Pharmac Update: Primary Care Prescribers for the week ending 04 November 2022
Pharmac seeks feedback on the funding of paediatric cancer medicines
Pharmac is seeking feedback on rule 8.1b of the Pharmaceutical Schedule a unique exception that means any medicine currently used to treat cancer in a paediatric setting is automatically funded without a Pharmac assessment.
This review only relates to the funding of new medicines. All paediatric cancer medicines currently used will continue to be funded by Pharmac.
We have published a detailed consultation document that explores the specific issues we would like input on as part of this review.
For further information and to make a submission, please visit the Pharmac website
Paracetamol oral liquid brand change: Paracare and Paracare Double Strength
The funded brand of paracetamol oral liquid high and low strength is changing.
Paracetamol 250 mg per 5 ml
• previous brand: Paracare Double Strength (1000mL)
• new brand: Pamol (200mL), supplied by Aspen Pharma funded from 1 November 2022.
Schedule restrictions
The dispensing restrictions in place since 1 June 2022 to help manage the current stock levels will continue to apply to Pamol over the transition period, and will be reviewed at a later date. We will update our website with further details about this.
Paracetamol 120 mg per 5 ml (200mL)
• previous brand: Paracare
• interim brand: Avallon funded from 1 September 2022
• new brand: Ethics, supplied by Multichem NZ funded from 1 January 2023.
He Ako Hiringa have developed a resource with additional information for healthcare professionals which can be found on the He Ako Hiringa website.
Both strengths of paracetamol oral liquid, as well as the currently funded ibuprofen liquid, are colour free. Therefore, when prescribing and dispensing, this similarity may need to be specifically highlighted to patients, whānau or caregivers. Both new brands are Medsafe approved.
People can learn more about this brand change through Health Navigator NZ.
For more information please see Paracetamol oral liquid: Brand change Pharmac | New Zealand Government.
Supply issue: Dulaglutide (Trulicity)
Pharmac has been informed by the supplier of dulaglutide (Trulicity), Eli Lilly, that there are supply issues with the diabetes medicine due to unanticipated increases in global demand and an out of stock of another supplier’s GLP 1 receptor agonist. This may mean Aotearoa experiences constrained supply until mid 2023.
Eli Lilly has committed to maintaining supplies of Trulicity at levels that will support existing patients already on treatment in Aotearoa. They tell us that, while the supply situation remains dynamic, existing patients in Aotearoa should be able to fill their dulaglutide prescriptions without interruption.
To safeguard stock for people currently using dulaglutide, we are asking health professionals to strongly consider not starting new people on this medicine. Pharmac is actively exploring all options to minimise the impact on patients from this supply issue and we will continue to update patients and healthcare providers as further information comes to hand.
For further information please see Dulaglutide (Trulicity): Supply issue on the Pharmac website.
Supply issue: Pregabalin s29 alternative listed 1 November 2022
Aspen, who supply Pregabalin Pfizer, has advised that due to manufacturer level issues and freight challenges, its brand of pregabalin 25 mg and 75 mg capsules may be briefly out of stock towards the middle of November.
From 1 November 2022, an alternative brand of pregabalin 25 mg and 75 mg capsules, Milpharm, will be funded.
Milpharm pregabalin is not currently approved by Medsafe and will need to be prescribed and supplied under Section 29 of the Medicines Act While not approved in New Zealand, this brand is approved and used in the United Kingdom.
We are working closely with Aspen to understand when this supply issue will be resolved, and will provide any updates on the Medicines Notices page.
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 50 mg tablets.
Back orders are cleared, and some stock remains in the supply chain. The next shipment is due early November. 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.
Konsyl-D and the alternative we listed, Macro Organic Psyllium Husk, are out of stock. The next shipment of psyllium husk is due in New Zealand in early November. Resupply date for Konsyl D is December 2022. Senna (Senokot) is out of stock. We are advised that the next shipment will arrive in
New Zealand in early December 2022. Stocks of Micolette are low, with new section 29 stock 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
Morphine ampoule: Brand change
The funded brand of morphine sulphate ampoules is changing from DBL Morphine Sulphate to Medsurge as a result of our annual tender process. We expect stock of DBL Morphine Sulphate to begin running out some time in December 2022. The Medsurge brand has been listed in the Schedule from 1 October, and both brands will be funded until March 2023.
Packaging of the Medsurge brand will look different. Both brands of morphine ampoule use colour coding to differentiate between strengths, and the colour coding is not the same between brands. The Medsurge individual ampoules will also be colour coded, matching the corresponding packaging.
The Medsurge 15 mg per mL and 30 mg per mL ampoules have similar shades of brown colour coding on the packaging and individual ampoules. Attention is required to ensure the correct strength is chosen for administration.
He Ako Hiringa have developed an educational resource to support healthcare professionals with this brand change: Morphine ampoules | He Ako Hiringa
Further information is available on the Pharmac website.
COVID 19: Information for prescribers
Evusheld: Available to be administered in general practice
From 3 October 2022 Evusheld (tixagevimab with cilgavimab) is available for community supply and primary care administration to those who meet Pharmac’s access criteria. Evusheld is used for COVID 19 pre exposure prophylaxis.
Guidance on Evusheld and its use is available on the He Ako Hiringa website and Ministry of Health website.
Updated Access Criteria
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
Promethazine hydrochloride (Allersoothe) Oral liq 1 mg per ml
We've been alerted to a supply issue with Allersoothe. The supplier still has some product available. However, an out of stock is possible due to a delay in the release of the next batch. Some stock is expected to arrive via air freight by mid November 2022. Further supplies will be ready to ship by the end of November.
This issue only affects the oral liquid. The Allersoothe tablets are unaffected by this supply issue.
Further information is available on the Pharmac website.
Celecoxib (100 and 200 mg cap): Supply issue update
The funded brand of Celecoxib is changing due to supply issues with the current brand. Currently, there is a supply issue affecting both the Celecoxib Pfizer 100 mg and 200 mg capsules. Final shipment of Celecoxib Pfizer expected early December.
Further stock of the new brand, Celebrex, is expected in November.
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.
Approximately 40,000 45,000 New Zealanders continue to live with chronic hepatitis C even though an effective treatment called Maviret has been funded since February 2019.
Hep C can now be diagnosed with a quick and easy finger prick test.
Ministry of Health are looking for more GP practices to be part of the testing programme. Contact your local coordinator to learn more about taking part.
Hepatitis C regional coordinators
Region Co ordinator Email Phone
Northern Region: Leanne Kirton Leanne.Kirton@nra.health.nz 021 318 295
Te Manawa Taki (Midland) Region Jo de Lisle Jo.DeLisle@healthshare.co.nz 027 549 2122
Central Region Caitlin Robinson Caitlin.Robinson@tuora.org.nz 027 700 5945
South Island Region Rob Hallinan Rob.Hallinan@cdhb.health.nz 027 213 8104
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
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
Get involved with the test-and-treat programme to help eliminate hepatitis C
We want you!