Schedule Update - effective 1 December 2011 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 December 2011

Cumulative for September, October, November and December 2011 Section H for December 2011

Contents

Summary of PHARMAC decisions effective 1 December 2011 ....................... 3 Medicines Regulation Changes...................................................................... 5 Close Control rule amendment...................................................................... 5 Fluconazole 150 mg capsule – restriction amended ...................................... 6 Losartan – removal of Special Authority ........................................................ 6 Solu Medrol – new pack sizes........................................................................ 6 Enoxaparin sodium – Special Authority change............................................. 7 News in Brief ................................................................................................. 7 Tender News .................................................................................................. 8 Looking Forward ........................................................................................... 8 Sole Subsidised Supply products cumulative to December 2011 ................... 9 New Listings ................................................................................................ 19 Changes to Restrictions ............................................................................... 22 Changes to Subsidy and Manufacturer’s Price............................................. 47 Changes to General Rules............................................................................ 53 Changes to Brand Name ............................................................................. 61 Changes to Sole Subsidised Supply ............................................................. 62 Delisted Items ............................................................................................. 63 Items to be Delisted .................................................................................... 67 Section H changes to Part II ........................................................................ 70 Section H changes to General Rules ............................................................ 71 Index ........................................................................................................... 72

Summary of PharmaC decisions

effeCtive 1 DeCember 2011 New listings (page 19) • Calcium carbonate (Arrow-Calcium) tab 1.25 g (500 mg elemental) • Amlodipine (Apo-Amlodipine) tab 2.5 mg • Metoprolol tartrate (Lopresor) inj 1 mg per ml, 5 ml • Betamethasone diproprionate with calcipotriol (Daivobet) oint 500 μg with calcipotriol 50 μg, 30 g OP, and topical gel 500 μg with calcipotriol 50 μg, 30 g OP • Methylprednisolone sodium succinate (Solu-Medrol) inj 40 mg per ml, 1 ml, and inj 62.5 mg per ml, 2 ml, 1 inj packs – Retail pharmacy-Specialist • Methylprednisolone sodium succinate (Solu-Medrol) inj 500 mg – new pharmacode only • Ibuprofen (Arrowcare) tab 200 mg • Paclitaxel (Paclitaxel Actavis) inj 100 mg, 150 mg and 300 mg – PCT only Specialist • Spacer device (Space Chamber Plus) 230 ml (single patient) Changes to restrictions (pages 22-26) • Dentist prescriptions – period of supply extended for prescription medicines, not controlled drugs. • Exoxaparin sodium (Clexane) inj 20 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg and 150 mg – amended Special Authority criteria • Losartan (Cozaar and Lostaar) tab 12.5 mg , 25 mg, 50 mg and 100 mg, and (Arrow-Losartan & Hydrochlorothiazide and Hyzaar) tab 50 mg with hydrochlorothiazide 12.5 mg – removal of Special Authority • Condoms (Durex Extra Safe) 56 mm – removal of reference to extra strength • Fluconazole (Ozole and Pacific) cap 150 mg – maximum of 1 cap per prescription can be waived by endorsement of Retail pharmacy-Specialist • Lignocaine with or without chlorhexidine (Pfizer) gel 2%, 10 ml urethral syringes – addition of endorsement “only subsidised for urethral or cervical administration” • Spacer device autoclavable (Space Chamber) 230 ml (autoclavable) – reduced quantity of 5 devices available on a PSO • Extemporaneously compounded oral liquid mixtures – references have been added to various pharmaceuticals were standardised formula exist for compounding with Ora products. Decreased subsidy (pages 47-48) • Calcium carbonate (Calci Tab 500) tab 1.25 g (500 mg elemental) • Calcium carbonate (Calci Tab 600) tab 1.25 g (600 mg elemental) • Losartan (Cozaar) tab 12.5 mg, 25 mg, 50 mg and 100 mg

Summary of PharmaC decisions – effective 1 December 2011 (continued) • Losartan (Hyzaar) tab 50 mg with hydrochlorothiazide 12.5 mg • Calcipotriol (Daivonex) crm 50 μg per g (30 g OP and 100 g OP), oint 50 μg per g (100 g OP) and soln 50 μg per ml (30 ml OP) • Ciprofloxacin (Rex Medical) tab 250 mg, 500 mg and 750 mg • Allopurinol (Apo-Allopurinol) tab 100 mg, 250 tab pack, and 300 mg, 100 tab pack • Paracetamol (Paracare Junior) oral liq 120 mg per 5 ml • Mask for spacer device (EZ-fit Paediatric Mask) size 2 • Peak flow meter (Breath-Alert) low range and normal range • Glycerin with sodium saccharin (Ora-Sweet SF) suspension • Glycerin with sucrose (Ora-Sweet) suspension • Methylcellulose (Ora-Plus) suspension • Methylcellulose with glycerin and sodium saccharin (Ora-Blend SF) suspension • Methylcellulose with glycerin and sucrose (Ora-Blend) suspension increased subsidy (pages 47-48) • Testosterone cypionate (Depo-Testosterone) inj long-acting 100 mg per ml, 10 ml

Pharmaceutical Schedule - Update News

Medicines Regulation Changes

In July 2011 the Medicines Amendment Regulations 2011 were enacted. Some changes to the Pharmaceutical Schedule General Rules have already been amended from 1 August 2011. The final changes from the Amendment Regulations (regulations 14, 15 and 18) come into effect from 1 December 2011. Previously dentists could only prescribe within their scope of practice for patients under their care in quantities up to five days with one repeat of five days. The Medicines Amendment Regulations change the period of supply except for medicines listed under the Misuse of Drugs Act (i.e. opioid analgesics). From 1 December 2011 dentists will be able to prescribe within their scope of practice up to three months’ supply for a patient under their care. Midwives’ scope of practice has also been amended to permit them to prescribe within their scope of practice as determined by an authorisation granted under Section 21 of the Heath Practitioners Competence Assurance Act 2003. Previously they could only prescribe for a period not exceeding three months’ supply for antenatal, intrapartum and post natal care. The changes now mean for oral contraceptives, the period of supply has been extended, and midwives can prescribe up to six months supply.

Extemporaneously compounded products

The explanatory notes in Section C, extemporaneously compounded products and galenicals, have been amended to include a list of the pharmaceuticals that have evidence of stability for compounding in the Ora products and for which the Emixt website has standardised formulas and batch sheets for pharmacy to use. PHARMAC endorses the recommendations of the Emixt website and encourages New Zealand pharmacists to use these formulations when compounding. The Emixt website address is www. pharminfotech.co.nz. It should be noted that only those oral liquid mixture that fully comply with the Pharmaceutical Schedule subsidy rules will be fully subsidised. If a formula does not fully comply with all the requirements of Sections B and C of the Pharmaceutical Schedule then the product may be partially or not subsidised. Not all community pharmacies will have appropriate equipment to compound all formulations. Pharmacists should use appropriate clinical judgement in determining what is appropriate.

Pharmaceutical Schedule - Update News

Fluconazole 150 mg capsule – restriction amended

From 1 December 2011 the restriction on Fluconazole 150 mg capsule will be amended. Subsidy will still be restricted to one 150 mg capsule when prescribed by a Practitioner providing the prescription is endorsed with Certified Condition for patients with vaginal candida albicans where topical imidazole is not recommended. The maximum of one capsule per prescription may by waived by a Specialists endorsement or on the recommendation of a Specialist.

Losartan – removal of Special Authority

The Special Authority restriction that applies to losartan tablets 12.5 mg, 25 mg, 50 mg, 100 mg and tablets 50 mg with hydrochlorothiazide 12.5 mg will be removed from 1 December 2011. We have awarded a tender for losartan 12.5 mg, 25 mg, 50 mg, 100 mg tablets to Mylans’ brand (Lostaar), and to Arrow Pharmaceuticals for losartan 50 mg with hydrochlorothiazide 12.5 mg tablets (Arrow-Losartan & Hydrochlorothiazide) resulting in a substantial price reduction. Removing the Special Authority restriction will remove the requirement for prescribers to complete Special Authority applications.

Solu Medrol – new pack sizes

Pzifer has notified PHARMAC of a global change of formulation to three presentations of Solu Medrol injection 40 mg per ml, 1 ml, 62.5 mg per ml, 2 ml and 500 mg. The new formulations have a preservative-free diluent (without benzyl alcohol) and Pfizer has prepared information for the market. There has also been a pack size change from a 25 injection pack to a single injection pack for both the injection 40 mg per ml, 1 ml and 62.5 mg per ml, 2 ml.

Pharmaceutical Schedule - Update News

Enoxaparin sodium – Special Authority change

The Special Authority criteria for enoxaparin sodium (Clexane) injection will be amended from 1 December 2011. The change will allow patients on any oral anticoagulation, either warfarin or dabigatran, to gain a subsidy for enoxaparin via Special Authority to enable cessation/re-establishment of existing oral anticoagulation treatment pre/post surgery.

News in Brief

• A new strength of amlodipine will be fully funded from 1 December 2011. Amlodipine 2.5 mg will be supplied by Apotex under the name Apo-Amlodipine. • An endorsement is being added to both lignocaine gel 2%, 10 ml urethral syringe and lignocaine with chlorhexidine gel 2% with chlorhexidine 0.5%, 10 ml urethral syringe from 1 December 2011. Prescribers will now have to endorse the prescription, and PSO, with Certified Condition in order for the patient to receive full subsidy for these pharmaceuticals. Lignocaine gel and lignocaine with chlorhexidine gel will only funded for urethral and cervical use. • Pfizer has notified PHARMAC of a global change to Dantrium IV. The chemical name has changed from dantrolene sodium to dantrolene sodium hemiheptahydrate. Dantruim IV is not subsidised in the community but is in Part II Section H of the Pharmaceutical Schedule. • There has been a brand name change for mask for spacer devices. Foremount Child’s Silicone Mask will be listed as EZ-fit Paediatric Mask from 1 December 2011. The pharmacode remains the same. The PSO order quantity for spacer device autoclavable will also reduce from 20 to five devices from 1 December 2011. • Cefaclor Sandoz brand of cefaclor monohydrate cap 250 mg was listed fully subsidised from 1 March 2011 as a result of a Tender agreement. Due to an out-ofstock, reference pricing and Sole Supply was suspended. As supplies of Cefaclor Sandoz are now back in the market we are notifying the implementation of the Tender timelines. Reference pricing will occur on the RanbaxyCefaclor brand from 1 March 2012 and Cefaclor Sandoz will have Sole Supply Status from 1 June 2012. The Ranbaxy-Cefaclor brand of cefaclor 250 mg capsules will be delisted from 1 March 2012. Cefaclor Sandoz 250 mg capsules will have Hospital Sole Supply from 1 June 2012

tender News

Sole Subsidised Supply changes – effective 1 January 2012

Chemical Name Omeprazole Omeprazole Omeprazole Presentation; Pack size Cap 10 mg; 90 cap Cap 20 mg; 90 cap Cap 40 mg; 90 cap Sole Subsidised Supply brand (and supplier) Omezol Relief (Mylan) Omezol Relief (Mylan) Omezol Relief (Mylan)

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 January 2012 • Bimatoprost (Lumigan) eye drops 0.03%, 3 ml OP – subsidy and price decrease • Hypromellose (Methopt) eye drops 0.5%, 15 ml OP – price increase

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Abacavir sulphate Acarbose Acetazolamide Aciclovir Amantadine hydrochloride Aminophylline Amitriptyline Amlodipine Amoxycillin

Presentation

Oral liq 20 mg per ml Tab 300 mg Tab 50 mg & 100 mg Tab 250 mg Tab dispersible 200 mg, 400 mg & 800 mg Cap 100 mg Inj 25 mg per ml, 10 ml Tab 25 mg & 50 mg Tab 5 mg & 10 mg Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg Grans for oral liq 250 mg per 5 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 Crm Tab 100 mg Tab 100 mg Tab dispersible 300 mg Tab 50 mg & 100 mg Inj 600 µg, 1 ml Tab 50 mg Inj 50 mg Tab 500 mg Tab 10 mg Tab 2.5 mg & 5 mg Inj 600 mg Scalp app 0.1% Eye drops 0.5% Eye drops 0.25% Tab 5 mg Crm, aqueous, BP Lotn, BP Inj 100 iu per ml, 1 ml Cap 0.25 µg & 0.5 µg

Brand Name Expiry Date*

Ziagen Ziagen Glucobay Diamox Lovir Symmetrel DBL Aminophylline Amitrip Apo-Amlodipine Ibiamox Alphamox Ospamox Curam Curam 2014 2012 2014 2013 2014 2014 2014 2014 2014 2013 2012 2012

Amoxycillin clavulanate

Aqueous cream Ascorbic acid Aspirin Atenolol Atropine sulphate Azathioprine Azithromycin Baclofen Bendrofluazide Benzylpenicillin sodium (Penicillin G) Betamethasone valerate Betaxolol hydrochloride Bisacodyl Calamine Calcitonin Calcitriol

AFT Vitala-C Ethics Aspirin EC Ethics Aspirin Atenolol Tablet USP AstraZeneca Imuprine Imuran Arrow-Azithromycin Pacifen ArrowBendrofluazide Sandoz Beta Scalp Betoptic Betoptic S Lax-Tab healthE API Miacalcic Airflow

2014 2013 2013 2012 2012 2013 2012 2012 2014 2014 2012 2014 2013 2012 2014 2012

*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 December 2011

Generic Name

Calcium carbonate Calcium folinate Captopril Cefaclor monohydrate Ceftriaxone sodium Cephalexin monohydrate Cetomacrogol Cetirizine hydrochloride Chloramphenicol Chlorhexidine gluconate Ciclopiroxolamine Cilazapril Cilazapril with hydrochlorothiazide Citalopram hydrobromide Clobetasol propionate

Presentation

Tab eff 1.75 g (1 g elemental) Tab 15 mg Tab 12.5 mg, 25 mg & 50 mg Oral liq 5 mg per ml Grans for oral liq 125 mg per 5 ml Inj 500 mg Inj 1 g Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Crm BP Oral liq 1 mg per ml Tab 10 mg Eye drops 0.5% Eye oint 1% Soln 4% Handrub 1% with ethanol 70% Nail soln 8% Tab 0.5 mg, 2.5 mg & 5 mg Tab 5 mg with hydrochlorothiazide 12.5 mg Tab 20 mg Crm 0.05% Oint 0.05% Scalp app 0.05% 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 Tab 75 mg Crm 1% Vaginal crm 1% with applicator Vaginal crm 2% with applicator Soln BP Tab 500 µg Powder for soln for oral use 4.4 g Crm 10% Tab 50 mg Tab 50 mg

Brand Name Expiry Date*

Calsource DBL Leucovorin Calcium m-Captorpril Capoten Ranbaxy-Cefaclor Veracol Aspen Ceftriaxone Cefalexin Sandoz Cefalexin Sandoz PSM Cetirizine - AFT Zetop Chlorafast Chlorsig Orion healthE Batrafen Zapril Inhibace Plus Arrow-Citalopram Dermol Dermol Dermol Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3 Catapres Dixarit Catapres Apo-Clopidogrel Clomazol Clomazol Clomazol Midwest Colgout Electral Itch-Soothe Nausicalm Cycloblastin 2014 2014 2013 2013 2013 2012 2013 2014 2012 2014 2012 2012 2013 2013 2014 2012

Clonidine

2012

Clonidine hydrochloride

2012

Clopidogrel Clotrimazole

2013 2014 2013 2013 2013 2013 2012 2012 2013

Coal tar Colchicine Compound electrolytes Crotamiton Cyclizine hydrochloride Cyclophosphamide

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Cyproterone acetate Cyproterone acetate with ethinyloestradiol Desmopressin Dexamethasone Dexamethasone sodium phosphate

Presentation

Tab 50 mg & 100 mg Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs Nasal spray 10 µg per dose Eye oint 0.1% Eye drops 0.1% Inj 4 mg per ml, 1 ml & 2 ml

Brand Name Expiry Date*

Siterone Ginet 84 Desmopressin-PH&T Maxidex Maxidex Hospira Maxitrol Maxitrol 2012 2014 2014 2014 2013 2013 2014

Dexamethasone with neomycin Eye oint 0.1% with neomycin sulphate and polymyxin b sulphate 0.35% and polymyxin B sulphate 6,000 u per g Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin B sulphate 6,000 u per ml Dextrose Dextrose with electrolytes Inj 50%, 10 ml Soln with electrolytes

Biomed Pedialyte – Fruit Pedialyte – Bubblegum Pedialyte – Plain Voltaren Voltaren Ophtha Voltaren Diclofenac Sandoz DHC Continus Dilzem Cardizem CD Pytazen SR Laxofast 50 Laxofast 120 Laxsol Donepezil-Rex Apo-Doxazosin Doxine AFT Arrow-Enalapril Clexane Comtan DBL Ergometrine

2014 2013

Diclofenac sodium

Inj 25 mg per ml, 3 ml Eye drops 1 mg per ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Tab EC 25 mg & 50 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 Tab 2 mg & 4 mg Tab 100 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 Inj 500 µg per ml, 1 ml

2014

2012 2013 31/12/11

Dihydrocodeine tartrate Diltiazem hydrochloride

Dipyridamole Docusate sodium Docusate sodium with sennosides Donepezil hydrochloride Doxazosin mesylate Doxycycline hydrochloride Emulsifying ointment Enalapril Enoxaparin sodium (low molecular weight heparin) Entacapone Ergometrine maleate

2014 2014 2013 2012 2014 2014 2014 2012 2012 2012 2014

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Erythromycin ethyl succinate Escitalopram Ethinyloestradiol Etidronate disodium Exemestane Felodipine Fentanyl

Presentation

Tab 400 mg Tab 10 mg & 20 mg Tab 10 µg Tab 200 mg Tab 25 mg Tab long-acting 5 mg Tab long-acting 10 mg Transdermal patch 12.5 µg per hour, 25 µg per hour, 50 µg per hour, 75 µg per hour, 100 µg per hour Inj 50 µg per ml, 2 ml & 10 ml Oral liq 30 mg per 1 ml (6 mg elemental per 1 ml) Inj 250 mg, 500 mg & 1 g Cap 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Eye drops 0.1% Cap 20 mg Tab dispersible 20 mg, scored Tab 250 mg Metered aqueous nasal spray, 50 µg per dose Inj 10 mg per ml, 2 ml Tab 40 mg Crm 2% Oint 2% Cap 100 mg, 300 mg & 400 mg Tab 600 mg Inj 40 mg per ml, 2 ml Tab 80 mg Liquid TDDS 5 mg & 10 mg Tab 600 µg Inj 5 mg per ml, 1 ml Oral liq 2 mg per ml Tab 500 µg, 1.5 mg & 5 mg Crm 1% Powder Inj 50 mg per ml, 1 ml Tab 5 mg & 20 mg

Brand Name Expiry Date*

E-Mycin Loxalate NZ Medical and Scientific Arrow-Etidronate Aromasin Felo 5 ER Felo 10 ER Mylan Fentanyl Patch Boucher and Muir Ferodan Flucloxin AFT AFT AFT FML Fluox Fluox Flutamin Flixonase Hayfever & Allergy Frusemide-Claris Diurin 40 Foban Foban Nupentin Lipazil Pfizer Apo-Gliclazide healthE Nitroderm TTS Lycinate Serenace Serenace Serenace Pharmacy Health ABM Solu-Cortef Douglas 2012 2013 2012 2012 2014 2012 2013

Fentanyl citrate Ferrous sulphate Flucloxacillin sodium

2012 2013 2014 2012

Fluorometholone Fluoxetine hydrochloride Flutamide Fluticasone propionate Furosemide Fusidic acid Gabapentin Gemfibrozil Gentamicin sulphate Gliclazide Glycerol Glyceryl trinitrate Haloperidol

2012 2013 2013 31/1/13 2013 2012 2013 31/7/12 2013 2012 2014 2013 2014 2013

Hydrocortisone

2014 2013 2012

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Hydrocortisone acetate Hydrocortisone with miconazole Hydrocortisone with wool fat and mineral oil Hydroxocobalamin Hydroxychloroquine sulphate Hyoscine N-butylbromide Ibuprofen Imiquimod Indapamide Ipratropium bromide

Presentation

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 Inj 20 mg, 1 ml Tab 10 mg Tab long-acting 800 mg Oral liq 100 mg per 5 ml Crm 5% Tab 2.5 mg Aqueous nasal spray, 0.03%, 15 ml OP Nebuliser soln, 250 µg per ml, 1 ml & 2 ml Inj 50 mg per ml, 2 ml Tab 20 mg Tab long-acting 40 mg Cap 10 mg & 20 mg Cap 100 mg Shampoo 2% Oral liq 10 g per 15 ml 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) Viscous soln 2% Inj 1%, 5 ml & 20 ml Crm 2.5% with prilocaine 2.5% (5 g tubes) Crm 2.5% with prilocaine 2.5%; 30 g OP Tab 5 mg, 10 mg & 20 mg Cap 250 mg Eye drops 0.1%

Brand Name Expiry Date*

Colifoam Micreme H DP Lotn HC ABM Hydroxocobalamin Plaquenil Buscopan Gastrosoothe Brufen SR Fenpaed Aldara Dapa-Tabs Univent Univent Ferrum H Ismo 20 Corangin Oratane Itrazole Sebizole Laevolac 3TC 3TC Hysite Letara Jadelle Xylocaine Viscous Xylocaine EMLA EMLA Arrow-Lisinopril Douglas Lomide 2012 2014 2014 2014 2014 2012 2013 2014 2013 2013 2012 2012 31/12/13 2014 2013 2013 2012 2013 2014 2012 2012 2014 2014 2013 2014 2013 2013

Iron polymaltose Isosorbide mononitrate Isotretinoin Itraconazole Ketoconazole Lactulose Lamivudine Latanoprost Letrozole Levonorgestrel Lignocaine hydrochloride Lignocaine with prilocaine

Lisinopril Lithium carbonate Lodoxamide trometamol

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Loperamide hydrochloride Loratadine

Presentation

Cap 2 mg Oral liq 1 mg per ml Tab 10 mg Tab 1 mg & 2.5 mg Liq 0.5% Shampoo 1% Size 2 Tab 100 mg Tab 135 mg Tab 160 mg Tab 50 mg Suppos 500 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 Inj 25 mg per ml, 2 ml & 20 ml Tab 2.5 mg & 10 mg Tab 4 mg & 100 mg 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 Tab 10 mg 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

Brand Name Expiry Date*

Diamide Relief Lorapaed Loraclear Hayfever Relief Ativan A-Lices A-Lices EZ-fit Paediatric Mask De-Worm Colofac Apo-Megestrol Purinethol Asacol Pentasa Apotex Methatabs Biodone Biodone Forte Biodone Extra Forte Hospira Methoblastin Medrol Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Pfizer Metamide Multichem Apo-Moclobemide m-Mometasone m-Mometasone RA-Morph RA-Morph RA-Morph RA-Morph 2013 2013

Lorazepam Malathion Mask for spacer device Mebendazole Mebeverine hydrochloride Megestrol acetate Mercaptopurine Mesalazine Metformin hydrochloride Methadone hydrochloride

2013 2013 2015 2014 2014 2012 2013 2014 2012 2012 2013 2012

Methotrexate Methylprednisolone Methylprednisolone sodium succinate

2013 2012 2012 2012

Metoclopramide hydrochloride Miconazole nitrate Moclobemide Mometasone furoate Morphine hydrochloride

2014 2014 2012 2012 2012

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Morphine sulphate

Presentation

Inj 5 mg per ml, 1 ml Inj 10 mg per ml, 1 ml Inj 15 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Tab long-acting 10 mg, 30 mg, 60 mg & 100 mg Cap long-acting 10 mg, 30 mg, 60 mg & 100 mg Tab immediate release 10 mg & 20 mg

Brand Name Expiry Date*

DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate DBL Morphine Sulphate Arrow-Morphine LA m-Elson Sevredol Hospira Konsyl-D Naphcon Forte Noflam 250 Noflam 500 Naltraccord AstraZeneca Viramune Suspension Viramune Habitrol Habitrol Habitrol Apo-Nicotinic Acid Arrow-Norfloxacin Primolut N Noriday 28 Nilstat Nilstat Nilstat Midwest Dr Reddy’s Omeprazole Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron Ox-Pam 2014 2014 2014 2012 2014 2013 2014 2012 2013 2013 2014 2012 2013 2014 2012 2014

2013

Morphine tartrate Mucilaginous laxatives Naphazoline hydrochloride Naproxen Natrexone hydrochloride Neostigmine Nevirapine

Inj 80 mg per ml, 1.5 ml & 5 ml Dry Eye drops 0.1% Tab 250 mg Tab 500 mg Tab 50 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Tab 200 mg

Nicotine

Gum 2 mg & 4 mg (classic, fruit, mint) Lozenge 1 mg & 2 mg Patch 7 mg, 14 mg & 21 mg Tab 50 mg & 500 mg Tab 400 mg Tab 5 mg Tab 350 µg Oral liq 100,000 u per ml Cap 500,000 u Tab 500,000 u Powder Inj 40 mg Tab disp 4 mg & 8 mg Tab 4 mg & 8 mg

2014

Nicotinic acid Norfloxacin Norethisterone Nystatin

Omeprazole

Ondansetron

2013

Oxazepam

Tab 10 mg & 15 mg

2014

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Oxytocin

Presentation

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 40 mg Tab 20 mg & 40 mg Oral liq 250 mg per 5 ml Eye oint with soft white paraffin Tab 20 mg Low range & 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 Crm 5% Lotn 5% Inj 50 mg per ml, 1 ml Inj 50 mg per ml, 2 ml

Brand Name Expiry Date*

Syntocinon Syntocinon Syntometrine Pantocid IV Dr Reddy’s Pantoprazole Paracare Double Strength Lacri-Lube Loxamine Breath-Alert Pegasys Pegasys Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Pegasys RBV Combination Pack Permax Lyderm A-Scabies DBL Pethidine Hydrochloride DBL Pethidine Hydrochloride Cilicaine VK AFT AFT Apo-Pindolol Pizaccord Sandomigran Coloxyl Span-K Redipred Innovacon hCG One Step Pregnancy Test Cilicaine 2012 2012 2012 2014 2012 2012 2012 2014 2012

Pantoprazole

2014 2013 2014 2013 2013 2015 31/12/12

Paracetamol Paraffin liquid with soft white paraffin Paroxetine hydrochloride Peak flow meter Pegylated interferon alpha-2A

Pergolide Permethrin Pethidine hydrochloride

2014 2014 2014

Phenoxymethylpenicillin (Pencillin V)

Cap potassium salt 250 mg & 500 mg 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% Tab long-acting 600 mg Oral liq 5 mg per ml Cassette Inj 1.5 mega u

2013

Pindolol Pioglitazone Pizotifen Poloxamer Potassium chloride Prednisone sodium phosphate Pregnancy tests – hCG urine Procaine penicillin

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Promethazine hydrochloride Pyridostigmine bromide Pyridoxine hydrochloride Quinine sulphate Ranitidine hydrochloride Rifabutin Ropinirole hydrochloride Roxithromycin Salbutamol

Presentation

Oral liq 5 mg per 5 ml Tab 60 mg Tab 25 mg Tab 50 mg Tab 300 mg Oral liq 150 mg per 10 ml Tab 150 mg & 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 50 mg & 100 mg Tab 10 mg Tab 20 mg Tab 40 mg Tab 80 mg Inj 23.4%, 20 ml Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml Grans effervescent 4 g sachets Eye drops 2% Nasal spray, 4% Inj cartridge 16 iu (5.3 mg) Inj cartridge 36 iu (12 mg) Tab 80 mg & 160 mg 800 ml 230 ml (single patient) Tab 25 mg & 100 mg Inj 12 mg per ml, 0.5 ml Tab 50 mg & 100 mg Tab 20 mg Cap 400 µg

Brand Name Expiry Date*

Promethazine Winthrop Elixir Mestinon PyridoxADE Apo-Pyridoxine Q 300 Peptisoothe Arrow-Ranitidine Mycobutin Ropin ArrowRoxithromycin Salapin Asthalin Asthalin Duolin 2012 2014 2014 2012 2014 2013 2013 2012 2013 2012 2012

Salbutamol with ipratropium bromide Selegiline hydrochloride Sertraline Simvastatin

Apo-Selegiline Arrow-Sertraline Arrow-Simva 10mg Arrow-Simva 20mg Arrow-Simva 40mg Arrow-Simva 80mg Biomed Micolette Ural Rexacrom Rex Genotropin Genotropin Mylan Volumatic Space Chamber Plus Spirotone Arrow-Sumatriptan Arrow-Sumatriptan Genox Tamsulosin-Rex

2012 2013 2014

Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Sodium citro-tartrate Sodium cromoglycate Somatropin Sotalol Spacer device

2013 2013 2013 2013 2012 31/12/12 2012 2015

Spironolactone Sumatriptan Tamoxifen citrate Tamsulosin hydrochloride

2013 2013 2014 2013

Sole Subsidised Supply Products – cumulative to December 2011

Generic Name

Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terazosin hydrochloride Testosterone undecanoate Tetracosactrin Timolol maleate Tobramycin

Presentation

Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium, 500 ml & 1,000 ml Tab 10 mg Tab 1 mg, 2 mg & 5 mg Cap 40 mg Inj 250 µg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.3% Eye oint 0.3% Inj 40 mg per ml, 2 ml Tab 100 mg Cap 50 mg Crm 0.02% Oint 0.02% 0.1% in Dental Paste USP Tab 500 mg Eye drops 0.5% & 1% Cap 5 mg Eye drops 0.25% Inj 500 mg Tab 40 mg & 80 mg Tab, strong, BPC Tab (BPC cap strength) Cap 100 mg Oral liq 10 mg per ml Caps 137.4 mg (50 mg elemental) Tab 7.5 mg

Brand Name Expiry Date*

Pinetarsol 2014

Normison Arrow Arrow-Testosterone Synacthen Synacthen Depot Apo-Timol Tobrex Tobrex DBL Tobramycin Tasmar Arrow-Tramadol Aristocort Aristocort Oracort Cycklokapron Mydriacyl Navoban Enuclene Mylan Isoptin B-PlexADE MultiADE Retrovir Retrovir Zincaps Apo-Zopiclone

2014 2013 2012 2014 2012 2014

Tolcapone Tramadol hydrochloride Triamcinolone acetonide

2014 2014 2014

Tranexamic acid Tropicamide Tropisetron Tyloxapol Vancomycin hydrochloride Verapamil hydrochloride Vitamin B complex Vitamins Zidovudine [AZT] Zinc sulphate Zopiclone December changes in bold

2013 2014 2012 2014 2014 2014 2013 2013 2013 2014 2014

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Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 December 2011

38 51 51 63 CALCIUM CARBONATE ❋ Tab 1.25 g (500 mg elemental) ................................................. 6.38 AMLODIPINE ❋ Tab 2.5 mg ............................................................................... 2.45 METOPROLOL TARTRATE ❋ Inj 1 mg per ml, 5 ml ............................................................... 24.00 BETAMETHASONE DIPROPRIONATE WITH CALCIPOTRIOL Oint 500 µg with calcipotriol 50 µg .......................................... 26.12 Topical gel 500 µg with calcipotriol 50 µg ............................... 26.12 METHYLPREDNISOLONE SODIUM SUCCINATE – Retail pharmacy-Specialist Inj 40 mg per ml, 1 ml .............................................................. 6.06 Inj 62.5 mg per ml, 2 ml ......................................................... 16.50 IBUPROFEN ❋ Tab 200 mg ............................................................................ 12.75 PACLITAXEL – PCT only – Specialist Inj 100 mg ............................................................................. 91.67 Inj 150 mg ........................................................................... 137.50 Inj 300 mg ........................................................................... 275.00 SPACER DEVICE a) Up to 20 dev available on a PSO b) Only on a PSO 230 ml (single patient) .............................................................. 4.72 250 100 5 30 g OP 30 g OP 1 1 1,000 1 1 1 ✔ Arrow-Calcium ✔ Apo-Amlodipine ✔ Lopresor ✔ Daivobet ✔ Daivobet ✔ Solu-Medrol ✔ Solu-Medrol ✔ Arrowcare ✔ Paclitaxel Actavis ✔ Paclitaxel Actavis ✔ Paclitaxel Actavis

96 148

165

✔ Space Chamber Plus

Effective 1 November 2011

28 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 10.95 14 ✔ Apo-Clarithromycin a) Maximum of 14 tab per prescription b) Subsidised only if prescribed for helicobacter pylori eradication and prescription is endorsed accordingly. Note: the prescription is considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxycillin or metronidazole. SODIUM NITROPRUSSIDE – Maximum of 50 strip per prescription ❋ Test strip – Not on a BSO ........................................................ 14.14 50 strip OP ✔ Ketostix

31 84

FLUCONAZOLE Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 ✔ Ozole a) Maximum of 1 cap per prescription b) Patient has vaginal candida albicans and the Practitioner considers that a topical imidazole (used intravaginally) is not recommended and the prescription is endorsed accordingly. Cap 200 mg – Retail pharmacy-Specialist ............................... 13.34 28 ✔ Ozole

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

New listings - effective 1 November 2011 (continued)

115 153 167 PARACETAMOL ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 9.38 MEGESTROL ACETATE – Retail pharmacy-Specialist Tab 160 mg ............................................................................ 57.92 TIMOLOL MALEATE ❋ Eye drops 0.5% ........................................................................ 2.08 1,000 30 5 ml OP ✔ Parafast ✔ Megace ✔ Arrow-Timolol

Effective 1 October 2011

49 LOSARTAN – Special Authority see SA0911 – Retail pharmacy ❋ Tab 12.5 mg ............................................................................ 2.88 ❋ Tab 25 mg ............................................................................... 3.20 ❋ Tab 50 mg ............................................................................... 5.22 Tab 50 mg with hydrochlorothiazide 12.5 mg ............................ 4.89 ❋ Tab 100 mg ............................................................................. 8.68 62 ACITRETIN – Special Authority see SA0954 – Retail pharmacy Cap 10 mg ............................................................................. 38.66 Cap 25 mg ............................................................................. 83.11 LEVOTHYROXINE ❋ Tab 25 µg ................................................................................ 3.89 ‡ Safety cap for extemporaneously compounded oral liquid preparations. ❋ Tab 50 µg ................................................................................ 4.05 ‡ Safety cap for extemporaneously compounded oral liquid preparations. 90 90 90 30 90 60 60 90 90 ✔ Lostaar ✔ Lostaar ✔ Lostaar ✔ Arrow-Losartan & Hydrochlorothiazide ✔ Lostaar ✔ Novatretin ✔ Novatretin ✔ Synthroid ✔ Synthroid

80 82

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 Tab 250 mg ............................................................................. 4.19 14 ✔ Apo-Clarithromycin CIPROFLOXACIN Tab 250 mg – Up to 5 tab available on a PSO ............................ 2.20 Tab 500 mg – Up to 5 tab available on a PSO ............................ 3.00 Tab 750 mg – Retail pharmacy-Specialist ................................. 5.15 FLUCONAZOLE Cap 50 mg – Retail pharmacy-Specialist ................................... 4.77 ALLOPURINOL ❋ Tab 100 mg ........................................................................... 15.90 ❋ Tab 300 mg ........................................................................... 16.75 PARACETAMOL ❋‡ Oral liq 120 mg per 5 ml ......................................................... 2.21 a) Up to 200 ml available on a PSO b) Not in combination TIMOLOL MALEATE ❋ Eye drops 0.25% ...................................................................... 2.08 28 28 28 28 1,000 500 500 ml ✔ Cipflox ✔ Cipflox ✔ Cipflox ✔ Ozole ✔ Apo-Allopurinol ✔ Apo-Allopurinol ✔ Ethics Paracetamol

84 112

115

167

5 ml OP

✔ Arrow-Timolol

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

New listings - effective 9 September 2011

49 DIGOXIN ❋ Tab 62.5 µg – Up to 30 tab available on a PSO .......................... 5.56 ❋ Tab 250 µg – Up to 30 tab available on a PSO ........................... 6.05 200 100 ✔ Lanoxin PG ✔ Lanoxin

Effective 1 September 2011

45 PRAVASTATIN – Special Authority see SA0932 – Retail pharmacy See prescribing guideline Tab 20 mg ............................................................................... 5.44 Tab 40 mg ................................................................................ 9.28 CANDESARTAN – Special Authority see SA0933 – Retail pharmacy ❋ Tab 4 mg – No more than 1.5 tab per day ............................... 48.66 ❋ Tab 8 mg – No more than 1.5 tab per day ................................ 57.90 ❋ Tab 16 mg – No more than 1 tab per day ................................. 70.62 ❋ Tab 32 mg – No more than 1 tab per day .............................. 115.50 FINASTERIDE – Special Authority see SA0928 – Retail pharmacy Tab 5 mg ................................................................................. 5.10 LEVOTHYROXINE ❋ Tab 100 µg .............................................................................. 4.21 ‡ Safety cap for extemporaneously compounded oral liquid preparations. TERBINAFINE Tab 250 mg ............................................................................. 1.78 30 30 90 90 90 90 30 90 ✔ Cholvastin ✔ Cholvastin ✔ Candestar ✔ Candestar ✔ Candestar ✔ Candestar ✔ Rex Medical ✔ Synthroid

70 76

✔ Dr Reddy’s Terbinafine

MEFENAMIC ACID – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Cap 250 mg ............................................................................. 1.25 50 (9.16) Ponstan BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy Tab 50 mg .............................................................................. 10.00 28 ✔ Bicalaccord

153

▲

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 December 2011

27 SULPHASALAZINE ❋ Tab 500 mg ........................................................................... 11.68 For sulfasalazine oral liquid formulation refer, page 172 100 ✔ Salazopyrin

URSODEOXYCHOLIC ACID – Special Authority see SA1003 – Retail pharmacy Cap 300 mg .......................................................................... 179.00 100 For ursodeoxycholic acid oral liquid formulation refer, page 172 CLOPIDOGREL Tab 75 mg .............................................................................. 16.25 For clopidogrel oral liquid formulation refer, page 172 DIPYRIDAMOLE ❋ Tab 25 mg ................................................................................ 8.36 For dipyridamole oral liquid formulation refer, page 172 90

✔ Actigall

✔ Apo-Clopidogrel

✔ Persantin

ENOXAPARIN SODIUM – Special Authority see SA1174 0975 – Retail pharmacy Inj 20 mg ............................................................................... 39.20 10 Inj 40 mg ............................................................................... 52.30 10 Inj 60 mg ............................................................................... 78.85 10 Inj 80 mg ............................................................................. 105.12 10 Inj 100 mg ........................................................................... 135.20 10 Inj 120 mg ........................................................................... 168.00 10 Inj 150 mg ........................................................................... 192.00 10

✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane ✔ Clexane

➽ SA1174 0975 Special Authority for Subsidy Initial application — (Pregnancy or Malignancy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Low molecular weight heparin treatment is required during a patients pregnancy; or 2 For the treatment of venous thromboembolism where the patient has a malignancy. Initial application — (Venous thromboembolism other than in pregnancy or malignancy) from any relevant practitioner. Approvals valid for 1 month for applications meeting the following criteria: Any of the following: 1 For the short-term treatment of venous thromboembolism prior to establishing a therapeutic INR with oral anti-coagulant treatment; or 2 For the prophylaxis and treatment of venous thromboembolism in high risk surgery; or 3 To enable cessation/re-establishment of existing warfarin oral anticoagulant treatment pre/post surgery; or 4 For the prophylaxis and treatment of venous thromboembolism in Acute Coronary Syndrome surgical intervention; or 5 To be used in association with cardioversion of atrial fibrillation. Renewal — (Pregnancy or Malignancy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Low molecular weight heparin treatment is required during a patient’s pregnancy; or 2 For the treatment of venous thromboembolism where the patient has a malignancy. Renewal —(Venous thromboembolism other than in pregnancy or malignancy) from any relevant practitioner. Approvals valid for 1 month where low molecular weight heparin treatment or prophylaxis is required for a second or subsequent event (surgery, ACS, cardioversion, or prior to oral anti-coagulation).

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 December 2011 (continued)

47 ENALAPRIL ❋ Tab 20 mg ................................................................................ 3.24 For enalapril oral liquid formulation refer, page 172 LOSARTAN – Special Authority see SA0911 – Retail pharmacy ❋ Tab 12.5 mg ............................................................................ 2.88 0.96 (10.45) ❋ Tab 25 mg ............................................................................... 3.20 1.07 (10.45) ❋ Tab 50 mg ............................................................................... 5.22 1.74 (8.70) Tab 50 mg with hydrochlorothiazide 12.5 mg ............................ 4.89 90 ✔ Arrow-Enalapril

90 30 90 30 90 30 30

✔ Lostaar Cozaar ✔ Lostaar Cozaar ✔ Lostaar Cozaar ✔ Arrow-Losartan & Hydrochlorothiazide Hyzaar ✔ Lostaar

(10.45) ❋ Tab 100 mg ............................................................................. 8.68 90 2.89 30 (10.45) Cozaar ➽ SA0911 Special Authority for Subsidy Initial application — (ACE inhibitor intolerance) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patient has persistent ACE inhibitor induced cough that is not resolved by ACE inhibitor retrial (same or new ACE inhibitor); or 2 Patient has a history of angioedema. Initial application — (Unsatisfactory response to ACE inhibitor) from any relevant practitioner. Approvals valid without further renewal unless notified where patient is not adequately controlled on maximum tolerated dose of an ACE inhibitor. Initial application — (Patient had an approval for Losartan with hydrochlorothiazide prior to 1 May 2008) from any relevant practitioner. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment. 50 FLECAINIDE ACETATE - Retail pharmacy-Specialist ▲ Tab 100 mg ............................................................................ 80.92 For flecainide acetate oral liquid formulation refer, page 172 CARVEDILOL Tab 25 mg .............................................................................. 33.75 For carvediolol oral liquid formulation refer, page 172 LABETALOL ❋ Tab 100 mg ............................................................................ 10.06 For labetolol oral liquid formulation refer, page 172 METOPROLOL TARTRATE ❋ Tab 50 mg ............................................................................. 16.50 For metoprolol tartrate oral liquid formulation refer, page 172 SOTALOL ❋ Tab 80 mg ............................................................................. 27.50 For sotalol oral liquid formulation refer, page 172 Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber. 60 ✔ Tambocor

✔ Dilatrend

100

✔ Hybloc

100

✔ Lopresor

500

✔ Mylan

▲

❋ 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 December 2011 (continued)

51 AMLODIPINE ❋ Tab 5 mg ................................................................................. 2.65 For amlodipine oral liquid formulation refer, page 172 DILTIAZEM HYDROCHLORIDE ❋ Tab 60 mg ............................................................................... 8.50 For diltiazem hydrochoride oral liquid formulation refer, page 172 VERAPAMIL HYDROCHLORIDE ❋ Tab 80 mg ............................................................................. 11.74 For verapamil oral liquid formulation refer, page 172 SILDENAFIL – Special Authority see SA1086 – Retail pharmacy Tab 100 mg .......................................................................... 47.00 For sildenafil oral liquid formulation refer, page 172 CONDOMS ❋ 56 mm extra strength – Up to 144 dev available on a PSO........ 13.36 HYDROCORTISONE ❋ Tab 20 mg ............................................................................. 20.95 For hydrocortisone oral liquid formulation refer, page 172 100 ✔ Apo-Amlodipine

100

✔ Dilzem

100

✔ Isoptin

✔ Viagra

66 72

144 100

✔ Durex Extra Safe ✔ Douglas

FLUCONAZOLE Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 ✔ Ozole 1.30 ✔ Pacific a) Maximum of 1 cap per prescription; can be waived by endorsement - Retail pharmacy -Specialist b) Patient has vaginal candida albicans and the practitioner considers that a topical imidazole (used intravaginally) is not recommended and the prescription is endorsed accordingly; can be waived by endorsement - Retail pharmacy -Specialist. TERBINAFINE Tab 250 mg ............................................................................. 1.78 12.75 (25.50) For terbinafine oral liquid formulation refer, page 172 14 100 Apo-Terbinafine ✔ Dr Reddy’s Terbinafine

PYRAZINAMIDE – Retail pharmacy-Specialist No patient co-payment payable ❋ Tab 500 mg ........................................................................... 59.00 For pyrazinamide oral liquid formulation refer, page 172 RIFABUTIN – Retail pharmacy-Specialist No patient co-payment payable ❋ Cap 150 mg .......................................................................... 213.19 For rifabutin oral liquid formuatlion refer, page 172 NITROFURANTOIN ❋ Tab 50 mg .............................................................................. 22.20 For nitrofurantoin oral liquid formulation refer, page 172

100

✔ AFT-Pyrazinamide

✔ Mycobutin

100

✔ Nifuran

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 December 2011 (continued)

112 ALLOPURINOL ❋ Tab 300 mg ............................................................................. 4.03 100 ✔ Apo-Allopurinol ✔ Apo-Allopurinol S29

S29

20.15 For allopurinol oral liquid formulation refer, page 172 112 BACLOFEN ❋ Tab 10 mg ................................................................................ 4.75 For baclofen oral liquid formulation refer, page 172 LEVODOPA WITH CARBIDOPA ❋ Tab 100 mg with carbidopa 25 mg ......................................... 10.00 20.00 For levodopa with carbidopa oral liquid formulation refer, page 172

500

✔ Apo-Allopurinol S29

S29

100

✔ Pacifen

113

50 100

✔ Sindopa ✔ Sinemet

114

LIGNOCAINE Gel 2%, 10 ml urethral syringe ................................................ 43.26 10 ✔ Pfizer a) Up to 5 each available on a PSO b) Subsidised only if prescribed for urethral or cervical administration and the prescription is endorsed accordingly. LIGNOCAINE WITH CHLORHEXIDINE Gel 2% with chlorhexidine 0.05%, 10 ml urethral syringes ........ 43.26 10 ✔ Pfizer a) Up to 5 each available on a PSO b) Subsidised only if prescribed for urethral or cervical administration and the prescription is endorsed accordingly. GABAPENTIN – Special Authority see SA1071 – Retail pharmacy ▲ Cap 300 mg ............................................................................ 11.50 For gabapentin oral liquid formulation refer, page 172 100 ✔ Nupentin

114

121

122

GABAPENTIN (NEURONTIN) – Special Authority see SA0973 – Retail pharmacy ▲ Cap 300 mg ............................................................................ 39.76 100 For gabapentin (Neurontin) oral liquid formulation refer, page 172 LEVETIRACETAM Tab 500 mg ........................................................................... 28.71 For levetiracetam oral liquid formulation refer, page 172 DOMPERIDONE ❋ Tab 10 mg ................................................................................ 7.99 For domperidone oral liquid formulation refer, page 172 60

✔ Neurontin

123

✔ Levetiracetam-Rex

125

100

✔ Motilium

▲

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 December 2011 (continued)

155 AZATHIOPRINE – Retail pharmacy-Specialist ❋ Tab 50 mg ............................................................................. 18.45 For azathioprine oral liquid formulation refer, page 172 TACROLIMUS – Special Authority see SA0669 – Retail pharmacy Cap 5 mg .......................................................................... 1,070.00 For tacrolimus oral liquid formulation refer, page 172 100 ✔ Imuprine

158

✔ Prograf

165

SPACER DEVICE AuTOCLAVABLE a) Up to 20 5 dev available on a PSO b) Only on a PSO 230 ml (autoclavable) – Subsidy by endorsement .................... 11.60 1 ✔ Space Chamber Available where the prescriber requires a spacer device that is capable of sterilisation in an autoclave and the PSO is endorsed accordingly. ACETAZOLAMIDE ❋ Tab 250 mg ........................................................................... 10.40 For acetazolamide oral liquid formulation refer, page 172 100 ✔ Diamox

168

172

SECTION C: EXTEMPORANEOUSLY COMPOUNDED PRODUCTS AND GALENICALS Explanatory notes Oral liquid mixtures Oral liquid mixtures are subsidised for patients unable to swallow subsidised solid oral dose forms where no suitable alternative proprietary formulation is subsidised. Suitable alternatives include dispersible and sublingual formulations, oral liquid formulations or rectal formulations. Before extemporaneously compounding an oral liquid mixture, other alternatives such as dispersing the solid dose form (if appropriate) or crushing the solid dose form in jam, honey or soft foods such as yoghurt should be explored. The Emixt website http://www.pharminfotech.co.nz has evidence-based formulations which are intended to standardise compounded oral liquids within New Zealand. Pharmaceuticals with standardised formula for compounding in Ora products Acetazolamide 25 mg/ml Allopurinol 20 mg/ml Amlodipine 1 mg/ml Azathioprine 50 mg/ml Baclofen 10 mg/ml Carvedilol 1 mg/ml Clopidogrel 5 mg/ml Diltiazem hydrochloride 12 mg/ml Dipyridamole 10 mg/ml Domperidone 1 mg/ml Enalapril 1 mg/ml Flecainide 20 mg/ml Gabapentin 100 mg/ml Gabapentin (Neurontin) 100 mg/ml Hydrocortisone 1 mg/ml Labetolol 10 mg/ml Levetiracetam 100 mg/ml Levodopa with carbidopa (5 mg levodopa+ 1.25 mg carbidopa)/ml Metoprolol tartrate 10 mg/ml Nitrofurantoin 10 mg/ml Pyrazinamide 100 mg/ml Rifabutin 20 mg/ml Sildenafil 2 mg/ml Sotalol 15 mg/ml Sulphasalazine 100 mg/ml Tacrolimus 1 mg/ml Terbinafine 25 mg/ml ursodeoxycholic acid 50 mg/ml Valganciclovir 60 mg/ml* Verapamil hydrochloride 50 mg/ml *Note this is a DCS formulation

PHARMAC endorses the recommendations of the Emixt website and encourages New Zealand pharmacists to use these formulations when compounding is appropriate. The Emixt website also provides stability and expiry data for compounded products. For the majority of products compounded with Ora-Blend, Ora-Blend SF, OraPlus, Ora-Sweet or Ora-Sweet SF a four week expiry is appropriate. Please note that no oral liquid mixture will be eligible for Subsidy unless all the requirements of Section B and C of the Schedule applicable to that pharmaceutical are met. Some community pharmacies may not have appropriate equipment to compound all of the listed products, please use appropriate clinical judgement. 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 2011

28 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 10.95 14 ✔ Apo-Clarithromycin 23.30 ✔ Klamycin a) Maximum of 14 tab per prescription a) If the prescription is for clarithromycin 250 mg tablets and the prescription is dispensed from 14 September 2011 and the prescription meets the restrictions for clarithromycin 250 mg tablets then the prescription can be endorsed accordingly. b) Subsidised only if prescribed for helicobacter pylori eradication and prescription is endorsed accordingly. Note: the prescription is considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxycillin or metronidazole. Note: Pharmacists may endorse the prescription if it is prescribed for the 250 mg tablets and is for an amount of 500 mg or less, or has a valid Special Authority approval. SODIUM NITROPRUSSIDE – Maximum of 50 20 strip per prescription ❋ Test strip – Not on a BSO ........................................................ 14.14 14.14 POLOXAMER – Only on a prescription Not funded for use in the ear ❋ Oral drops 10% ........................................................................ 3.78 POTASSIUM IODATE Tab 256 268 µg (150 µg elemental iodine) .............................. 7.55 Note – Amendment to potassium iodate strength only. PHYTOMENADIONE Inj 2 mg per 0.2 ml – Up to 5 inj available on a PSO ................... 8.00 May be administered orally. Inj 10 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 9.21 May be administered orally. Note – Refer to news stories on page 5 50 strip OP ✔ Ketostix 20 strip OP ✔ Ketostix

30 ml OP 90

✔ Coloxyl ✔ NeuroKare

5 5

✔ Konakion MM ✔ Konakion MM

SODIUM CHLORIDE Not funded for use as a nasal drop. Only funded for nebuliser use when in conjunction with an antibiotic intended for nebuliser use Inf 0.9% – Up to 2,000 ml available on a PSO ........................... 3.06 500 ml ✔ Baxter 4.06 1,000 ml ✔ Baxter Only if prescribed on a prescription for renal dialysis, maternity or post-natal care in the home of the patient, or on a PSO for emergency use. (500 ml and 1,000 ml packs) Inj 23.4%, 20 ml ..................................................................... 31.25 5 ✔ Biomed Inj 0.9%, 5 ml – Up to 5 inj available on a PSO ......................... 10.85 50 ✔ Multichem 15.50 ✔ Pfizer Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 16.10 50 ✔ Multichem 15.50 ✔ Pfizer Inj 0.9%, 20 ml ......................................................................... 4.72 6 ✔ Pharmacia 11.79 30 ✔ Pharmacia 8.41 20 ✔ Multichem

▲

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 2011 (continued)

45 PRAVASTATIN – Special Authority see SA0932 below – Retail pharmacy See prescribing guideline below Tab 10 mg ............................................................................. 27.46 30 ✔ Pravachol Tab 20 mg ............................................................................... 5.44 30 ✔ Cholvastin (42.58) Pravachol Tab 40 mg ............................................................................... 9.28 30 ✔ Cholvastin (65.31) Pravachol ➽ SA0932 Special Authority for Subsidy Initial application —(Confirmed HIV/AIDS) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater; and 2 Confirmed HIV infection; and 3 Patient is being treated with an HIV protease inhibitor. DEXAMETHASONE SODIUM PHOSPHATE Dexamethasone sodium phosphate injection will not be funded for oral use ❋ Inj 4 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 21.50 5 ❋ Inj 4 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 31.00 5 EFAVIRENZ – Special Authority see SA1025 – Retail pharmacy Tab 50 mg ........................................................................... 158.33 Note – addition of Section 29 to Stocrin tab 50 mg only. 30

✔ Hospira ✔ Hospira ✔ Stocrin S29

135

MIDAZOLAM Note: Midazolam injection will be funded if prescribed for intranasal administration for use in palliative care. Note that only the Hypnovel brand is currently indicated for intranasal administration. Tab 7.5 mg ............................................................................ 10.38 100 (25.00) Hypnovel ‡ Safety cap for extemporaneously compounded oral liquid preparations. Inj 1 mg per ml, 5 ml .............................................................. 10.75 10 ✔ Hypnovel (14.73) Pfizer Inj 5 mg per ml, 3 ml .............................................................. 11.90 5 ✔ Hypnovel (19.64) Pfizer Note – Refer to news stories on page 5. EYE PREPARATIONS Eye preparations are only funded for use in the eye. The exception is pilocarpine eye drops 1%, 2% and 4% which are subsidised for oral use pursuant to the Standard Formulae. Note – the above restriction applies to all eye drops, except pilocarpine eye drops 1%, 2% and 4%, listed in the Eye Preparations therapeutic subgroup as listed on pages 166 to 170 of the Pharmaceutical Schedule.

166

Effective 1 October 2011

139 VARENICLINE TARTRATE – Special Authority see SA1161 1135 – Retail pharmacy a) Varenicline will not be funded Close Control in amounts less than 2 weeks of treatment. b) A maximum of 3 months’ varenicline will be subsidised on each Special Authority approval. Tab 1 mg ............................................................................... 67.74 28 ✔ Champix 135.48 56 ✔ Champix Tab 0.5 mg × 11 and 1 mg × 14 .......................................... 60.48 25 OP ✔ Champix ➽ SA1161 1135 Special Authority for Subsidy continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

S29

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2011 (continued)

continued... Initial application from any relevant practitioner. Approvals valid for 5 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 funded 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 6 The patient is not pregnant; and 7 The patient will not be prescribed more than 3 months’ funded varenicline (see note). Renewal from any relevant practitioner. Approvals valid for 5 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 funded 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; and 6 The patient will not be prescribed more than 3 months’ funded varenicline (see note). The patient may not have had an approval in the past 12 months. Note: a maximum of 3 months’ varenicline will be subsidised on each Special Authority approval. 152 SUNITINIB – Special Authority see SA1162 1055 – 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

➽ SA1162 1055 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 0-12); 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 defined as: Any of the following: 5.1 Lactate dehydrogenase level > 1.5 times upper limit of normal; or 5.2 Haemoglobin level < lower limit of normal; or 5.3 Corrected serum calcium level > 10 mg/dL (2.5 mmol/L) ; or continued...

▲

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

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2011 (continued)

continued... 5.4 Interval of < 1 year from original diagnosis to the start of systemic therapy; or 5.5 Karnofsky performance score of ≤ 70; or 5.6 ≥ 2 sites of organ metastasis; 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. Poor prognosis patients are defined as having at least 3 of criteria 5.1-5.6. Intermediate prognosis patients are defined as having 1 or 2 of criteria 5.1-5.6 NCCN clinical practice guidelines for kidney cancer are available at http://www.nccn.org/professionals/ physician_gls/f_guidelines.asp 157 TRASTUZUMAB – PCT only – Specialist – Special Authority see SA1163 1017 Inj 150 mg vial .................................................................. 1,350.00 1 Inj 440 mg vial .................................................................. 3,875.00 1 Inj 1 mg for ECP ....................................................................... 9.36 1 mg ✔ Herceptin ✔ Herceptin ✔ Baxter

➽ SA1163 1017 Special Authority for Subsidy Initial application — (metastatic breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: where Both: 1 Tthe patient has metastatic breast cancer expressing HER-2 IHC 3+ or FISH+ (including FISH or other current technology); and 2 Trastuzumab to be discontinued at disease progression. Renewal — (metastatic breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology); and 2 The cancer has not progressed at any time point during the previous 12 months whilst on trastuzumab. Initial application — (early breast cancer) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 15 months for applications meeting the following criteria: All of the following: 1 The patient has early breast cancer expressing HER 2 IHC 3+ or ISH + (including FISH or other current technology); and 2 Maximum cumulative dose of 106 mg/kg (12 months’ treatment); and 3 Any of the following: 3.1 9 weeks’ concurrent treatment with adjuvant chemotherapy is planned; or 3.2 12 months’ concurrent treatment with adjuvant chemotherapy is planned; or 3.3 12 months’ sequential treatment following adjuvant chemotherapy is planned; or 3.4 Other treatment regimen, in association with adjuvant chemotherapy, is planned. Note: For patients with previous Special Authority approvals for a maximum cumulative dose of 20 mg/kg (9 weeks treatment) granted after 1 April 2009 the approval period has been extended to allow claims for a maximum cumulative dose of 106 mg/kg (12 months treatment). 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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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2011 (continued)

continued... Renewal — (early breast cancer)* only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 1 The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology); and 2 Either: 2.1 Both: 2.2.1 The patient received prior adjuvant trastuzumab treatment for early breast cancer; and 2.2.2 Trastuzumab to be discontinued at disease progression; or 2.2 The cancer has not progressed at any time point during the previous 12 months whilst on trastuzumab. Note: *For patients with relapsed HER-2 positive disease who have previously received adjuvant trastuzumab for early breast cancer. 178 SECTION D: SPECIAL FOODS EXPLANATORY NOTES Who can apply for Special Authority? Initial Applications:Only from a dietitian, relevant specialist or a vocationally registered general practitioner. Reapplications: Only from a dietitian, relevant specialist or a vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or a vocationally registered general practitioner. Other general practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted. All applications must be made on an official form available from the PHARMAC website www.pharmac.govt.nz. All applications must include specific details as requested on the form relating to the application. A supporting letter may be included if desired. Applications must be forwarded to: Ministry of Health Sector Services Private Bag 3015 WHANGANUI 4540 Freefax 0800 100 131 180 SPECIAL FOODS Special Foods – applies to all Special Authority application forms in Section D of the Pharmaceutical Schedule. Special Authority for Subsidy Initial application —only from a dietitian, relevant specialist or vocationally registered general practitioner. Renewal —only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted.

▲

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 October 2011 (continued)

196 AMINO ACID FORMULA – Special Authority see SA1111 – Hospital pharmacy [HP3] Powder .................................................................................... 6.00 48.5 g OP ✔ Vivonex Pediatric 56.00 400 g OP ✔ Neocate ✔ Neocate LCP Powder (tropical) .................................................................... 56.00 400 g OP ✔ Neocate Advance Powder (unflavoured) ............................................................. 56.00 400 g OP ✔ Elecare ✔ Elecare LCP ✔ Neocate Advance Powder (vanilla) ..................................................................... 56.00 400 g OP ✔ Elecare Note – this is a change to the initial application criteria for transition from Old Form (SA0603) only. The remainder of the Special Authority criteria remains consistent with other Special Authority changes detailed above. ➽ SA1111 Special Authority for Subsidy Initial application — (Transition from Old Form (SA0603)) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient is currently receiving funded amino acid formula under Special Authority form SA0603; and 2 An assessment as to whether the infant can be transitioned to a cows milk protein, soy, or extensively hydrolysed infant formula has been undertaken; and 3 The outcome of the assessment is that the infant continues to require an amino acid infant formula; and 4 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted. 197 EXTENSIVELY HYDROLYSED FORMULA – Special Authority see SA1112 – Hospital pharmacy [HP3] Powder .................................................................................. 15.21 450 g OP ✔ Pepti Junior Gold 19.01 ✔ Pepti Junior Note – this is a change to the initial application criteria for transition from Old Form (SA0603) only. The remainder of the Special Authority criteria remains consistent with other Special Authority changes detailed above. ➽ SA1112 Special Authority for Subsidy Initial application — (Transition from Old Form (SA0603)) only from a dietitian, relevant specialist, vocationally registered general practitioner or general practitioner on the recommendation of a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 All of the following: 1.1 The infant is currently receiving funded amino acid formula under Special Authority form SA0603; and 1.2 The infant is to be trialled on, or transitioned to, an extensively hydrolysed formula; and 1.3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted; or 2 All of the following: 2.1 The patient is currently receiving funded extensively hydrolysed formula under Special Authority form SA0603; and 2.2 An assessment as to whether the infant can be transitioned to a cows milk protein or soy infant formula has been undertaken; and 2.3 The outcome of the assessment is that the infant continues to require an extensively hydrolysed infant formula; and 2.4 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted. 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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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 October 2011 (continued)

191 ORAL FEED 1.5KCAL/ML – Special Authority see SA1104 – Hospital pharmacy [HP3] a) Note - Repeats for Fortisip and Ensure Plus will be fully subsidised where the initial dispensing was before 1 April 2011. b) Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly. Liquid (banana) – Higher subsidy of $1.26 per 200 ml with Endorsement ........................................................................ 0.72 200 ml OP (1.26) Ensure Plus (1.26) Fortisip Liquid (chocolate) – Higher subsidy of up to $1.33 per 237 ml with Endorsement .................................................................. 0.72 200 ml OP (1.26) Ensure Plus 0.85 237 ml OP (1.33) Ensure Plus 0.72 200 ml OP (1.26) Fortisip Liquid (coffee latte) – Higher subsidy of up to $1.33 per 237 ml with Endorsement ..................................................... 0.85 237 ml OP (1.33) Ensure Plus Liquid (fruit of the forest) – Higher subsidy of $1.26 per 200 ml with Endorsement .................................................................. 0.72 200 ml OP (1.26) Ensure Plus Liquid (strawberry) – Higher subsidy of up to $1.33 per 237 ml with Endorsement ..................................................... 0.72 200 ml OP (1.26) Ensure Plus 0.85 237 ml OP (1.33) Ensure Plus 0.72 200 ml OP (1.26) Fortisip Liquid (toffee) – Higher subsidy of $1.26 per 200 ml with Endorsement ......................................................................... 0.72 200 ml OP (1.26) Fortisip Liquid (tropical fruit) – Higher subsidy of $1.26 per 200 ml with Endorsement .................................................................. 0.72 200 ml OP (1.26) Fortisip Liquid (vanilla) – Higher subsidy of up to $1.33 per 237 ml with Endorsement .................................................................. 0.72 200 ml OP (1.26) Ensure Plus 0.85 237 ml OP (1.33) Ensure Plus 0.72 200 ml OP (1.26) Fortisip ORAL FEED 2KCAL/ML – Special Authority see SA1105 – Hospital pharmacy [HP3] a) Repeats for Two Cal HN will be fully subsidised where the initial dispensing was before 1 April 2011. b) Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly. Liquid (vanilla) – Higher subsidy of $2.25 per 237 ml with Endorsement ......................................................................... 1.14 237 ml OP (2.25) Two Cal HN

193

▲

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 2011 (continued)

192 ORAL FEED WITH FIBRE 1.5 KCAL/ML – Special Authority see SA1104 – Hospital pharmacy [HP3] a) Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly. b) Repeats for Fortisip Multi Fibre will be fully subsidised where the initial dispensing was before 1 April 2011. Liquid (chocolate) – Higher subsidy of $1.26 per 200 ml with Endorsement ........................................................................ 0.72 200 ml OP (1.26) Fortisip Multi Fibre Liquid (strawberry) – Higher subsidy of $1.26 per 200 ml with Endorsement ........................................................................ 0.72 200 ml OP (1.26) Fortisip Multi Fibre Liquid (vanilla) – Higher subsidy of $1.26 per 200 ml with Endorsement ........................................................................ 0.72 200 ml OP (1.26) Fortisip Multi Fibre

Effective 14 September 2011

28 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 23.30 14 ✔ Klamycin a) Maximum of 14 tab per prescription a) If the prescription is for clarithromycin 250 mg tablets and the prescription is dispensed from 14 September 2011 and the prescription meets the restrictions for clarithromycin 250 mg tablets then the prescription can be endorsed accordingly. b) Subsidised only if prescribed for helicobacter pylori eradication and prescription is endorsed accordingly. Note: the prescription is considered endorsed if clarithromycin is prescribed in conjunction with a proton pump inhibitor and either amoxycillin or metronidazole. Note: Pharmacists may endorse the prescription if it is prescribed for the 250 mg tablets and is for an amount of 500 mg or less, or has a valid Special Authority approval.

Effective 1 September 2011

26 BUDESONIDE Cap 3 mg – Special Authority see SA1155 0913 – Retail pharmacy ............................................................. 166.50 90 ✔ Entocort CIR

➽ SA1155 0913 Special Authority for Subsidy Initial application – (Crohn's disease) from any relevant practitioner. Approvals valid for 6 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn’s disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Severe acne following treatment with conventional corticosteroid therapy; or 2.5 History of severe psychiatric problems associated with corticosteroid treatment; or 2.6 History of major mental illness (such as bipolar affective disorder) where the risk of conventional corticosteroid treatment causing relapse is considered to be high; or 2.7 Relapse during pregnancy (where conventional corticosteroids are considered to be contraindicated). Initial application – (collagenous and lymphocytic colitis (microscopic colitis)) from any relevant practitioner. Approvals valid for 6 months for patients with diagnosis of microscopic colitis (collagenous or lymphocytic colitis) by colonoscopy with biopsies. continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2011 (continued)

continued... Initial application – (gut graft versus host disease) from any relevant practitioner. Approvals valid for 6 months for patients with gut graft versus host disease following allogenic bone marrow transplantation* Note: Indication marked with * is an unapproved Indication. Renewal from any relevant practitioner. Approvals valid for 6 3 months where the treatment remains appropriate and the patient is benefiting from treatment. The patient may not have had more than 1 prior approval in the last year. Note: Clinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate. 81 BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u Inj 600 mg – Up to 5 inj available on a PSO ............................................................................ 11.50

✔ Sandoz

ADALIMUMAB – Special Authority see SA1156 1059 – Retail pharmacy Inj 40 mg per 0.8 ml prefilled pen ....................................... 1,799.92 2 ✔ HumiraPen Inj 40 mg per 0.8 ml prefilled syringe ................................. 1,799.92 2 ✔ Humira ➽ SA1156 1059 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 and hydroxychloroquine sulphate (at maximum tolerated doses); and 2.5 Either Any of the following: 2.5.1 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with 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 of oral or parenteral methotrexate in combination with intramuscular gold; or 2.5.3 Patient has tried and not responded to at least three months of therapy at the maximum tolerated dose of leflunomide alone or in combination with oral or parenteral methotrexate 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...

▲

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 2011 (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. Initial application - (ankylosing spondylitis) only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: Either: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2011 (continued)

continued... 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 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 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 the following 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) measures: a modified Schober’s test of less than or equal to 4 cm and lumbar side flexion measurement of less than or equal to 10 cm (mean of left and right); 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. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI measure 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 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 15 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 September 2011 (continued)

continued... 2.5 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 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 3 to 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: All of the following: 1 Either: 1.1 Applicant is a dermatologist; or continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

S29

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2011 (continued)

continued... 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 had "whole body" severe chronic plaque psoriasis at the start of treatment; 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 had severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot at the start of treatment; 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 Physician considers that the patient has benefited from treatment and that continued treatment is appropriate; and 4 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 3 to 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% 30% 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

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 2011 (continued)

102 ETANERCEPT – Special Authority see SA1157 1060 – Retail pharmacy Inj 25 mg .............................................................................. 949.96 Inj 50 mg autoinjector ......................................................... 1,899.92 Inj 50 mg prefilled syringe................................................... 1,899.92 4 4 4 ✔ Enbrel ✔ Enbrel ✔ Enbrel

➽ SA1157 1060 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 either oral corticosteroids (prednisone 0.25 mg/kg or at the maximum tolerated dose); and or a full trial of serial intra-articular corticosteroid injections; 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 disease-modifying agent; and 56 Both: 56.1 Either: 56.1.1 Patient has persistent symptoms of poorly-controlled and active disease in at least 20 active, swollen, tender joints; or 56.1.2 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 56.2 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 and hydroxychloroquine sulphate (at maximum tolerated doses); and 2.5 Either Any of the following: 2.5.1 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with 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 of oral or parenteral methotrexate in combination with intramuscular gold; or 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 September 2011 (continued)

continued... 2.5.3 Patient has tried and not responded to at least three months of therapy at the maximum tolerated dose of leflunomide alone or in combination with oral or parenteral methotrexate 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: 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 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 2011 (continued)

continued... 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 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 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 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 the following 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) measures: a modified Schober’s test of less than or equal to 4 cm and lumbar side flexion measurement of less than or equal to 10 cm (mean of left and right); 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. Notes: The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI measure 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 15 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: continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy Unapproved medicine supplied under Section 29 ‡ safety cap reimbursed Sole Subsidised Supply

S29

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2011 (continued)

continued... 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 - (juvenile idiopathic arthritis) only from a named specialist, 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 3 to 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 3 to 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 in doses no greater than 50 mg ever 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 had "whole body" severe chronic plaque psoriasis at the start of treatment; 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 had severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot at the start of treatment; 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 September 2011 (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: A 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 pre-treatment 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 3 to 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% 30% 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. 128 OLANZAPINE Tab 2.5 mg – Special Authority (Zyprexa brand only) see SA0741 below – Retail pharmacy .................................... 2.00 (51.07) Tab 5 mg – Special Authority (Zyprexa brand only) see SA0741 below – Retail pharmacy .................................... 3.85 (101.21) 2.2.2 Either: 2.2.2.1

✔ Dr Reddy’s Olanzapine ✔ Olanzine Zyprexa ✔ Dr Reddy’s Olanzapine ✔ Olanzine Zyprexa

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

S29

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 September 2011 (continued)

continued... Tab 10 mg – Special Authority (Zyprexa brand only) see SA0741 below – Retail pharmacy .................................... 6.35 (204.49) 28 ✔ Dr Reddy’s Olanzapine ✔ Olanzine Zyprexa

➽ SA0741 Special Authority for Subsidy Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Patient presents with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patient suffering from schizophrenia and related psychoses or acute mania in bipolar disorder who is likely to benefit from antipsychotic treatment; and 2.2 Either: 2.2.1 An effective dose of risperidone had been trialled and has been discontinued because of unacceptable side effects; or 2.2.2 An effective dose of risperidone had been trialled and has been discontinued because of inadequate clinical response after 4 weeks; or 3 The patient has suffered from an acute episode of schizophrenia or bipolar mania and has been treated with olanzapine short-acting intra-muscular injection. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Note: Initial prescriptions to be written by psychiatrists or psychiatric registrars and subsequent prescriptions can be written by General Practitioners. 131 OLANZAPINE Wafer 5 mg – Special Authority see SA0739 – Retail pharmacy ................................................... 6.36 28 (102.19) Zyprexa Zydis Wafer 10 mg – Special Authority see SA0739 – Retail pharmacy ................................................... 8.76 28 (204.37) Zyprexa Zydis ➽ SA0739 Special Authority for Subsidy Initial application only from a psychiatrist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient meets the current criteria for standard olanzapine tablets; and 2 The patient is unable to take standard olanzapine tablets, or once stabilized refuses to take olanzapine tablets; or the patient is non-adherent to oral therapy with standard olanzapine tablets; and 3 The patient is under direct supervision for administration of medicine. Renewal only from a psychiatrist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is unable to take standard olanzapine tablets, or once stabilized refuses to take olanzapine tablets; and 2 The patient is under direct supervision for administration of medicine. Note: Initial prescriptions to be written by psychiatrists and subsequent prescriptions can be written by psychiatric registrars or General Practitioners.

▲

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 2011 (continued)

149 THALIDOMIDE – PCT only – Specialist – Special Authority see SA1124 Only on a controlled drug form Cap 50 mg ........................................................................... 490.00 504.00 Cap 100 mg ...................................................................... 1,008.00

28 28

✔ Thalidomide Pharmion ✔ Thalomid ✔ Thalomid

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 December 2011

38 CALCIUM CARBONATE ( subsidy) ❋ Tab 1.25 g (500 mg elemental) ................................................. 6.38 ❋ Tab 1.5 g (600 mg elemental) ................................................... 7.66 LOSARTAN ( subsidy) ❋ Tab 12.5 mg ............................................................................. 0.96 (10.45) ❋ Tab 25 mg ............................................................................... 1.07 (10.45) ❋ Tab 50 mg ............................................................................... 1.74 (8.70) Tab 50 mg with hydrochlorothiazide 12.5 mg ............................ 4.89 (10.45) ❋ Tab 100 mg ............................................................................. 2.89 (10.45) CALCIPOTRIOL ( subsidy) Crm 50 µg per g ..................................................................... 16.00 45.00 Oint 50 µg per g ...................................................................... 45.00 Soln 50 µg per ml .................................................................. 16.00 TESTOSTERONE CYPIONATE – Retail pharmacy-Specialist ( subsidy) Inj long-acting 100 mg per ml, 10 ml ....................................... 76.50 CIPROFLOXACIN ( subsidy) Tab 250 mg – Up to 5 tab available on a PSO ............................ 2.36 (3.35) Tab 500 mg – Up to 5 tab available on a PSO ............................ 3.21 (4.90) Tab 750 mg – Retail pharmacy-Specialist .................................. 5.52 (7.54) ALLOPURINOL ( subsidy) ❋ Tab 100 mg .............................................................................. 3.98 (5.44) ❋ Tab 300 mg .............................................................................. 3.35 (4.03) PARACETAMOL ( subsidy) ❋‡ Oral liq 120 mg per 5 ml ......................................................... 4.42 a) Up to 200 ml available on a PSO b) Not in combination MASK FOR SPACER DEVICE ( subsidy) Size 2 ........................................................................................ 2.99 250 250 30 Cozaar 30 Cozaar 30 Cozaar 30 Hyzaar 30 Cozaar ✔ Calci-Tab 500 ✔ Calci-Tab 600

30 g OP 100 g OP 100 g OP 30 ml OP 1 30

✔ Daivonex ✔ Daivonex ✔ Daivonex ✔ Daivonex ✔ Depo-Testosterone

73 82

Rex Medical 30 Rex Medical 30 Rex Medical 250 Apo-Allopurinol 100 Apo-Allopurinol 1,000 ml ✔ Paracare Junior

112

115

165

✔ EZ-fit Paediatric Mask

▲

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 December 2011 (continued)

165 PEAK FLOW METER ( subsidy) a) Up to 10 dev available on a PSO b) Only on a PSO Low range .............................................................................. 11.44 Normal range ......................................................................... 11.44 SPACER DEVICE ( subsidy) a) Up to 20 dev available on a PSO b) Only on a PSO 230 ml (single patient)............................................................... 4.72 FUSIDIC ACID ( price) Eye drops 1% ............................................................................ 4.50 GLYCERIN WITH SODIUM SACCHARIN – Only in combination ( subsidy) Only in combination with Ora-Plus. Suspension ............................................................................. 36.80 GLYCERIN WITH SUCROSE – Only in combination ( subsidy) Only in combination with Ora-Plus. Suspension ............................................................................. 36.80 METHYLCELLULOSE ( subsidy) Suspension – Only in combination .......................................... 36.80

1 1

✔ Breath-Alert ✔ Breath-Alert

165

1 5 g OP

✔ Space Chamber ✔ Fucithalmic

166 176

473 ml

✔ Ora-Sweet SF

176

473 ml 473 ml

✔ Ora-Sweet ✔ Ora-Plus

177 177 177

METHYLCELLULOSE WITH GLYCERIN AND SODIUM SACCHARIN – Only in combination ( subsidy) Suspension ............................................................................ 36.80 473 ml ✔ Ora-Blend SF METHYLCELLULOSE WITH GLYCERIN AND SUCROSE – Only in combination ( subsidy) Suspension ............................................................................ 36.80 473 ml ✔ Ora-Blend

Effective 1 November 2011

39 CHARCOAL ( price) ❋ Tab 300 mg ............................................................................. 7.13 (9.77) PRAVASTATIN ( subsidy) See prescribing guideline Tab 20 mg ............................................................................... 5.44 (42.58) Tab 40 mg ............................................................................... 9.28 (65.31) 100 Red Seal

30 Pravachol 30 Pravachol ✔ Fintral

70 84

FINASTERIDE – Special Authority see SA0928 – Retail pharmacy ( subsidy) Tab 5 mg .................................................................................. 5.10 30 TERBINAFINE ( subsidy) Tab 250 mg ........................................................................... 12.75 (25.50) 100

Apo-Terbinafine

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 November 2011 (continued)

153 BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy ( subsidy) Tab 50 mg ............................................................................. 10.71 30 ✔ Bicalox

Effective 1 October 2011

29 OMEPRAZOLE ( subsidy) ❋ Cap 10 mg ............................................................................... 0.97 ❋ Cap 20 mg ............................................................................... 1.26 ❋ Cap 40 mg ............................................................................... 1.86 43 59 SODIUM CHLORIDE ( subsidy) Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 16.10 BETAMETHASONE VALERATE ( subsidy) ❋ Crm 0.1% ................................................................................. 3.20 ❋ Oint 0.1% ................................................................................. 3.20 CO-TRIMOXAZOLE ( subsidy) ❋ Tab trimethoprim 80 mg and sulphamethoxazole 400 mg – Up to 30 tab available on a PSO .......................................... 20.97 30 30 30 ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole ✔ Multichem ✔ Beta Cream ✔ Beta Ointment

50 50 g OP 50 g OP

500

✔ Trisul

SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ( price) ❋ Tab 100 mg ............................................................................. 5.32 100 (17.10) Daclin ❋ Tab 200 mg ............................................................................. 6.72 100 (30.20) Daclin DOTHIEPIN HYDROCHLORIDE ( subsidy) Tab 75 mg ............................................................................. 10.50 Cap 25 mg ............................................................................... 6.17 100 100 ✔ Dopress ✔ Dopress

118

135

TRIAZOLAM ( price) Tab 125 µg .............................................................................. 5.10 100 (7.25) ‡ Safety cap for extemporaneously compounded oral liquid preparations. Tab 250 µg .............................................................................. 4.10 100 (8.70) ‡ Safety cap for extemporaneously compounded oral liquid preparations. BUDESONIDE ( subsidy) Powder for inhalation, 200 µg per dose .................................. 15.20 Powder for inhalation, 400 µg per dose .................................. 25.60

Hypam Hypam

160

200 dose OP ✔ Budenocort 200 dose OP ✔ Budenocort

Effective 1 September 2011

28 HYOSCINE N-BUTYLBROMIDE ( subsidy) ❋ Inj 20 mg, 1 ml – Up to 5 inj available on a PSO ......................... 9.57 5 ✔ Buscopan

▲

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 September 2011 (continued)

38 39 42 CALCIUM CARBONATE ( subsidy) ❋ Tab eff 1.75 g (1 g elemental).................................................... 6.21 ZINC SULPHATE ( subsidy) ❋ Cap 137.4 mg (50 mg elemental) ............................................ 11.00 PROTAMINE SULPHATE ( price) ❋ Inj 10 mg per ml, 5 ml ............................................................ 22.40 (95.87) CLOTRIMAZOLE ( subsidy) ❋ Crm 1% ..................................................................................... 0.54 a) Only on a prescription b) Not in combination MICONAZOLE NITRATE ( subsidy) ❋ Crm 2% .................................................................................... 0.46 a) Only on a prescription b) Not in combination 30 100 10 Artex 20 g OP ✔ Clomazol ✔ Calsource ✔ Zincaps

15 g OP

✔ Multichem

HYDROCORTISONE ( subsidy) ❋ Crm 1% – Only on a prescription ............................................ 14.00 500 g ✔ Pharmacy Health ❋ Powder – Only in combination ................................................. 44.00 25 g ✔ ABM Up to 5% in a dermatological base (not proprietary Topical Corticosteriod – Plain) with or without other dermatological galenicals. BETAMETHASONE VALERATE WITH FUSIDIC ACID ( price) Crm 0.1% with fusidic acid 2%. ................................................. 3.49 (10.45) a) Maximum of 15 g per prescription b) Only on a prescription 15 g OP Fucicort

TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN – Only on a prescription ( subsidy) ❋ Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium .......................................................... 3.05 500 ml ✔ Pinetarsol 5.82 1,000 ml ✔ Pinetarsol IMIQUIMOD – Special Authority see SA0923 – Retail pharmacy ( subsidy) Crm 5% ................................................................................... 62.00 ERGOMETRINE MALEATE ( subsidy) Inj 500 µg per ml, 1 ml – Up to 5 inj available on a PSO ........... 31.00 NORETHISTERONE ( subsidy) ❋ Tab 5 mg – Up to 30 tab available on a PSO ............................ 26.50 MEBENDAZOLE – Only on a prescription ( subsidy) Tab 100 mg ........................................................................... 24.19 12 5 100 24 ✔ Aldara ✔ DBL Ergometrine ✔ Primolut N ✔ De-Worm

65 70 76 79

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 2011 (continued)

81 AMOXYCILLIN ( subsidy) Inj 250 mg .............................................................................. 12.96 Inj 500 mg ............................................................................. 15.08 Inj 1 g – Up to 5 inj available on a PSO..................................... 21.94 BENZYLPENICILLIN SODIUM (PENICILLIN G) ( subsidy) Inj 600 mg – Up to 5 inj available on a PSO.............................. 11.50 FLUCLOXACILLIN SODIUM ( subsidy) Inj 250 mg .............................................................................. 10.86 Inj 500 mg ............................................................................. 11.32 Inj 1 g – Up to 5 inj available on a PSO..................................... 14.28 PROCAINE PENICILLIN ( subsidy) Inj 1.5 mega u – Up to 5 inj available on a PSO ...................... 123.50 MORPHINE SULPHATE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Inj 5 mg per ml, 1 ml – Up to 5 inj available on a PSO ................ 5.51 Inj 10 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 4.79 Inj 15 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.01 Inj 30 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.30 118 PETHIDINE HYDROCHLORIDE ( subsidy) a) Only on a controlled drug form b) No patient co-payment payable Inj 50 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.51 Inj 50 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 5.83 127 128 LITHIUM CARBONATE ( subsidy) Cap 250 mg ............................................................................. 9.42 OLANZAPINE ( subsidy) Tab 2.5 mg .............................................................................. 2.00 (51.07) Tab 5 mg .................................................................................. 3.85 (101.21) Tab 10 mg ................................................................................ 6.35 (204.49) OLANZAPINE ( subsidy) Wafer 5 mg ............................................................................... 6.36 (102.19) Wafer 10 mg ............................................................................. 8.76 (204.37) 10 10 10 10 10 10 10 5 ✔ Ibiamox ✔ Ibiamox ✔ Ibiamox ✔ Sandoz ✔ Flucloxin ✔ Flucloxin ✔ Flucloxin ✔ Cilicaine

81 82

82 117

5 5 5 5

✔ DBL Morphine Sulphate ✔ DBL Morphine Sulphate ✔ DBL Morphine Sulphate ✔ DBL Morphine Sulphate

5 5

✔ DBL Pethidine Hydrochloride ✔ DBL Pethidine Hydrochloride ✔ Douglas

100 28

Zyprexa 28 Zyprexa 28 Zyprexa 28 Zyprexa Zydis 28 Zyprexa Zydis

131

▲

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 September 2011 (continued)

135 TEMAZEPAM ( subsidy) Tab 10 mg ................................................................................ 1.27 ‡ Safety cap for extemporaneously compounded oral liquid preparations. CYCLOPHOSPHAMIDE ( subsidy) Inj 1 g – PCT – Retail pharmacy-Specialist ............................... 26.70 Inj 2 g – PCT only – Specialist ................................................. 56.90 CALCIUM FOLINATE ( subsidy) Tab 15 mg – PCT – Retail pharmacy-Specialist ....................... 82.45 FLUDARABINE PHOSPHATE – PCT only – Specialist ( subsidy) Inj 50 mg for ECP .................................................................. 105.00 CETIRIZINE HYDROCHLORIDE ( subsidy) ❋‡ Oral liq 1 mg per ml ................................................................ 3.52 AMINOPHYLLINE ( subsidy) ❋ Inj 25 mg per ml, 10 ml – Up to 5 inj available on a PSO .......... 53.75 FUSIDIC ACID ( price) Eye drops 1% ............................................................................ 4.50 (11.52) ACETAZOLAMIDE ( subsidy) ❋ Tab 250 mg ........................................................................... 17.03 25 ✔ Normison

141

1 1 10

✔ Endoxan ✔ Endoxan ✔ DBL Leucovorin Calcium

142

143 159 164 166

50 mg OP ✔ Baxter 200 ml 5 5 g OP Fucithalmic 100 ✔ Diamox ✔ Cetirizine - AFT ✔ DBL Aminophylline

168 180

CARBOHYDRATE SUPPLEMENT – Special Authority see SA1090 – Hospital pharmacy [HP3] ( subsidy) Powder .................................................................................... 5.29 400 g OP ✔ Polycal

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 General Rules

Effective 1 December 2011

20 3.1 Doctors’, Dentists’, Dietitians’, Midwives’, Nurse Prescribers’ and Optometrists’ Prescriptions (other than oral contraceptives) The following provisions apply to all Prescriptions, other than those for an oral contraceptive, written by a Doctor, Dentist, Dietitian, Midwife, Nurse Prescriber or Optometrist unless specifically excluded: 3.1.1 For a Community Pharmaceutical other than a Class B Controlled Drug, only a quantity sufficient to provide treatment for a period not exceeding three Months will be subsidised. 3.1.2 For methylphenidate hydrochloride and dexamphetamine sulphate (except for Dentist prescriptions), only a quantity sufficient to provide treatment for a period not exceeding one Month will be subsidised. 3.1.3 For a Class B Controlled Drug: a) other than Dentist prescriptions and other than methylphenidate hydrochloride and dexamphetamine sulphate, only a quantity: ia) sufficient to provide treatment for a period not exceeding 10 days; and iib) which has been dispensed pursuant to a Prescription sufficient to provide treatment for a period not exceeding one Month, will be subsidised. b) for a Dentist prescription only such quantity as is necessary to provide treatment for a period not exceeding five days will be subsidised. 3.1.4 Subject to clauses 3.1.3 and 3.1.7, for a Doctor, Dentist, Dietitian, Midwife or Nurse Prescriber and 3.1.7 for an Optometrist, where a practitioner has prescribed a quantity of a Community Pharmaceutical sufficient to provide treatment for: a) one Month or less than one Month, but dispensed by the Contractor in quantities smaller than the quantity prescribed, the Community Pharmaceutical will only be subsidised as if that Community Pharmaceutical had been dispensed in a Monthly Lot; b) more than one Month, the Community Pharmaceutical will be subsidised only if it is dispensed: i) in a 90 Day Lot, where the Community Pharmaceutical is a Pharmaceutical covered by Section F Part I of the Pharmaceutical Schedule; or ii) if the Community Pharmaceutical is not a Pharmaceutical referred to in Section F Part I of the Pharmaceutical Schedule, in Monthly Lots, unless: A) the eligible person or his/her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criterion (Criteria) applies and signs that statement to this effect; or B) both: 1) the Practitioner endorses the Community Pharmaceutical on the Prescription with the words “certified exemption” written in the Practitioner’s own handwriting, or signed or initialed by the Practitioner; and 2) every Community Pharmaceutical endorsed as “certified exemption” is covered by Section F Part II of the Pharmaceutical Schedule. 3.1.5 A Community Pharmaceutical is only eligible for Subsidy if the Prescription under which it has been dispensed was presented to the Contractor: a) for a Class B Controlled Drug, within eight days of the date on which the Prescription was written; or b) for any other Community Pharmaceutical, within three Months of the date on which the Prescription was written. 3.1.6 No subsidy will be paid for any Prescription, or part thereof, that is not fulfilled within: a) in the case of a Prescription for a total supply of from one to three Months, three Months from the date the Community Pharmaceutical was first dispensed; or b) in any other case, one Month from the date the Community Pharmaceutical was first dispensed. Only that part of any Prescription that is dispensed within the time frames specified above is eligible for Subsidy. 3.1.7 If a Community Pharmaceutical: 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 General Rules – effective 1 December 2011 (continued)

continued... a) is stable for a limited period only, and the Practitioner Doctor, Dietitian, Midwife, Nurse Prescriber or Optometrist has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that may be dispensed at any one time; or b) is stable for a limited period only, and the Contractor has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that should be dispensed at any one time in all the circumstances of the particular case; or c) is Close Control, The actual quantity dispensed will be subsidised in accordance with any such specification.

3.2 Oral Contraceptives The following provisions apply to all Prescriptions written by a Doctor, Midwife or Nurse Prescriber for an oral contraceptive: 3.2.1 The prescribing Doctor, Midwife or Nurse Prescriber must specify on the Prescription the period of treatment for which the Community Pharmaceutical is to be supplied. This period must not exceed: a) three Months if prescribed by a Midwife; or b) six Months if prescribed by a Doctor or Nurse Practitioner. 3.2.2 Where the period of treatment specified in the Prescription does not exceed six Months, the Community Pharmaceutical is to be dispensed: a) in Lots as specified in the Prescription if the Community Pharmaceutical is Close Control; or b) where no Lots are specified, in one Lot sufficient to provide treatment for the period prescribed. 3.2.3 An oral contraceptive is only eligible for Subsidy if the Prescription under which it has been dispensed was presented to the Contractor within three Months of the date on which it was written. 3.2.4 An oral contraceptive prescribed by a Midwife is only eligible for Subsidy if the Prescription under which it has been dispensed has been written within the period of post natal care of the eligible person. 3.2.5 Where a Community Pharmaceutical in a Prescription is Close Control and a repeat on the Prescription remains unfulfilled after six Months from the date the Community Pharmaceutical was first dispensed only the actual quantity supplied by the Contractor within this time limit will be eligible for Subsidy. 3.3 Dentists’ Prescriptions The following provisions apply to every Prescription written by a Dentist: 3.3.1 The maximum quantity of a Community Pharmaceutical that will be subsidised is as follows: a) where the Community Pharmaceutical is a Controlled Drug, only such quantity as is necessary to provide treatment for a period not exceeding five days; and b) in any other case, only such quantity as is necessary to provide treatment for a period not exceeding five days and, where the Prescription specifies a repeat, one further period not exceeding five days. 3.3.2 Notwithstanding clause 3.3.1, if, in the opinion of the Dentist, an eligible person needs extended treatment with sodium fluoride for up to three Months, the Community Pharmaceutical will be subsidised for that extended period. A Prescription for any such extended supply of sodium fluoride will be subsidised only if it is dispensed in Monthly Lots, unless the eligible person or his her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criterion (Criteria) applies and signs that statement to this effect. 3.3.3 A Community Pharmaceutical is only eligible for Subsidy if the Prescription under which it has been dispensed has been presented to the Contractor: a) for a Class B Controlled Drug, within eight days of the date on which the Prescription was written; or b) for any other Community Pharmaceutical, within three Months of the date on which the Prescription was written. 3.3.4 No Subsidy will be paid for any Prescription, or part thereof, that is not fulfilled within: a) one Month from the date the Community Pharmaceutical was first dispensed; or continued...

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to General Rules – effective 1 December 2011 (continued)

continued... b) in the case of sodium fluoride, three Months from the date the Community Pharmaceutical was first dispensed. Only that part of any Prescription that is dispensed within the time frames specified above is eligible for Subsidy.

Effective 1 November 2011

13 “Annotation” means written annotation of a prescription by a dispensing pharmacist in the pharmacist’s own handwriting following confirmation from the Prescriber if required, and “Annotated” has a corresponding meaning. The Annotation must include the details specified in the Schedule, including the date the prescriber was contacted (if applicable) and be initialled by the dispensing pharmacist. “Hospital Pharmacy-Specialist” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy to an Outpatient either a) on a prescription signed by a Specialist, or b) where the treatment with the Community Pharmaceutical has been recommended by a Specialist, on the Prescription of a Practitioner which is either: a) to an Outpatient; and b) Prescription signed by a Specialist; or if the treatment of an Outpatient with the Community Pharmaceutical has been recommended by a Specialist, on the Prescription of a Practitioner i) endorsed with the words “recommended by [name of specialist and year of authorisation]” and signed by the Practitioner, or ii) Annotated by the dispensing pharmacist, following verbal confirmation from the Practitioner of the name of the Specialist and date of recommendation, with the words “recommended by [name of specialist and date of authorisation], confirmed by [Practitioner]”. Where the Contractor has an electronic record of such an Endorsement or Annotation from a previous prescription for the same Community Pharmaceutical written by a prescriber for the same patient, they may annotate the prescription accordingly. “As recommended by a Specialist” to be interpreted as: a) follows a substantive consultation with an appropriate Specialist; b) the consultation to relate to the Patient for whom the Prescription is written; c) consultation to mean communication by referral, telephone, letter, facsimile or email; d) except in emergencies consultation to precede annotation of the Prescription; and e) both the specialist and the General Practitioner must keep a written record of the consultation. For the purposes of the definition it makes no difference whether or not the Specialist is employed by a hospital. “Retail Pharmacy-Specialist” means that the Community Pharmaceutical is only eligible for Subsidy if it is either: a) supplied on a Prescription or Practitioner’s Supply Order signed by a Specialist, or, b) in the case of treatment recommended by a Specialist, supplied on a Prescription or Practitioner’s Supply Order and either: i) endorsed with the words “recommended by [name of Specialist and year of authorisation]” and signed by the Practitioner, or ii) Annotated by the dispensing pharmacist, following verbal confirmation from the Practitioner of the name of the Specialist and date of recommendation, with the words “recommended by [name of specialist and year of authorisation], confirmed by [Practitioner]”. Where the Contractor has an electronic record of such an Endorsement or Annotation from a previous prescription for the same Community Pharmaceutical written by a prescriber for the same patient, they may annotate the prescription accordingly. “As recommended by a Specialist” to be interpreted as: a) follows a substantive consultation with an appropriate Specialist; 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 General Rules – effective 1 November 2011 (continued)

continued... b) c) d) e) the consultation to relate to the Patient for whom the Prescription is written; consultation to mean communication by referral, telephone, letter, facsimile or email; except in emergencies consultation to precede annotation of the Prescription; and both the Specialist and the General Practitioner must keep a written record of consultation.

2.1 Community Pharmaceuticals eligible for Subsidy include every medicine, therapeutic medical device or related product, or related thing listed in Sections B to G of the Schedule, and every preparation (having an inert base) of any of them, is hereby declared to be a Community Pharmaceutical for the purposes of the Schedule, subject to: 2.1.1 clauses 2.2 and 2.23 of the Schedule; and 2.1.2 clauses 3.1 to 4.4 of the Schedule; and 2.1.3 the conditions (if any) specified in Sections B to G of the Schedule; 2.2 The following medicines, therapeutic medical devices, or related products or related things are not eligible for Subsidy: 2.2.1 substances, or combinations of substances, ordered for any purpose other than: a) treatment of a patient’s medical or dental condition; or b) pregnancy tests; or c) the prevention of sexually transmitted disease; or d) contraception. 2.2.2 substances and combinations of substances packed under pressure in aerosol cans or other similar devices, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.3 electrode jellies; 2.2.4 eye drops packed in single-dose units, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.5 insect repellents and similar preparations; 2.2.6 oral preparations in long-acting form, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.7 substances or combinations of substances in lozenge or similar form, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.8 machine-spread plasters; 2.2.9 preparations prescribed as foods, unless they are specified in Section D of the Schedule; 2.2.10 substances, combinations of substances, or articles, in the form of proprietary medicines or proprietary articles, unless they are deemed or declared to be Pharmaceuticals elsewhere in the Schedule; 2.2.11 shampoos, other than extemporaneously prepared medicated shampoos, or shampoos specified in Sections B to G of the Schedule intended for the treatment of a patient’s medical condition; 2.2.12 toilet preparations; 2.2.13 tooth pastes and powders; 2.2.14 lubricating jellies and catheter lubricants; 2.2.15 sterile diluents for nebulising solutions; 2.2.16 substances in a form intended to enable delivery by transdermal diffusion or osmosis or by the insertion of any solid object or substance into the eye cavity, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.17 substances in a form intended for intravenous delivery (other than by injection), unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.18 substances packed in pre-loaded syringes known as Min-I-Jets, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.19 Community Pharmaceuticals prescribed as cough mixtures, unless they are specified in Sections B to G of the Schedule otherwise than in combination with other ingredients; 2.2.20 vitamin preparations in capsule form, unless they are specified in Sections B to G of the Schedule; 2.2.21 substances prescribed for use as irrigating solutions, unless it is specified in Sections B to G of the Schedule that they may be prescribed for such use. 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 General Rules – effective 1 November 2011 (continued)

continued... 2.23 No claim by a Contractor for payment in respect of the supply of Community Pharmaceuticals will be allowed unless the Community Pharmaceuticals so supplied: 2.23.1 comply with the appropriate standards prescribed by regulations for the time being in force under the Medicines Act 1981; or 2.23.2 in the absence of any such standards, comply with the appropriate standards for the time being prescribed by the British Pharmacopoeia; or 2.23.3 in the absence of the standards prescribed in clauses 2.23.1 and 2.23.2, comply with the appropriate standards for the time being prescribed by the British Pharmaceutical Codex; or 2.23.4 in the absence of the standards prescribed in clauses 2.23.1, 2.23.2 and 2.23.3, are of a grade and quality not lower than those usually applicable to Community Pharmaceuticals intended to be used for medical purposes. 25 4.7 Alteration to Presentation of Pharmaceutical Dispensed A Contractor, when dispensing a subsidised Community Pharmaceutical, may alter the presentation of a Pharmaceutical dispensed to another subsidised presentation but may not alter the dose, frequency and/ or total daily dose. This may only occur when it is not practicable for the contractor to dispense the requested presentation. If the change will result in additional cost to the DHBs, then annotation of the prescription by the dispensing pharmacist must occur stating the reason for the change, and the Contractor must initial the change for the purposes of Audit. a) the Practitioner must authorise and initial the alteration; or b) in cases where PHARMAC has approved and notified in writing such a change in dispensing of a named Pharmaceutical due to an out of stock event or short supply, the Contractor must annotate and initial the alteration. 4.8 Amendment of Schedule PHARMAC may amend the terms of the Schedule from time to time by notice in writing given in such manner as PHARMAC thinks fit, and in accordance with such protocols as agreed with the Pharmacy Guild of New Zealand (Inc) from time to time.

Effective 1 October 2011

14 Close Control means dispensing: • in quantities less than one 90 Day Lot (or for oral contraceptives, less than one 180 Day Lot) for a Community Pharmaceutical referred to in Section F Part I, or • in quantities less than a Monthly Lot for any other Community Pharmaceutical, where any of A), or B) or C) apply. • This Close Control rule defines patient groups or medicines which are eligible for more frequent dispensing periods and the conditions that must be met to enable any claim for payment for additional dispensing to be made. A. Frequency of dispensing for persons in residential care Pharmaceuticals can be dispensed in quantities of not less than 28 days to: • any person whose placement in a Residential Disability Care institution is funded by the Ministry of Health or a DHB; or • a person assessed as requiring long term residential care services and residing in an age related residential care facility; on the request of the person, their agent or caregiver or community residential service provider, provided the following conditions are met: I. the quantity or period of supply to be dispensed at any one time is not less than 28 days’ supply (except under conditions outlined in B.i below); and II. the prescribing Practitioner or dispensing pharmacist has 1) included the name of the patient’s residential placement or facility on the prescription; 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 General Rules – effective 1 October 2011 (continued)

continued... 2) included the patient’s NHI number on the prescription; and 3) specified the maximum quantity or period of supply to be dispensed at any one time. Any person meeting the criteria above who is being initiated onto a new medicine or having their dose changed is able to have their medicine dispensed in accordance with B.i below.

B. Flexible periods of supply for trial periods or safety The Schedule specifies for community patients a default length of dispensing (monthly/three monthly) for each pharmaceutical. Prescribers can request, and pharmacists may dispense, a higher frequency of dispensing in the following circumstances: If the prescribing Practitioner has met the prescribing conditions set out in B.iii below, and the pharmaceutical or patient fits within the provisions of B.i and B.ii below, a pharmacist may dispense more frequently than the Schedule default period of supply. i) Trial Periods The Community Pharmaceutical has been prescribed for a patient who requires close monitoring due to recent initiation onto, or dose change for, the Community Pharmaceutical (applicable to the patient’s first changed Prescription only); or ii) Safety 1) the Community Pharmaceutical is any of the following: a. a tri-cyclic antidepressant; or b. an antipsychotic; or c. a benzodiazepine; or d. a Class B Controlled Drug; or 2) the Community Pharmaceutical has been prescribed for a patient who: a. is not a resident in a Penal Institution, or one of the residential placements or facilities referenced in clause A above; and b. in the opinion of the prescribing Practitioner, is intellectually impaired or frail, infirm or unable to manage their medicine without additional support.

For B.i and B.ii all of the following conditions must be met: iii) The prescribing Practitioner has: 1) endorsed each Community Pharmaceutical on the Prescription clearly with the words “Close Control” or “CC”; and 2) initialled the endorsement in their own handwriting; and 3) specified the maximum quantity or period of supply to be dispensed at any one time. 4) For trial periods each Community Pharmaceutical on the Prescription must be endorsed with either “Close Control Trial”, “CCT” or Trial Period and the period of supply included e.g. CC Trial 1 week. C. Pharmaceutical Supply Management More frequent dispensing may be required from time to time to manage stock supply issues or emergency situations. Pharmacists may dispense more frequently than the Schedule would otherwise allow when all of the following conditions are met: i) PHARMAC has approved and notified pharmacists to annotate prescriptions for a specified Community Pharmaceutical(s) “Close Control” without prescriber endorsement for a specified time; and ii) the dispensing pharmacist has: 1) clearly annotated each of the approved Community Pharmaceuticals that appear on the prescription with the words “Close Control” or “CC”; and 2) initialled the annotation in their own handwriting; and 3) has complied with maximum quantity or period of supply to be dispensed at any one time, as specified by PHARMAC at the time of notification. 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 General Rules – effective 1 October 2011 (continued)

continued... If a dispensing frequency is expressly stated in the Medicines Act, Medicines Regulations or Pharmacy Services Agreement a pharmacy can dispense at that specified dispensing frequency. However, no claim shall be made to any DHB for subsidised payment for dispensing fees in any case where dispensing occurs more frequently than authorised by the provisions of the Schedule.

“Close Control” means the dispensing of a Community Pharmaceutical, in accordance with a Prescription, in quantities less than one 90 Day Lot (or for oral contraceptives, less than one 180 Day Lot) for a Community Pharmaceutical referred to in Section F Part I, or in quantities less than a Monthly Lot for any other Community Pharmaceutical, where any of a), b) or c) apply. a) All of the following conditions are met: i) the Community Pharmaceutical has been prescribed for a patient who: 1) is not a resident in a Penal Institution, Rest Home or Residential Disability Care Institution; and 2) either of the following: i) in the opinion of the prescribing Practitioner is: a) frail; or b) infirm; or c) unable to manage their medication without additional support; or d) intellectually impaired; or e) requires close monitoring due to recent initiation onto, or dose change for, the Community Pharmaceutical (applicable to the patient’s first changed Prescription only); and f) requires that Community Pharmaceutical to be dispensed in a smaller quantity than that for which it is currently funded, or ii) the Community Pharmaceutical is any of the following: a) a tri-cyclic antidepressant; or b) an antipsychotic; or c) a benzodiazepine; or d) a Class B Controlled Drug; and ii) the prescribing Practitioner has: A) endorsed each Community Pharmaceutical on the Prescription clearly with the words “Close Control” or “CC”; and B) initialled the endorsement in their own handwriting; and C) specified the maximum quantity or period of supply to be dispensed at any one time. b) All of the following conditions are met: i) The Community Pharmaceutical is prescribed for a patient who is a resident in a Rest Home or Residential Disability Care Institution; and A) the quantity or period of supply to be dispensed at any one time is not less than 28 days’ supply; and B) the prescriber or pharmacist has written the name of the Rest Home or Residential Disability Care Institution on the prescription; and C) the prescriber or pharmacist has: 1) written on the Prescription the words “Close Control” or “CC” (this applies to all medicines prescribed on the prescription), and 2) initialled the endorsement/annotation in their own handwriting; and 3) specified the maximum quantity or period of supply to be dispensed at any one time. c) All of the following conditions are met: i) where PHARMAC has approved and notified pharmacists to annotate prescriptions for a specified Community Pharmaceutical(s) “Close Control” without prescriber endorsement for a specified time; and ii) the dispensing pharmacist has: A) clearly annotated each of the approved Community Pharmaceuticals that appear on the prescription with the words “Close Control” or “CC”; and B) initialed the annotation in their own handwriting; 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 General Rules – effective 1 October 2011 (continued)

continued... C) specified the maximum quantity or period of supply to be dispensed at any one time, as specified by PHARMAC at the time of notification.

Changes to General Rules – effective 1 September 2011

25 4.6 Substitution Where a Practitioner has prescribed a brand of a Community Pharmaceutical that has no Subsidy or has a Manufacturer’s Price that is greater than the Subsidy and there is an alternative fully subsidised Community Pharmaceutical available, a Contractor may dispense the fully subsidised Community Pharmaceutical, subject to unless either or both of the following circumstances apply: a) the Contractor having received a general Authority to Substitute from the Practitioner in relation to the particular medicine or medicines in general; or there is a clinical reason why substitution should not occur; or b) the Practitioner having indicated their Authority to Substitute on the prescription; or the prescriber has marked the prescription with a statement such as ‘no brand substitution permitted’. c) the Practitioner having given their Authority to Substitute in relation to the particular prescription. Such an Authority to Substitute is valid whether or not there is a financial implication for the Pharmaceutical Budget. When dispensing a subsidised alternative brand, the Contractor must annotate and sign initial the prescription and inform the patient of the brand change.

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 Brand Name

Effective 1 December 2011

165 MASK FOR SPACER DEVICE a) Up to 20 dev available on a PSO b) Only on a PSO c) Only for children aged six years and under Size 2 ........................................................................................... 2.99

✔ Foremount Child’s Silicone Mask EZ-fit Paediatric Mask

Effective 1 November 2011

38 FERROUS SULPHATE ❋ Tab long-acting 325 mg (105 mg elemental) ............................. 1.01 (4.26) 5.06 (15.58) 30 Ferrograd Ferro-Gradumet 150 Ferrograd Ferro-Gradumet

Effective 1 September 2011

59 HYDROCORTISONE ❋ Crm 1% – Only on a prescription ............................................ 14.00 ERGOMETRINE MALEATE Inj 500 µg per ml, 1 ml – Up to 5 inj available on a PSO ........... 31.00 MORPHINE SULPHATE a) Only on a controlled drug form b) No patient co-payment payable Inj 5 mg per ml, 1 ml – Up to 5 inj available on a PSO ................ 5.51 Inj 10 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 4.79 Inj 15 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.01 Inj 30 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.30 500 g ✔ Pharmacy Health PSM ✔ DBL Ergometrine Mayne

117

5 5 5 5

✔ DBL Morphine Sulphate Mayne ✔ DBL Morphine Sulphate Mayne ✔ DBL Morphine Sulphate Mayne ✔ DBL Morphine Sulphate Mayne

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Changes to Brand Names – effective 1 September 2011 (continued)

118 PETHIDINE HYDROCHLORIDE a) Only on a controlled drug form b) No patient co-payment payable Inj 50 mg per ml, 1 ml – Up to 5 inj available on a PSO .............. 5.51 Inj 50 mg per ml, 2 ml – Up to 5 inj available on a PSO .............. 5.83

5 5

✔ DBL Pethidine Hydrochloride Mayne ✔ DBL Pethidine Hydrochloride Mayne ✔ DBL Leucovorin Calcium Mayne ✔ DBL Aminophylline Mayne

142

CALCIUM FOLINATE Tab 15 mg – PCT – Retail pharmacy-Specialist ....................... 82.45

164

AMINOPHYLLINE ❋ Inj 25 mg per ml, 10 ml – Up to 5 inj available on a PSO. ......... 53.75

Changes to Sole Subsidised Supply

Effective 1 December 2011

For the list of new Sole Subsidised Supply products effective 1 December 2011 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 9-18.

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 December 2011

33 PANCREATIC ENZYME Tab EC 5,600 BP u lipase, 5,000 BP u amylase, 330 BP u protease .............................................................. 58.44 Cap 8,000 BP u lipase, 9,000 BP u amylase, 430 BP u protease .............................................................. 67.26 CILAZAPRIL ❋ Tab 2.5 mg ............................................................................... 2.06 ❋ Tab 5 mg ................................................................................. 3.28 Note – Zapril tab 2.5 mg and 5 mg, 90 tab packs remain listed. METOPROLOL TARTRATE ❋ Tab 100 mg ........................................................................... 10.90 Note – Lopresor tab 100 mg, 60 tab pack remains listed.

300 300 30 30

✔ Pancrex V Forte ✔ Pancrex V ✔ Zapril ✔ Zapril

✔ Lopresor

SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Tab 200 mg ............................................................................. 3.36 50 (15.87)

Clinoril

197

EXTENSIVELY HYDROLYSED FORMULA – Special Authority see SA1112 – Hospital pharmacy [HP3] Powder .................................................................................. 19.01 450 g OP ✔ Pepti Junior Note – Pepti Junior Gold powder 450 g OP remains listed.

Effective 1 November 2011

32 BLOOD GLUCOSE DIAGNOSTIC TEST STRIP The number of test strips available on a prescription is restricted to 50 unless: 1) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or 2) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or 3) Prescribed for a pregnant woman with diabetes and endorsed accordingly. Blood glucose test strips ........................................................ 10.82 25 test OP ✔ Optium 5 second test PANCREATIC ENZYME Tab EC 1,900 BP u lipase, 1,700 BP u amylase, 110 BP u protease ............................................................... 32.46 IPECACUANHA ❋ Tincture................................................................................... 41.20 (43.40) DIGOXIN ❋ Tab 250 µg – Up to 30 tab available on a PSO ........................ 15.13

300 500 ml

✔ Pancrex V

PSM 250 ✔ Lanoxin

▲

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 2011 (continued)

63 SALICYLIC ACID Powder – Only in combination ................................................ 15.00 500 g ✔ ABM 1) Only in combination with a dermatological base or proprietary Topical Corticosteroid – Plain or collodion flexible, 2) With or without other dermatological galenicals. 3) Maximum 20 g or 20 ml per prescription when prescribed with white soft paraffin or collodion flexible. SULPHUR Precipitated – Only in combination ............................................. 6.35 100 g (9.25) PSM 1) Only in combination with a dermatological base or proprietary Topical Corticosteroid – Plain 2) With or without other dermatological galenicals. BUPRENORPHINE HYDROCHLORIDE – Only on a controlled drug form Inj 0.3 mg per ml, 1 ml ............................................................. 7.42 (9.38) MORPHINE SULPHATE a) Only on a controlled drug form b) No patient co-payment payable Tab long-acting 10 mg .............................................................. 1.80 Tab long-acting 30 mg .............................................................. 3.15 (3.60) Tab long-acting 60 mg .............................................................. 7.20 Tab long-acting 100 mg ............................................................ 7.85 (8.50) SALBUTAMOL WITH IPRATROPIUM BROMIDE Aerosol inhaler, 100 µg with ipratropium bromide, 20 µg per dose ................................................................... 13.50 SULPHACETAMIDE SODIUM ❋ Eye drops 10% .......................................................................... 4.41 5 Temgesic

114

117

10 10 10 10

✔ LA-Morph LA-Morph ✔ LA-Morph LA-Morph

161

200 dose OP ✔ Combivent 15 ml OP ✔ Bleph 10

163 192

AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority SA1108 – Hospital pharmacy [HP3] Liquid (berry) .......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ 31.20 125 ml OP ✔ Lophlex LQ Liquid (citrus) ......................................................................... 15.65 62.5 ml OP ✔ Lophlex LQ 31.20 125 ml OP ✔ Lophlex LQ Liquid (orange) ........................................................................ 15.65 62.5 ml OP ✔ Lophlex LQ 31.20 125 ml OP ✔ Lophlex LQ Infant formula ....................................................................... 174.72 400 g OP ✔ XP Analog LCP

Effective 1 October 2011

44 COMPOUND ELECTROLYTES Powder for soln for oral use 5 g – Up to 10 sach available on a PSO .................................................................................... 2.24 NAPROXEN SODIUM ❋ Tab 550 mg ............................................................................. 9.95

10 100

✔ Enerlyte ✔ Synflex

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 2011 (continued)

116 FENTANYL CITRATE a) Only on a controlled drug form b) No patient co-payment payable Inj 50 µg per ml, 2 ml ............................................................... 3.22 (6.10) Inj 50 µg per ml, 10 ml ............................................................. 8.41 (15.65)

5 Hospira 5 Hospira

139

NICOTINE Nicotine will not be funded Close Control in amounts less than 4 weeks of treatment. Gum 2 mg (Classic) – Up to 384 piece available on a PSO ....... 14.97 96 Gum 2 mg (Fruit) – Up to 384 piece available on a PSO .......... 14.97 96 Gum 2 mg (Mint) – Up to 384 piece available on a PSO ........... 14.97 96 Gum 4 mg (Classic) – Up to 384 piece available on a PSO ....... 20.02 96 Gum 4 mg (Fruit) – Up to 384 piece available on a PSO .......... 20.02 96 Gum 4 mg (Mint) – Up to 384 piece available on a PSO ........... 20.02 96 THALIDOMIDE – PCT only – Specialist – Special Authority see SA1124 Cap 50 mg ........................................................................... 490.00 CLOPIDOGREL Tab 75 mg ............................................................................... 5.05 Note – Apo-Clopidogrel tab 75 mg, 90 tablet pack, remains subsidised. DIGOXIN ❋ Tab 62.5 µg – Up to 30 tab available on a PSO .......................... 6.94 Note – Lanoxin PG tab 62.5 µg, 240 tablet pack, remains subsidised. 28

✔ Habitrol ✔ Habitrol ✔ Habitrol ✔ Habitrol ✔ Habitrol ✔ Habitrol ✔ Thalidomide Pharmion ✔ Apo-Clopidogrel

149

250

✔ Lanoxin PG

SULPHUR Precipitated – Only in combination ............................................ 6.50 100 g ✔ ABM 1) Only in combination with a dermatological base or proprietary Topical Corticosteroid – Plain, refer, page 171 2) With or without other dermatological galenicals. CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 Tab 250 mg ............................................................................. 5.53 10 ✔ Klacid Note – Klacid tab 250 mg, 14 tablet pack, remains subsidised. RITONAVIR – Special Authority see SA1025 – Retail pharmacy Cap 100 mg ......................................................................... 121.27 NAPROXEN SODIUM ❋ Tab 275 mg ............................................................................. 5.69 SUMATRIPTAN Inj 12 mg per ml, 0.5 ml – Maximum of 10 inj per prescription ............................................................... 36.00 (80.00) 84 120 ✔ Norvir ✔ Sonaflam

92 97 125

2 OP Imigran ✔ ReVia

139

NALTREXONE HYDROCHLORIDE – Special Authority see SA0909 – Retail pharmacy Tab 50 mg ........................................................................... 123.00 30

▲

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 2011

143 CLADRIBINE – PCT only – Specialist Inj 2 mg per ml, 5 ml ............................................................ 873.00 1 ✔ Litak S29 Note – Litak inj 2 mg per ml, 5 ml delist has been revoked. Litak will remain subsidised. TAMOXIFEN CITRATE ❋ Tab 20 mg ............................................................................... 5.25 (6.66) IPRATROPIUM BROMIDE Aqueous nasal spray, 0.03% .................................................... 8.06 (12.66) METHYL HYDROXYBENZOATE Powder .................................................................................. 10.00 SODIUM BICARBONATE Powder BP – Only in combination ............................................. 9.80 (11.99) Only in extemporaneously compounded omeprazole suspension. 60 Tamoxifen Sandoz 30 ml OP Apo-Ipravent 25 g 500 g ✔ ABM ✔ ABM Biomed

155

164

177 177

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 January 2012

29 OMEPRAZOLE ❋ Cap 10 mg ............................................................................... 0.97 ❋ Cap 20 mg ............................................................................... 1.26 ❋ Cap 40 mg ............................................................................... 1.86 30 30 30 ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole

Effective 1 February 2012

45 PRAVASTATIN See prescribing guideline Tab 20 mg ............................................................................... 5.44 (42.58) Tab 40 mg ............................................................................... 9.28 (65.31) FINASTERIDE – Special Authority see SA0928 – Retail pharmacy Tab 5 mg .................................................................................. 5.10 TERBINAFINE Tab 250 mg ........................................................................... 12.75 (25.50) PARACETAMOL WITH CODEINE ❋ Tab paracetamol 500 mg with codeine phosphate 8 mg ............. 2.45 BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy Tab 50 mg ............................................................................. 10.71 SPACER DEVICE a) Up to 20 dev available on a PSO b) Only on a PSO 230 ml (single patient)............................................................... 4.72

30 Pravachol 30 Pravachol 30 100 Apo-Terbinafine 100 30 ✔ ParaCode ✔ Bicalox ✔ Fintral

70 84

118 153 165

✔ Space Chamber

Effective 1 March 2012

45 PRAVASTATIN See prescribing guideline Tab 10 mg .............................................................................. 27.46

✔ Pravachol

▲

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 March 2012 (continued)

49 LOSARTAN – Special Authority see SA0911 – Retail pharmacy ❋ Tab 12.5 mg ............................................................................. 0.96 (10.45) ❋ Tab 25 mg ............................................................................... 1.07 (10.45) ❋ Tab 50 mg ............................................................................... 1.74 (8.70) Tab 50 mg with hydrochlorothiazide 12.5 mg ............................ 4.89 (10.45) ❋ Tab 100 mg ............................................................................. 2.89 (10.45) LEVOTHYROXINE ❋ Tab 100 µg ............................................................................ 46.75 ‡ Safety cap for extemporaneously compounded oral liquid preparations. Note – Synthroid tab 100 µg, 90 tab pack, listed 1 September 2011. CIPROFLOXACIN Tab 250 mg – Up to 5 tab available on a PSO ............................ 2.36 (3.35) Tab 500 mg – Up to 5 tab available on a PSO ............................ 3.21 (4.90) Tab 750 mg – Retail pharmacy-Specialist .................................. 5.52 (7.54) 30 Cozaar 30 Cozaar 30 Cozaar 30 Hyzaar 30 Cozaar 1,000 ✔ Synthroid

30 Rex Medical 30 Rex Medical 30 Rex Medical

MEFENAMIC ACID – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Cap 250 mg ............................................................................. 2.50 100 (18.33) Ponstan ALLOPURINOL ❋ Tab 100 mg .............................................................................. 3.98 (5.44) ❋ Tab 300 mg .............................................................................. 3.35 (4.03) 4.03 20.15 250 Apo-Allopurinol 100 100 500 Apo-Allopurinol ✔ Apo-Allopurinol S29

S29

112

✔ Apo-Allopurinol S29

S29

113

SELEGILINE HYDROCHLORIDE ❋ Tab 5 mg ................................................................................ 16.06

100

✔ Apo-Selegiline S29

S29

115

PARACETAMOL ❋‡ Oral liq 120 mg per 5 ml ......................................................... 4.42 a) Up to 200 ml available on a PSO b) Not in combination MIDAZOLAM Tab 7.5 mg ............................................................................. 10.38 (25.00) ‡ Safety cap for extemporaneously compounded oral liquid preparations

1,000 ml

✔ Paracare Junior

135

100 Hypnovel

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 March 2012 (continued)

180 CARBOHYDRATE SUPPLEMENT – Special Authority see SA1090 – Hospital pharmacy [HP3] Powder .................................................................................. 36.50 5,000 g ✔ Morrex Maltodextrin 182.50 25,000 g ✔ Morrex Maltodextrin ORAL FEED 1 KCAL/ML – Special Authority see SA1104 – Hospital pharmacy [HP3] Powder (chocolate) .................................................................. 4.22 400 g OP Powder (strawberry) ................................................................. 4.22 400 g OP Powder (vanilla) ....................................................................... 4.22 400 g OP ✔ Ensure ✔ Ensure ✔ Ensure

190

191

ORAL FEED 1.5KCAL/ML – Special Authority see SA1104 – Hospital pharmacy [HP3] Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly. Liquid (coffee latte) – Higher subsidy of up to $1.33 per 237 ml with Endorsement ..................................................... 0.85 237 ml OP (1.33) Ensure Plus

Effective 1 May 2012

31 84 185 SODIUM NITROPRUSSIDE – Maximum of 50 strip per prescription ❋ Test strip – Not on a BSO ........................................................ 14.14 ORNIDAZOLE Tab 500 mg ........................................................................... 12.38 20 strip OP ✔ Ketostix 10 ✔ Tiberal

PAEDIATRIC ORAL FEED 1.5KCAL/ML – Special Authority see SA1100 – Hospital pharmacy [HP3] Liquid (strawberry) ................................................................... 1.60 200 ml OP ✔ NutriniDrink Liquid (vanilla) .......................................................................... 1.60 200 ml OP ✔ NutriniDrink PAEDIATRIC ORAL FEED WITH FIBRE 1.5KCAL/ML – Special Authority see SA1100 – Hospital pharmacy [HP3] Liquid (chocolate) .................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre Liquid (strawberry) ................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre Liquid (vanilla) .......................................................................... 1.60 200 ml OP ✔ NutriniDrink Multifibre AMINOACID FORMULA WITHOUT PHENYLALANINE – Special Authority see SA1108 – Hospital pharmacy [HP3] Liquid (tropical) ...................................................................... 30.00 250 ml OP ✔ Easiphen AMINOACID FORMULA WITH MINERALS WITHOUT PHENYLALANINE – Special Authority see SA1108 – Retail pharmacy Powder .................................................................................. 23.38 100 g OP ✔ Metabolic Mineral Mixture

185

195 195

Effective 1 June 2012

112 QUININE SULPHATE ❋ Tab 200 mg ........................................................................... 15.95 (17.20) ‡ Safety cap for extemporaneously compounded oral liquid preparations. 250 Q 200

▲

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

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 December 2011

17 20 AMLODIPINE Tab 2.5 mg – 1% DV Mar-12 to 2014 ...................................... 2.45 BETAMETHASONE DIPROPRIONATE WITH CALCIPOTRIOL Oint 500 µg with calcipotriol 50 µg .......................................... 26.12 Topical gel 500 µg with calcipotriol 50 µg ............................... 26.12 CALCIPOTRIOL ( price) Crm 50 µg per g ..................................................................... 16.00 45.00 Oint 50 µg per g ...................................................................... 45.00 Soln 50 µg per ml .................................................................. 16.00 CALCIUM CARBONATE Tab 1.25 g (500 mg elemental) – 1% DV Feb-12 to 2014 .......... 6.38 CEFACLOR MONOHYDRATE (Addition of HSS) Cap 250 mg – 1% DV Mar-12 to 2013 .................................... 24.57 DANTROLENE SODIUM HEMIHEPTAHYDRATE Inj 20 mg ............................................................................. 800.00 FUSIDIC ACID ( price) Eye drops 1% ........................................................................... 4.50 GLYCERIN WITH SODIUM SACCHARIN ( price) Suspension ............................................................................. 36.80 GLYCERIN WITH SUCROSE ( price) Suspension ........................................................................... 36.80 MASK FOR SPACER DEVICE Size 2 ........................................................................................ 2.99 METHYLCELLULOSE ( price) Suspension ............................................................................. 36.80 100 30 g 30 g 30 g 100 g 100 g 30 ml 250 100 6 5g 473 ml 473 ml 1 473 ml Apo-Amlodipine Daivobet Daivobet Daivonex Daivonex Daivonex Daivonex Arrow-Calcium Cefaclor Sandoz Dantrium IV Fucithalmic Ora-Sweet SF Ora-Sweet EZ-fit Paediatric Mask Ora-Plus Ora-Blend SF Ora-Blend Solu-Medrol Solu-Medrol Lopresor

22 23 27 34 36 36 42 45 45 45 46

METHYLCELLULOSE WITH GLYCERIN AND SODIUM SACCHARIN ( price) Suspension ............................................................................ 36.80 473 ml METHYLCELLULOSE WITH GLYCERIN AND SUCROSE ( price) Suspension ............................................................................ 36.80 METHYLPREDNISOLONE SODIUM SUCCINATE Inj 40 mg per ml, 1 ml – 1% DV Dec-09 to 2012 ....................... 6.06 Inj 62.5 mg per ml, 2 ml – 1% DV Dec-09 to 2012 .................. 16.50 METOPROLOL TARTRATE Inj 1 mg per ml, 5 ml ............................................................... 24.00 Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated 473 ml 1 1 5

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 December 2011 (continued)

50 PACLITAXEL Inj 100 mg .............................................................................. 91.67 Inj 150 mg ........................................................................... 137.50 Inj 300 mg ........................................................................... 275.00 Note – HSS still remains on Paclitaxel Ebewe PEAK FLOW METER Low Range .............................................................................. 11.44 Normal Range ......................................................................... 11.44 QUININE SULPHATE Tab 200 mg ............................................................................ 17.20 Note – Q 200 tab 200 mg to be delisted 1 February 2012. 1 1 1 Paclitaxel Actavis Paclitaxel Actavis Paclitaxel Actavis

1 1 250

Breath-Alert Breath-Alert Q 200

REMIFENTANIL HYDROCHLORIDE (delayed HSS and delisting) Inj 1 mg vial – 1% DV Feb Jan-12 to 2014 ............................. 27.95 5 Remifentanil-AFT 50.75 Ultiva Inj 2 mg vial – 1% DV Feb Jan -12 to 2014 ............................ 41.80 5 Remifentanil-AFT 101.50 Ultiva Note – HSS for Remifentanil-AFT delayed from January 2012 until February 2012. The delisting of Ultiva inj 1 mg and 2 mg has also been delayed until 1 February 2012. SPACER DEVICE 230 ml (single patient)............................................................... 4.72 TESTOSTERONE CYPIONATE ( price) Inj long-acting 100 mg per ml, 10 ml – 1% DV Feb-12 to 2014 .................................................... 76.50 1 Space Chamber Plus

60 62

Depo-Testosterone

Section H changes to General Rules

Effective 1 December 2011

14 Discretionary Community Supply Pharmaceuticals 7.5 Subject to rules 7.6 and 7.7, DHB Hospitals must not fund for use in the community, any pharmaceuticals that are not Discretionary Community Supply Pharmaceuticals unless they have been approved under Hospital Exceptional Circumstances. 7.6 DHB Hospitals may fund from their own budgets, any Pharmaceutical that is listed in Sections A-G of the Pharmaceutical Schedule without Hospital Exceptional Circumstances (HEC) approval provided that: a) the quantity supplied does not exceed that sufficient for: i) up to 5 days treatment, or one original pack (where appropriate to provide less); or ii) more than 5 days treatment, provided that the relevant DHB Hospital has a dispensing for discharge policy and the quantity supplied is in accordance with that policy; and b) the Pharmaceutical is supplied consistent with any restrictions applying to that Pharmaceutical in Sections A-G of the Pharmaceutical Schedule. 7.7 DHB Hospitals may fund from their own budgets any Pharmaceutical without Hospital Exceptional Circumstances approval provided that the Pharmaceutical is only being supplied to the patient for them to use in the 24 hours leading up to a procedure to be performed in a DHB Hospital.

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 Acitretin ............................................................ 20 Aldara ............................................................... 50 Acetazolamide ............................................ 26, 52 Actigall ............................................................. 22 Adalimumab...................................................... 35 AFT-Pyrazinamide ............................................. 24 Allopurinol....................................... 20, 25, 47, 68 Amino acid formula ........................................... 32 Aminoacid formula with minerals without phenylalanine ..................................... 69 Aminoacid formula without phenylalanine .... 64, 69 Aminophylline ............................................. 52, 62 Amlodipine............................................ 19, 24, 70 Amoxycillin ....................................................... 51 Apo-Allopurinol ............................... 20, 25, 47, 68 Apo-Allopurinol S29 .................................... 25, 68 Apo-Amlodipine .................................... 19, 24, 70 Apo-Clarithromycin ............................... 19, 20, 27 Apo-Clopidogrel .......................................... 22, 65 Apo-Ipravent ..................................................... 66 Apo-Selegiline S29 ............................................ 68 Apo-Terbinafine..................................... 24, 48, 67 Arrow-Calcium ............................................ 19, 70 Arrowcare ......................................................... 19 Arrow-Enalapril ................................................. 23 Arrow-Losartan & Hydrochlorothiazide ........ 20, 23 Arrow-Timolol ................................................... 20 Artex ................................................................. 50 Azathioprine ...................................................... 26 B Baclofen ........................................................... 25 Benzylpenicillin sodium (penicillin g) ........... 35, 51 Beta Cream ....................................................... 49 Betamethasone diproprionate with calcipotriol ............................................... 19, 70 Betamethasone valerate .................................... 49 Betamethasone valerate with fusidic acid ........... 50 Beta Ointment ................................................... 49 Bicalaccord ....................................................... 21 Bicalox........................................................ 49, 67 Bicalutamide ......................................... 21, 49, 67 Bleph 10 ........................................................... 64 Blood glucose diagnostic test strip .................... 63 Breath-Alert................................................. 48, 71 Budenocort ....................................................... 49 Budesonide ................................................. 34, 49 Buprenorphine hydrochloride ............................. 64 Buscopan ......................................................... 49 C Calci-Tab 500 ................................................... 47 Calci-Tab 600 ................................................... 47 Calcipotriol.................................................. 47, 70 Calcium carbonate .......................... 19, 47, 50, 70 Calcium folinate .......................................... 52, 62 Calsource ......................................................... 50 Candesartan...................................................... 21 Candestar ......................................................... 21 Carbohydrate supplement............................ 52, 69 Carvedilol .......................................................... 23 Cefaclor monohydrate ....................................... 70 Cefaclor Sandoz ................................................ 70 Cetirizine - AFT.................................................. 52 Cetirizine hydrochloride ..................................... 52 Champix ........................................................... 28 Charcoal ........................................................... 48 Cholvastin ................................................... 21, 28 Cilazapril ........................................................... 63 Cilicaine ............................................................ 51 Cipflox .............................................................. 20 Ciprofloxacin ......................................... 20, 47, 68 Cladribine.......................................................... 66 Clarithromycin........................... 19, 20, 27, 34, 65 Clexane ............................................................. 22 Clinoril .............................................................. 63 Clomazol........................................................... 50 Clopidogrel ................................................. 22, 65 Clotrimazole ...................................................... 50 Combivent ........................................................ 64 Condoms .......................................................... 24 Co-trimoxazole .................................................. 49 Coloxyl ............................................................. 27 Compound electrolytes...................................... 64 Cozaar .................................................. 23, 47, 68 Cyclophosphamide ........................................... 52 D Daclin ............................................................... 49 Daivobet ..................................................... 19, 70 Daivonex ..................................................... 47, 70 Dantrium IV ....................................................... 70 Dantrolene sodium hemiheptahydrate ................ 70 DBL Aminophylline ...................................... 52, 62 DBL Ergometrine ......................................... 50, 61 DBL Leucovorin Calcium ............................. 52, 62 DBL Morphine Sulphate ............................... 51, 61 DBL Pethidine Hydrochloride ....................... 51, 62 Depo-Testosterone...................................... 47, 71 De-Worm .......................................................... 50 Dexamethasone sodium phosphate ................... 28 Diamox ....................................................... 26, 52 Digoxin ................................................. 21, 63, 65 Dilatrend ........................................................... 23 Diltiazem hydrochloride ..................................... 24 Dilzem .............................................................. 24

Index

Pharmaceuticals and brands Dipyridamole..................................................... 22 Domperidone .................................................... 25 Dopress ............................................................ 49 Dothiepin hydrochloride..................................... 49 Dr Reddy’s Olanzapine ................................ 44, 45 Dr Reddy’s Omeprazole............................... 49, 67 Dr Reddy’s Terbinafine ................................ 21, 24 Durex Extra Safe................................................ 24 E Easiphen ........................................................... 69 Efavirenz ........................................................... 28 Elecare ............................................................. 32 Elecare LCP ...................................................... 32 Enalapril ............................................................ 23 Enbrel ............................................................... 40 Endoxan............................................................ 52 Enerlyte ............................................................ 64 Enoxaparin sodium............................................ 22 Ensure .............................................................. 69 Ensure Plus................................................. 33, 69 Entocort CIR ..................................................... 34 Ergometrine maleate ................................... 50, 61 Etanercept......................................................... 40 Ethics Paracetamol ........................................... 20 Extensively hydrolysed formula.................... 32, 63 Eye preparations ............................................... 28 EZ-fit Paediatric Mask............................ 47, 61, 70 F Fentanyl citrate.................................................. 65 Ferrograd .......................................................... 61 Ferro-Gradumet................................................. 61 Ferrous sulphate ............................................... 61 Finasteride ............................................ 21, 48, 67 Fintral ......................................................... 48, 67 Flecainide acetate.............................................. 23 Flucloxacillin sodium ......................................... 51 Flucloxin ........................................................... 51 Fluconazole ........................................... 19, 20, 24 Fludarabine phosphate ...................................... 52 Foremount Child’s Silicone Mask ....................... 61 Fortisip ............................................................. 33 Fortisip Multi Fibre ............................................. 34 Fucicort ............................................................ 50 Fucithalmic ........................................... 48, 52, 70 Fusidic acid........................................... 48, 52, 70 G Gabapentin ....................................................... 25 Gabapentin (neurontin) ...................................... 25 Glycerin with sodium saccharin ................... 48, 70 Glycerin with sucrose .................................. 48, 70 H Habitrol ............................................................. 65 Herceptin .......................................................... 30 Humira.............................................................. 35 HumiraPen ........................................................ 35 Hybloc .............................................................. 23 Hydrocortisone ..................................... 24, 50, 61 Hyoscine n-butylbromide .................................. 49 Hypam .............................................................. 49 Hypnovel .................................................... 28, 68 Hyzaar .................................................. 23, 47, 68 I Ibuprofen .......................................................... 19 Imiquimod ........................................................ 50 Imuprine ........................................................... 26 Ibiamox............................................................. 51 Imigran ............................................................. 65 Ipecacuanha ..................................................... 63 Ipratropium bromide .......................................... 66 Isoptin .............................................................. 24 K Ketostix................................................. 19, 27, 69 Klacid ............................................................... 65 Klamycin..................................................... 27, 34 Konakion MM.................................................... 27 L Labetalol ........................................................... 23 LA-Morph ......................................................... 64 Lanoxin ....................................................... 21, 63 Lanoxin PG ................................................. 21, 65 Levetiracetam ................................................... 25 Levetiracetam-Rex ............................................ 25 Levodopa with carbidopa .................................. 25 Levothyroxine ....................................... 20, 21, 68 Lignocaine ........................................................ 25 Lignocaine with chlorhexidine ............................ 25 Litak ................................................................. 66 Lithium carbonate ............................................. 51 Lophlex LQ........................................................ 64 Lopresor ......................................... 19, 23, 63, 70 Losartan ......................................... 20, 23, 47, 68 Lostaar ....................................................... 20, 23 M Mask for spacer device ......................... 47, 61, 70 Mebendazole..................................................... 50 Mefenamic acid .......................................... 21, 68 Megace............................................................. 20 Megestrol acetate.............................................. 20 Metabolic Mineral Mixture.................................. 69 Methylcellulose ........................................... 48, 70 Methylcellulose with glycerin and sodium saccharin..................................... 48, 70

Index

Pharmaceuticals and brands Methylcellulose with glycerin and sucrose ... 48, 70 Methyl hydroxybenzoate .................................... 66 Methylprednisolone sodium succinate ......... 19, 70 Metoprolol tartrate ........................... 19, 23, 63, 70 Miconazole nitrate ............................................. 50 Midazolam .................................................. 28, 68 Morphine sulphate................................. 51, 61, 64 Morrex Maltodextrin .......................................... 69 Motilium ........................................................... 25 Mycobutin......................................................... 24 N Naltrexone hydrochloride ................................... 65 Naproxen sodium ........................................ 64, 65 Neocate ............................................................ 32 Neocate Advance .............................................. 32 Neocate LCP ..................................................... 32 NeuroKare......................................................... 27 Neurontin .......................................................... 25 Nicotine ............................................................ 65 Nifuran .............................................................. 24 Nitrofurantoin .................................................... 24 Norethisterone .................................................. 50 Normison .......................................................... 52 Norvir ............................................................... 65 Novatretin ......................................................... 20 Nupentin ........................................................... 25 NutriniDrink ....................................................... 69 NutriniDrink Multifibre ........................................ 69 O Olanzapine ............................................ 44, 45, 51 Olanzine ...................................................... 44, 45 Omeprazole................................................. 49, 67 Optium 5 second............................................... 63 Ora-Blend ................................................... 48, 70 Ora-Blend SF............................................... 48, 70 Oral feed 1.5kcal/ml .................................... 33, 69 Oral feed 1 kcal/ml ............................................ 69 Oral feed 2kcal/ml ............................................. 33 Oral feed with fibre 1.5 Kcal/ml.......................... 34 Ora-Plus ..................................................... 48, 70 Ora-Sweet................................................... 48, 70 Ora-Sweet SF .............................................. 48, 70 Ornidazole......................................................... 69 Ozole .................................................... 19, 20, 24 P Pacifen ............................................................. 25 Paclitaxel .................................................... 19, 71 Paclitaxel Actavis ........................................ 19, 71 Paediatric oral feed 1.5kcal/ml........................... 69 Paediatric oral feed with fibre 1.5kcal/ml............ 69 Pancreatic enzyme ............................................ 63 Pancrex V ......................................................... 63 Pancrex V Forte ................................................. 63 Paracare Junior ........................................... 47, 68 Paracetamol.......................................... 20, 47, 68 Paracetamol with codeine ................................. 67 ParaCode .......................................................... 67 Parafast ............................................................ 20 Peak flow meter .......................................... 48, 71 Pepti Junior................................................. 32, 63 Pepti Junior Gold............................................... 32 Persantin .......................................................... 22 Pethidine hydrochloride ............................... 51, 62 Phytomenadione ............................................... 27 Pinetarsol.......................................................... 50 Poloxamer ........................................................ 27 Polycal.............................................................. 52 Ponstan ...................................................... 21, 68 Potassium iodate .............................................. 27 Pravachol.............................................. 28, 48, 67 Pravastatin ...................................... 21, 28, 48, 67 Primolut N......................................................... 50 Procaine penicillin ............................................. 51 Prograf ............................................................. 26 Protamine sulphate ........................................... 50 Pyrazinamide .................................................... 24 Q Q 200 ......................................................... 69, 71 Quinine sulphate ......................................... 69, 71 R Remifentanil-AFT............................................... 71 Remifentanil hydrochloride ................................ 71 ReVia ................................................................ 65 Rifabutin ........................................................... 24 Ritonavir ........................................................... 65 S Salazopyrin ....................................................... 22 Salbutamol with ipratropium bromide................. 64 Salicylic acid ..................................................... 64 Selegiline hydrochloride .................................... 68 Sildenafil ........................................................... 24 Sindopa ............................................................. 25 Sinemet ............................................................ 25 Sodium bicarbonate .......................................... 66 Sodium chloride .......................................... 27, 49 Sodium nitroprusside ............................ 19, 27, 69 Solu-Medrol ................................................ 19, 70 Sonaflam .......................................................... 65 Sotalol .............................................................. 23 Space Chamber .................................... 26, 48, 67 Space Chamber Plus ................................... 19, 71 Spacer device ........................... 19, 26, 48, 67, 71 Stocrin .............................................................. 28 Sulindac...................................................... 49, 63

Index

Pharmaceuticals and brands Sulphacetamide sodium .................................... 64 Sulphasalazine .................................................. 22 Sulphur ....................................................... 64, 65 Sumatriptan ...................................................... 65 Sunitinib ........................................................... 29 Sutent ............................................................... 29 Synflex.............................................................. 64 Synthroid .............................................. 20, 21, 68 T Tacrolimus........................................................ 26 Tambocor ......................................................... 23 Tamoxifen citrate............................................... 66 Tamoxifen Sandoz............................................. 66 Tar with triethanolamine lauryl sulphate and fluorescein .............................................. 50 Temazepam ...................................................... 52 Temgesic .......................................................... 64 Terbinafine ...................................... 21, 24, 48, 67 Testosterone cypionate ............................... 47, 71 Thalidomide ................................................ 46, 65 Thalidomide Pharmion................................. 46, 65 Thalomid........................................................... 46 Tiberal .............................................................. 69 Timolol maleate................................................. 20 Trastuzumab ..................................................... 30 Triazolam .......................................................... 49 Trisul ................................................................ 49 Two Cal HN....................................................... 33 u Ultiva ................................................................ 71 Ursodeoxycholic acid ........................................ 22 V Varenicline tartrate ............................................ 28 Verapamil hydrochloride .................................... 24 Viagra ............................................................... 24 Vivonex Pediatric............................................... 32 X XP Analog LCP .................................................. 64 Z Zapril ................................................................ 63 Zincaps ............................................................. 50 Zinc sulphate..................................................... 50 Zyprexa ................................................. 44, 45, 51 Zyprexa Zydis .............................................. 45, 51

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 December 2011

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 December 2011 Cumulative for September, October, November and December 2011 Section H for December 2011 Contents Summary of PHARMAC decisions effective 1 December 2011 ….. 3 Medicines Regulation Changes…. 5…

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