Schedule Update - effective 1 March 2012 (text extract)

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Pharmaceutical Management Agency

Update

New Zealand Pharmaceutical Schedule

Effective 1 March 2012

Cumulative for January, February and March 2012 Section H cumulative for December 2011, January, February and March 2012

Contents

Summary of PHARMAC decisions effective 1 March 2012 ............................. 3 Named Patient Pharmaceutical Assessment (NPPA) ....................................... 4 Pharmacy Brand Switch Payment for Losartan .............................................. 5 PHARMAC resource ordering website............................................................ 5 Ethinyloestradiol with levonorgestrel ............................................................ 5 Special Authority changes ............................................................................. 6 Rizatriptan – New Listing............................................................................... 6 Discontinuation of Famox 20 mg and 40 mg tablets and Arthrexin 100mg suppositories ..................................................................... 6 News in Brief ................................................................................................. 7 Tender News .................................................................................................. 8 Looking Forward ........................................................................................... 8 Sole Subsidised Supply products cumulative to March 2012......................... 9 New Listings ................................................................................................ 20 Changes to Restrictions ............................................................................... 22 Changes to Subsidy and Manufacturer’s Price............................................. 32 Changes to Section A .................................................................................. 36 Changes to General Rules............................................................................ 39 Changes to Sole Subsidised Supply ............................................................. 40 Delisted Items ............................................................................................. 41 Items to be Delisted .................................................................................... 44 Section H changes to Part II ........................................................................ 47 Section H changes to General Rules ............................................................ 52 Index ........................................................................................................... 58

Summary of PharmaC decisions

effeCtIve 1 marCh 2012 New listings (page 20) • Adrenaline (Aspen Adrenaline) inj 1 in 10,000, 10 ml • Amoxycillin clavulanate (Curam Duo) tab amoxycillin 500 mg with potassium clavulanate 125 mg • Clindamycin (Clindamycin ABM) cap hydrochloride 150 mg • Gemcitabine hydrochloride (Gemcitabine Actavis) inj 200 mg and 1 g – PCT only – Specialist – Special Authority • Octreotide (somatostatin analogue) (Octreotide MaxRx) inj 50 µg per ml, 100 µg per ml, 500 µg per ml • Rizatriptan (Rizamelt) tab orodispersible 10 mg • Ursodeoxycholic acid (Ursosan) cap 250 mg • Pharmacy Services (BSF Lostaar) brand switch fee – no patient co-payment payable - may only be claimed once per patient • Pharmacy Services (BSF Arrow-Losartan & Hydrochlorothiazide) brand switch fee – no patient co-payment payable - may only be claimed once per patient • Tetrabenazine (Motetis) tab 25 mg • Thiotepa (THIO-TEPA S29) inj 15 mg – PCT only - Specialist • Zinc and castor oil (Multichem) oint 500 g Changes to restrictions (pages 22-25) • Losartan (Lostaar) tab 12.5 mg, 25 mg, 50 mg and 100 mg tab – brand switch fee • Losartan with hydrochlorothiazide (Arrow-Losartan & Hydrochlorothiazide) tab 50 mg with hydrochlorothiazide 12.5 mg – brand switch fee • Propranolol (Cardinol) tab 10 mg and 40 mg – removal of stat • Rizatriptan – amend presentation description from rizatriptan benzoate wafer to rizatriptan orodispersible tab • Ursodeoxycholic acid – Special Authority criteria amendment • Zoledronic acid – Special Authority criteria amendment Decreased subsidy (page 32) • Cefazolin sodium (Hospira) inj 500 mg and 1 g • Cefuroxime sodium (Zinacef) inj 750 mg • Clarithromycin (Klamycin) tab 500 mg • Glyceryl trinitrate (Nitrolingual Pumpspray) oral pump spray 400 µg per dose • Temozolomide (Temodal) cap 5 mg, 20 mg, 100 mg and 250 mg • Tetrabenazine (Xenazine 25) tab 25 mg Increased subsidy (page 32) • Orphenadrine hydrochloride (Disipal)

4 Pharmaceutical Schedule - Update News

Named Patient Pharmaceutical Assessment (NPPA)

From 1 March 2012, PHARMAC’s Exceptional Circumstances (EC) schemes will be replaced with Named Patient Pharmaceutical Assessment (NPPA). The changes are aimed at providing greater clarity for clinicians applying for funding of a pharmaceutical for an individual patient. Patients receiving funded treatment under the EC schemes will continue to receive funding after this date under their original EC approval conditions, including where renewal criteria, if any, are met. As with Exceptional Circumstances, NPPA provides a mechanism for individual patients to receive funding consideration for medicines not listed in the Pharmaceutical Schedule (either at all or for their clinical circumstances). NPPA more closely aligns with full Schedule assessments than EC, benefiting patient populations over time. From 1 March 2012 applications for NPPA funding will be able to be completed and submitted online at www.pharmac.govt.nz/ nppa Significant features of the new NPPA scheme include:

• greater clarity of the reasons that PHARMAC will consider funding treatments for individuals outside the Schedule assessment process; • establishment of three pathways under which NPPA applications will be considered – Unusual Clinical Circumstances, Urgent Assessment and Hospital Pharmaceuticals in the Community; • the publication of summaries of the outcome of NPPA applications (while continuing to protect patient privacy) to provide better clarity and understanding for applicants about the likely outcome of their application; and • improved nation-wide consistency in medicines funding decision making. For more information, including the NPPA Policy, criteria and contact details, visit our website at http://www.pharmac.govt.nz/ healthpros/nppa

Pharmaceutical Schedule - Update News

Pharmacy Brand Switch Payment for Losartan

Brand switch payments for pharmacies will be payable for dispensings of losartan ( Lostaar brand) and losartan with hydrochlorothiazide (Arrow-Losartan & Hydrochlorothiazide) from 1 March 2012. The brand switch fee is claimable via a Pharmacode on the first dispensing after 1 March 2012 for patients who have switched brands. Pharmacies should claim a fee even if the patient switched to the Sole Supply brand prior to 1 March 2012. The brand switch fee for losartan will be paid only once for each patient during the claim period. The brand switch fee will not be able to be claimed for this pharmaceutical for dispensing after 31 May 2012. Further pharmacy brand switch payment information is available on the PHARMAC website at http://www.pharmac.govt.nz/ health pros/SchedulePrinted

PHARMAC resource ordering website

The PHARMAC resource ordering website has recently been updated. All PHARMAC patient information and health professional resources on specific PHARMAC programmes, as well as information to help support in brand changes, are available to order for free from the site, with many items also available to download. Check out www.pharmaconline.co.nz.

Ethinyloestradiol with levonorgestrel

As a result of the tender, there will be two new brands of ethinyloestradiol with levonorgestrel tablets listed on the Pharmaceutical Schedule. Ava 30 ED (ethinyloestradiol 30 µg with levonorgestrel 150 µg and 7 inert tablets) is to be supplied by Arrow Pharmaceuticals (Arrow) and will be listed from 1 April 2012 and awarded sole supply from 1 September 2012. Ava 20 ED (ethinyloestradiol 20 µg with levonorgestrel 100 µg and 7 inert tablets) will also be supplied by Arrow and listed from 1 July 2012 and awarded sole supply from 1 December 2012.

Pharmaceutical Schedule - Update News

Special Authority changes

Ursodeoxycholic acid The Special Authority criteria for ursodeoxycholic acid will be widened for use as part of conditioning therapy in stem cell of bone marrow transplant recipients to prevent veno-occlusive disease from 1 March 2012. Treatment is to be funded for up to 3 months. Zoledronic acid (Aclasta) The Special Authority criteria for zoledronic acid 5 mg in 100 ml solution for infusion (Aclasta) will be amended from 1 March 2012. The amendment will enable prescribers to apply for renewal applications annually for patients needing ongoing treatment.

Rizatriptan – New Listing

As a result of the tender there will be a new brand of rizatriptan orodispersible tablets 10 mg listed on the Pharmaceutical Schedule from 1 March 2012. Rizamelt is supplied by Mylan and is supplied in a 30 tablet pack size. Maxalt Melt will be referenced priced from May 2012 and delisted from August 2012.

Discontinuation of Famox 20 mg and 40 mg tablets and Arthrexin 100 mg suppositories

Mylan is discontinuing the supply of the Famox brand of famotidine 20 mg and 40 mg tablets. Current supplies are expected to last until the end of July 2012 for Famox 20 mg (stock expires August 2012) and to the end of October 2012 for Famox 40 mg (stock expires October 2012). Alternative H2 antagonists are available. Ranitidine hydrochloride tablets are fully funded. Mylan is also discontinuing the supply of the Arthrexin brand of indomethacin 100 mg suppositories. Current supply is expected to last until the end of October 2012 (stock expires October 2012). Alternative nonsteroidal anti-inflammatory drugs are funded including diclofenac sodium suppositories which are fully funded.

Pharmaceutical Schedule - Update News

News in Brief

• A new brand of clindamycin capsules will be fully funded from 1 March 2012. Clindamycin 150 mg capsules will be supplied by ABM under the name Clindamycin ABM. • A new brand of adrenaline injection 1 in 10,000, 10 ml will be fully funded from 1 March 2012. This will be supplied by Aspen under the name Aspen Adrenaline. • A new brand of the Pharmaceutical Cancer Treatment thiotepa inj 15 mg (THIO-TEPA) will be listed Cost Brand Source from 1 March 2012. It will also be supplied under section 29 like the current thiotepa injection, and can only be claimed by DHB hospital pharmacies • A new brand of the Pharmaceutical Cancer Treatment gemcitabine hydrochloride inj 1 g and 200 mg (Gemcitabine Actavis S29) will be listed from 1 March 2012. Gemcitabine Actavis is not currently registered with Medsafe therefore must be supplied and prescribed in accordance with the provisions of section 29 of the Medicines Act 1981. Gemcitabine hydrochloride continues to have the dispensing restriction of PCT only – Specialist. • A new brand of octreotide (somatostatin analogue) will be fully funded from 1 March 2012. All three strengths (50 µg per ml, 100 µg per ml and 500 µg per ml) will be supplied by Max Health under the name Octreotide MaxRx. Octreotide MaxRx will be subsidised under the existing Special Authority approval.

tender News

Sole Subsidised Supply changes – effective 1 April 2012

Chemical Name Amlodipine Clarithromycin Fluconazole Fluconazole Fluconazole Paracetamol Timolol maleate Timolol maleate Presentation; Pack size Tab 2.5 mg; 100 tab Tab 250 mg; 14 tab Cap 50 mg; 28 cap Cap 150 mg; 1 cap Cap 200 mg; 28 cap Tab 500 mg; 1,000 tab Eye drops 0.25%; 5 ml OP Eye drops 0.5%; 5 ml OP Sole Subsidised Supply brand (and supplier) Apo-Amlodipine (Apotex) Apo-Clarithromycin (Apotex) Ozole (Douglas) Ozole (Douglas) Ozole (Douglas) Parafast (Arrow) Arrow-Timolol (Arrow) Arrow-Timolol (Arrow)

Looking forward

This section is designed to alert both pharmacists and prescribers to possible future changes to the Pharmaceutical Schedule. It may also assist pharmacists, distributors and wholesalers to manage stock levels. Possible decisions for implementation 1 april 2012 • Amino acid formula (Elecare, Elecare LCP, Neocate, Neocate LCP, Neocate Advance, Vivonex Pediatric) powder – amend Special Authority to remove “transition from old form” • Extensively hydrolysed formula (Pepti Junior Gold) powder – amend Special Authority to remove “transition from old form” • Lapatinib ditosylate (Tykerb) tab 250 mg – new listing – Special Authority – Retail pharmacy • Pazopanib (Votrient) tab 200 mg and 400 mg – new listing – Special Authority – Retail pharmacy • Dornase alfa (Pulmozyme) nebuliser soln, 2.5 mg per 2.5 ml ampule – price and subsidy decrease for and removal of the restriction of the FEV1% level of <65% for entry into the one month treatment trial. • Trastuzumab inj 150 mg and 440 mg (Herceptin) and inj 1 mg for ECP (Baxter) – amend Special Authority criteria to include patients with early intolerance to lapatinib • Sodium cromoglycate (Vicrom) aerosol inhaler, 5 mg per dose CFC-free – change of brand name to Intal Forte

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Abacavir sulphate Acarbose Acetazolamide Aciclovir Allopurinol 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 Tab 100 mg & 300 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 50 mg Tab 5 mg Crm, aqueous, BP Lotn, BP

Brand Name Expiry Date*

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

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

2014 2013 2013 2012 2012 2013 2012 2012 2014 2014 2012 2014 2014 2013 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 March 2012

Generic Name

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

Presentation

Inj 100 iu per ml, 1 ml Cap 0.25 µg & 0.5 µg 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 250 mg, 500 mg & 750 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

Brand Name Expiry Date*

Miacalcic Airflow 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 Cipflox 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 2014 2012 2014 2014 2013 2013 2013 2012 2013 2014 2012 2014 2012 2012 2013 2013 2014 2014 2012

Clonidine

2012

Clonidine hydrochloride

2012

Clopidogrel Clotrimazole

2013 2014 2013 2013 2013 2013

Coal tar Colchicine Compound electrolytes

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

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

Presentation

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

Brand Name Expiry Date*

Itch-Soothe Nausicalm Cycloblastin Siterone Ginet 84 Desmopressin-PH&T Maxidex Maxidex Hospira Maxitrol Maxitrol 2012 2012 2013 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

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

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

2014 2014 2013 2012 2014 2014 2014 2012

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Enoxaparin sodium (low molecular weight heparin) Entacapone Ergometrine maleate Erythromycin ethyl succinate Escitalopram Ethinyloestradiol Etidronate disodium Exemestane Felodipine Fentanyl

Presentation

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 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) Tab 5 mg 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

Brand Name Expiry Date*

Clexane Comtan DBL Ergometrine E-Mycin Loxalate NZ Medical and Scientific Arrow-Etidronate Aromasin Felo 5 ER Felo 10 ER Mylan Fentanyl Patch Boucher and Muir Ferodan Rex Medical 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 2012 2012 2014 2012 2013 2012 2012 2014 2012 2013

Fentanyl citrate Ferrous sulphate Finasteride Flucloxacillin sodium

2012 2013 2014 2014 2012

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

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

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Haloperidol

Presentation

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 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

Brand Name Expiry Date*

Serenace Serenace Serenace Pharmacy Health ABM Solu-Cortef Douglas 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 2014 2014 2012 2013 2014 2013 2013 2012 2012 31/12/13 2014 2013 2013

Hydrocortisone

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

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

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

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Lignocaine with prilocaine

Presentation

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% Cap 2 mg Oral liq 1 mg per ml Tab 10 mg Tab 1 mg & 2.5 mg Tab 12.5 mg, 25 mg, 50 mg & 100 mg Tab 50 mg with hydrochlorothiazide 12.5 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%

Brand Name Expiry Date*

EMLA EMLA Arrow-Lisinopril Douglas Lomide Diamide Relief Lorapaed Loraclear Hayfever Relief Ativan Lostaar Arrow-Losartan & Hydroclorothiazide 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 2012 2014 2014 2013 2013 2013

Lisinopril Lithium carbonate Lodoxamide trometamol Loperamide hydrochloride Loratadine

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

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

Methotrexate Methylprednisolone Methylprednisolone sodium succinate

2013 2012 2012 2012

Metoclopramide hydrochloride Miconazole nitrate

2014 2014

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Moclobemide Mometasone furoate Morphine hydrochloride

Presentation

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 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*

Apo-Moclobemide m-Mometasone m-Mometasone RA-Morph RA-Morph RA-Morph RA-Morph 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 2014 2014 2014 2012 2014 2013 2012 2013 2013 2014 2012 2013 2014 2012 2012 2012 2012

Morphine sulphate

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

2014

Nicotinic acid Norfloxacin Norethisterone Nystatin

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Omeprazole

Presentation

Cap 10 mg, 20 mg & 40 mg Powder Inj 40 mg Tab disp 4 mg & 8 mg Tab 4 mg & 8 mg

Brand Name Expiry Date*

Omezol Relief Midwest Dr Reddy’s Omeprazole Dr Reddy’s Ondansetron Dr Reddy’s Ondansetron Ox-Pam Syntocinon Syntocinon Syntometrine Pantocid IV Dr Reddy’s Pantoprazole Ethics Paracetamol Paracare Double Strength Paracetamol + Codeine (Relieve) 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 2014

Ondansetron

2013

Oxazepam Oxytocin

Tab 10 mg & 15 mg 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 120 mg per 5 ml Oral liq 250 mg per 5 ml Tab paracetamol 500 mg with codeine phosphate 8 mg Eye oint with soft white paraffin Tab 20 mg Low range & 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

2014 2012

Pantoprazole

2014 2013 2014

Paracetamol

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

2014 2013 2013 2015 31/12/12

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

2013

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Pindolol Pioglitazone Pizotifen Poloxamer Potassium chloride Pravastatin Prednisone sodium phosphate Pregnancy tests – hCG urine Procaine penicillin Promethazine hydrochloride Pyridostigmine bromide Pyridoxine hydrochloride Quinine sulphate Ranitidine hydrochloride Rifabutin Ropinirole hydrochloride Roxithromycin Salbutamol

Presentation

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 Tab 20 mg & 40 mg Oral liq 5 mg per ml Cassette Inj 1.5 mega u 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%

Brand Name Expiry Date*

Apo-Pindolol Pizaccord Sandomigran Coloxyl Span-K Cholvastin Redipred Innovacon hCG One Step Pregnancy Test Cilicaine Promethazine Winthrop Elixir Mestinon PyridoxADE Apo-Pyridoxine Q 300 Peptisoothe Arrow-Ranitidine Mycobutin Ropin ArrowRoxithromycin Salapin Asthalin Asthalin Duolin 2012 2012 2012 2014 2012 2014 2012 2012 2014 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

2012 2013 2014

Sodium chloride Sodium citrate with sodium lauryl sulphoacetate Sodium citro-tartrate Sodium cromoglycate

2013 2013 2013 2013 2012

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Somatropin Sotalol Spacer device

Presentation

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 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 Tab 250 mg Inj long-acting 100 mg per ml, 10 ml Cap 40 mg Inj 250 µg Inj 1 mg per ml, 1 ml Tab 10 mg Eye drops 0.3% 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)

Brand Name Expiry Date*

Genotropin Genotropin Mylan Volumatic Space Chamber Plus Spirotone Arrow-Sumatriptan Arrow-Sumatriptan Genox Tamsulosin-Rex Pinetarsol 31/12/12 2012 2015

Spironolactone Sumatriptan Tamoxifen citrate Tamsulosin hydrochloride Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terazosin hydrochloride Terbinafine Testosterone cypionate Testosterone undecanoate Tetracosactrin Timolol maleate Tobramycin

2013 2013 2014 2013 2014

Normison Arrow Dr Reddy’s Terbinafine Depo-Testosterone 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

2014 2013 2014 2014 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

2013 2014 2012 2014 2014 2014 2013 2013

Sole Subsidised Supply Products – cumulative to March 2012

Generic Name

Zidovudine [AZT] Zinc sulphate Zopiclone March changes in bold

Presentation

Cap 100 mg Oral liq 10 mg per ml Caps 137.4 mg (50 mg elemental) Tab 7.5 mg

Brand Name Expiry Date*

Retrovir Retrovir Zincaps Apo-Zopiclone 2013 2014 2014

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Per

Brand or Generic Mnfr ✔ fully subsidised

New Listings

Effective 1 March 2012

34 54 61 81 URSODEOXYCHOLIC ACID – Special Authority see SA1188– Retail pharmacy Cap 250 mg ............................................................................ 71.50 100 ADRENALINE Inj 1 in 10,000, 10 ml – Up to 5 inj available on a PSO ............. 49.00 ZINC AND CASTOR OIL Oint BP ..................................................................................... 3.83 AMOXYCILLIN CLAVULANATE Tab amoxycillin 500 mg with potassium clavulanate 125 mg – Up to 30 tab available on a PSO ....................................... 12.55 CLINDAMYCIN Cap hydrochloride 150 mg – Maximum of 4 cap per prescription; can be waived by endorsement - Retail pharmacy Specialist .............................................................................. 9.90 TETRABENAZINE Tab 25 mg ............................................................................ 178.00 RIZATRIPTAN Tab orodispersible 10 mg ........................................................ 18.00 THIOTEPA – PCT only – Specialist Inj 15 mg ............................................................................ CBS 10 500 g ✔ Ursosan ✔ Aspen Adrenaline ✔ Multichem

100

✔ Curam Duo

16 112 30 1

✔ Clindamycin ABM ✔ Motetis ✔ Rizamelt ✔ THIO-TEPA S29

115 125 141 143

GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA1087 Inj 1 g ..................................................................................... 62.50 1 ✔ Gemcitabine Actavis

S29

Inj 200 mg .............................................................................. 12.50

✔ Gemcitabine Actavis

S29

152

OCTREOTIDE (SOMATOSTATIN ANALOGUE) – Special Authority see SA1016 – Retail pharmacy Inj 50 µg per ml, 1 ml ............................................................. 19.24 5 ✔ Octreotide MaxRx Inj 100 µg per ml, 1 ml ........................................................... 36.38 5 ✔ Octreotide MaxRx Inj 500 µg per ml, 1 ml ......................................................... 131.25 5 ✔ Octreotide MaxRx PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Lostaar is 2397145 (BSF Lostaar Brand switch fee to be delisted 1 June 2012) ❋ Brand switch fee........................................................................ 0.01 1 fee 1 fee ✔ BSF Lostaar ✔ BSF Arrow-Losartan & Hydrochlorothiazide

171

The Pharmacode for BSF Arrow-Losartan & Hydrochlorothiazide is 2397153 (BSF Arrow-Losartan & Hydrochlorothiazide Brand switch fee to be delisted 1 June 2012)

Effective 1 February 2012

79 CEFUROXIME SODIUM Inj 1.5 g – Retail pharmacy-Specialist – Subsidy by endorsement ......................................................................... 2.65 1 ✔ Mylan Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.

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

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

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Brand or Generic Mnfr ✔ fully subsidised

New Listings – Effective 21 February 2011 (continued)

171 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Bicalaccord is 2397137 (BSF Bicalaccord Brand switch fee to be delisted 1 May 2012) 1 fee ✔ BSF Bicalaccord

Effective 1 January 2012

45 54 79 ATORVASTATIN – See prescribing guideline ❋ Tab 10 mg ............................................................................... 2.90 ❋ Tab 20 mg ............................................................................... 4.36 ❋ Tab 40 mg ............................................................................... 6.51 ❋ Tab 80 mg ............................................................................... 9.67 GLYCERYL TRINITRATE ❋ Aerosol spray 400 µg per dose – Up to 250 dose available on a PSO ............................................................................... 4.45 30 30 30 30 ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin ✔ Dr Reddy’s Atorvastatin

250 dose OP ✔ Glytrin

CEFAZOLIN SODIUM – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg ............................................................................... 3.99 5 ✔ AFT Inj 1 g ...................................................................................... 3.99 5 ✔ AFT CEFUROXIME SODIUM Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ..................................................................... 6.96 5 ✔ m-Cefuroxime Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Tab 100 mg ............................................................................. 2.66 50 (8.55) ❋ Tab 200 mg ............................................................................. 3.36 50 (15.10) TEMOZOLOMIDE – Special Authority see SA1063 – Retail pharmacy Cap 5 mg ............................................................................... 16.00 5 Cap 20 mg ............................................................................. 72.00 5 Cap 100 mg ......................................................................... 350.00 5 Cap 250 mg ......................................................................... 820.00 5

98 147

Aclin Aclin ✔ Temaccord ✔ Temaccord ✔ Temaccord ✔ Temaccord

Effective 21 December 2011

146 DOXORUBICIN – PCT only – Specialist Inj 200 mg ............................................................................ 150.00 1 ✔ Adriamycin

Effective 14 December 2011

143 GEMCITABINE HYDROCHLORIDE – PCT only – Specialist – Special Authority see SA1087 Inj 1 g .................................................................................... 62.50 1 ✔ DBL Gemcitabine

▲

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 March 2012

49 LOSARTAN – brand switch fee payable ❋ 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 90 90 90 30 90 ✔ Lostaar ✔ Lostaar ✔ Lostaar ✔ Arrow-Losartan & Hydrochlorothiazide ✔ Lostaar ✔ Ursosan ✔ Actigall

URSODEOXYCHOLIC ACID – Special Authority see SA1188 1003 – Retail pharmacy Cap 250 mg ............................................................................ 71.50 100 Cap 300 mg – For ursodeoxycholic acid oral liquid formulation refer, page 172 ................................................ 179.00 100

➽ SA1188 1003 Special Authority for Subsidy Initial application – (Pregnancy/Cirrhosis) - from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 Patient diagnosed with cholestasis of pregnancy; or 2 Both: 2.1 Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and 2.2 Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis) Note: Liver biopsy is not usually required for diagnosis but is helpful to stage the disease. Initial application – (Haematological Transplant) - from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Patient at risk of veno-occlusive disease or has hepatic impairment and is undergoing conditioning treatment prior to allogenic stem cell or bone marrow transplantation, and 2 Treatment for up to 13 weeks. Renewal – (Pregnancy/Cirrhosis) - from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Note: Ursodeoxycholic acid is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transplant centre. Treatment failure – doubling of serum bilirubin levels, absence of a significant decrease in ALP or ALT and AST, development of varices, ascites or encephalopathy, marked worsening of pruritus or fatigue, histological progression by two stages, or to cirrhosis, need for transplantation. 51 111 PROPRANOLOL (removal of stat) ❋ Tab 10 mg ............................................................................... 3.55 ❋ Tab 40 mg ............................................................................... 4.65

100 100

✔ Cardinol ✔ Cardinol ✔ Aclasta

ZOLEDRONIC ACID – Special Authority see SA1187 1035 – Retail pharmacy Soln for infusion 5 mg in 100 ml ............................................ 600.00 100 ml

➽ SA1187 1035 Special Authority for Subsidy Initial application – (Paget’s disease) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Paget’s disease; and 2 Any of the following: 2.1 Bone or articular pain; or 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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Changes to Restrictions - effective 1 March 2012 (continued)

continued... 2.2 Bone deformity; or 2.3 Bone, articular or neurological complications; or 2.4 Asymptomatic disease, but risk of complications; or 2.5 Preparation for orthopaedic surgery; and 3 The patient will not be prescribed more than one infusion in the 12-month approval period. Initial application – (Underlying cause - Osteoporosis) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Any of the following: 1.1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mineral density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note); or 1.2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 1.3 History of two significant osteoporotic fractures demonstrated radiologically; or 1.4 Documented T-Score ≤ -3.0 (see Note); or 1.5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Garvan) which incorporates BMD measurements (see Note); or 1.6 Patient has had a Special Authority approval for alendronate (Underlying cause – Osteoporosis); and 2 The patient will not be prescribed more than one infusion in a 12-month period. Initial application – (Underlying cause - glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is receiving systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents) and has already received or is expected to receive therapy for at least three months; and 2 Any of the following: 2.1 The patient has documented BMD ≥ 1.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -1.5) (see Note); or 2.2 patient has a history of one significant osteoporotic fracture demonstrated radiologically; or 2.3 The patient has had a Special Authority approval for alendronate (Underlying cause – glucocorticosteroid therapy); and 3 The patient will not be prescribed more than one infusion in the 12-month approval period. Renewal – (Paget’s disease) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 The patient has relapsed (based on increases in serum alkaline phosphatase); or 1.2 The patient’s serum alkaline phosphatase has not normalised following previous treatment with zoledronic acid; or 1.3 Symptomatic disease (prescriber determined); and 2 The patient will not be prescribed more than one infusion in the 12-month approval period. The patient may not have had a must have had no more than 1 prior approval for Paget’s disease within the last 12 months. Renewal – (Underlying cause was, and remains, glucocorticosteroid therapy) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The patient is continuing systemic glucocorticosteriod therapy (≥ 5 mg per day prednisone equivalents); and 2 The patient will not be prescribed more than one infusion in the 12-month approval period. The patient may not have had a must have had no more than 1 prior approval for underlying cause continued... glucocorticosteroid therapy within the last 12 months. Three months supply may be dispensed at one time ❋ Three months or six months, as if endorsed “certified exemption” by the prescriber. applicable, dispensed all-at-once

▲

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 March 2012 (continued)

continued... Renewal – (Underlying cause was glucocorticosteroid therapy but patient now meets the ‘Underlying cause – osteoporosis’ criteria) from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Any of the following: 1.1 History of one significant osteoporotic fracture demonstrated radiologically and documented BMD ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note); or 1.2 History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age; or 1.3 History of two significant osteoporotic fractures demonstrated radiologically; or 1.4 Documented T-Score ≤ -3.0 (see Note); or 1.5 A 10-year risk of hip fracture ≥ 3%, calculated using a published risk assessment algorithm (e.g. FRAX or Garvan) which incorporates BMD measurements (see Note); or 1.6 Patient has had a Special Authority approval for alendronate (Underlying cause was glucocorticosteroid therapy but patient now meets the ‘Underlying cause – Osteoporosis’ criteria); and 2 The patient will not be prescribed more than one infusion in a 12-month period. The patient must have had no more than 1 prior approval for underlying cause osteoporosis in the last 12 months. Notes: a) BMD (including BMD used to derive T-Score) must be measured using dual-energy x-ray absorptiometry (DXA). Quantitative ultrasound and quantitative computed tomography (QCT) are not acceptable. b) Evidence used by National Institute for Health and Clinical Excellence (NICE) guidance indicates that patients aged 75 years and over who have a history of significant osteoporotic fracture demonstrated radiologically are very likely to have a T-Score ≤ -2.5, and therefore do not require BMD measurement for treatment with bisphosphonates. c) Osteoporotic fractures are the incident events for severe (established) osteoporosis, and can be defined using the WHO definitions of osteoporosis and fragility fracture. The WHO defines severe (established) osteoporosis as a T-score below -2.5 with one or more associated fragility fractures. Fragility fractures are fractures that occur as a result of mechanical forces that would not ordinarily cause fracture (minimal trauma). The WHO has quantified this as forces equivalent to a fall from a standing height or less. d) A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. 125 RIZATRIPTAN BENZOATE Wafer Tab orodispersible 10 mg ............................................ 18.00 25.32 30 3 ✔ Rizamelt ✔ Maxalt melt

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

continued...

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 February 2012

30 INSULIN GLARGINE Note: Only for patients meeting one of the following criteria: a) Type 1 diabetes; or b) Other condition related diabetes (e.g. Cystic Fibrosis, diabetes in pregnancy, pancreatectomy patients); or c) Type 2 diabetes after there has been unacceptable hypoglycaemic events with a 3 month trial of an insulin regimen; or d) Type 2 diabetes who require insulin therapy and who require assistance from a carer or healthcare professional to administer their insulin injections. ▲ Inj 100 u per ml, 10 ml ............................................................ 63.00 1 ✔ Lantus ▲ Inj 100 u per ml, 3 ml ............................................................. 94.50 5 ✔ Lantus ▲ Inj 100 u per ml, 3 ml disposable pen ...................................... 94.50 5 ✔ Lantus SoloStar BICALUTAMIDE – Special Authority see SA0941 – Retail pharmacy – brand switch fee payable Tab 50 mg ............................................................................. 10.00 28 ✔ Bicalaccord BORTEZOMIB – PCT only – Specialist ➽ SA1127 Special Authority for Subsidy Initial application – treatment-naïve multiple myeloma/amyloidosis - 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: Both: 1 Either: 1.1 The patient has treatment-naïve symptomatic multiple myeloma; or 1.2 The patient has treatment-naïve symptomatic systemic AL amyloidosis*; and 2 Maximum of 9 treatment cycles. Note: Indications marked with * are Unapproved Indications. Initial application – relapsed/refractory multiple myeloma/amyloidosis - only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 8 months for applications meeting the following criteria: All of the following: 1 Either: 1.1 The patient has relapsed or refractory multiple myeloma; or 1.2 The patient has relapsed or refractory systemic AL amyloidosis*; and 2 The patient has received only one prior front line chemotherapy for multiple myeloma or amyloidosis; and 3 The patient has not had prior publicly funded treatment with bortezomib; and 4 Maximum of 4 further treatment cycles. Note: Indications marked with * are Unapproved Indications. Renewal – relapsed/refractory multiple myeloma/amyloidosis - only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for 8 months for applications meeting the following criteria: Both: 1 The patient’s disease obtained at least a partial response from treatment with bortezomib at the completion of cycle 4; and 2 Maximum of 4 further treatment cycles (making a total maximum of 8 consecutive treatment cycles). Note: Responding relapsed/refractory multiple myeloma patients should receive no more than 2 additional cycles of treatment beyond the cycle at which a confirmed complete response was first achieved. A line of therapy is considered to comprise either: a) a known therapeutic chemotherapy regimen and supportive treatments or b) a transplant induction chemotherapy regimen, stem cell transplantation and supportive treatments. Refer to datasheet for recommended dosage and number of doses of bortezomib per treatment cycle. continued...

▲

152 145

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

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 February 2012 (continued)

161 INHALED CORTICOSTEROIDS WITH LONG-ACTING BETA-ADRENOCEPTOR AGONISTS ➽ SA1179 0958 Special Authority for Subsidy Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient is a child under the age of 12; and 1.2 Both: Has, for 3 months of more, been treated with: 1.2.1 An inhaled long-acting beta adrenoceptor agonist; and 1.2.2 Inhaled corticosteroids at a dose of at least 400 µg per day beclomethasone or budesonide, or 200 μg per day fluticasone; and 1.2 Has been treated with inhaled corticosteroids of at least 400 µg per day beclomethasone or budesonide, or 200 µg per day fluticasone; and 1.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product; or 2 All of the following: 2.1 Patient is over the age of 12; and 2.2 Both: Has, for 3 months or more, been treated with: 2.2.1 An inhaled long-acting beta adrenoceptor agonist; and 2.2.2 Inhaled corticosteroids at a dose of at least 800 µg per day beclomethasone or budesonide, or 500 μg per day fluticasone; and 2.2 Has been treated with inhaled corticosteroids of at least 800 µg per day beclomethasone or budesonide, or 500 µg per day fluticasone; and 2.3 The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product. Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.

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 February 2012 (continued)

161 EFORMOTEROL FUMARATE – See prescribing guideline Additional subsidy by endorsement for Oxis Turbuhaler is available for patients where the initial dispensing was before 1 July 2011. Pharmacists may annotate prescriptions for patients who were being prescribed Oxis Turbuhaler prior to 1 July 2011 in which case the prescription is deemed to be endorsed. The pharmacist must be able to show a clear documented dispensing history for the patient. The prescription must been endorsed accordingly. Powder for inhalation, 6 µg per dose, breath activated – Higher subsidy of $16.90 per 60 dose with Endorsement ..... 11.51 60 dose OP (16.90) Oxis Turbuhaler Powder for inhalation, 12 µg per dose, and monodose device .. 23.02 60 dose (35.80) Foradil Note: Repeats for eformoterol fumarate will be fully subsidised where the initial dispensing is before 1 February 2012. BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 0958 – Retail pharmacy Additional subsidy by endorsement for budesonide with eformoterol powder for inhalation (Symbicort Turbuhaler) is available for patients where the initial dispensing was before 1 July 2011. Pharmacists may annotate prescriptions for patients who were being prescribed budesonide with eformoterol powder for inhalation (Symbicort Turbuhaler) prior to 1 July 2011 in which case the prescription is deemed to be endorsed. The pharmacist must be able to show a clear documented dispensing history for the patient. The prescription must been endorsed accordingly. Aerosol inhaler 100 µg with eformoterol fumarate 6 µg ........... 26.49 120 dose OP ✔ Vannair Powder for inhalation 100 µg with eformoterol fumarate 6 µg – Higher subsidy of $55.00 per 120 dose with Endorsement ....... 55.00 120 dose OP ✔ Symbicort Turbuhaler 100/6 Aerosol inhaler 200 µg with eformoterol fumarate 6 µg ............ 31.25 120 dose OP ✔ Vannair Powder for inhalation 200 µg with eformoterol fumarate 6 µg – Higher subsidy of $60.00 per 120 dose with Endorsement ... 60.00 120 dose OP ✔ Symbicort Turbuhaler 200/6 Powder for inhalation 400 µg with eformoterol fumarate 12 µg ................................................................................. 60.00 60 dose OP ✔ Symbicort Turbuhaler 400/12 a) Higher subsidy of $60.00 per 60 dose with Endorsement a) b) No more than 2 dose per day 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. Soln 7% .................................................................................. 23.50 90 ml OP ✔ Biomed SODIUM BICARBONATE Powder BP – Only in combination .............................................. 8.95 500 g 9.80 (29.50) Only in extemporaneously compounded omeprazole and lansoprazole suspension. ✔ Midwest David Craig

162

164

177

▲

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

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

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Changes to Restrictions - effective 1 January 2012

187 Standard Supplements ➽ SA1104 Special Authority for Subsidy Initial application — (Children) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is under 18 years of age; and 2 Any of the following: 2.1 The patient has a condition causing malabsorption; or 2.2 The patient has failure to thrive; or 2.3 The patient has increased nutritional requirements; and 3 Nutrition goal has been set (eg reach a specific weight or BMI). Renewal — (Children) 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 1 year for applications meeting the following criteria: All of the following: 1 The patient is under 18 years of age; and 2 The treatment remains appropriate and the patient is benefiting from treatment; and 3 A nutrition goal has been set (eg reach a specific weight or BMI). Initial application — (Adults (This category cannot be processed electronically - fax paper copy)) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Any of the following: Patient is Malnourished 1.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 1.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or 1.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months; and 2 Any of the following: Patient has not responded to first-line dietary measures over a 4 week period by: 2.1 Increasing their food intake frequency (eg snacks between meals); or 2.2 Using high-energy foods (e.g. milkshakes, full fat milk, butter, cream, cheese, sugar etc); or 2.3 Using over the counter supplements (e.g. Complan); and 3 A nutrition goal has been set (e.g. to reach a specific weight or BMI). Renewal —(Adults) 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: Both: 1 A nutrition goal has been set (eg reach a specific weight or BMI); and 2 Any of the following: Patient is Malnourished 2.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 2.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or 2.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months. Initial application — (Adults transitioning from hospital Discretionary Community Supply) only from 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 has had up to a 30 day supply of a 1.0 or a 1.5 kcal/ml Standard Oral Supplement; and 2 A nutrition goal has been set (eg reach a specific weight or BMI); and continued... Patients pay a manufacturer’s surcharge when the Manufacturer’s Price is greater than the Subsidy

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

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Brand or Generic Mnfr ✔ fully subsidised

Changes to Restrictions - effective 1 January 2012 (continued)

continued... 3 Any of the following: Patient is Malnourished 3.1 Patient has a body mass index (BMI) of less than 18.5 kg/m2; or 3.2 Patient has unintentional weight loss greater than 10% within the last 3-6 months; or 3.3 Patient has a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3-6 months. Initial application — (Specific medical condition) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 Is being feed via a nasogastric tube or a nasogastric tube is to be inserted for feeding; or 2 Malignancy and is considered likely to develop malnutrition as a result; or 3 Is undergoing a bone marrow transplant; or 4 Tempomandibular surgery. Renewal — (Specific medical condition) 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 1 year for applications meeting the following criteria: Any of the following: 1 Is being fed via a nasogastric tube; or 2 Malignancy and is considered likely to develop malnutrition as a result; or 3 Has undergone a bone marrow transplant; or 4 Tempomandibular surgery. Initial application — (Chronic disease OR tube feeding) only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Is being fed via a tube or a tube is to be inserted for the purpose of feeding (not nasogastric tube - refer to specific medical condition criteria); or 2 Cystic Fibrosis; or 3 Liver disease; or 4 Chronic Renal failure; or 5 Inflammatory bowel disease; or 6 Chronic obstructive pulmonary disease with hypercapnia; or 7 Short bowel syndrome; or 8 Bowel fistula; or 9 Severe chronic neurological conditions. Renewal —(Chronic disease OR tube feeding for patients who have previously been funded under Special Authority forms SA0702 or SA0583) 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 without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Is being fed via a tube or a tube is to be inserted for the purpose of feeding (not nasogastric tube - refer to specific medical condition criteria); or 2 Cystic Fibrosis; or 3 Liver disease; or 4 Chronic Renal failure; or 5 Inflammatory bowel disease; or 6 Chronic obstructive pulmonary disease with hypercapnia; or 7 Short bowel syndrome; or 8 Bowel fistula; or 9 Severe chronic neurological conditions.

▲

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 January 2012 (continued)

196 EXTENSIVELY HYDROLYSED FORMULA – Special Authority see SA1112 – Hospital pharmacy [HP3] Powder .................................................................................. 15.21 450 g OP ✔ Pepti Junior Gold ➽ 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. Initial application only from a dietitian, relevant specialist or vocationally registered general practitioner. Approvals valid for 6 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Cows milk formula is inappropriate due to severe intolerance or allergy to its protein content; and 1.2 Either: 1.2.1 Soy milk formula has been trialled without resolution of symptoms; or 1.2.2 Soy milk formula is considered clinically inappropriate or contraindicated; or 2 Severe malabsorption; or 3 Short bowel syndrome; or 4 Intractable diarrhea; or 5 Biliary atresia; or 6 Cholestatic liver diseases causing malsorption; or 7 Chylous ascite; or 8 Chylothorax; or 9 Cystic fibrosis; or 10 Proven fat malabsorption; or 11 Severe intestinal motility disorders causing significant malabsorption; or 12 Intestinal failure. 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. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 An assessment as to whether the infant can be transitioned to a cows milk protein or soy infant formula has been undertaken; and 2 The outcome of the assessment is that the infant continues to require an extensively hydrolysed infant formula; and 3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted. 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

continued... Renewal —(Step Down from Amino Acid Formula) 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 infant is currently receiving funded amino acid formula; and 2 The infant is to be trialled on, or transitioned to, an extensively hydrolysed formula; and 3 General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and the date contacted.

Changes to Restrictions - effective 1 January 2012 (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 Subsidy and Manufacturer’s Price

Effective 1 March 2012

28 CLARITHROMYCIN ( subsidy) Tab 500 mg – Subsidy by endorsement .................................. 10.95 14 (23.30) Klamycin 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. GLYCERYL TRINITRATE ( subsidy) ❋ Oral pump spray 400 µg per dose – Up to 250 dose available on a PSO ............................................................................... 4.45 POVIDONE IODINE ( price) Antiseptic soln 10% ................................................................... 0.19 (4.45) 1.28 (8.25) Skin preparation, povidone iodine 10% with 30% alcohol .................................................................. 1.63 (3.65)

54 62

250 dose OP ✔ Nitrolingual Pumpspray 15 ml Betadine 100 ml Betadine 100 ml Betadine Skin Prep

CEFAZOLIN SODIUM – Subsidy by endorsement ( subsidy) Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg ............................................................................... 3.99 (5.00) 5 Hospira Inj 1 g ....................................................................................... 3.99 (8.00) 5 Hospira CEFUROXIME SODIUM ( subsidy) Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ..................................................................... 6.96 (10.71) 5 Zinacef ORPHENADRINE HYDROCHLORIDE ( subsidy) Tab 50 mg ............................................................................. 35.15 TETRABENAZINE ( subsidy) Tab 25 mg ............................................................................ 178.00 250 112 ✔ Disipal ✔ Xenazine 25 ✔ Temodal ✔ Temodal ✔ Temodal ✔ Temodal

115 115 148

TEMOZOLOMIDE – Special Authority see SA1063 – Retail pharmacy ( subsidy) Cap 5 mg ................................................................................ 16.00 5 Cap 20 mg ............................................................................. 72.00 5 Cap 100 mg .......................................................................... 350.00 5 Cap 250 mg ......................................................................... 820.00 5

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 February 2012

39 FERROUS SULPHATE WITH FOLIC ACID ( price) ❋ Tab long-acting 325 mg (105 mg elemental) with folic acid 350 µg ........................................................... 1.80 (4.29) SODIUM CHLORIDE ( subsidy) Inj 0.9%, 10 ml – Up to 5 inj available on a PSO ....................... 11.50 CEFACLOR MONOHYDRATE ( subsidy) Cap 250 mg ............................................................................ 24.57 30 Ferrograd-Folic 50 100 ✔ Multichem ✔ Ranbaxy Cefaclor

43 79 96 115

IBUPROFEN – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ( subsidy) ❋ Tab 200 mg ............................................................................ 12.75 1,000 ✔ Ethics Ibuprofen ❋ Tab 400 mg .............................................................................. 0.77 30 (4.56) Brufen ❋ Tab 600 mg ............................................................................. 1.15 30 (6.84) Brufen BENZTROPINE MESYLATE ( subsidy) Inj 1 mg per ml, 2 ml ............................................................... 95.00 a) Up to 5 inj available on a PS0 b) Only on a PSO FLUTICASONE ( subsidy,  price) Powder for inhalation, 50 µg per dose ....................................... 7.50 FLUTICASONE ( price) Powder for inhalation, 100 µg per dose ..................................... 7.50 Powder for inhalation, 250 µg per dose ................................... 13.60 5 ✔ Cogentin

160 160

60 dose OP ✔ Flixotide Accuhaler 60 dose OP ✔ Flixotide Accuhaler 60 dose OP ✔ Flixotide Accuhaler

161

EFORMOTEROL FUMARATE ( subsidy) Note: Repeats for eformoterol fumarate will be fully subsidised where the initial dispensing is before 1 February 2012. Powder for inhalation, 6 µg per dose, breath activated ............ 11.51 60 dose OP (16.90) Oxis Turbuhaler Powder for inhalation, 12 µg per dose, and monodose device ................................................................................. 23.02 60 dose (35.80) Foradil BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 – Retail pharmacy ( subsidy) Powder for inhalation 100 µg with eformoterol fumarate 6 µg .. 55.00 120 dose OP ✔ Symbicort Turbuhaler 100/6 Powder for inhalation 200 µg with eformoterol fumarate 6 µg .. 60.00 120 dose OP ✔ Symbicort Turbuhaler 200/6 Powder for inhalation 400 µg with eformoterol fumarate 12 µg.................................................................... 60.00 60 dose OP ✔ Symbicort Turbuhaler 400/12 BUDESONIDE WITH EFORMOTEROL – Special Authority see SA1179 – Retail pharmacy( subsidy) Aerosol inhaler 100 µg with eformoterol fumarate 6 µg ............ 26.49 120 dose OP ✔ Vannair Aerosol inhaler 200 µg with eformoterol fumarate 6 µg ............ 31.25 120 dose OP ✔ Vannair

162

▲

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 January 2012

40 53 53 53 54 72 FOLIC ACID ( subsidy) Oral liq 50 µg per ml ............................................................... 24.00 AMILORIDE ( subsidy) ‡ Oral liq 1 mg per ml ................................................................. 30.00 METHYLDOPA ( subsidy) ❋ Tab 125 mg ........................................................................... 14.25 ❋ Tab 250 mg ........................................................................... 15.10 ❋ Tab 500 mg ........................................................................... 23.15 SPIRONOLACTONE ( subsidy) ‡ Oral liq 5 mg per ml ................................................................. 30.00 CHLOROTHIAZIDE ( subsidy) ‡ Oral liq 50 mg per ml ............................................................... 26.00 DEXAMETHASONE ( subsidy) Oral liq 1 mg per ml – Retail pharmacy-Specialist ................... 45.00 Oral liq prescriptions: 1) Must be written by a Paediatrician or Paediatric Cardiologist; or 2) On the recommendation of a Paediatrician or Paediatric Cardiologist. TRIAMCINOLONE ACETONIDE ( subsidy) Inj 10 mg per ml, 1 ml ............................................................ 23.00 Inj 40 mg per ml, 1 ml ............................................................ 56.48 25 ml OP 25 ml OP 100 100 100 25 ml OP 25 ml OP 25 ml OP ✔ Biomed ✔ Biomed ✔ Prodopa ✔ Prodopa ✔ Prodopa ✔ Biomed ✔ Biomed ✔ Biomed

5 5

✔ Kenacort-A ✔ Kenacort-A40

CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 ( subsidy) Tab 250 mg ............................................................................. 4.19 14 (7.75) Klacid (7.75) Klamycin FLUCONAZOLE ( subsidy) Cap 50 mg – Retail pharmacy-Specialist ................................... 4.77 28 (6.82) Pacific Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 (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 intra vaginally) is not recommended and the prescription is endorsed accordingly; can be waived by endorsement - Retail pharmacy - Specialist. Cap 200 mg – Retail pharmacy-Specialist ............................... 13.34 28 (19.05) Pacific TRIMETHOPRIM ( subsidy) ❋ Tab 300 mg – Up to 30 tab available on a PSO .......................... 8.94 METRONIDAZOLE ( subsidy) Tab 200 mg – Up to 30 tab available on a PSO ........................ 10.45 Tab 400 mg ........................................................................... 18.15 50 100 100 ✔ TMP ✔ Trichozole ✔ Trichozole

84 85

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 January 2012 (continued)

116 118 PARACETAMOL ( subsidy) ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 9.38 DOXEPIN HYDROCHLORIDE ( subsidy) Cap 10 mg ............................................................................... 6.30 Cap 25 mg ............................................................................... 6.86 Cap 50 mg ............................................................................... 8.55 NORTRIPTYLINE HYDROCHLORIDE ( subsidy) Tab 10 mg ............................................................................... 6.69 Tab 25 mg ............................................................................. 14.77 CLONAZEPAM ( subsidy) Tab 500 µg .............................................................................. 6.68 Tab 2 mg ............................................................................... 12.75 BETAHISTINE DIHYDROCHLORIDE ( subsidy) ❋ Tab 16 mg ............................................................................. 10.00 TIMOLOL MALEATE ( subsidy) ❋ Eye drops 0.25% ...................................................................... 2.08 (2.37) ❋ Eye drops 0.5% ........................................................................ 2.08 (2.29) BIMATOPROST – Retail pharmacy-Specialist ( subsidy) See prescribing guideline ▲ Eye drops 0.03% .................................................................... 18.50 HYPROMELLOSE ( price) ❋ Eye drops 0.5% ........................................................................ 2.00 (3.92) 1,000 100 100 100 100 180 100 100 84 5 ml OP Apo-Timop 5 ml OP Apo-Timop ✔ Pharmacare ✔ Anten ✔ Anten ✔ Anten ✔ Norpress ✔ Norpress ✔ Paxam ✔ Paxam ✔ Vergo 16

119

121

125 167 168 169

3 ml OP 15 ml OP

✔ Lumigan

Methopt

▲

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 Section A

Effective 1 March 2012

3 PHARMAC and the Pharmaceutical Schedule A list of Discretionary Community Supply Pharmaceuticals, in Section H of the Pharmaceutical Schedule, identifies those products that currently are not subsidised from the Pharmaceutical Budget as Community Pharmaceuticals in Sections A to G of the Pharmaceutical Schedule but which DHBs can at their discretion fund for use in the community from their own budgets without specific Hospital Exceptional Circumstances Hospital Pharmaceuticals in the Community approval. Exceptional Circumstances policies The purpose of the Exceptional Circumstances policies are to provide: • funding from within the Pharmaceutical Budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule (“Community Exceptional Circumstances”); or • an assessment process for the DHB Hospitals to determine whether they can fund medication, to be used in the community, in circumstances where the medication is neither a Community Pharmaceutical nor a Discretionary Community Supply Pharmaceutical and where the patient does not meet the criteria for Community Exceptional Circumstances (“Hospital Exceptional Circumstances”); or • funding from the Pharmaceutical Budget for pharmaceuticals for the treatment of cancer in their DHB Hospital, or in association with Outpatient services provided in their DHB hospital, in circumstances where the pharmaceutical is not identified as a Pharmaceutical Cancer Treatment (“Cancer Exceptional Circumstances”) in Sections A-H of the Pharmaceutical Schedule. Upon receipt of an application for approval for Community Exceptional Circumstances or Hospital Exceptional Circumstances, the Exceptional Circumstances Panel first decides whether an application will be assessed initially under the Community Exceptional Circumstances criteria or the Hospital Exceptional Circumstances criteria. Cancer Exceptional Circumstances is a separate process. Hospital Exceptional Circumstances If the application is first assessed but not approved under the Community Exceptional Circumstances criteria, the Exceptional Circumstances Panel may recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances. If the application is first assessed under the Hospital Exceptional Circumstances criteria, the Exceptional Circumstances Panel may: a) recommend against the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget, in which case a DHB Hospital must not fund the pharmaceutical from its own budget; b) recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances, in which case a DHB Hospital may, but is not obliged to, fund the pharmaceutical from its own budget; c) defer its decision until further assessment under the Community Exceptional Circumstances criteria can undertaken; or d) recommend interim funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances until further assessment under the Community Exceptional Circumstances criteria can be undertaken. Permission to fund a pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that such funding is cost-effective for the relevant DHB in the region in which the patient resides. If the patient being treated with a pharmaceutical under Hospital Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/ her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. 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

continued... Applications for Hospital Exceptional Circumstances should be made on the standard application form available from the PHARMAC website www.pharmac.govt.nz or the address below: The Coordinator, Hospital Exceptional Circumstances Panel Phone: (04) 916 7521 PHARMAC, PO Box 10 254 or fax (09) 523 6870 Wellington Email: ecpanel@pharmac.govt.nz 12 Cancer Exceptional Circumstances Permission to fund a pharmaceutical for the treatment of cancer under Cancer Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that the proposed use meets the criteria. Community Exceptional Circumstances In order to qualify for Community Exceptional Circumstances approval one of the following criteria must be met: a) the condition must be rare; or b) the reaction to alternative funded treatment must be unusual; or c) an unusual combination of circumstances applies. Rare and unusual are considered to be in the order of less than 10 people nationally. Where one of the above Community Exceptional Circumstances entry criteria is met, the application may then be further examined under supplementary criteria, assessing suitability of the pharmaceutical, clinical benefit, the cost effectiveness of the treatment, and the patient’s ability to pay for the treatment. Where these documented criteria are met, a subsidy sufficient to fully fund the pharmaceutical will be made available to the specific patient on whose behalf the application was made. Community Exceptional Circumstances funding is only available where the criteria are met and is not available for financial reasons alone. Applications for Community Exceptional Circumstances, Hospital Exceptional Circumstances and Cancer Exceptional Circumstances should be made on the standard application form available from the PHARMAC website www.pharmac.govt.nz or the address below: The Coordinator, Hospital Exceptional Circumstances Panel Phone: (04) 916 7521 PHARMAC, PO Box 10 254 or fax (09) 523 6870 Wellington Email: ecpanel@pharmac.govt.nz Named Patient Pharmaceutical Assessment policy The Named Patient Pharmaceutical Assessment (NPPA) Policy is PHARMAC’s process for considering applications about named patients seeking funding for treatments not listed on the Schedule, either at all or for the named patient’s clinical circumstances. For PHARMAC to perform its legislative function of maintaining and managing a Schedule that applies consistently throughout New Zealand, the NPPA Policy will, and must, operate in a way that does not undermine the Schedule decision making process. Together, the Schedule process and the NPPA Policy, ensure there is a pathway for consideration of an individual’s clinical circumstances. If an individual has a set of clinical circumstances not covered by the NPPA Policy, the Schedule decision making process is available. It is not the purpose of the NPPA Policy to provide access to every treatment not listed on the Schedule. There are three main pathways by which named patients can be considered for funding under the NPPA Policy. PHARMAC will exercise its discretion to determine the most appropriate pathway for an application under the NPPA Policy based on the information that is provided. PHARMAC will assess applications that meet the prerequisites described below according to its Decision Criteria before deciding whether to approve applications for funding. The Decision Criteria will be used to assess both the individual clinical circumstances of each NPPA applicant, and the implications of each NPPA funding decision on PHARMAC's ability to carry out its legislative functions. For more information on NPPA, or to apply, visit the PHARMAC website at http://www.pharmac.govt.nz/ nppa, or call the Panel Coordinators at (04) 9167553 or (04) 9167521.

Changes to Section A - effective 1 March 2012 (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 Section A - effective 1 March 2012 (continued)

12 Unusual Clinical Circumstance (UCC) The purpose of the Unusual Clinical Circumstances (UCC) pathway is to provide a process for consideration for funding for named patients whose clinical circumstances are so unusual that PHARMAC is unlikely, for administrative reasons, to consider listing treatments for these circumstances on the Schedule. The prerequisite requirements for UCC consideration are: • The patient has reasonably tried and failed all alternative funded treatments (or alternative treatments have been contraindicated, or there are no other treatments available), or the patient has experienced such serious side effects with all other relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The patient is experiencing an indication or set of clinical circumstances that are so unusual that PHARMAC is unlikely to consider listing treatments for these on the Schedule; and • Generally, PHARMAC has not already considered/is not considering, through the Schedule decision making process, the treatment for the patient’s clinical circumstances, or has not considered the treatment at all. Urgent Assessment (UA) The purpose of the Urgent Assessment (UA) pathway is to provide a process for PHARMAC to consider funding treatments for named patients where PHARMAC is also considering or is likely to consider the treatment for Schedule listing, but the patient’s clinical circumstances justify urgent assessment, prior to a decision on Schedule listing. The prerequisite requirements for UA are: • The patient has reasonably tried and failed all alternative funded treatments (or alternative treatments have been contraindicated, or there are no other treatments available), or the patient has experienced such serious side effects with all other relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The patient is experiencing an indication or set of clinical circumstances that may be experienced by a population group (either currently or over time); and • The patient has serious clinical circumstances and not receiving the treatment within six to 12 months would lead to either a significant deterioration in a serious clinical condition or the patient would miss the opportunity for significant improvement in clinical outcome (length or quality of life); and • The treatment has either not been prioritised by PHARMAC, or if it has, PHARMAC has funded the treatment under the NPPA Policy for the same clinical circumstances prior to prioritisation. • PHARMAC has not declined to list, on the Schedule, this treatment for these clinical circumstances. Hospital Pharmaceuticals in the Community (HPC) The purpose of the Hospital Pharmaceuticals in the Community (HPC) pathway is to allow District Health Board hospitals to fund a medicine for a patient in the community if it would be more affordable for the DHB than paying for the treatment that would otherwise need to be provided. PHARMAC’s approval is required for any such funding, given DHBs’ legislative obligation to act consistently with the Schedule. The prerequisite requirements for HPC are: • The patient has reasonably tried and failed all alternative cheaper funded treatments (or these alternative treatments have been contraindicated) or the patient has experienced such serious side effects with all other cheaper relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The application is for a DHB hospital to fund a treatment for use in the community for a patient under the care of a DHB hospital clinician (in-patient or out-patient); and • The treatment is not being used to treat a cancer; and • The treatment costs less for the DHB than the most likely alternative intervention or outcome; and • The treatment is being sought for a short-term episode of care (usually a maximum of three months) and is not generally for the treatment of a chronic condition.

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 March 2012

14 “Cancer Exceptional Circumstances” means the policies and criteria administered by PHARMAC relating to the ability to fund, pharmaceuticals for the treatment of cancer that are not identified as Pharmaceutical Cancer Treatments in Sections A-H of the Pharmaceutical Schedule. “ “Community Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule. “Exceptional Circumstances Named Patient Pharmaceutical Assessment Advisory Panel” – means the panel of clinicians, appointed by the PHARMAC Board, that is responsible for administering advising, within its Terms of Reference, on the policy in relation to Community Exceptional Circumstances and Hospital Exceptional Circumstances Named Patient Pharmaceutical Assessment applications and Exceptional Circumstances renewal applications submitted after 1 March 2012 (EC renewal application form located at http://www. pharmac.govt.nz/healthpros/EC/ECForms). “Hospital Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to the ability to fund, from a DHB Hospital’s own budget, pharmaceuticals for use in the community by a specific patient where a subsidy is not available from the Pharmaceutical Budget or under Community Exceptional Circumstances. “Hospital Pharmaceuticals in the Community (HPC)” – means the pathway under the Named Patient Pharmaceutical Assessment policy to allow District Health Board hospitals to fund a medicine for a patient in the community if this is more affordable for the DHB than paying for the treatment that would otherwise need to be provided. “Unusual Clinical Circumstances (UCC)” – means the pathway under the Named Patient Pharmaceutical Assessment policy for funding consideration for named patients whose clinical circumstances are so unusual that PHARMAC is unlikely, for administrative reasons, to consider listing treatments for these circumstances on the Schedule. “Urgent Assessment (UA)” – means the pathway under the Named Patient Pharmaceutical Assessment policy for funding consideration for treatments for named patients where PHARMAC is also considering or is likely to consider the treatment for Schedule listing, but the patient’s clinical circumstances justify urgent assessment, prior to a decision on Schedule listing. 4.4 Pharmaceutical Cancer Treatments 4.4.2 DHBs must only provide access to Pharmaceuticals for the treatment of cancer that are listed as Pharmaceutical Cancer Treatments in Sections A to G of the Schedule, provided that DHBs may provide access to an unlisted pharmaceutical for the treatment of cancer where that unlisted pharmaceutical: a) has Cancer Exceptional Circumstances approval; or a) b) has Named Patient Pharmaceutical Assessment (NPPA) Community Exceptional Circumstances or Hospital Exceptional Circumstances approval; or b) c) is being used as part of a bona fide clinical trial which has Ethics Committee approval; or c) d) is being used and funded as part of a paediatric oncology service; or d) e) was being used to treat the patient in question prior to 1 July 2005.

▲

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 Sole Subsidised Supply

Effective 1 March 2012

For the list of new Sole Subsidised Supply products effective 1 March 2012 refer to the bold entries in the cumulative Sole Subsidised Supply table pages 9-19.

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 March 2012

45 PRAVASTATIN See prescribing guideline Tab 10 mg .............................................................................. 27.46 LOSARTAN ❋ 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. 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 30

✔ Pravachol

Cozaar 30 Cozaar 30 Cozaar 30 Hyzaar 30 Cozaar 1,000 ✔ Synthroid

76 82

30 Rex Medical 30 Rex Medical 30 Rex Medical

97 113

MEFENAMIC ACID – Additional subsidy by Special Authority see SA1038 above – Retail pharmacy ❋ Cap 250 mg ............................................................................. 2.50 100 (18.33) Ponstan ALLOPURINOL ❋ Tab 100 mg .............................................................................. 3.98 (5.44) ❋ Tab 300 mg – For allopurinol oral liquid formulation refer, page 172 .............................................................................. 4.03 20.15 3.35 (4.03) 250 Apo-Allopurinol 100 500 100 ✔ Apo-Allopurinol S29 ✔ Apo-Allopurinol S29 Apo-Allopurinol 100 1,000 ml ✔ Apo-Selegiline S29 ✔ Paracare Junior

114 116

SELEGILINE HYDROCHLORIDE ❋ Tab 5 mg ................................................................................ 16.06 PARACETAMOL ❋‡ Oral liq 120 mg per 5 ml ......................................................... 4.42 a) Up to 200 ml available on a PSO b) Not in combination

▲

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 March 2012 (continued)

134 MIDAZOLAM Tab 7.5 mg ............................................................................. 10.38 (25.00) ‡ Safety cap for extemporaneously compounded oral liquid preparations. 100 Hypnovel

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) ................................................................... 9.50 400 g OP Powder (strawberry) ................................................................. 4.22 400 g OP Powder (vanilla) ....................................................................... 9.50 400 g OP ✔ Ensure ✔ Ensure ✔ Ensure

190

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 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 DAUNORUBICIN – PCT only – Specialist Inj 5 mg per ml, 4 ml ............................................................... 99.00 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 1 30 ✔ ParaCode ✔ Mayne ✔ Bicalox ✔ Fintral

70 85

118 144 152 165

✔ Space Chamber

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 January 2012

29 39 74 OMEPRAZOLE ❋ Cap 10 mg ............................................................................... 0.97 ❋ Cap 20 mg ............................................................................... 1.26 ❋ Cap 40 mg ............................................................................... 1.86 CHARCOAL ❋ Tab 300 mg ............................................................................. 7.13 (9.77) OESTRADIOL ❋ TDDS 25 µg per day ................................................................. 3.01 (10.86) a) Higher subsidy of $10.86 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription ❋ TDDS 50 µg per day ................................................................. 4.12 (13.18) a) Higher subsidy of $13.18 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription ❋ TDDS 100 µg per day ............................................................... 7.05 (16.14) a) Higher subsidy of $16.14 per 8 patch with Special Authority see SA1018 b) No more than 2 patch per week c) Only on a prescription 30 30 30 ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole ✔ Dr Reddy’s Omeprazole

100 Red Seal 8 Estraderm TTS 25

8 Estraderm TTS 50

8 Estraderm TTS 100

CLINDAMYCIN Inj phosphate 150 mg per ml, 4 ml – Retail pharmacySpecialist ............................................................................ 16.00 1 ✔ Dalacin C Note – Dalacin C inj phosphate 150 mg per ml, 4 ml, 10 injection pack remains listed. DARUNAVIR – Special Authority see SA1025 – Retail pharmacy Tab 300 mg ...................................................................... 1,190.00 120 ✔ Prezista

▲

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

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted

Effective 1 April 2012

80 CLARITHROMYCIN – Maximum of 500 mg per prescription; can be waived by Special Authority see SA1131 Tab 250 mg ............................................................................. 4.19 14 (7.75) Klacid Klamycin FLUCONAZOLE Cap 50 mg – Retail pharmacy-Specialist ................................... 4.77 28 (6.82) Pacific Cap 150 mg – Subsidy by endorsement ................................... 0.91 1 (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. Cap 200 mg – Retail pharmacy-Specialist ............................... 13.34 28 (19.05) Pacific PARACETAMOL ❋ Tab 500 mg – Up to 30 tab available on a PSO .......................... 9.38 TIMOLOL MALEATE ❋ Eye drops 0.25% ...................................................................... 2.08 (2.37) ❋ Eye drops 0.5% ........................................................................ 2.08 (2.29) 1,000 5 ml OP Apo-Timop 5 ml OP Apo-Timop ✔ Pharmacare

116 167

Effective 1 May 2012

96 38 171 IBUPROFEN – Additional subsidy by Special Authority see SA 1038 – Retail pharmacy ❋ Tab 200 mg ........................................................................... 12.75 1,000 ✔ Ethics Ibuprofen CALCIUM CARBONATE ❋ Tab 1.25 g (500 mg elemental) ................................................. 6.38 ❋ Tab 1.5 g (600 mg elemental).................................................... 7.66 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Bicalaccord is 2397137 250 250 1 fee ✔ Calci-Tab 500 ✔ Calci-Tab 600 ✔ BSF Bicalaccord

Effective 1 June 2012

28 CLARITHROMYCIN Tab 500 mg – Subsidy by endorsement .................................. 10.95 14 (23.30) Klamycin 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.

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 June 2012 (continued)

54 GLYCERYL TRINITRATE ❋ Oral pump spray 400 µg per dose – Up to 250 dose available on a PSO ............................................................................... 4.45 CEFUROXIME SODIUM Inj 750 mg – Maximum of 1 inj per prescription; can be waived by endorsement ..................................................................... 6.96 (10.71)

250 dose OP ✔ Nitrolingual Pumpspray

5 Zinacef

CEFAZOLIN SODIUM – Subsidy by endorsement Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly. Inj 500 mg ............................................................................... 3.99 5 (5.00) Hospira Inj 1 g ...................................................................................... 3.99 5 (8.00) Hospira QUININE SULPHATE ❋ Tab 200 mg ............................................................................ 15.95 (17.20) TEMOZOLOMIDE – Special Authority see SA1063 below – Retail pharmacy Cap 5 mg ............................................................................... 16.00 Cap 20 mg ............................................................................. 72.00 Cap 100 mg ......................................................................... 350.00 Cap 250 mg .......................................................................... 820.00 PHARMACY SERVICES – May only be claimed once per patient ❋ Brand switch fee........................................................................ 0.01 The Pharmacode for BSF Lostaar is 2397145 ❋ Brand switch fee ....................................................................... 0.01 The Pharmacode for BSF Arrow-Losartan is 2397153 250 Q 200 5 5 5 5 1 fee 1 fee ✔ Temodal ✔ Temodal ✔ Temodal ✔ Temodal ✔ BSF Lostaar ✔ BSF Arrow-Losartan & Hydrochlorothiazide

113 148

171

Effective 1 July 2012

50 98 DIGOXIN ❋ Tab 62.5 µg – Up to 30 tab available on a PSO .......................... 5.56 200 ✔ Lanoxin PG ❋ Tab 250 µg – Up to 30 tab available on a PSO ........................... 6.05 100 ✔ Lanoxin Note – Lanoxin PG tab 62.5 µg, 240 tab pack, and Lanoxin tab 250 µg 240 tab pack, remain subsidised. SULINDAC – Additional subsidy by Special Authority see SA1038 – Retail pharmacy ❋ Tab 100 mg ............................................................................. 5.32 100 (17.10) ❋ Tab 200 mg ............................................................................. 6.72 100 (30.20)

Daclin Daclin

Effective 1 September 2012

▲

MUCILAGINOUS LAXATIVES – Only on a prescription ❋ Sugar Free................................................................................. 3.31 (10.60) Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

275 g OP Mucilax

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

Check your Schedule for full details Schedule page ref

Subsidy (Mnfr’s price) $

Per

Brand or Generic Mnfr ✔ fully subsidised

Items to be Delisted - effective 1 September 2012 (continued)

177 PROPYLENE GLYCOL Only in extemporaneously compounded methyl hydroxybenzoate 10% solution. Liq .......................................................................................... 12.00 500 ml

✔ ABM

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

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to Part II

Effective 1 March 2012

25 CLINDAMYCIN (new listing and amended presentation description) Cap hydrochloride 150 mg – 1% DV May-12 to 2013 ............... 9.90 Note – Dalacin C cap hydrochloride 150 mg to be delisted 1 May 2012 ADRENALINE Inj 1 in 10,000, 10 ml .............................................................. 49.00 AMOXYCILLIN CLAVULANATE Tab amoxycillin 500 mg with potassium clavulanate 125 mg ............................................................. 12.55 GEMCITABINE HYDROCHLORIDE (new listing) Inj 1 g ..................................................................................... 62.50 Inj 200 mg .............................................................................. 12.50 16 Clindamycin ABM

16 18

Aspen Adrenaline

100 1 1

Curam Duo ✔ Gemcitabine Actavis

S29

✔ Gemcitabine Actavis

S29

OCTREOTIDE (SOMATOSTATIN ANALOGUE) Inj 50 µg per ml, 1 ml – 1% DV May-12 to 2014 ..................... 19.24 5 Octreotide MaxRx Inj 100 µg per ml, 1 ml – 1% DV May-12 to 2014 ................... 36.38 5 Octreotide MaxRx Inj 500 µg per ml, 1 ml – 1% DV May-12 to 2014 ................. 131.25 5 Octreotide MaxRx Note – Hospira inj 50 µg per ml, 100 µg per ml and 500 µg per ml, 1 ml to be delisted 1 May 2012 RIZATRIPTAN BENZOATE (new listing and amended presentation description) Wafer Tab orodispersible 10 mg – 1% DV May-12 to 2014 .... 18.00 30 Note – Maxalt Melt wafer 10 mg to be delisted 1 May 2012 URSODEOXYCHOLIC ACID Cap 250 mg – 1% DV May-12 to 2014 ................................... 71.50 Note – Actigall cap 300 mg to be delisted 1 May 2012 100 Rizamelt

Ursosan

Effective 1 February 2012

20 23 BENZTROPINE MESYLATE Inj 1 mg per ml, 2 ml ............................................................... 95.00 CEFUROXIME SODIUM Inj 1.5 g – 1% DV Apr-12 to 2014 ............................................. 2.65 Note - Zinacef inj 1.5 g to be delisted 1 April 2012. MEROPENEM ( price) Inj 500 mg ........................................................................... 105.00 Inj 1 g ................................................................................... 210.00 Note – Merrem inj 500 mg and 1 g to be delisted 1 March 2012. NORTRIPTYLINE HYDROCHLORIDE (amend pack size) Tab 25 mg .............................................................................. 14.77 5 1 Cogentin Mylan

10 10

Merrem Merrem

180

Norpress

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 February 2012 (continued)

55 QUININE SULPHATE Tab 200 mg ............................................................................ 17.20 Note – Q 200 to be delisted 1 February 2012 TOLBUTAMIDE Tab 500 mg ............................................................................ 12.00 Note – Diatol tab 500 mg to be delisted 1 February 2012 ZINC AND CASTOR OIL ( price) Ointment – 1% DV Apr-12 to 2014 ............................................ 1.63 250 Q 200

100

Diatol

20 g

Orion

Effective 1 January 2012

17 19 AMILORIDE ( price) Oral liq 1 mg per ml ................................................................ 30.00 ATORVASTATIN Tab 10 mg ................................................................................ 2.90 Tab 20 mg ................................................................................ 4.36 Tab 40 mg ................................................................................ 6.51 Tab 80 mg ................................................................................ 9.67 20 23 23 BETAHISTINE DIHYDROCHLORIDE ( price) Tab 16 mg ............................................................................. 10.00 CEFACLOR MONOHYDRATE (removal of HSS) Cap 250 mg – 1% DV Mar-12 to 2013 ..................................... 24.57 25 ml 30 30 30 30 Biomed Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Dr Reddy’s Atorvastatin Vergo 16 Cefaclor Sandoz AFT AFT

84 100

CEFAZOLIN SODIUM Inj 500 mg – 1% DV Mar-12 to 2014 ........................................ 3.99 5 Inj 1 g – 1% DV Mar-12 to 2014 ............................................... 3.99 5 Note – Hospira cefazolin sodium inj 500 mg and 1 g to be delisted 1 March 2012. CEFUROXIME SODIUM Inj 750 mg – 1% DV Mar-12 to 2014 ........................................ 6.96 Note – Zinacef inj 750 mg to be delisted 1 March 2012. CHLORHEXIDINE IN ALCOHOL Soln 2% with 70% alcohol, 500 ml (tinted red) ...................... 114.72 CHLOROTHIAZIDE ( price) Oral liq 50 mg per ml .............................................................. 26.00 CLARITHROMYCIN (HSS delayed) Tab 500mg – 1% DV Apr-12 Jan-12 to 2014 ........................... 10.95 5

m-Cefuroxime

24 24 25

12 25 ml 14

healthE Biomed Apo-Clarithromycin

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 January 2012 (continued)

25 CLONAZEPAM ( price) Tab 500 µg ............................................................................... 6.68 Tab 2 mg ................................................................................ 12.75 DEXAMETHASONE ( price) Oral liq 1 mg per ml ................................................................ 45.00 EFAVIRENZ Tab 50 mg ............................................................................ 158.33 Tab 200 mg .......................................................................... 474.99 Tab 600 mg .......................................................................... 474.99 FOLIC ACID ( price) Oral liq 50 µg per ml ............................................................... 24.00 100 100 25 ml 30 90 30 25 ml Paxam Paxam Biomed Stocrin Stocrin Stocrin Biomed

28 30

34 36

GLYCERYL TRINITRATE Aerosol spray 400 µg per dose – 1% DV Mar-12 to 2014 ......... 4.45 250 dose Glytrin Note – Nitrolingual Pumpspray aerosol spray 400 µg per dose to be delisted 1 March 2012. HYPROMELLOSE ( price) Eye drops 0.5% ......................................................................... 3.92 IMIPENEM WITH CILASTATIN ( price) Inj 500 mg with cilastatin 500 mg ........................................... 18.37 MEROPENEM Inj 500 mg – 1% DV Mar-12 to 2014 ...................................... 10.50 Inj 1 g – 1% DV Mar-12 to 2014 ............................................. 21.00 Note – Merrem inj 500 mg and 1 g to be delisted 1 March 2012. METHYLDOPA ( price) Tab 125 mg ........................................................................... 14.25 Tab 250 mg ........................................................................... 15.10 Tab 500 mg ........................................................................... 23.15 METRONIDAZOLE ( price) Tab 200 mg ........................................................................... 10.45 Tab 400 mg ........................................................................... 18.15 NORTRIPTYLINE HYDROCHLORIDE ( price) Tab 10 mg ............................................................................... 6.69 Tab 25 mg ............................................................................. 14.77 SODIUM CHLORIDE ( price) Inj 0.9%, 10 ml ........................................................................ 11.50 SPIRONOLACTONE ( price) Oral liq 5 mg per ml ................................................................ 30.00 15 ml 1 1 1 Methopt Primaxin Penembact Penembact

38 38 44

100 100 100 100 100 100 250 50 25 ml

Prodopa Prodopa Prodopa Trichozole Trichozole Norpress Norpress Multichem Biomed

59 60

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes Part II - effective 1 January 2012 (continued)

61 TEMOZOLOMIDE Cap 5 mg – 1% DV Mar-12 to 2014 ........................................ 16.00 5 Cap 20 mg – 1% DV Mar-12 to 2014 ...................................... 72.00 5 Cap 100 mg – 1% DV Mar-12 to 2014 .................................. 350.00 5 Cap 250 mg – 1% DV Mar-12 to 2014 .................................. 820.00 5 Note – Temodal cap 5 mg, 20 mg, 100 mg and 250 mg to be delisted 1 March 2012. TRIAMCINOLONE ACETONIDE ( price) Inj 10 mg per ml, 1 ml ............................................................ 23.00 Inj 40 mg per ml, 1 ml ............................................................ 56.48 5 5 Temaccord Temaccord Temaccord Temaccord

Kenacort-A Kenacort-A40

TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 5 ml ............................................................. 10.31 1 Kenacort-A Inj 40 mg per ml, 5 ml ............................................................. 23.44 1 Kenacort-A40 Note – Kenacort-A inj 10 mg per ml, 5 ml and Kenacort-A40 inj 40 mg per ml, 5 ml delisted 1 January 2012. TRIMETHOPRIM ( price) Tab 300 mg ............................................................................. 8.94 50 TMP

Effective 14 December 2011

35 GEMCITABINE HYDROCHLORIDE Inj 1 g ..................................................................................... 62.50 1 DBL Gemcitabine

Effective 21 December 2011

146 DOXORUBICIN – PCT only – Specialist Inj 200 mg ............................................................................ 150.00 1 Adriamycin

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 .................................... 24.57 100 30 g 30 g 30 g 100 g 100 g 30 ml 250 100 Apo-Amlodipine Daivobet Daivobet Daivonex Daivonex Daivonex Daivonex Arrow-Calcium Cefaclor Sandoz

22 23

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

27 34 36 36 42 45 45 45 46 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 6 5g 473 ml 473 ml 1 473 ml Dantrium IV Fucithalmic Ora-Sweet SF Ora-Sweet EZ-fit Paediatric Mask Ora-Plus Ora-Blend SF Ora-Blend Solu-Medrol Solu-Medrol Lopresor Paclitaxel Actavis Paclitaxel Actavis Paclitaxel Actavis

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 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. 473 ml 1 1 5 1 1 1

46 50

1 1 250

Breath-Alert Breath-Alert Q 200

REMIFENTANIL HYDROCHLORIDE (delayed HSS and delisting) 5 Remifentanil-AFT Inj 1 mg vial – 1% DV Feb Jan-12 to 2014 ............................. 27.95 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. Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

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

60 62 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

Depo-Testosterone

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to General Rules

Effective 1 March 2012

3 PHARMAC and Section H of the Pharmaceutical Schedule: A list of Discretionary Community Supply Pharmaceuticals, in Section H of the Pharmaceutical Schedule, identifies those products that currently are not subsidised from the Pharmaceutical Budget as Community Pharmaceuticals in Sections A to G of the Pharmaceutical Schedule but which DHBs can at their discretion fund for use in the community from their own budgets without specific Hospital Exceptional Circumstances Hospital Pharmaceuticals in the Community approval. Named Patient Pharmaceutical Assessment policy The Named Patient Pharmaceutical Assessment (NPPA) Policy is PHARMAC’s process for considering of applications about named patients seeking funding for treatments not listed on the Schedule, either at all or for the named patient’s clinical circumstances. For PHARMAC to perform its legislative function of maintening and managing a Schedule that applies consistently throughout New Zealand, the NPPA Policy will, and must, operate in a way that does not undermine the Schedule decision making process. Together, the Schedule process and the NPPA Policy, ensure there is a pathway for consideration of an individual’s clinical circumstances. If an individual has a set of clinical circumstances not covered by the NPPA Policy, the Schedule decision making process is available. It is not the purpose of the NPPA Policy to provide access to every treatment not listed on the Schedule. There are three main pathways by which named patients can be considered for funding under the NPPA Policy. PHARMAC will exercise its discretion to determine the most appropriate pathway for an application under the NPPA Policy based on the information that is provided. PHARMAC will assess applications that meet the prerequisites described below according to its Decision Criteria before deciding whether to approve applications for funding. The Decision Criteria will be used to assess both the individual clinical circumstances of each NPPA applicant, and the implications of each NPPA funding decision on PHARMAC's ability to carry out its legislative functions. For more information on NPPA, or to apply, visit the PHARMAC website at http://www.pharmac.govt.nz/ nppa, or call the Panel Coordinators at (04) 9167553 or (04) 9167521. 8 Unusual Clinical Circumstance (UCC) The purpose of the Unusual Clinical Circumstances (UCC) pathway is to provide a process for consideration for funding for named patients whose clinical circumstances are so unusual that PHARMAC is unlikely, for administrative reasons, to consider listing treatments for these circumstances on the Schedule. The prerequisite requirements for UCC consideration are: • The patient has reasonably tried and failed all alternative funded treatments (or alternative treatments have been contraindicated, or there are no other treatments available), or has experienced such serious side effects with all other relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The patient is experiencing an indication or set of clinical circumstances that are so unusual that PHARMAC is unlikely to consider listing treatments for these on the Schedule; and • Generally, PHARMAC has not already considered/is not considering, through the Schedule decision making process, the treatment for the patient’s clinical circumstances, or has not considered the treatment at all.

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

Section H page ref

Price (ex man. excl. GST) $ Per

Brand or Generic Manufacturer

Section H changes to General Rules - effective 1 March 2012 (continued)

8 Urgent Assessment (UA) The purpose of the Urgent Assessment (UA) pathway is to provide a process for PHARMAC to consider funding treatments for named patients where PHARMAC is also considering or is likely to consider the treatment for Schedule listing, but the patient’s clinical circumstances justify urgent assessment, prior to a decision on Schedule listing. The prerequisite requirements for UA are: • The patient has reasonably tried and failed all alternative funded treatments (or alternative treatments have been contraindicated, or there are no other treatments available), or has experienced such serious side effects with all other relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The patient is experiencing an indication or set of clinical circumstances that may be experienced by a population group (either currently or over time); and • The patient has serious clinical circumstances and not receiving the treatment within six to 12 months would lead to either a significant deterioration in a serious clinical condition or the patient would miss the opportunity for significant improvement in clinical outcome (length or quality of life); and • The treatment has either not been prioritised by PHARMAC, or if it has, PHARMAC has funded the treatment under the NPPA Policy for the same clinical circumstances prior to prioritisation. • PHARMAC has not declined to list, on the Schedule, this treatment for these clinical circumstances. Hospital Pharmaceuticals in the Community (HPC) The purpose of the Hospital Pharmaceuticals in the Community (HPC) pathway is to allow District Health Board hospitals to fund a medicine for a patient in the community if this is more affordable for the DHB than paying for the treatment that would otherwise need to be provided. PHARMAC’s approval is required for any such funding, given DHBs’ legislative obligation to act consistently with the Schedule. The prerequisite requirements for HPC are: • The patient has reasonably tried and failed all alternative cheaper funded treatments (or these alternative treatments have been contraindicated) or has experienced such serious side effects with all other cheaper relevant funded treatments that treatment has been ceased or cannot reasonably be continued; and • The application is for a DHB hospital to fund a treatment for use in the community for a patient under the care of a DHB hospital clinician (in-patient or out-patient); and • The treatment is not being used to treat a cancer; and • The treatment costs less for the DHB than the most likely alternative intervention or outcome; and • The treatment is being sought for a short-term episode of care (usually a maximum of three months) and is not generally for the treatment of a chronic condition. Exceptional Circumstances policies The purpose of the Exceptional Circumstances policies are to provide: • funding from within the Pharmaceutical Budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule (“Community Exceptional Circumstances”); or • an assessment process for DHB Hospitals to determine whether they can fund medication, to be used in the community, in circumstances where the medication is neither a Community Pharmaceutical nor a Discretionary Community Supply Pharmaceutical and where the patient does not meet the criteria for Community Exceptional Circumstances (“Hospital Exceptional Circumstances”); or • funding from the Pharmaceutical Budget for pharmaceuticals for the treatment of cancer in their DHB Hospital, or in association with Outpatient services provided in their DHB Hospital, in circumstances where the pharmaceutical is not identified as a Pharmaceutical Cancer Treatment (“Cancer Exceptional Circumstances”) in Sections A-H of the Pharmaceutical Schedule. continued... Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

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Section H changes to General Rules - effective 1 March 2012 (continued)

continued... Upon receipt of an application for approval for Community Exceptional Circumstances or Hospital Exceptional Circumstances, the Exceptional Circumstances Panel first decides whether an application will be assessed initially under the Community Exceptional Circumstances criteria or the Hospital Exceptional Circumstances criteria. Cancer Exceptional Circumstances is a separate process. 8 Hospital Exceptional Circumstances (HEC) If the application is first assessed but not approved under the Community Exceptional Circumstances criteria, the Exceptional Circumstances Panel may recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances. If the application is first assessed under the Hospital Exceptional Circumstances criteria, the Exceptional Circumstances Panel may: a) recommend against the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget, in which case a DHB Hospital must not fund the pharmaceutical from its own budget; b) recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances, in which case a DHB Hospital may, but is not obliged to, fund the pharmaceutical from its own budget; c) defer its decision until further assessment under the Community Exceptional Circumstances criteria can undertaken; or d) recommend interim funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances until further assessment under the Community Exceptional Circumstances criteria can be undertaken.

Permission to fund a pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that such funding is cost-effective for the relevant DHB in the region in which the patient resides. If the patient being treated with a pharmaceutical under Hospital Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/ her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. 9 Community Exceptional Circumstances (CEC) In order to qualify for Community Exceptional Circumstances approval one of the following entry criteria must be met: a) the condition must be rare; or b) the reaction to alternative funded treatment must be unusual; or c) an unusual combination of circumstances applies. Rare and unusual are considered to be in the order of less than 10 people nationally. Where one of the above Community Exceptional Circumstances entry criteria is met, the application may then be further examined under supplementary criteria, assessing suitability of the pharmaceutical, clinical benefit, the cost effectiveness of the treatment, and the patient’s ability to pay for the treatment. Where these documented criteria are met, a subsidy sufficient to fully fund the pharmaceutical will be made available to the specific patient on whose behalf the application was made. Community Exceptional Circumstances funding is only available where the criteria are met and is not available for financial reasons alone.

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

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Section H changes to General Rules - effective 1 March 2012 (continued)

9 Cancer Exceptional Circumstances (CaEC) Permission to fund a pharmaceutical for the treatment of cancer from the Hospital’s own budget under Cancer Exceptional Circumstances will only be granted by PHARMAC where it has been demonstated that the proposed use meets the criteria. If the patient being treated with a pharmaceutical under Cancer Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/ her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. Applications for Community Exceptional Circumstances, Hospital Exceptional Circumstances and Cancer Exceptional Circumstances should be made on the standard application form available from the PHARMAC website www.pharmac.govt.nz or the address below: The Coordinator, Exceptional Circumstances Panel Phone (04) 916 7553 CEC PHARMAC (04) 916 7521 HEC PO Box 10 254 (04) 916 7553 CaEC Wellington 6143 or fax (09) 523 6870 Email: ecpanel@pharmac.govt.nz 9

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

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Section H changes to General Rules - effective 1 March 2012 (continued)

10 “Cancer Exceptional Circumstances” means the policies and criteria administered by PHARMAC relating to the ability to fund pharmaceuticals for the treatment of cancer that are not identified as Pharmaceutical Cancer Treatments in Sections A-H of the Pharmaceutical Schedule. “Community Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule. “Named Patient Pharmaceutical Assessment Advisory Exceptional Circumstances Panel” means the panel of clinicians, appointed by the PHARMAC Board, that is responsible for administering advising, within its Terms of Reference, on policies in relation to Community Exceptional Circumstances and Hospital Exceptional Circumstances Named Patient Pharmaceutical Assessment applications and Exceptional Circumstances renewal applications submitted after 1 March 2012 (EC renewal application forms available at http://www. pharmac.govt.nz/healthpros/EC/ECForms) “Hospital Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to the ability to fund, from a DHB Hospital’s own budget, pharmaceuticals for use in the community by a specific patient where a subsidy is not available from the Pharmaceutical Budget or under Community Exceptional Circumstances. “Hospital Pharmaceuticals in the Community (HPC)” – means the pathway under the Named Patient Pharmaceutical Assessment policy to allow District Health Board hospitals to fund a medicine for a patient in the community if this is more affordable for the DHB than paying for the treatment that would otherwise need to be provided. “Unusual Clinical Circumstances (UCC)” – means the pathway under the Named Patient Pharmaceutical Assessment policy for funding consideration for named patients whose clinical circumstances are so unusual that PHARMAC is unlikely, for administrative reasons, to consider listing treatments for these circumstances on the Schedule. “Urgent Assessment (UA)” – means the pathway under the Named Patient Pharmaceutical Assessment policy for funding consideration for treatments for named patients where PHARMAC is also considering or is likely to consider the treatment for Schedule listing, but the patient’s clinical circumstances justify urgent assessment, prior to a decision on Schedule listing. 7 Discretionary Community Supply Pharmaceuticals 7.2 PHARMAC may, in its discretion, list any pharmaceutical that is not a Community Pharmaceutical as a Discretionary Community Supply Pharmaceutical, including a pharmaceutical that PHARMAC is made aware of by HPAC, the Named Patient Pharmaceutical Assessment Advisory Panel Exceptional Circumstances Panel, a DHB Hospital or relevant hospital personnel. 7.5 Subject to rule 7.6, 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 Pharmaceuticals in the Community (HPC) 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 Pharmaceuticals in the Community (HPC) Hospital Exceptional Circumstances (HEC) approval provided that: a) the quantity supplied does not exceed that sufficient for: continued... i) up to 5 days treatment, or one original pack, (where inappropriate to provide less); or Products with Hospital Supply Status (HSS) are in bold. Expiry date of HSS period is 30 June of the year indicated unless otherwise stated

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Section H changes to General Rules - effective 1 March 2012 (continued)

continued... 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 Section A-G of the Pharmaceutical Schedule. Note dispensing for discharge as described in rule 7.6 is at the discretion of individual DHBs. 8 Pharmaceutical Cancer Treatments 8.4 DHBs must not fund Pharmaceuticals for the treatment of cancer or Pharmaceutical Cancer Treatments for indications related to the treatment of cancer, if they are not listed in Sections A to G of the Pharmaceutical Schedule, unless the unlisted pharmaceutical: a) has Cancer Exceptional Circumstances approval; or a) b) has Named Patient Pharmaceutical Assessment Community Exceptional Circumstances or Hospital Exceptional Circumstances approval; or b) c) is being used as part of a bona fide clinical trial which has Ethics Committee approval; or c) d) is being used and funded as part of a paediatric oncology service; or d) e) was being used to treat the patient in question prior to 1 July 2005.

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 Aclasta .............................................................. 22 Aclin .................................................................. 21 Actigall .............................................................. 22 Adrenaline.................................................... 20, 47 Adriamycin .................................................. 21, 50 Allopurinol.......................................................... 41 Amiloride ..................................................... 34, 48 Amlodipine......................................................... 50 Amoxycillin clavulanate ................................ 20, 47 Anten ................................................................. 35 Apo-Allopurinol .................................................. 41 Apo-Allopurinol S29 ........................................... 41 Apo-Amlodipine ................................................. 50 Apo-Clarithromycin ............................................ 48 Apo-Selegiline .................................................... 41 Apo-Terbinafine.................................................. 42 Apo-Timop................................................... 35, 44 Arrow-Calcium ................................................... 50 Arrow-Losartan & Hydrochlorothiazide ............... 22 Aspen Adrenaline ......................................... 20, 47 Atorvastatin.................................................. 21, 48 B Benztropine mesylate ................................... 33, 47 Betadine............................................................. 32 Betadine Skin Prep ............................................. 32 Betahistine dihydrochloride........................... 35, 48 Betamethasone diproprionate with calcipotriol .... 50 Bicalaccord ........................................................ 25 Bicalox............................................................... 42 Bicalutamide ................................................ 25, 42 Bimatoprost ....................................................... 35 Bortezomib ........................................................ 25 Breath-Alert........................................................ 51 Brufen................................................................ 33 BSF Arrow-Losartan & Hydrochlorothiazide .. 20, 45 BSF Bicalaccord ........................................... 21, 44 BSF Lostaar ................................................. 20, 45 Budesonide with eformoterol ........................ 27, 33 C Calci-Tab 500 .................................................... 44 Calci-Tab 600 .................................................... 44 Calcipotriol......................................................... 50 Calcium carbonate ....................................... 44, 50 Carbohydrate supplement................................... 42 Cardinol ............................................................. 22 Cefaclor monohydrate ............................ 33, 48, 50 Cefaclor Sandoz ........................................... 48, 50 Cefazolin sodium ............................. 21, 32, 45, 48 Cefuroxime sodium .............. 20, 21, 32, 45, 47, 48 Charcoal ............................................................ 43 Chlorhexidine in alcohol...................................... 48 Chlorothiazide .............................................. 34, 48 Ciprofloxacin ...................................................... 41 Clarithromycin.................................. 32, 34, 44, 48 Clindamycin ........................................... 20, 43, 47 Clindamycin ABM......................................... 20, 47 Clonazepam ................................................. 35, 49 Cogentin ...................................................... 33, 47 Cozaar ............................................................... 41 Curam Duo .................................................. 20, 47 D Daclin ................................................................ 45 Daivobet ............................................................ 50 Daivonex ............................................................ 50 Dalacin C ........................................................... 43 Dantrium IV ........................................................ 51 Dantrolene sodium hemiheptahydrate ................. 51 Darunavir ........................................................... 43 Daunorubicin ..................................................... 42 DBL Gemcitabine ......................................... 21, 50 Depo-Testosterone............................................. 52 Dexamethasone ........................................... 34, 49 Diatol ................................................................. 48 Digoxin .............................................................. 45 Disipal ............................................................... 32 Doxepin hydrochloride........................................ 35 Doxorubicin ................................................. 21, 50 Dr Reddy’s Atorvastatin................................ 21, 48 Dr Reddy’s Omeprazole...................................... 43 E Efavirenz ............................................................ 49 Eformoterol fumarate.................................... 27, 33 Ensure ............................................................... 42 Ensure Plus........................................................ 42 Estraderm TTS 100 ............................................ 43 Estraderm TTS 25 .............................................. 43 Estraderm TTS 50 .............................................. 43 Ethics Ibuprofen ........................................... 33, 44 Extensively hydrolysed formula........................... 30 EZ-fit Paediatric Mask......................................... 51 F Ferrograd-Folic................................................... 33 Ferrous sulphate with folic acid .......................... 33 Finasteride ......................................................... 42 Fintral ................................................................ 42 Flixotide Accuhaler ............................................. 33 Fluconazole .................................................. 34, 44 Fluticasone ........................................................ 33 Folic acid ..................................................... 34, 49 Foradil ......................................................... 27, 33 Fucithalmic ........................................................ 51 Fusidic acid........................................................ 51

Index

Pharmaceuticals and brands G Gemcitabine Actavis..................................... 20, 47 Gemcitabine hydrochloride ............... 20, 21, 47, 50 Glycerin with sodium saccharin .......................... 51 Glycerin with sucrose ......................................... 51 Glyceryl trinitrate .............................. 21, 32, 45, 49 Glytrin .......................................................... 21, 49 H Hypnovel ........................................................... 42 Hypromellose............................................... 35, 49 Hyzaar ............................................................... 41 I Ibuprofen ..................................................... 33, 44 Inhaled Corticosteroids with Long-Acting Beta-Adrenoceptor Agonists ............................ 26 Imipenem with cilastatin ..................................... 49 Insulin glargine ................................................... 25 K Kenacort-A................................................... 34, 50 Kenacort-A40............................................... 34, 50 Klacid .......................................................... 34, 44 Klamycin................................................ 32, 34, 44 L Lanoxin .............................................................. 45 Lanoxin PG ........................................................ 45 Lantus ............................................................... 25 Lantus SoloStar ................................................. 25 Levothyroxine .................................................... 41 Lopresor ............................................................ 51 Losartan ...................................................... 22, 41 Lostaar .............................................................. 22 Lumigan ............................................................ 35 M m-Cefuroxime .............................................. 21, 48 Mask for spacer device ...................................... 51 Maxalt melt ........................................................ 24 Mefenamic acid ................................................. 41 Merrem .............................................................. 47 Methopt ....................................................... 35, 49 Methylcellulose .................................................. 51 Methylcellulose with glycerin and sodium saccharin............................................ 51 Methylcellulose with glycerin and sucrose .......... 51 Meropenem ................................................. 47, 49 Methyldopa .................................................. 34, 49 Methylprednisolone sodium succinate ................ 51 Metoprolol tartrate .............................................. 51 Metronidazole .............................................. 34, 49 Midazolam ......................................................... 42 Morrex Maltodextrin ........................................... 42 Motetis .............................................................. 20 Mucilaginous laxatives ....................................... 45 Mucilax .............................................................. 45 N Nitrolingual Pumpspray ................................ 32, 45 Norpress ................................................ 35, 47, 49 Nortriptyline hydrochloride...................... 35, 47, 49 O Octreotide MaxRx ......................................... 20, 47 Octreotide (somatostatin analogue) .............. 20, 47 Oestradiol .......................................................... 43 Omeprazole........................................................ 43 Ora-Blend .......................................................... 51 Ora-Blend SF...................................................... 51 Oral feed 1.5kcal/ml ........................................... 42 Oral feed 1 kcal/ml ............................................. 42 Ora-Plus ............................................................ 51 Ora-Sweet.......................................................... 51 Ora-Sweet SF ..................................................... 51 Orphenadrine hydrochloride................................ 32 Oxis Turbuhaler ............................................ 27, 33 P Paclitaxel ........................................................... 51 Paclitaxel Actavis ............................................... 51 Paracare Junior .................................................. 41 Paracetamol........................................... 35, 41, 44 Paracetamol with codeine .................................. 42 ParaCode ........................................................... 42 Paxam ......................................................... 35, 49 Peak flow meter ................................................. 51 Penembact......................................................... 49 Pepti Junior Gold................................................ 30 Pharmacy services........................... 20, 21, 44, 45 Ponstan ............................................................. 41 Povidone iodine ................................................. 32 Pravachol..................................................... 41, 42 Pravastatin ................................................... 41, 42 Prezista.............................................................. 43 Primaxin ............................................................ 49 Prodopa ....................................................... 34, 49 Propranolol ........................................................ 22 Propylene glycol ................................................ 46 Q Q 200 .................................................... 45, 48, 51 Quinine sulphate .................................... 45, 48, 51 R Ranbaxy Cefaclor ............................................... 33 Remifentanil-AFT................................................ 51 Remifentanil hydrochloride ................................. 51 Rizamelt................................................. 20, 24, 47 Rizatriptan.............................................. 20, 24, 47 Rizatriptan benzoate ..................................... 24, 47 S Selegiline hydrochloride ..................................... 41

Index

Pharmaceuticals and brands Sodium bicarbonate ........................................... 27 Sodium chloride ..................................... 27, 33, 49 Solu-Medrol ....................................................... 51 Space Chamber ................................................. 42 Space Chamber Plus .......................................... 52 Spacer device .............................................. 42, 52 Spiriva ............................................................... 24 Spironolactone ............................................. 34, 49 Standard Supplements ....................................... 28 Stocrin ............................................................... 49 Sulindac....................................................... 21, 45 Symbicort Turbuhaler 100/6 ......................... 27, 33 Symbicort Turbuhaler 200/6 ......................... 27, 33 Symbicort Turbuhaler 400/12 ....................... 27, 33 Synthroid ........................................................... 41 T Temaccord .................................................. 21, 50 Temodal ...................................................... 32, 45 Temozolomide ................................. 21, 32, 45, 50 Terbinafine ......................................................... 42 Testosterone cypionate ...................................... 52 Tetrabenazine............................................... 20, 32 Thiotepa............................................................. 20 THIO-TEPA ........................................................ 20 Timolol maleate............................................ 35, 44 TMP............................................................. 34, 50 Tolbutamide ....................................................... 48 Triamcinolone acetonide .............................. 34, 50 Trichozole .................................................... 34, 49 Trimethoprim ............................................... 34, 50 U Ultiva ................................................................. 51 Ursodeoxycholic acid ............................. 20, 22, 47 Ursosan ................................................. 20, 22, 47 V Vannair ........................................................ 27, 33 Vergo 16 ...................................................... 35, 48 X Xenazine 25 ....................................................... 32 Z Zinacef ......................................................... 32, 45 Zinc and castor oil ........................................ 20, 48 Zoledronic acid .................................................. 22

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 March 2012

Abstract

Pharmaceutical Management Agency Update New Zealand Pharmaceutical Schedule Effective 1 March 2012 Cumulative for January, February and March 2012 Section H cumulative for December 2011, January, February and March 2012 Contents Summary of PHARMAC decisions effective 1 March 2012 …..…

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