Additional subsidy by endorsement is available for pregnant women. The prescription must be endorsed accordingly.
Indication marked with * is an Unapproved Indication.
Clinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate.
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.
Only in extemporaneously compounded omeprazole suspension.
For omeprazole suspension refer
The number of test strips available on a prescription is restricted to 50 unless:
Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; or
Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; or
Prescribed for a pregnant woman with diabetes and endorsed accordingly.
SensoCard blood glucose test strips are subsidised only if prescribed for a patient who is severely visually impaired and is using a SensoCard Plus Talking Blood Glucose Monitor.
A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005 or is prescribed for a pregnant woman with diabetes.
Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly.
Subsidy is available for disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly.
Liver biopsy is not usually required for diagnosis but is helpful to stage the disease.
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.
Not funded for use in the ear.
Note: Only for the prevention or treatment of constipation in the terminally ill.
Subject to a budgetary cap. Applications will be considered and approved subject to funding availability.
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
|
The Co-ordinator, Gaucher’s Treatment Panel |
Phone: (04) 460 4990 |
|
PHARMAC, PO Box 10 254 |
Facsimile: (04) 916 7571 |
|
Wellington |
Email: gaucherpanel@pharmac.govt.nz |
For folinic mouthwash, pilocarpine oral liquid or saliva substitute formula refer
Alpha tocopheryl acetate is available fully subsidised for specific patients at the Medical Director of PHARMAC’s discretion. Refer to PHARMAC website www.pharmac.govt.nz for the “Alpha tocopheryl acetate information sheet and application form”.
For magnesium hydroxide mixture refer
Erythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy.
The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over:
GFR (ml/min) (male) = (140 - age) × Ideal Body Weight (kg) / 814 × serum creatinine (mmol/l)
GFR (ml/min) (female) = Estimated GFR (male) × 0.85
Note: Marevan and Coumadin are not interchangeable.
Rivaroxaban is only currently indicated and subsidised for up to 5 weeks therapy for prophylaxis of venous thromboembolism following a total hip replacement and up to 2 weeks therapy for prophylaxis of venous thromboembolism following a total knee replacement.
Dabigatran will not be funded Close Control in amounts less than 4 weeks of treatment.
Only if prescribed on a prescription for renal dialysis, maternity or post-natal care in the home of the patient, or on a PSO for emergency use. (500 ml and 1,000 ml packs)
Not funded for use as a nasal drop. Only funded for nebuliser use when in conjunction with an antibiotic intended for nebuliser use.
On a prescription or Practitioner’s Supply Order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent; or
On a bulk supply order; or
When used in the extemporaneous compounding of eye drops.
For phosphate supplementation
Treatment with HMG CoA Reductase Inhibitors (statins) is recommended for patients with dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater.
A patient who has failed to reduce their LDL cholesterol to < 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapies.
Other treatment options including fibrates, resins and nicotinic acid should be considered after failure of statin therapy.
If a patient's LDL cholesterol cannot be calculated because the triglyceride level is too high then a repeat test should be performed and if the LDL cholesterol again cannot be calculated then it can be considered that the LDL cholesterol is greater than 2.0 mmol/litre.
A patient who has failed to reduce their LDL cholesterol to ≤ 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapies.
Other treatment options including fibrates, resins and nicotinic acid should be considered after failure of statin therapy.
If a patient's LDL cholesterol cannot be calculated because the triglyceride level is too high then a repeat test should be performed and if the LDL cholesterol again cannot be calculated then it can be considered that the LDL cholesterol is greater than 2.0 mmol/litre.
For the purposes of this Special Authority, a relevant specialist is defined as a haematologist.
Oral liquid restricted to children under 12 years of age.
Perindopril and trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are “certified condition” or an appropriate description of the patient such as “congestive heart failure”, “CHF”, “congestive cardiac failure” or “CCF”.
Definition of Congestive Heart Failure
At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer’s surcharge: “Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include patients post myocardial infarction with an ejection fraction of less than 40%.”
For lignocaine hydrochloride refer to NERVOUS SYSTEM, Anaesthetics, Local
Treatment should be started with small doses and titrated upwards as necessary.
Hypertension should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg.
May be supplied on a PSO for reasons other than emergency.
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
The Coordinator, PAH Panel
PHARMAC, PO Box 10-254, WELLINGTON
Tel: (04) 916 7512, Fax: (04) 974 4858, Email: PAH@pharmac.govt.nz
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
The Coordinator, PAH Panel
PHARMAC, PO Box 10-254, WELLINGTON
Tel: (04) 916 7512, Fax: (04) 974 4858, Email: PAH@pharmac.govt.nz
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
The Coordinator, PAH Panel
PHARMAC, PO Box 10-254, WELLINGTON
Tel: (04) 916 7512, Fax: (04) 974 4858, Email: PAH@pharmac.govt.nz
Applicants are recommended to either have used or be familiar with using a decision support tool accredited by their professional body.
Applicants are recommended to either have used or be familiar with using a decision support tool accredited by their professional body.
For systemic antibacterials, refer to INFECTIONS, Antibacterials
For systemic antibacterials, refer to INFECTIONS, Antibacterials
For systemic antifungals, refer to INFECTIONS, Antifungals
Only in combination with aqueous cream, 10% urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion
Up to 5% in a dermatological base (not proprietary Topical Corticosteriod – Plain) with or without other dermatological galenicals. Refer
For systemic corticosteroids, refer to CORTICOSTEROIDS AND RELATED AGENTS
Only if prescribed for a dialysis patient and the prescription is endorsed accordingly.
Only if prescribed for a patient identified with Methicillin-resistant Staphylococcus aureus (MRSA) prior to elective surgery in hospital and the prescription is endorsed accordingly; or
Only if prescribed for a patient with recurrent Staphylococcus aureus infection and the prescription is endorsed accordingly
Only in combination with a dermatological galenical or as a diluent for a proprietary Topical Corticosteroid – Plain.
Up to 10 %
Only in combination with a dermatological base or proprietary Topical Corticosteriod – Plain, refer
With or without other dermatological galenicals.
Only in combination with a dermatological base or proprietary Topical Corticosteroid – Plain or collodion flexible, refer
With or without other dermatological galenicals.
Maximum 20 g or 20 ml per prescription when prescribed with white soft paraffin or collodion flexible.
Only in combination with a dermatological base or proprietary Topical Corticosteroid – Plain, refer
With or without other dermatological galenicals.
Only if prescribed for a patient with severe photosensitivity secondary to a defined clinical condition and the prescription is endorsed accordingly.
Superficial basal cell carcinoma
Surgical excision remains first-line treatment for superficial basal cell carcinoma as it has a higher cure rate than imiquimod and allows histological assessment of tumour clearance.
Imiquimod has not been evaluated for the treatment of superficial basal cell carcinoma within 1 cm of the hairline, eyes, nose, mouth or ears.
Imiquimod is not indicated for recurrent, invasive, infiltrating, or nodular basal cell carcinoma.
External anogenital warts
Imiquimod is only indicated for external genital and perianal warts (condyloma acuminata).
Every effort should be made to biopsy the lesion to confirm that it is a superficial basal cell carcinoma.
For salicylic acid preparations refer to PSORIASIS AND ECZEMA PREPARATIONS
Subsidised only if prescribed for post-herpetic neuralgia or diabetic peripheral neuropathy and the prescription is endorsed accordingly.
For aspirin & chloroform application refer
One of each size is permitted on a PSO.
The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon and Marvelon.
The additional subsidy will fund Mercilon and Marvelon up to the manufacturer’s price for each of these products as identified on the Schedule at 1 November 1999.
Special Authorities approved before 1 November 1999 remain valid until the expiry date and can be renewed providing that women are still either:
on a Social Welfare benefit; or
have an income no greater than the benefit.
The approval numbers of Special Authorities approved before 1 November 1999 are interchangeable for products within the combined oral contraceptives and progestogen-only contraceptives groups, except Loette and Microgynon 20 ED
The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon and Marvelon.
The additional subsidy will fund Mercilon and Marvelon up to the manufacturer’s price for each of these products as identified on the Schedule at 1 November 1999.
Special Authorities approved before 1 November 1999 remain valid until the expiry date and can be renewed providing that women are still either:
on a Social Welfare benefit; or
have an income no greater than the benefit.
The approval numbers of Special Authorities approved before 1 November 1999 are interchangeable for products within the combined oral contraceptives and progestogen-only contraceptives groups, except Loette and Microgynon 20 ED
Prescribers may code prescriptions “contraceptive” (code “O”) when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows:
$3.00 prescription charge (patient co-payment) will apply.
prescription may be written for up to six months supply.
Prescriptions coded in any other way are subject to the non contraceptive prescription charges, and the non-contraceptive period of supply. ie. Prescriptions may be written for up to three months supply.
Patients with enlarged prostates are the appropriate candidates for therapy with finasteride.
For urinary tract Infections refer to INFECTIONS, Antibacterials
Oral liq prescriptions:
Must be written by a Paediatrician or Paediatric Cardiologist; or
On the recommendation of a Paediatrician or Paediatric Cardiologist.
Dexamethasone sodium phosphate injection will not be funded for oral use.
Restricted to children under 12 years of age.
Prescriptions with a valid Special Authority (CHEM) number will be reimbursed at the level of the lowest priced TDDS product within the specified dose group.
HRT should be taken at the lowest dose for the shortest period of time necessary to control symptoms. Patients should be reviewed 6 monthly in line with the updated NZGG “Evidence-based Best Practice Guideline on Hormone Replacement Therapy March 2004”.
Applications are not to be made for use in patients as contraception except where they meet the above criteria.
Applications are not to be made for use in patients as contraception except where they meet the above criteria.
Subject to budgetary cap. Applications will be considered and approved subject to funding availability.
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
NZGHC Coordinator
PHARMAC, PO Box 10-254, WELLINGTON
Tel: 0800 808 476, Fax: (09) 929 3221, Email: growthhormone@pharmac.govt.nz
Only if prescribed for prophylaxis of endocarditis and the prescription is endorsed accordingly.
Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Subsidised only if prescribed for a dialysis or cystic fibrosis patient, or the treatment of confirmed ciprofloxacin-resistant gonorrhoea, or the treatment of suspected meningitis in patients who have a known allergy to penicillin, and the prescription or PSO is endorsed accordingly.
Waiver by endorsement must state that the prescription is for dialysis or cystic fibrosis patient.
Waiver by endorsement must state that the prescription is for dialysis or cystic fibrosis patient.
Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Caution is advised if using azithromycin as an antibiotic in the treatment of cystic fibrosis patients with pneumonia.
Testing for non-tuberculosis mycobacteria should occur annually.
Indications marked with * are Unapproved Indications
Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly; can be waived by Special Authority see SA1130.
Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Only if prescribed for a dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly.
Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and the prescription is endorsed accordingly.
Only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly.
Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudomembranous colitis or for prophylaxis of endocarditis and the prescription is endorsed accordingly.
Indications marked with * are Unapproved Indications (refer to Section A: General Rules, Part I (Interpretations and Definitions) and Part IV (Miscellaneous Provisions) rule 4.6).
For topical antibiotics, refer to DERMATOLOGICALS
For anti-infective eye preparations, refer to SENSORY ORGANS
For topical antibacterials, refer to DERMATOLOGICALS
Patient has vaginal candida albicans and the practitioner considers that a topical imidazole (used intr-vaginally) is not recommended and the prescription is endorsed accordingly; can be waived by endorsement - Retail pharmacy - Specialist.
For topical antifungals refer to DERMATOLOGICALS
For topical antifungals refer to GENITO URINARY
Note: There is no co-payment charge for all pharmaceuticals listed in the Antituberculotics and Antileprotics group regardless of immigration status.
Lamivudine should be added to adefovir dipivoxil if a patient develops documented resistance to adefovir dipivoxil, defined as:
Adefovir dipivoxil should be stopped 6 months following HBeAg seroconversion for patients who were HBeAg+ prior to commencing adefovir dipivoxil.
The recommended dose of adefovir dipivoxil is no more than 10mg daily.
In patients with renal insufficiency adefovir dipivoxil dose should be reduced in accordance with the datasheet guidelines.
Adefovir dipivoxil should be avoided in pregnant women and children.
Tenofovir disoproxil fumarate should be stopped 6 months following HBeAg seroconversion for patients who were HBeAg positive prior to commencing this agent and 6 months following HBsAg seroconversion for patients who were HBeAg negative prior to commencing this agent.
The recommended dose of Tenofovir disoproxil fumarate for the treatment of all three indications is 300 mg once daily.
In patients with renal insufficiency (calculated creatinine clearance less than 50ml/min), Tenofovir disoproxil fumarate dose should be reduced in accordance with the approved Medsafe datasheet guidelines.
Tenofovir disoproxil fumarate is not approved for use in children.
Endorsement for treatment of HIV/AIDS: Prescription is deemed to be endorsed if tenofovir disoproxil fumarate is co-prescribed with another anti-retroviral subsidised under Special Authority SA1025 and the prescription is annotated accordingly by the Pharmacist or endorsed by the prescriber.
Note:
Tenofovir disoproxil fumarate prescribed under endorsement for the treatment of HIV/AIDS is included in the count of up to 4 subsidised antiretrovirals for the purposes of Special Authority SA1025
For eye preparations refer to Eye Preparations, Anti-Infective Preparations
Combivir counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority.
Note: Kivexa counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority.
Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 subsidised antiretrovirals.
Subsidies for a combination of up to four antiretroviral medications. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals.
Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 subsidised antiretrovirals.
Subsidies for a combination of up to four antiretroviral medications. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals.
Some antiretrovirals are unapproved or contraindicated for this indication. Practitioners prescribing these medications should exercise their own skill, judgement, expertise and discretion, and make their own prescribing decisions with respect to the use of a Pharmaceutical for an indication for which it is not approved or contraindicated.
Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 subsidised antiretrovirals.
Subsidies for a combination of up to four antiretroviral medications. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals.
Tenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 4 subsidised antiretrovirals.
Subsidies for a combination of up to four antiretroviral medications. The combination of a protease inhibitor and low-dose ritonavir given as a booster (either as part of a combination product or separately) will be counted as one protease inhibitor for the purpose of accessing funding to antiretrovirals.
Consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure.
Consider reducing treatment to 24 weeks if serum HCV RNA level at Week 4 is undetectable by sensitive PCR assay (less than 50IU/ml) AND Baseline serum HCV RNA is less than 400,000IU/ml
Approved dose is 180 mcg once weekly.
The recommended dose of Pegylated Interferon-alpha 2a is 180 mcg once weekly.
In patients with renal insufficiency (calculated creatinine clearance less than 50ml/min), Pegylated Interferon-alpha 2a dose should be reduced to 135 mcg once weekly.
In patients with neutropaenia and thrombocytopaenia, dose should be reduced in accordance with the datasheet guidelines.
Pegylated Interferon-alpha 2a is not approved for use in children.
Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or an infectious disease physician. All subjects undergoing treatment require careful monitoring for side effects.
Patients should be otherwise fit.
Hepatocellular carcinoma should be excluded by ultrasound examination and alpha-fetoprotein level.
Diagnosis
Anti-HCV positive on at least two occasions with a positive PCR for HCV-RNA and preferably confirmed by a supplementary RIBA test; or
PCR-RNA positive for HCV on at least 2 occasions if antibody negative; or
Anti-HCV positive on at least two occasions with a positive supplementary RIBA test with a negative PCR for HCV RNA but with a liver biopsy consistent with 2(b) following.
Establishing Active Chronic Liver Disease
Confirmed HCV infection and serum ALT/AST levels measured on at least three occasions over six months averaging > 1.5 × upper limit of normal. (ALT is the preferable enzyme); or
Liver biopsy showing significant inflammatory activity (active hepatitis) with or without cirrhosis. This is not a necessary requirement for those patients with coagulopathy. (Some patients have active disease on histology with normal transaminase enzymes).
Autoimmune liver disease. (Interferon may exacerbate autoimmune liver disease as well as other autoimmune diseases such as thyroid disease).
Pregnancy.
Neutropenia (<2.0 × 109) and/or thrombocytopenia.
Continuing alcohol abuse and/or continuing intravenous drug users.
The current recommended dosage is 3 million units of interferon alpha-2a or interferon alpha-2b administered subcutaneously 3 times a week for 52 weeks (twelve months)
The patient’s response to interferon treatment should be reviewed at either three or four months. Interferon treatment should be discontinued in patients who do not show a substantial reduction (50%) in their mean pre-treatment ALT level at this stage.
is available 1 March until vaccine supplies are exhausted each year for patients who meet the following criteria, as set by the Ministry of Health:
all people 65 years of age and over;
people under 65 years of age with:
the following cardiovascular disease:
ischaemic heart disease,
congestive heart disease,
rheumatic heart disease,
congenital heart disease, or
cerebo-vascular disease;
the following chronic respiratory disease:
asthma, if on a regular preventative therapy, or
other chronic respiratory disease with impaired lung function;
diabetes;
chronic renal disease;
any cancer, excluding basal and squamous skin cancers if not invasive;
the following other conditions:
autoimmune disease,
immune suppression,
HIV,
transplant recipients,
neuromuscular and CNS diseases,
haemoglobinopathies,
children on long term aspirin, or
pregnancy.
people under 18 years of age living within the boundaries of the Canterbury District Health Board.
The following conditions are excluded from funding:
asthma not requiring regular preventative therapy,
hypertension and/or dyslipidaemia without evidence of end-organ disease,
Doctors are the only Contractors entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria for subsidised immunisation and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.
Individual DHBs may fund patients over and above the above criteria. The claiming process for these additional patients should be determined between the DHB and Contractor.
Influenza Vaccine does not fall within the definition Community Pharmaceutical as it is not funded directly from the Pharmaceutical Budget. Pharmacists are unable to claim for the dispensing of influenza vaccine from the Funder.
Subsidy for patients with existing approvals prior to 1 September 2010. Approvals valid without further renewal unless notified. No new approvals will be granted from 1 September 2010.
"Inadequate response" is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment.
The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI measure must be no more than 1 month old at the time of initial application.
Average normal chest expansion corrected for age and gender:
18-24 years - Male: 7.0 cm; Female: 5.5 cm
25-34 years - Male: 7.5 cm; Female: 5.5 cm
35-44 years - Male: 6.5 cm; Female: 4.5 cm
45-54 years - Male: 6.0 cm; Female: 5.0 cm
55-64 years - Male: 5.5 cm; Female: 4.0 cm
65-74 years - Male: 4.0 cm; Female: 4.0 cm
75+ years - Male: 3.0 cm; Female: 2.5 cm
A treatment course is defined as a minimum of 12 weeks of etanercept treatment
"Inadequate response" is defined as: for whole body severe chronic plaque psoriasis, a PASI score of greater than 15, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment; for severe chronic plaque psoriasis of the face, hand or foot, at least 2 of the 3 PASI symptom subscores for erythema, thickness and scaling are rated as severe or very severe, and the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably while still on treatment but no longer than 1 month following cessation of the most recent prior treatment.
The BASDAI must have been determined at the completion of the 3 month exercise trial, but prior to ceasing NSAID treatment. The BASDAI measure must be no more than 1 month old at the time of initial application.
Average normal chest expansion corrected for age and gender:
18-24 years - Male: 7.0 cm; Female: 5.5 cm
25-34 years - Male: 7.5 cm; Female: 5.5 cm
35-44 years - Male: 6.5 cm; Female: 4.5 cm
45-54 years - Male: 6.0 cm; Female: 5.0 cm
55-64 years - Male: 5.5 cm; Female: 4.0 cm
65-74 years - Male: 4.0 cm; Female: 4.0 cm
75+ years - Male: 3.0 cm; Female: 2.5 cm
A treatment course is defined as a minimum of 12 weeks adalimumab treatment
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.
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.
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.
In line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body.
Etidronate for osteoporosis should be prescribed for 14 days (400 mg in the morning) and repeated every three months. It should not be taken at the same time of the day as any calcium supplementation (minimum dose – 500 mg per day of elemental calcium). Etidronate should be taken at least 2 hours before or after any food or fluid, except water.
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.
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.
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.
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.
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.
Evidence used by the UK National Institute for Health and Clinical Excellence (NICE) in developing its 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 raloxifene funding.
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.
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.
The bone mineral density (BMD) measurement used to derive the T-score must be made using dual-energy x-ray absorptiometry (DXA). Quantitative ultrasound and quantitative computed tomography (QCT) are not acceptable
Antiresorptive agents and their adequate doses for the purposes of this Special Authority are defined as: alendronate sodium tab 70 mg or tab 70 mg with cholecalciferol 5,600 iu once weekly; raloxifene hydrochloride tab 60 mg once daily; zoledronic acid 5 mg per year. If an intolerance of a severity necessitating permanent treatment withdrawal develops during the use of one antiresorptive agent, an alternate antiresorptive agent must be trialled so that the patient achieves the minimum requirement of 12 months’ continuous therapy.
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.
A maximum of 18 months of treatment (18 cartridges) will be subsidised.
Subsidised only if prescribed for urethral or cervical administration and the prescription is endorsed accordingly.
Subsidised only if prescribed for urethral or cervical administration and the prescription is endorsed accordingly.
Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets).
For methadone hydrochloride oral liquid refer
Prescribers should note that oxycodone is significantly more expensive than long-acting morphine sulphate and clinical advice suggests that it is reasonable to consider this as a second-line agent to be used after morphine.
For Anti-inflammatory NSAIDS refer to MUSCULOSKELETAL
Note:
There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide.
Subsidised by endorsement
When prescribed for a patient who cannot swallow whole tablets or capsules and the prescription is endorsed accordingly; or
When prescribed in a daily dose that is not a multiple of 20 mg in which case the prescription is deemed to be endorsed. Note: Tablets should be combined with capsules to facilitate incremental 10 mg doses.
PSO must be endorsed “not for anaesthetic procedures”.
``Optimal treatment with other antiepilepsy agents'' is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance.
Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages.
As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective.
Vigabatrin is associated with a risk of irreversible visual field defects, which may be asymptomatic in the early stages.
Subsidy for patients pre-approved by PHARMAC on 1 August 2009. Approvals valid without further renewal unless notified.
No new approvals will be granted from 1 August 2009.
"Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance.
As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective.
For phenobarbitone oral liquid refer
"Optimal treatment" is defined as treatment which is indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Women of childbearing age are not required to have a trial of sodium valproate.
As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anticonvulsant therapy and have assessed quality of life from the patient's perspective.
For Beta Adrenoceptor Blockers refer to CARDIOVASCULAR SYSTEM
For Anti-inflammatory NSAIDS refer to MUSCULOSKELETAL
Not more than one prescription per month.
For Antispasmodics refer to ALIMENTARY TRACT
Ziprasidone is subsidised for patients suffering from schizophrenia or related psychoses after a trial of an effective dose of risperidone or quetiapine that has been discontinued, or is in the process of being discontinued, because of unacceptable side effects or inadequate response, and the prescription is endorsed accordingly.
Risperidone depot injection should ideally be used as monotherapy (i.e. without concurrent use of any other antipsychotic medication). In some cases, it may be clinically appropriate to attempt to treat a patient with typical antipsychotic agents in depot injectable form before trialing risperidone depot injection.
The patient should be monitored for post-injection syndrome for at least three hours after each injection.
Risperdal Quicklets cost significantly more than risperidone tablets and should only be used where necessary.
Diagnosis: Schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present.
Treatment: Before initiating atypical antipsychotic therapy, physicians should consider whether the patient is likely to respond to and/or tolerate conventional antipsychotic therapy and, where appropriate, trial one or more conventional agent prior to use of an atypical agent.
Budget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC).
Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below).
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
|
The coordinator |
Phone: 04 460 4990 |
|
Multiple Sclerosis Treatment Assessment Committee |
Facsimile: 04 916 7571 |
|
PHARMAC PO Box 10 254 |
|
|
Wellington |
Completed application forms must be sent to the coordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity.
Notification of MSTAC's decision will be sent to the patient, the applying clinician and the patient's GP (if specified).
These agents will NOT be subsidised if dispensed from a community or hospital pharmacy. Regular supplies will be distributed to all approved patients or their clinicians by courier.
Prescribers must send quarterly prescriptions for approved patients to the MSTAC coordinator.
Only prescriptions for 6 million iu of interferon beta-1-alpha per week, or 8 million iu of interferon beta-1-beta every other day, or 20 mg glatiramer acetate daily will be subsidised.
Appeals against MSTAC's decision and/or the processing of any application may be lodged with the MSTAC coordinator. Concerns that cannot be or have not been adequately addressed by MSTAC will be forwarded to a separate Appeal Committee if necessary.
Switching between treatments is permitted within the 12 month approval period without reapproval by MSTAC. The MSTAC coordinator should be notified of the change and a new prescription provided.
Diagnosis of multiple sclerosis (MS) must be confirmed by a neurologist. Diagnosis should as a rule include MRI confirmation. For patients diagnosed before MRI was widely utilised in New Zealand, confirmation of diagnosis via clinical assessment and laboratory/ancillary data must be provided; and
patients must have active relapsing MS (confirmed by MR scan where necessary) with or without underlying progression; and
patients must have either:
EDSS score 2.5 - 5.5 with 2+ relapses:
experienced at least 2 significant relapses of MS in the previous 12 months, and
an EDSS score of between 2.5 and 5.5 inclusive; or
EDSS score 2.0 with 3+ relapses:
experienced at least 3 significant relapses of MS in the previous 12 months, and
an EDSS score of 2.0; and
Each relapse must:
be confirmed by a neurologist or general physician (the patient may not necessarily have been seen during the relapse but the neurologist/physician must be satisfied that the clinical features were characteristic and met the specified criteria);
be associated with characteristic new symptom(s)/sign(s) or substantial worsening of previously experienced symptom(s)/sign(s);
last at least one week;
follow a period of stability of at least one month;
be severe enough to change either the EDSS or at least one of the Kurtzke functional systems scores by at least 1 point;
be distinguishable from the effects of general fatigue; and
not be associated with a fever (T>37.5°C); and
applications must be made at least four weeks after the date of the onset of the last known relapse; and
patients must have no previous history of lack of response to beta-interferon or glatiramer acetate (see criteria for stopping).
applications must be submitted to the Multiple Sclerosis Treatment Assessment Committee (MSTAC) by the patient's neurologist or a general physician; and
patients must agree (via informed consent) to co-operate if as a result of their meeting the stopping criteria, funding is withdrawn. Patients must agree to the collection of clinical data relating to their MS and use of those data by PHARMAC; and
patients must agree to allow clinical data to be collected and reviewed by MSTAC annually for each year in which they receive funding for beta-interferon or glatiramer acetate.
Confirmed progression of disability that is sustained for six months during a minimum of one year of treatment. Progression of disability is defined as any of:
an increase of 2 EDSS points where starting EDSS was 2.0; or
an increase of 1.5 EDSS points where starting EDSS was 2.5 or 3.0; or
an increase of 1 EDSS point where starting EDSS 3.5 or greater; or
an increase in EDSS score to 6.0 or more; or
stable or increasing relapse rate over 12 months of treatment (compared with the relapse rate on starting treatment)(see note); or
pregnancy and/or lactation; or
within the 12 month approval year, intolerance to interferon beta-1-alpha, and/or interferon beta-1-beta and/or glatiramer acetate; or
non-compliance with treatment, including refusal to undergo annual assessment or refusal to allow the results of the assessment to be submitted to MSTAC; or
patients may, subject to conclusions drawn from published evidence available at the time, be excluded if they develop a high titre of neutralising anti-bodies to beta-interferon or glatiramer acetate.
Note: Patients who have a stable or increasing relapse rate over 12 months of treatment (compared with the relapse rate on starting treatment) and who do not meet any of the other Stopping Criteria at annual review may switch to a different class of funded treatment (i.e. patients may switch from either of the beta-interferons [interferon beta-1-beta or interferon beta-1-alpha] to glatiramer acetate or vice versa). Patients may switch classes of treatment for this reason only once, after which they will be required to stop funded treatment if they meet any of the Stopping Criteria at annual review (including the criterion relating to stable or increasing relapse rate over 12 months of treatment).
A "subsidised formulation of a stimulant" refers to currently subsidised methylphenidate hydrochloride tablet formulations (immediate-release, sustained-release and extended-release) or dexamphetamine sulphate tablets.
Modafinil will not be subsidised for hypersomnia associated with any condition other than narcolepsy.
Nicotine will not be funded Close Control in amounts less than 4 weeks of treatment.
a maximum of 3 months' varenicline will be subsidised on each Special Authority approval.
Varenicline will not be funded Close Control in amounts less than 2 weeks of treatment.
A maximum of 3 months' varenicline will be subsidised on each Special Authority approval.
Indications marked with * are Unapproved Indications, oxaliplatin is indicated for adjuvant treatment of stage III (Duke's C) colon cancer after complete resection of the primary tumour.
Indications marked with * are Unapproved Indications, # capecitabine is approved for stage III (Duke's stage C) colon cancer.
Indications marked with a * are Unapproved Indications.
Indications marked with a * are Unapproved Indications.
Cholangiocarcinoma encompasses epithelial tumours of the hepatobiliary tree, including tumours of bile ducts, ampulla of vater and gallbladder.
Indications marked with a * are Unapproved Indications.
Indications marked with a * are Unapproved Indications.
Indications marked with a * are Unapproved Indications.
Indications marked with a * are Unapproved Indications.
It is recommended that treatment with anagrelide be initiated only on the recommendation of a haematologist.
Prescription must be written by a registered prescriber in the thalidomide risk management programme operated by the supplier.
Maximum dose of 400 mg daily as monotherapy or in a combination therapy regimen.
Indication marked with * is an Unapproved Indication.
Indication marked with a * is an Unapproved Indication. Temozolomide is not subsidised for the treatment of relapsed glioblastoma multiforme. Reapplications will not be approved.
Studies of temozolomide show that its benefit is predominantly in those patients with a good performance status (WHO grade 0 or 1 or Karnofsky score >80), and in patients who have had at least a partial resection of the tumour.
Indications marked with * are Unapproved Indications.
Indications marked with * are Unapproved Indications.
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 known therapeutic chemotherapy regimen and supportive treatments; or
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.
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz, and prescriptions should be sent to:
|
The CML/GIST Co-ordinator |
Phone: (04) 460 4990 |
|
PHARMAC |
Facsimile: (04) 916 7571 |
|
PO Box 10 254 |
|
|
Wellington |
Funded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) in blast crisis, accelerated phase, or in chronic phase.
Maximum dose of 600 mg/day for accelerated or blast phase, and 400 mg/day for chronic phase CML.
Subsidised for use as monotherapy only.
Initial approvals valid seven months.
Subsequent approval(s) are granted on application and are valid for six months. The first reapplication (after seven months) should provide details of the haematological response. The third reapplication should provide details of the cytogenetic response after 14-18 months from initiating therapy. All other reapplications should provide details of haematological response, and cytogenetic response if such data is available. Applications to be made and subsequent prescriptions can be written by a haematologist or an oncologist.
Prescribers should consider discontinuation of treatment if after 6 months from initiating therapy a patient did not obtain a haematological response as defined as any one of the following three levels of response:
complete haematologic response (as characterised by an absolute neutrophil count (ANC) > 1.5 × 109/L, platelets > 100 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or
no evidence of leukaemia (as characterised by an absolute neutrophil count (ANC) > 1.0 × 109/L, platelets > 20 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or
return to chronic phase (as characterised by BM and PB blasts < 15%, BM and PB blasts and promyelocytes < 30%, PB basophils < 20% and absence of extramedullary disease other than spleen and liver).
Prescribers should consider discontinuation of treatment if after 18 months from initiating therapy a patient did not obtain a major cytogenetic response defined as 0-35% Ph+ metaphases.
Funded for patients:
with a diagnosis (confirmed by an oncologist) of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST); and
who have immunohistochemical documentation of c-kit (CD117) expression by the tumour.
Maximum dose of 400 mg/day.
Applications to be made and subsequent prescriptions can be written by an oncologist.
Initial and subsequent applications are valid for one year. The re-application criterion is an adequate clinical response to the treatment with imatinib (prescriber determined).
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz, and prescriptions should be sent to:
|
The CML/GIST Co-ordinator |
Phone: (04) 460 4990 |
|
PHARMAC |
Facsimile: (04) 916 7571 |
|
PO Box 10 254 |
|
|
Wellington |
Funded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) in blast crisis, accelerated phase, or in chronic phase.
Maximum dose of 140 mg/day for accelerated or blast phase, and 100 mg/day for chronic phase CML.
Subsidised for use as monotherapy only.
Initial approvals valid seven months.
Subsequent approval(s) are granted on application and are valid for six months. The first reapplication (after seven months) should provide details of the haematological response. The third reapplication should provide details of the cytogenetic response after 14-18 months from initiating therapy. All other reapplications should provide details of haematological response, and cytogenetic response if such data is available. Applications to be made and subsequent prescriptions can be written by a haematologist or an oncologist.
Note: Dasatinib is indicated for the treatment of adults with chronic, accelerated or blast phase CML with resistance or intolerance to prior therapy including imatinib.
Prescribers should consider discontinuation of treatment if, after 6 months from initiating therapy, a patient did not obtain a haematological response as defined as any one of the following three levels of response:
complete haematologic response (as characterised by an absolute neutrophil count (ANC) > 1.5 × 109/L, platelets > 100 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or
no evidence of leukaemia (as characterised by an absolute neutrophil count (ANC) > 1.0 × 109/L, platelets > 20 × 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or
return to chronic phase (as characterised by BM and PB blasts < 15%, BM and PB blasts and promyelocytes < 30%, PB basophils < 20% and absence of extramedullary disease other than spleen and liver).
Prescribers should consider discontinuation of treatment if, after 18 months from initiating therapy, a patient did not obtain a major cytogenetic response defined as 0-35% Ph+ metaphases.
Sunitinib treatment should be stopped if disease progresses.
Poor prognosis patients are defined as having at least 3 of criteria 5.1-5.6. Intermediate prognosis patients are defined as having 1 or 2 of criteria 5.1-5.6
Indications marked with * are Unapproved Indications.
In patients with Acromegaly octreotide treatment should be discontinued if IGF1 levels have not decreased after 3 months treatment. In patients treated with radiotherapy octreotide treatment should be withdrawn every 2 years, for 1 month, for assessment of remission. Octreotide treatment should be stopped where there is biochemical evidence of remission (normal IGF1 levels) following octreotide treatment withdrawal for at least 4 weeks
The use of octreotide in patients with fistulae, oesophageal varices, miscellaneous diarrhoea and hypotension will not be funded as a Special Authority item
For GnRH ANALOGUES – refer to HORMONE PREPARATIONS, Trophic Hormones
Mycophenolate powder for oral liquid is subsidised only for patients unable to swallow tablets and capsules, and when the prescription is endorsed accordingly.
Dispensing pharmacy should check which brand to dispense with the prescriber if prescribed generically.
Indications marked with * are Unapproved Indications.
'Indolent, low-grade lymphomas' includes follicular, mantle, marginal zone and lymphoplasmacytic/Waldenstrom macroglobulinaemia.
'Aggressive CD20 positive NHL' includes large B-cell lymphoma and Burkitt's lymphoma/leukaemia
'Chronic lymphocytic leukaemia (CLL)' includes small lymphocytic lymphoma. A line of chemotherapy treatment is considered to comprise a known standard therapeutic chemotherapy regimen and supportive treatments. 'Good performance status' means ECOG score of 0-1, however, in patients temporarily debilitated by their CLL disease symptoms a higher ECOG (2 or 3) is acceptable where treatment with rituximab is expected to improve symptoms and improve ECOG score to <2.
Indications marked with * are Unapproved Indications.
'Indolent, low-grade lymphomas' includes follicular, mantle, marginal zone and lymphoplasmacytic/Waldenstrom macroglobulinaemia.
'Aggressive CD20 positive NHL' includes large B-cell lymphoma and Burkitt's lymphoma/leukaemia
*For patients with relapsed HER-2 positive disease who have previously received adjuvant trastuzumab for early breast cancer.
Subsidised only for bladder cancer.
Subsidy applies for either primary or rescue therapy.
Rescue therapy defined as unresponsive to calcineurin inhibitor treatment as defined by refractory rejection; or intolerant to calcineurin inhibitor treatment due to any of the following:
GFR<30 ml/min; or
Rapidly progressive transplant vasculopathy; or
Rapidly progressive obstructive bronchiolitis; or
HUS or TTP; or
Leukoencepthalopathy; or
Significant malignant disease
Note: Repeats for eformoterol fumarate will be fully subsidised where the initial dispensing is before 1 February 2012.
The addition of inhaled long-acting beta-adrenoceptor agonists (LABAs) to inhaled corticosteroids is recommended:
For younger children (aged under 12 years) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 200 µg beclomethasone or budesonide (or 100 µg fluticasone).
For adults and older children (aged 12 years and over) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 400 µg beclomethasone or budesonide (or 200 µg fluticasone).
Note:
Further information on the place of inhaled corticosteroids and inhaled LABAs in the management of asthma can be found in the New Zealand guidelines for asthma in adults (www.nzgg.org.nz) and in the New Zealand guidelines for asthma in children aged 1-15 (www.paediatrics.org.nz).
Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz or:
|
The Co-ordinator, Cystic Fibrosis Advisory Panel |
Phone: (04) 460 4990 |
|
PHARMAC, PO Box 10 254 |
Facsimile: (04) 916 7571 |
|
Wellington |
Email: CFPanel@pharmac.govt.nz |
Prescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.
Not funded for use as a nasal drop.
Available where the prescriber requires a spacer device that is capable of sterilisation in an autoclave and the PSO is endorsed accordingly.
Only for children aged six years and under
For Vosol ear drops with hydrocortisone powder refer
For treatment of bacterial keratitis or severe bacterial conjunctivitis resistant to chloramphenicol.
Trusopt, Cosopt and Azopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma.
Trusopt, Cosopt and Azopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless:
that person has previously trialled all other such subsidised agents (except brimonidine tartrate); and
those trials have indicated that that person does not respond adequately to treatment with those other agents.
Bimatoprost, lantanoprost and travoprost are subsidised for use in the treatment of glaucoma as either monotherapy or as an adjunctive agent for patients in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure.
Bimatoprost, lantanoprost and travoprost should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless:
That person has previously trialled all other such subsidised agents (beta-blockers, pilocarpine, carbonic anhydrase inhibitors); and
Those trials have indicated that that person does not respond adequately to treatment with those other agents.
Minims for a general practice are considered to be “tools of trade” and are not approved as special authority items.
Brimonidine tartrate is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma.
Brimonidine tartrate should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless:
that person has previously trialled all other such subsidised agents (except dorzolamide hydrochloride); and
those trials have indicated that that person does not respond adequately to or does not tolerate treatment with those other agents.
Combigan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma.
Combigan should only be prescribed when:
less expensive first line agents for the treatment of glaucoma are contraindicated; or
the response to such subsidised agents is inadequate; or
the patient cannot tolerate such subsidised agents.
For acetylcysteine eye drops refer
Eye preparations are only funded for use in the eye. The exception is pilocarpine eye drops 1%, 2% and 4% which are subsidised for oral use pursuant to the Standard Formulae.
The Pharmacode for BSF Bicalaccord is 2397137
May only be claimed once per patient.
Only in extemporaneously compounded oral mixtures.
Only in extemporaneously compounded methyl hydroxybenzoate 10% solution.
Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric.
Only in extemporaneously compounded oral liquid preparations.
Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets).
Only in children up to 12 years
Only in extemporaneously compounded omeprazole and lansoprazole suspension.
Only in aspirin and chloroform application.
Only in extemporaneously compounded oral liquid preparations.
Only in combination with Ora-Plus.
Only in combination with Ora-Plus.
Each of these products is highly specialised and would be prescribed only by an expert for a specific disorder. The alternative is hospitalisation.
Elemental 028 Extra is more expensive than other products listed in this section and should only be used where the alternatives have been tried first and/or are unsuitable.
Where possible, the requirements for oral supplementation should be established in conjunction with assessment by a dietitian.
Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly.
Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly.
Additional subsidy by endorsement is available for patients being bolus fed through a feeding tube. The prescription must be endorsed accordingly.
The funding of gluten free foods is no longer being actively managed by PHARMAC from 1 April 2011. This means that we are no longer considering the listing of new products, or making subsidy, or other changes to the existing listings. As a result we anticipate that the range of funded items will reduce over time. Management of Coeliac disease with a gluten free diet is necessary for good outcomes. A range of gluten free options are available through retail outlets.