 Lorstat 20 Lorstat 40 Lorstat 80 Imuprine Imuran

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)

22 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 5 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 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 10 strip Optium Blood Ketone Test Strips Jadelle Methatabs Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Quetiapine Dr Reddy’s Risperidone

38 40 49

1 10 60 60 60 60 60

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)

52 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

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 .............................................................. 50 Acarbose ........................................................... 47 ACB ................................................................... 65 Acebutolol.......................................................... 65 Acetadote .................................................... 21, 71 Acetylcysteine.............................................. 21, 71 Aciclovir ............................................................ 72 Aclasta .............................................................. 25 Adalimumab....................................................... 28 Adapalene .......................................................... 22 Alendronate sodium ........................................... 51 Alendronate sodium with cholecalciferol ....... 51, 66 Alitraq ................................................................ 74 Alphamox .................................................... 22, 73 Alprazolam ......................................................... 53 Amiloride with hydrochlorothiazide ... 49, 59, 69, 73 Amizide........................................................ 69, 73 Amlodipine................................................... 65, 73 Amoxycillin ............................................ 22, 66, 73 Anastrozole .................................................. 23, 73 Andriol Testocaps .............................................. 65 Apidra .................................................... 24, 76, 79 Apidra SoloStar .................................................. 79 Apo-Amlodipine ................................................. 73 Apo-Ascorbic Acid ....................................... 57, 67 Apo-B-Complex ........................................... 56, 68 Apo-Clopidogrel ......................... 24, 48, 59, 69, 76 Apo-Diclo SR ..................................................... 64 Apo-Selegiline S29 ............................................. 20 Apo-Terazosin.............................................. 57, 67 Apo-Zopiclone.................................................... 54 Aremed ........................................................ 23, 73 Arrow-Alprazolam .............................................. 53 Arrow-Azithromycin ........................................... 51 Arrow-Clopidogrel .................................. 48, 56, 69 Arrow-Diazepam ................................................ 53 Arrow-Enalapril .................................................. 28 Arrow-Meloxicam............................................... 24 Ascorbic acid ......................................... 57, 67, 78 Aspen Ceftriaxone .............................................. 79 Ativan .......................................................... 54, 73 Atorvastatin................................ 49, 59, 66, 75, 78 Azamun ....................................................... 58, 68 Azathioprine ........................................... 58, 68, 78 Azithromycin ................................................ 51, 63 B B-D Micro-Fine............................................. 20, 71 B-D Ultra Fine..................................................... 71 B-D Ultra Fine II .................................................. 71 B-PlexADE ......................................................... 24 Bacillus calmette-guerin (BCG) vaccine ........ 21, 71 Barium sulphate ................................................. 75 Bendrofluazide ................................................... 65 Bisacodyl ........................................................... 62 Bonjela .............................................................. 59 Bricanyl Turbuhaler ............................................ 56 Brufen Retard ..................................................... 60 BSF Arrow-Enalapril ........................................... 21 Budenocort .................................................. 23, 73 Budesonide .................................................. 23, 73 Bupivacaine hydrochloride.................................. 66 Buserelin acetate ................................................ 66 Buspirone hydrochloride..................................... 53 C Calcium gluconate ............................................. 75 Capecitabine ................................................ 43, 55 Capoten ....................................................... 59, 75 Captopril .......................................... 20, 59, 71, 75 Ceftriaxone sodium ........ 24, 56, 58, 68, 69, 75, 79 CellCept ............................................................. 74 Cellcept ....................................................... 44, 58 Cephalexin ABM ........................................... 24, 75 Cephalexin monohydrate .............................. 24, 75 Cerezyme..................................................... 22, 57 Cetomacrogol .............................................. 71, 75 Champix ...................................................... 20, 72 Chlorafast .................................................... 23, 73 Chloramphenicol .......................................... 23, 73 Chlorhexidine ..................................................... 76 Chlorhexidine in alcohol...................................... 76 Cholestyramine with aspartame .......................... 57 Choline salicylate with cetalkonium chloride........ 59 Cilazapril ............................................................ 22 Cilicaine VK.................................................. 59, 78 Citanest ............................................................. 78 Clarithromycin.................................................... 22 Clinistix .............................................................. 65 Clinitest.............................................................. 65 Clomiphene citrate ............................................. 79 Clomipramine hydrochloride ............................... 64 Clopidogrel .......................... 24, 48, 56, 59, 69, 76 Clopress ............................................................ 64 Cotazym ECS ..................................................... 70 Coal tar ........................................................ 59, 67 Coloxyl .............................................................. 65 Copper............................................................... 65 Cromolux ..................................................... 57, 69 CT Plus+ .......................................................... 75 Cyclizine lactate ..................................... 26, 69, 76 Cyproheptadine hydrochloride ............................ 66 D D-Zol ................................................................. 64 Dacarbazine ........................................... 61, 62, 76

Index

Pharmaceuticals and brands Danazol.............................................................. 64 Danthron with poloxamer.................................... 79 Dapa-Tabs ......................................................... 79 Darunavir ..................................................... 20, 71 Daunorubicin ............................................... 56, 71 Deferiprone .................................................. 22, 73 Derbac-M .................................................... 58, 68 Diabur 5000 ....................................................... 65 Diamide Relief .............................................. 22, 73 Diastix ............................................................... 65 Diazepam........................................................... 53 Diclofenac sodium ............................................. 64 Diclohexal .......................................................... 64 Differin ............................................................... 22 Diurin 500 .......................................................... 64 Docusate sodium ............................................... 65 Donepezil hydrochloride ............................... 20, 71 Donepezil-Rex .............................................. 20, 71 Doribax .............................................................. 71 Doripenem ......................................................... 71 Dr Reddy’s Omeprazole...................................... 65 Dr Reddy’s Ondansetron .............................. 22, 74 Dr Reddy’s Quetiapine ........................................ 79 Dr Reddy’s Risperidone...................................... 79 Duphaston ......................................................... 64 Dydrogesterone.................................................. 64 E Elecare ........................................................ 24, 74 Elecare LCP ................................................. 24, 74 Elemental formula .............................................. 24 Efexor XR ........................................................... 38 EMLA........................................................... 60, 77 Enalapril ....................................................... 28, 64 Enbrel .................................................... 20, 33, 71 Ensure ................................................... 23, 59, 75 Ensure Plus.................................................. 74, 75 Ensure Plus HN ............................................ 23, 74 Ensure Plus RTH ................................................ 74 Enteral feed 1kcal/ml .......................................... 23 Enteral feed with fibre 1.5kcal/ml ........................ 23 Enteral feed with fibre 1 kcal/ml .......................... 23 Erlotinib hydrochloride.................................. 22, 73 Etanercept.............................................. 20, 33, 71 Ethambutol hydrochloride ....................... 51, 60, 76 Ethinyloestradiol with levonorgestrel ................... 64 Etravirine...................................................... 20, 71 Ezetimibe ........................................................... 39 Ezetimibe with simvastatin ................................. 40 Ezetrol ............................................................... 39 F Ferriprox ...................................................... 22, 73 Fluconazole ........................................................ 73 Fluconazole-Claris .............................................. 73 Fluorescite ......................................................... 78 Fluorouracil Ebewe ........................... 60, 61, 64, 76 Fluorouracil sodium.............. 27, 60, 61, 64, 66, 76 Fluox.................................................................. 67 Fluoxetine hydrochloride ..................................... 67 Flutamide ..................................................... 61, 76 Flutamin ....................................................... 61, 76 Fluvax ................................................................ 68 Fosamax ............................................................ 51 Fosamax Plus .............................................. 51, 66 Frusemide-Claris .......................................... 24, 76 Furosemide .......................... 24, 56, 64, 69, 76, 79 G Gabapentin (neurontin) ....................................... 60 GenRx Moclobemide .......................................... 64 Glucerna Select .................................................. 74 Glucerna Select RTH .......................................... 74 Glucobay ........................................................... 47 Glucose oxidase................................................. 65 Glycerol ....................................................... 61, 67 H Haloperidol .................................................. 60, 76 Humira............................................................... 28 HumiraPen ......................................................... 28 Hydrocortisone ...................................... 59, 64, 76 Hydrocortisone butyrate with chlorquinaldol........ 69 Hydrocortisone with cinchocaine ........................ 79 Hypam ............................................................... 54 Hypnovel ........................................................... 54 Hytrin Starter Pack ............................................. 67 I Ibuprofen ........................................................... 60 Imiglucerase ................................................ 22, 57 Imuprine ............................................................ 78 Imuran ................................................... 58, 68, 78 Indapamide ............................................ 57, 68, 79 Indomethacin ..................................................... 80 Influenza vaccine................................................ 68 Influvac .............................................................. 68 Insulin glulisine ...................................... 24, 76, 79 Insulin pen needles....................................... 20, 71 Insulin syringes, disposable with attached needle ............................................... 71 Intal Spincaps .................................................... 61 Intelence ...................................................... 20, 71 Interferon alpha-2a ............................................. 51 Ioscan ............................................................... 78 Ipratropium bromide ............................... 58, 68, 79 Ipratropium Steri-Neb ................................... 58, 68 Isogel........................................................... 56, 68 Isopropyl alcohol................................................ 72

Index

Pharmaceuticals and brands Isopto Carpine.................................................... 39 Isotretinoin ......................................................... 50 J Jadelle ............................................................... 79 Jevity ........................................................... 23, 74 Jevity RTH ................................................... 23, 74 K Keppra ............................................................... 64 Ketone blood beta-ketone electrodes .................. 79 Ketovite ............................................................. 65 Ketovite Liquid ................................................... 65 Klacid ................................................................ 22 Konsyl-D.......................................... 24, 56, 68, 77 L Lax-Tab ............................................................. 62 Lax-Tabs............................................................ 62 Lemnis Fatty Cream HC...................................... 64 Levetiracetam .................................. 20, 38, 64, 72 Levetiracetam-Rex ................................. 20, 38, 72 Levonorgestrel ................................................... 79 Lignocaine ............................................. 52, 63, 80 Lignocaine hydrochloride ................. 26, 53, 60, 76 Lignocaine hydrochloride with adrenaline............ 77 Lignocaine with chlorhexidine ....................... 53, 63 Lignocaine with prilocaine ............................ 60, 77 Lipitor .................................................... 49, 59, 75 Locoid C ............................................................ 69 Loperamide hydrochloride ............................ 22, 73 Lorazepam ................................................... 54, 73 Lormetazepam ................................................... 54 Lorstat 10 .................................................... 66, 78 Lorstat 20 .................................................... 66, 78 Lorstat 40 .................................................... 66, 78 Lorstat 80 .................................................... 66, 78 Lovir .................................................................. 72 M m-Captopril .................................................. 20, 71 m-Enalapril ........................................................ 64 m-Eslon ....................................................... 60, 77 Mabthera ........................................................... 44 Malathion ............................................... 50, 58, 68 Marcain Heavy ................................................... 66 Marcain Isobaric ................................................ 66 Meloxicam ......................................................... 24 Mesna ............................................. 27, 61, 66, 77 Metamucil .................................................... 56, 68 Methadone hydrochloride ................................... 79 Methatabs .......................................................... 79 Methotrexate .......................................... 61, 62, 77 Methylergometrine ............................................. 69 Mercaptopurine .................................................. 73 Mianserin hydrochloride ............................... 42, 58 Micolette ............................................................ 80 Microlax ....................................................... 57, 67 Midazolam ......................................................... 54 Mitomycin C ...................................................... 77 Moclobemide ..................................................... 64 Moduretic .................................................... 49, 59 Morphine sulphate........................................ 60, 77 Morphine tartrate .................................... 60, 62, 77 Mucilaginous laxatives ..................... 24, 56, 68, 77 Mucilaginous laxatives with stimulants ............... 56 Mucilax ........................................................ 56, 68 MultiADE............................................................ 56 Multivitamins ............................................... 47, 65 Myaccord .............................................. 23, 44, 73 Myambutol............................................. 51, 60, 76 Mycophenolate mofetil ............... 23, 44, 58, 73, 74 Mycostatin ......................................................... 57 N Napamide .................................................... 57, 68 Naropin .............................................................. 78 Nausicalm.................................................... 26, 76 Navoban ............................................................ 53 Nedocromil ........................................................ 61 Neo-Naclex ........................................................ 65 Nepro ................................................................ 75 Nepro (strawberry) ............................................. 23 Neurontin ........................................................... 60 Nifuran ............................................................... 58 Nilstat .......................................................... 59, 77 Nitrados ............................................................. 54 Nitrazepam......................................................... 54 Nitrofurantoin ..................................................... 58 Noctamid ........................................................... 54 Normacol ..................................................... 56, 68 Normacol Plus ................................................... 56 Normison ........................................................... 54 Norvasc ............................................................. 65 Nuelin ................................................................ 61 Nutraplus ........................................................... 58 Nystatin ................................................. 57, 59, 77 O Oestriol .............................................................. 58 Oil in water emulsion .......................................... 77 Omeprazole........................................................ 65 OncoTICE..................................................... 21, 71 Ondansetron .......................................... 22, 53, 74 Optium Blood Ketone Test Strips ........................ 79 Oral supplement 1kcal/ml ............................. 23, 59 Oratane .............................................................. 50 Osmolite ...................................................... 23, 74 Osmolite RTH............................................... 23, 74 Ovestin .............................................................. 58

Index

Pharmaceuticals and brands Ox-Pam ............................................................. 54 Oxazepam .......................................................... 54 P Pacific Buspirone ............................................... 53 Paediatric oral feed 1kcal/ml............................... 23 Paediatric Seravit ............................................... 47 Pancreatic enzyme ............................................. 70 Panteston .......................................................... 65 Pediasure..................................................... 23, 75 Pediasure RTH ................................................... 75 Periactin ............................................................ 66 Pharmacy services............................................. 21 Phenate ............................................................. 79 Phenobarbitone Sodium Paediatric Oral Liquid .... 23 Phenoxymethylpenicillin (penicillin v) ............ 59, 78 Phentolamine mesylate ...................................... 78 Phenylephrine hydrochloride with zinc sulphate .. 66 Pilocarpine ......................................................... 39 Pinorax Forte ...................................................... 79 Pioglitazone ....................................................... 47 Piram-D ....................................................... 70, 74 Piroxicam..................................................... 70, 74 Pizaccord........................................................... 47 Plavix ..................................................... 48, 56, 69 Prezista........................................................ 20, 71 Prilocaine hydrochloride ..................................... 78 Proctosedyl........................................................ 79 Propofol ............................................................. 72 Provive MCT-LCT 1% ......................................... 72 Pulmocare ......................................................... 74 Purinethol .......................................................... 73 Q Questran-Lite ..................................................... 57 Quetiapine.............................................. 58, 74, 79 R Ranbaxy Amoxicillin ........................................... 66 Regitine ............................................................. 78 Renal oral feed 2kcal/ml ..................................... 23 Retinol palmitate .......................................... 72, 78 Rexacrom .......................................................... 27 Ridal ............................................................ 70, 72 Risperidone............................................ 70, 72, 79 Rituximab .......................................................... 44 Roferon-A .......................................................... 51 Ropivacaine hydrochloride with fentanyl ............. 78 S Selegiline hydrochloride ..................................... 20 Serenace ..................................................... 60, 76 Seroquel ...................................................... 58, 74 Sodibic ........................................................ 24, 78 Sodium bicarbonate ..................................... 24, 78 Sodium chloride........... 22, 28, 39, 57, 59, 63, 69, 74, 78 Sodium citrate with sodium lauryl sulphoacetate...................................... 57, 67, 80 Sodium citro-tartrate .......................................... 59 Sodium cromoglycate ...................... 27, 57, 61, 69 Sodium diotrizoate ............................................. 78 Sodium fluorescein ............................................ 78 Soft white paraffin with paraffin liquid ................. 78 Solu-Cortef .................................................. 59, 76 Sorbolene with glycerin ...................................... 72 Special food supplement .................................... 74 Standard formulae .............................................. 23 Sunitinib ...................................................... 21, 72 Suprefact ........................................................... 66 Sutent .......................................................... 21, 72 T Tamsulosin hydrochloride .................................. 80 Tamsulosin-Rex ................................................. 80 Tarceva........................................................ 22, 73 Temazepam ....................................................... 54 Tenofovir disoproxil fumarate ............................. 41 Tenoxicam ......................................................... 24 Terazosin hydrochloride ............................... 57, 67 Terbutaline sulphate ........................................... 56 Testosterone undecanoate.................................. 65 Theophylline ...................................................... 61 Tilade................................................................. 61 Tolvon ......................................................... 42, 58 Travatan....................................................... 47, 58 Travoprost ................................................... 47, 58 Triazolam ........................................................... 54 Triclosan............................................................ 50 Trifeme .............................................................. 64 Tropisetron ........................................................ 53 Two Cal HN........................................................ 75 U Univent .............................................................. 79 Ural.................................................................... 59 Urea................................................................... 58 Urex Forte .......................................................... 79 Uromitexan .................................................. 61, 77 V Valoid (AFT) ....................................................... 69 Varenicline tartrate ....................................... 20, 72 Vaxigrip ............................................................. 68 Venlafaxine ........................................................ 38 Veracol ........................................................ 24, 75 Vicrom ............................................................... 61 Viread ................................................................ 41 Vitala-C .............................................................. 78

Index

Pharmaceuticals and brands Vital HN ............................................................. 74 Vitamin B complex ................................. 24, 56, 68 Vitamins ............................................................ 56 Vytorin ............................................................... 40 W Water ..................................................... 57, 69, 75 X Xeloda ......................................................... 43, 55 Xylocaine ................................... 26, 53, 60, 76, 77 Xylocaine Viscous .............................................. 26 Z Zapril ................................................................. Zincfrin .............................................................. Zofran ................................................................ Zofran Zydis ....................................................... Zoledronic acid .................................................. Zopiclone ........................................................... 22 66 53 53 25 54

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.

If Undelivered, Return To: PO Box 10-254, Wellington 6143, New Zealand

Metadata

Title

Schedule Update - effective 1 November 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 November 2010 ….. 3 Pharmacy Brand Switch Payments begin 1 November …..…

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