2019/20 invitation to tender (medical)

Medicines

Tender Closed

PHARMAC is seeking feedback from medical groups, DHB hospital pharmacies and other interested parties on:

  • A proposal to tender certain pharmaceuticals for sole supply; and
  • The draft process and terms and conditions for the 2019/20 Invitation to Tender (2019/20 Tender).

PHARMAC welcomes all feedback on the draft 2019/20 Tender. Feedback received by the deadline may be considered by the Tender Medical Evaluation Subcommittee of PTAC and would be considered by the PHARMAC Board (or it’s Delegate, where applicable) prior to making a decision on this proposal.

All responses are due by 5pm, Friday 30 August 2019

Feedback should be provided by submitting an email or letter to the Tender Analysts:

Emailtender@pharmac.govt.nz

Letter:
Tender Analysts
PHARMAC
PO Box 10 254
Wellington 6143

DDI:    
Emma Clarke:  (04) 830 1987
Nerissa Ramlall:  (04) 830 3824

Feedback we receive is subject to the Official Information Act 1982 (OIA) and we will consider any request to have information withheld in accordance with our obligations under the OIA. Anyone providing feedback, whether on their own account or on behalf of an organisation, and whether in a personal or professional capacity, should be aware that the content of their feedback and their identity may need to be disclosed in response to an OIA request.

We are not able to treat any part of your feedback as confidential unless you specifically request that we do, and then only to the extent permissible under the OIA and other relevant laws and requirements. If you would like us to withhold any commercially sensitive, confidential proprietary, or personal information included in your submission, please clearly state this in your submission and identify the relevant sections of your submission that you would like it withheld. PHARMAC will give due consideration to any such request.

Details of the proposed 2019/20 Tender

In accordance with PHARMAC’s objective (to secure for eligible people in need of pharmaceuticals, the best health outcomes that are reasonably achievable from pharmaceutical treatment and from within the amount of funding provided), PHARMAC is consulting on a proposal to tender certain pharmaceuticals for Sole Subsidised Supply to community pharmacies and/or Hospital Supply Status for supply to DHB hospital pharmacies.

Attached to this letter (as Schedule Two) is a list of pharmaceuticals that we are considering tendering for Sole Subsidised Supply and/or Hospital Supply Status. Pharmaceuticals are sorted into therapeutic groups and then listed alphabetically in each group by chemical, form and strength. Each pharmaceutical has a ‘C’ and/or ‘H’ next to it to indicate whether it is proposed to be tendered for community and/or hospital supply.

In general, the proposed 2019/20 Tender process would be similar to the 2018/19 Tender. 

We are seeking feedback on the approach outlined in the following pages, in particular on:

  • The proposed tender process and timeline;
  • The actual or potential clinical implications of awarding Sole Subsidised Supply and/or Hospital Supply Status to the pharmaceuticals listed in Schedule Two, including the impact of a brand switch on patients and clinical staff; and
  • For hospital pharmaceuticals, your views on the appropriate Discretionary Variance (DV) Limit for each pharmaceutical, in the event you consider a 1% DV Limit to be clinically unacceptable.

Background

Since 1997 PHARMAC has been using the strategy of tendering pharmaceuticals for sole supply of pharmaceuticals for a fixed period of time. Regular tendering has proven to be an effective way to encourage competition among suppliers of pharmaceuticals. As in the past, the community and hospital tender processes would be run in unison, however, the pharmaceutical list for community and hospital supply may be different.

Key Aspects of Awarding a Tender for Community Pharmaceuticals:

  • For community pharmaceuticals, the tender winning brand would be the only subsidised brand for up to approximately 3 years. The Sole Subsidised Supply period would conclude on 30 June 2023 for all Tenders awarded from the 2019/20 Tender.
  • No other brand of the pharmaceutical would be listed (or subsidised) in Section B of the Pharmaceutical Schedule during the Sole Subsidised Supply period. 
  • Other brands could continue to be marketed, sold and dispensed during the Sole Subsidised Supply Status period, but they would not receive a subsidy. 
  • Any pharmaceutical that currently carries a manufacturer’s surcharge (that is, the additional patient charge above that of the patient co-payment) would become fully subsidised if a tender was awarded for that pharmaceutical.

Key Aspects of Awarding a Tender for DHB Hospital Pharmaceuticals:

  • For DHB hospital pharmaceuticals, the Hospital Supply Status brand would be the only brand DHB Hospitals could purchase (subject to any allowance for alternative brands under the agreed DV Limits) for up to approximately 3 years. The Hospital Supply Status period would conclude on 30 June 2023 for all tenders awarded from the 2019/20 Tender.
  • No other brand of the pharmaceutical would be listed in Section H of the Pharmaceutical Schedule during the Hospital Supply Status period.

Key Dates and Timeframes for the 2019/20 Tender:

The proposed timelines for the 2019/20 Tender are as follows:

Date

Event

2 August 2019

Consultation with suppliers, medical groups and interested parties on the proposed pharmaceutical list and draft 2019/20 Tender.

26 August 2019

Final date for receipt of Alternative Commercial Proposals (ACPs) to tendering by PHARMAC.

30 August 2019

Final date for all consultation to be received.

September 2019

PHARMAC considers feedback from consultation, negotiates with suppliers over any ACP proposals it considers would meet PHARMAC’s Factors for Consideration, and enters into provisional contracts with suppliers where appropriate.

September 2019

Meeting of the Tender Medical Evaluation Subcommittee of PTAC to consider clinical issues in relation to the proposed Tender list.

September/October 2019

Consultation and decisions on Alternative Commercial Proposals.

Early November 2019

Issuing of the 2019/20 Tender.

13 December 2019

Invitation to Tender closes.

From end of January 2020

Announcements on 2019/20 Tender decisions will commence.

Contractual obligations for suppliers

These are the draft terms and conditions which would form the terms of the 2019/20 Tender contract [PDF, 1.2 MB].

Proposed inclusion of the following provisions in the 2019/20 Invitation to Tender

Supplier Code of Conduct

The New Zealand Government is committed to sustainable and inclusive government procurement and the Supplier Code of Conduct outlines the Government’s expectations of suppliers in this respect.

PHARMAC expects suppliers to meet or exceed the minimum standards set out in the Supplier Code of Conduct and a provision has been included in Schedule 4 of the draft 2019/20 Tender as follows:

You shall comply with the New Zealand Government’s Supplier Code of Conduct(external link)."

Additional Special Terms

PHARMAC proposes to include additional special terms in Schedule 7 of the 2019/20 Tender for the supply of lacosamide as follows.

In respect of the identified Tender Items in Schedule 2 (lacosamide (current access) tab 50 mg, 100 mg, 150 mg and/or 200 mg or lacosamide (widened access) tab 50 mg, 100 mg, 150 mg and/or 200 mg) (“Lacosamide Tender Items”) and notwithstanding any other provision in this Agreement concerning the Sole Supply Status of the Lacosamide Tender Items, and without limiting any other actions that it may be necessary or appropriate for PHARMAC to take in response to patient safety concerns, PHARMAC may grant subsidised access, on a strictly limited basis, to an alternative brand of the relevant Lacosamide Tender Items during the Sole Supply Period to the extent that this is necessary to enable a limited number of patients to continue treatment following adverse effects or efficacy concerns in their treatment with the relevant Lacosamide Tender Items, in accordance with the following condition:

The maximum number of patients who are treated with the alternative brand of Lacosamide Tender Items shall not exceed 30 patients per calendar year, unless otherwise agreed, during the Sole Supply Period.

For the avoidance of doubt, this clause does not apply to the lacosamide (current access) inj 10 mg per ml, 20 ml Tender Item.

Unresolved Tender Bids

PHARMAC would review any unresolved Tender Bids from the 2017/18 Tender and the 2018/19 Tender prior to issuing the 2019/20 Tender, and may close the tender for some of these tender items, and reissue them as part of the 2019/20 Tender. The following Tender Bids remain unresolved, and may potentially be added to the 2019/20 Tender following consultation:

2017/18 Invitation to Tender

Chemical Name

Line Item

Amoxicillin clavulanate

Grans for oral liq amoxicillin 400 mg with potassium clavulanate 57 mg per 5 ml

Bumetanide

Tab 1 mg

Chlorhexidine gluconate

Mouthwash 0.2%

Colchicine

Tab 500 mcg

Diclofenac sodium

Eye drops 0.1%

Dorzolamide hydrochloride

Eye drops 2%

Ibuprofen

Tab long-acting 800 mg

Lidocaine [lignocaine] hydrochloride with adrenaline

Inj 2% with adrenaline 1:80,000, 2.2 ml dental cartridge

Methotrexate

Inj 7.5 mg prefilled syringe

Methotrexate

Inj 10 mg prefilled syringe

Methotrexate

Inj 15 mg prefilled syringe

Methotrexate

Inj 20 mg prefilled syringe

Methotrexate

Inj 25 mg prefilled syringe

Methotrexate

Inj 30 mg prefilled syringe

Midodrine

Tab 2.5 mg

Methotrexate

Inj 15 mg prefilled syringe

Methotrexate

Inj 20 mg prefilled syringe

Methotrexate

Inj 25 mg prefilled syringe

Methotrexate

Inj 30 mg prefilled syringe

Midodrine

Tab 2.5 mg

Midodrine

Tab 5 mg

Mitozantrone

Inj 2 mg per ml, 10 ml

Norethisterone

Tab 5 mg

Oxycodone hydrochloride

Oral liq 1 mg per ml

Tobramycin

Solution for inhalation 60 mg per ml, 5 ml

Zoledronic acid

Inj 4 mg per 100 ml

2018/19 Invitation to Tender

Chemical Name

Line Item

Aciclovir

Eye oint 3%

Adapalene

Crm 0.1%

Adapalene

Gel 0.1%

Adenosine

Inj 3 mg per ml, 10 ml

Amoxicillin clavulanate

Grans for oral liq amoxicillin 125 mg with potassium clavulanate 31.25 mg per 5 ml

Amoxicillin clavulanate

Grans for oral liq amoxicillin 250 mg with potassium clavulanate 62.5 mg per 5 ml

Amoxicillin clavulanate

Inj 500 mg with clavulanic acid 100 mg

Amoxicillin clavulanate

Inj 1000 mg with clavulanic acid 200 mg

Anagrelide hydrochloride

Cap 0.5 mg

Beclomethasone Dipropionate

Metered aqueous nasal spray, 50 mcg per dose

Beclomethasone Dipropionate

Metered aqueous nasal spray, 100 mcg per dose

Bendamustine

Inj 25 mg vial

Bendamustine

Inj 100 mg vial

Bortezomib

Inj 3.5 mg

Brinzolamide

Eye drops 1%

Bupivacaine hydrochloride with fentanyl

Inj 1.25mg with 2 mcg fentanyl per ml, 15 ml syringe

Bupivacaine hydrochloride with fentanyl

Inj 1.25mg with 2 mcg fentanyl per ml, 20 ml syringe

Bupivacaine hydrochloride with fentanyl

Inj 0.625 mg with fentanyl 2 mcg per ml, 200 ml bag

Bupivacaine hydrochloride with glucose

Inj 0.5% with glucose 8%, 4 ml ampoule

Calcium folinate

Inj 50 mg

Calcium folinate

Inj 1 g

Capecitabine

Tab 500 mg

Capecitabine

Tab 150 mg

Captopril

Oral liq 5 mg per ml

Cefalexin monohydrate

Cap 500 mg

Chloramphenicol

Eye oint 1%

Cyclizine lactate

Inj 50 mg per ml, 1 ml

Dapsone

Tab 100 mg

Dapsone

Tab 25 mg

Doxorubicin

Inj 50 mg

Enalapril

Tab 5 mg

Enalapril

Tab 10 mg

Enalapril

Tab 20 mg

Ethambutol hydrochloride

Tab 100 mg

Ethambutol hydrochloride

Tab 400 mg

Fentanyl

inj 10 mcg per ml, 50 ml prefilled syringe

Fentanyl

inj 10 mcg per ml, 10 ml syringe

Fentanyl

inj 20 mcg per ml, 100 ml bag

Fluorouracil sodium

Inj 50 mg per ml, 50 ml

Ganciclovir

Inj 500 mg

Hydrocortisone

Inj 50 mg per ml, 2 ml

Hydrocortisone

Crm 1% (pack size greater than or equal to 15 g and less than or equal to 100 g)

Hydrocortisone

Crm 1% (pack size greater than 100 g)

Iron sucrose

Inj 20 mg per ml, 5 ml ampoule

Levonorgestrel

0.75 mg - 1.5 mg

Levosimendan

Inj 2.5 mg per ml, 5 ml

Lidocaine [Ligocaine] hydrochloride with chlorhexidine

Gel 2% with 0.05% chlorhexidine, 10 ml urethral syringe

Loperamide hydrochloride [split market]

Tab 2 mg

Loratadine

Oral liq 1 mg per ml

Macrogol 3350 with ascorbic acid, potassium chloride and sodium chloride

Powder for oral soln 755.68 mg with ascorbic acid 85.16 mg, potassium chloride 10.55 mg, sodium chloride 37.33 mg and sodium sulphate 80.62 mg per g, 210 g sachet

Macrogol 3350 with ascorbic acid, potassium chloride and sodium chloride

Powder for oral soln 755.68 mg with ascorbic acid 85.16 mg, potassium chloride 10.55 mg, sodium chloride 37.33 mg and sodium sulphate 80.62 mg per g, 70 g sachet

Methylprednisolone aceponate

Crm 0.1%

Minocycline hydrochloride

Cap 100 mg

Minocycline hydrochloride

Tab 50 mg

Moxifloxacin

Inj 400 mg

Moxifloxacin

Tab 400 mg

Noradrenaline

Inj 0.06 mg per ml, 50 ml syringe

Noradrenaline

Inj 0.12 mg per ml, 100 ml bag

Noradrenaline

Inj 0.16 mg per ml, 50 ml syringe

Octreotide (somatostatin analogue)

LAR 10 mg pre-filled syringe

Octreotide (somatostatin analogue)

LAR 20 mg pre-filled syringe

Octreotide (somatostatin analogue)

LAR 30 mg pre-filled syringe

Olopatadine

Eye drops 0.1%

Ornidazole

Tab 500 mg

Pantoprazole

Inj 40 mg

Pegfilgrastim

Inj 6 mg per 0.6 ml prefilled syringe

Pemetrexed

Powder for infusion, 100 mg

Pemetrexed

Powder for infusion, 500 mg

Phenoxymethylpenicillin (Penicillin V)

Grans for oral liq 125 mg per 5 ml

Phenoxymethylpenicillin (Penicillin V)

Grans for oral liq 250 mg per 5 ml

Promethazine hydrochloride

Inj 25 mg per ml, 2 ml

Rocuronium bromide

Inj 10 mg per ml, 5 ml

Sodium chloride

Aqueous nasal spray isotonic

Sodium citrate

Oral liq 8.8% (300 mmol/l)

Sodium nitroprusside

Inj 50 mg

Spironolactone

Tab 25 mg

Spironolactone

Tab 100 mg

Sumatriptan

Inj 12 mg per ml, 0.5 ml

Tamsulosin [Current Access]

Tab 400 mcg

Tamsulosin [Widened Access]

Tab 400 mcg

Tenoxicam

Inj 20 mg

Teriparatide

Inj 250 mcg per ml

Tigecycline

Inj 50 mg

Tolcapone

Tab 100 mg

Urea

Crm 10%

Vitamin B complex (strong)

Tab

Zinc oxide

Powder

Should any unresolved Tender Bids be declined prior to the release of the 2019/20 Tender, PHARMAC would consider including those pharmaceuticals in the 2019/20 Tender. Currently unresolved Tender Bids have not been included in the draft pharmaceutical list set out in Schedule Two.

Distribution of Consultation Documents

Although this consultation letter has been widely distributed, should you consider that a particular person, group or agency should receive this letter and/or future tender documents, please feel free to contact PHARMAC or refer it on directly (note, all tender documents and consultations are also available from our website).  We also invite any person or group to contact PHARMAC should you wish to meet to discuss the proposals contained in this consultation letter.

Schedule Two: Possible pharmaceuticals for tender for sole supply [PDF, 1.2 MB]

Order of pharmaceuticals in this Schedule

Pharmaceuticals have been listed in groups according to the therapeutic group classification system used in the Pharmaceutical Schedule. Below is a list of these groups, and the corresponding page numbers for your ease of reference. Pharmaceuticals with indications that may apply to multiple therapeutic groups will only appear in one group.

Therapeutic Group

Page Numbers

Alimentary Tract and Metabolism

9 - 11

Blood and Blood Forming Organs

11

Cardiovascular System

12 – 16

Dermatologicals

16 – 19

Extemporaneously Compounded Preparations

20

Genito-Urinary System

20 – 21

Hormone Preparations – Systemic excluding contraceptives

21 - 23

Infections – Agents for Systemic Use

23 – 27

Musculoskeletal System

27

Nervous System

27 – 33

Oncology and Immunosuppressants

33 – 35

Respiratory System and Allergies

35 – 36

Sensory Organs

36 – 37

Various

37

Information provided for each pharmaceutical

For each pharmaceutical (as defined by chemical name, form and strength) we have provided the following information:

  • the current ex-manufacturer subsidy per unit of measure as at 1 July 2019;
  • the number of subsidised or partially subsidised units sold in the community in the year ending 30 June 2019;
  • an estimate of the annual community market value at current subsidies (estimated by multiplying the volume of units subsidised in the year ending 30 June 2019 by the relevant listed unit subsidy as at 1 July 2019); and
  • comments specifically relating to the Tender Item and/or its current listing on the Pharmaceutical Schedule.

Explanation of terms, symbols and abbreviations

Most terms and abbreviations used are self-explanatory: “tab” means tablet, “cap” means capsule, “liq” means liquid, “inj” means injection, “suppos” means suppository, “grans” mean granules and “OP” means original pack to be dispensed.

The following table explains the symbols used in the draft pharmaceutical list:

Symbol Explanation
Underlined Pharmaceutical line items where a sole supply contract is in force are underlined.  The price and subsidy for these pharmaceuticals are fixed until 30 June 2018 unless otherwise stated in the Comments column and a listing of a new brand could only occur after that date.
C To be tendered for Sole Subsidised Supply Status (community pharmaceuticals).
H To be tendered for Hospital Supply Status (DHB hospital pharmaceuticals).
PCT A reference in the Invitation to Tender to allow Pharmaceuticals Cancer Treatments to be listed in Section B of the Pharmaceutical Schedule as part of PHARMAC’s Pharmaceutical Cancer Treatments project.
+ PHARMAC has been advised of the existence of a patent.
* There is no fully funded product available for this line item (in relation to community supply).
@ Additional Stock Pharmaceuticals (ASP) means a Pharmaceutical, marked with an “@”, for which the supplier of the successful Tender Bid would be required to hold additional stock.
# A rebate currently exists.