Pharmac update

Pharmac Update: Primary Care Prescribers for the week ending 16 September 2022 Cancellation of existing Humira (adalimumab) Special Authority numbers from 1 October 2022 From 1 October 2022, Amgevita will be the main funded brand of adalimumab for all uses (current and new). From this date, all existing Humira Special Authority numbers will expire, and new Humira Special Authority criteria will come into place. If you have submitted a waiver for a patient to remain on Humira and it has been approved prior to 1 October, this will not be cancelled.

Post-1 October Humira Special Authority access criteria Repeat dispensings for Humira with an expired Special Authority will still be funded if the initial dispensing on that prescription occurred before 1 October.

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Identify patients using adalimumab and discuss the continuation of their treatment with Amgevita either when their Humira Special Authority is due for renewal, or before 1 October 2022 (whichever comes first)

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For patients who require ongoing funded access to Humira after 1 October, a new initial Special Authority must be completed

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For patients who have not yet trialled Amgevita, but their automatically issued initial Special Authority for Amgevita has expired, a waiver for an initial application can be completed

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Ensure you prescribe adalimumab by brand (either Amgevita or Humira)

Further information will be available on the Pharmac website. Resources to support you and your patients with this change can be found at amgevita.co.nz

Supply issue update: Docusate sodium with sennosides (Laxsol) tablets and other laxatives The Laxsol supply issue was caused by a lack some of the raw materials used to make the product.

This issue also affects Coloxyl.

Shipments are being released as they arrive. We're working closely with the supplier to understand when Laxsol supplies will return to normal. Both the supplier and Pharmac are aware of the critical nature of this product.

Other Laxatives: Supply issues We understand that Laxsol supply disruption is leading to knock-on stock shortages for other funded laxatives.

Supplies of docusate sodium (Coloxyl) 50 mg remain constrained. Konsyl-D and the alternative we listed, Macro Organic Psyllium Husk, are out of stock. Resupply of Macro Organic Psyllium Husk is expected mid-September, and Konsyl-D October. Senna (Senokot) is out of stock. Stocks of Micolette

are low, new s29 stock is arriving soon. It will take time for stock to make its way through the supply chain to individual pharmacies once it arrives in the country.

We are working closely with all suppliers concerned to speed up freight to Aotearoa where possible, or to find alternative products.

Our expert clinical advisors suggest that there may be suitable alternatives, including macrogol-3350 sachets (Molaxole) and lactulose. Where appropriate, please consider using alternatives while this supply issue persists.

Further information is available on the Pharmac website.

Testosterone cipionate (Depo-Testosterone) injections: Supply issue Pharmac has secured a section 29 alternative brand of testosterone inj 100 mg per ml. The alternative will be listed on the Pharmaceutical Schedule from 9 September 2022. We are working with the supplier to confirm stock availability dates and will update the Pharmac website as further details become available.

Paracetamol oral liquid: Brand change From 1 September 2022, we have listed a temporary new brand of paracetamol liquid.

Supplies of Paracare (120 mg per 5 ml) are likely to run out during September. Supplies of Paracare Double Strength (250 mg per 5 ml) are likely to begin running out during October. To cover the gap before the new contracted brands can enter the market, we’ve listed the Avallon brand.

A temporary supply of a paracetamol oral liquid 120 mg per 5 ml has been organised, and a 240 mg per 5 ml strength has been listed in case it is needed in a couple of months as a contingency option.

Due to increased global demand, we were not able to source a 250 mg per 5 ml product, despite our strong preference for this.

Key differences with the Avallon brand •

Flavour is strawberry-vanilla for both strengths (previously strawberry and orange)

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Colour is off-white for both strengths (previously pink and orange)

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A smaller pack size, 200 ml glass bottles with a child-resistant cap

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If the Avallon 240 mg per 5 ml paracetamol oral liquid is required, this would mean a temporary strength change to a 240 mg per 5 ml presentation. We are working on ways to support the health care sector if this is needed.

The 120 mg product has Medsafe approval. Restrictions will continue for these temporary brands to ensure everyone who needs paracetamol liquid can access this medicine. We apologise for any inconvenience this may cause.

We will communicate further with the sector if the 240 mg product is required.

Further information is available on the Pharmac website.

COVID-19: Information for prescribers Updated Access Criteria Pharmac has widened access to the three antiviral treatments it funds for treating early COVID-19: nirmatrelvir with ritonavir (Paxlovid), molnupiravir (Lagevrio) and remdesivir, an infusion treatment (Veklury). 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.

New Zealand'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.

Pregabalin 25 mg capsules: supply issue There is a supply issue affecting the pregabalin 25 mg capsules. The supplier has advised that due to delays at the manufacturing site, exacerbated by some freight challenges in New Zealand, they may have a brief out of stock of pregabalin 25 mg capsules.

There is still stock in the supply chain with wholesalers. Aspen expects the next delivery to arrive in early October 2022. It will take time for the shipment to clear quality assurance and make its way through the supply chain to pharmacies.

Further information is available on the Pharmac website.

Ondansetron dispersible tablets 4 mg and 8 mg: Supply issue Due to freight delays, there may be a brief out of stock of ondansetron 4 mg and 8 mg dispersible tablets from mid-September 2022. Some stock may remain in the supply chain. They expect their next shipment to arrive in late September 2022.

To help make the existing stock last longer, we have put these tablets on monthly dispensing from 1 October 2022. The film-coated tablets are not affected by this issue (Onrex brand).

Further information is available on the Pharmac website.

Lamotrigine brand information The bespoke exceptional circumstances process for alternative brands of lamotrigine closed on 1 September 2022. Current approvals will be extended indefinitely.

Further information is available on the Pharmac website.

Bromocriptine: Access change and discontinuation From 1 September 2022, bromocriptine is not funded. We previously limited access to people who were taking bromocriptine before 1 March 2021.

Further information is available on the Pharmac website.

Lisinopril 5, 10 and 20 mg capsules: New look Teva is changing their brand from Ethics Lisinopril to Teva Lisinopril. The capsules themselves remain unchanged. It is just different boxes and blister packs.

The new packaging comes with a different pharmacodes. We anticipate listing the new pharmacodes for all 3 strengths from 1 October 2022.

Further information is available on the Pharmac website.

Nutricia foods products: Supply issue affecting multiple products Most of the supply issues affecting Nutricia special foods products have been resolved. There will however continue to be supply issues for some products throughout 2022.

Check the Pharmac website regularly for updates on products.

Keep up to date on supply issues and brand changes Pharmac regularly updates its website with information about changes in brand and any current or emerging supply issues.

You can find information about current issues 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.