Pharmac Update
Primary Care Prescribers for the week ending 20 January 2023
2022 Year in Review
Te Pātaka Whaioranga - Pharmac is excited to share our Year in Review for 2022. We put this publication together to let you know about some of the key work we’ve achieved, in collaboration with our partners, last year.
It includes:
• how we’ve used the budget increase to fund more medicines for New Zealanders
• how we’ve managed the supply chain in a challenging environment
• how we’ve increased access to COVID-19 medicines in response to the pandemic
• how we’re progressing our hospital medical devices work
• what we’re doing in response to the independent Pharmac Review
• plus a whole lot more, including a lived experience story about HIV and spinal muscular atrophy (SMA) and our Top 20 medicines for 2021/22.
Find the Year in Review on the Pharmac website.
Decision to fund the diabetes treatment liraglutide (Victoza)
In response to a global supply issue for dulaglutide (brand name Trulicity), a treatment for type 2 diabetes, we are pleased to announce that Pharmac has made a decision to fund liraglutide (brand name Victoza) as an alternative treatment.
Liraglutide will be funded for people with type 2 diabetes who meet the current eligibility criteria for GLP-1 agonists. Initial applications for the funding of liraglutide can be made for the duration of the supply issue impacting dulaglutide. Once the dulaglutide supply issue has resolved, people who have already started treatment on liraglutide will be able to continue to receive funded liraglutide.
Supply of liraglutide will be available from early-to-mid March 2023. From 1 March 2023, liraglutide will be listed on the Pharmaceutical Schedule to enable funded access to occur as soon as supply is available.
We will continue to update our website with any information regarding the supply of dulaglutide and we are continuing to work with its supplier, Eli Lilly, on stock availability.
Pharmaceutical Schedule funding rules on prescribing and dispensing of Class B controlled drugs
Manatū Hauora, the Ministry of Health, have asked Pharmac to delay making a decision on the proposed changes to the Schedule funding Rules for Class B controlled drugs.
What this means:
Although the legislative changes for Class B controlled drugs came into effect on 22 December 2022, the Schedule Rules on prescribing and dispensing of Class B controlled drugs have not changed. This means a quantity sufficient to provide treatment for a period of up to 1 month in total will be subsidised.
Further information can be found on our website: Pharmaceutical Schedule Rules on prescribing and dispensing of Class B controlled drugs - Pharmac | New Zealand Government
Iloprost: Clarification
Any brand of nebuliser that has been used with the previously funded brand of inhaled iloprost (Ventavis) can be used with the newly listed brand of inhaled iloprost, Vebulis.
Vebulis and Ventavis have the same Mass Median Aerodynamic Diameter (MMAD) range requirements for the nebuliser being used. This means people can use any nebulisers that were suitable to use with the original product, Ventavis, and there is no need to change nebuliser for the new brand of iloprost.
The Vebulis Medsafe datasheet specified the Halolite branded nebuliser because this was the machine used to test the nebulising quality of the solution. It is not intended to suggest that the Halolite nebuliser is the only nebuliser to use with Vebulis.
Further information is available on the Pharmac website
Atomoxetine – Strattera brand: Discontinuation
Eli Lilly is discontinuing all strengths of their Strattera brand of atomoxetine. People can still access atomoxetine in all the same strengths. The Apo-Atomoxetine brand is already listed and remains available. This discontinuation is a global decision made by Eli Lilly.
Key dates:
April 2023 – Strattera brand depleted.
1 November 2023 – Strattera brand will be de-listed from the Pharmaceutical Schedule.
Further information is available on the Pharmac website
Brand change: Paracetamol oral liquid 120 mg per 5 ml
The funded brand of paracetamol oral liquid 120 mg per 5 ml is changing to Paracetamol (Ethics). There are currently two funded brands of the lower strength paracetamol oral liquid, Paracare and Avallon. Avallon was funded to ensure continued availability of a low strength paracetamol oral liquid over the transition period.
Key information for Paracetamol (Ethics) 120 mg per 5 ml:
o Listed from 1 January 2023
o 200 ml plastic bottles with a child-resistant cap
o Colour-free
o Strawberry-vanilla flavour
o Alcohol and sugar free
Similarities with other liquid analgesics:
The currently funded higher strength paracetamol oral liquid (Pamol 250 mg per 5 ml), and ibuprofen liquid are also colour free. Therefore, when prescribing and dispensing, this similarity may need to be specifically highlighted to patients, whānau or caregivers
Schedule restrictions
The dispensing restrictions in place since 1 June 2022 to help manage the current stock levels will continue to apply to Paracetamol (Ethics) over the transition period, and will be reviewed at a later date.
Key dates:
1 January 2023: Paracetamol (Ethics) 120 mg per 5 ml listed
1 June 2023: Paracare 120 mg per 5 ml delisted TBC: Avallon 120 mg per 5 ml delist date
Pregabalin Cap 150 mg: Alternative brand listed
Aspen, the supplier of Pregabalin Pfizer, has advised of a supply issue impacting its brand of pregabalin 150 mg. From 20 January 2023, Milpharm pregabalin 150 mg capsules will be funded.
We have previously communicated about a supply issue with the 25 mg and 75 mg strengths of the pregabalin, and subsequently listed the Milpharm brand of pregabalin 25 mg and 75 mg in November 2022.
This issue is due to manufacturer-level issues and is exacerbated by some freight challenges.
Milpharm pregabalin is not currently approved by Medsafe for use in New Zealand, meaning they will need to be prescribed and supplied under Section 29 of the Medicines Act 1981. We apologise for any inconvenience this causes. In this case, it was the only way to ensure people could continue to access pregabalin 150 mg.
Further information is available on the Pharmac website
Calamine cream: Supply issue
The supplier has of calamine cream has put a hold on stock due to a regulatory issue with Medsafe. The supplier will not be supplying more funded calamine cream, there is no issue with the stock currently in the market.
Further information is available on the Pharmac website
Oestradiol (Estradot) patches: Supply issue update
There have been several disruptions to supply of the Oestradiol (branded as Estradot) patches since August 2020.
Availability of oestradiol patches as at 19 January 2022:
We understand that stocks in pharmacies and wholesalers may differ from what's shown here. This is the advice that the supplier has given to Pharmac.
25 mcg
• Estradot stock available at the supplier (pharmacode 2358840).
• Estraderm MX is out of stock (pharmacode 2645475).
50 mcg
• Estradot stock available at the supplier(pharmacode 2358867).
• Limited stock of Estradiol TDP Mylan (pharmacode 2601591) is in the supply chain.
75 mcg
• Limited stock of Estradot is available, further stock expected early February 2023 (pharmacode 2514346).
• Estradiol TDP Mylan (pharmacode 2605317) is available.
100 mcg
• Estradot stock available (pharmacode 2358883).
The alternative brands listed are not Medsafe-approved, as such they need to be prescribed and dispensed in line with Section 29 of the Medicines Act
For more information, please see the Pharmac website
Nutricia foods products: Supply issue affecting multiple products
Nutricia continues to manage stock distribution to supply the market as consistently as possible. We have updated the stock situation as it stands on 20 December 2022. Please continue to order stock without stockpiling to ensure equitable access for all New Zealanders while buffer stocks are built up.
Please do not make prescriptions brand and/or flavour specific. This will allow flexibility for pharmacists when dispensing. If you need advice about alternative products available from Nutricia, please contact your Nutricia Representative.
Check the Pharmac website regularly for updates on products.
COVID-19: Information for prescribers
Current Access Criteria for antivirals
Check the Pharmac website to view the COVID-19 access criteria. Always check the criteria before prescribing as updates may have been made.
Pharmac website – COVID-19 oral antivirals: Access Criteria
You can read all about the available, and soon to be available, COVID-19 treatments on our website.
Aotearoa's COVID-19 treatment portfolio
COVID-19 antiviral Access Criteria assessment tool
Use the online tool to help identify who’s eligible for funded COVID-19 antiviral treatments.
Access Criteria Assessment Tool
Managing supply of other medications
Please prescribe normally and encourage patients not to stockpile medicines.
Pharmac, pharmacies and suppliers are working closely to maintain medicines supply, and to minimise disruption and fairly distribute any medicines in short supply.
More information about Pharmac’s response to COVID-19 is available on the Pharmac website.
We want you! Expressions of Interest for Pharmac’s Advisory Committees
Pharmac is looking for new members for our Advisory Committees. Do you work in primary care and bring a commitment to and understanding of te Tiriti in healthcare? We are particularly seeking to appoint General Practitioners to a number of our Advisory Committees to provide input from the primary care perspective.
Pharmac’s Advisory Committees provide us with specialist knowledge and expertise within specific clinical areas, such as diabetes, cancer, and mental health. Advisory Committees usually meet once a year, but maybe more or less frequently. You can find more information about Advisory Committees roles and responsibilities on the Pharmac website.
If you are interested in being involved in Pharmac’s clinical advice network, please send an email to advisorycommittees@pharmac.govt.nz letting us know your specific clinical area(s) of interest.
