Decision to fund betamethasone dipropionate with calcipotriol (Enstilar) foam spray for psoriasis

Medicines

Decision

We are pleased to announce the approval of a decision to fund a new topical psoriasis medicine, betamethasone dipropionate with calcipotriol foam spray (Enstilar) from 1 April 2020, through a listing agreement with Leo Pharma.

The decision also includes changes to pack sizes and prices for the following currently funded medicines supplied by Leo Pharma:

  • Calcipotriol ointment 50 mcg per g (Daivonex) – used topically for psoriasis – 120 g pack would replace 100 g pack from 1 July 2020
  • Sodium fusidate [fusidic acid] 250 mg tablets (Fucidin) – oral antibiotic used for the treatment of staphylococcal infections – 36 tablet pack would replace the 12 tablet pack from 1 December 2020
  • Hydrocortisone butyrate lipocream 0.1% (Locoid Lipocream) – used for skin conditions such as eczema, dermatitis and psoriasis – 100 g pack would remain listed and 30 g pack would be delisted.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 15 January 2020

No changes were made to this proposal as a result of consultation feedback.

Who we think will be most interested

  • People who have psoriasis and their whānau
  • Dermatologists and general practitioners
  • Other prescribers of medicines in the decision
  • Community and hospital pharmacies.

Details about this decision

Betamethasone dipropionate with calcipotriol foam spray (Enstilar)

From 1 April 2020, betamethasone dipropionate with calcipotriol foam spray (Enstilar) will be listed without restrictions in both Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical

Formulation

Brand

Pack size

Price and subsidy

Betamethasone dipropionate with calcipotriol

Foam spray 500 mcg with calcipotriol 50 mcg per g

Enstilar

60 g OP

$59.95

A confidential rebate will apply to Enstilar that would reduce the net price to the Funder.

Enstilar will have protection from delisting and subsidy reduction until 31 December 2022. This protection does not preclude other brands of betamethasone dipropionate with calcipotriol from being listed by PHARMAC during this period.

Calcipotriol ointment 50 mcg per g (Daivonex)

From 1 July 2020, a new 120 g pack size of calcipotriol ointment 50 mcg per g (Daivonex) will be listed without restrictions in both Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical

Formulation

Brand

Pack size

Price and subsidy

Calcipotriol

Oint 50 mcg per g

Daivonex

120 g OP

$40.00

Daivonex will have protection from delisting and subsidy reduction until 31 December 2022. This protection does not preclude other brands of calcipotriol from being listed by PHARMAC during this period.

The 120 g pack will replace the 100 g pack as the supplier is discontinuing the 100 g pack size. This means that the 100 g pack outlined below will be delisted at a future date to be confirmed, but not before 1 January 2021, to allow sufficient time for stock of the 100 g pack to be depleted by wholesalers and pharmacies.

Chemical

Formulation

Brand

Pack size

Price and subsidy

Calcipotriol

Oint 50 mcg per g

Daivonex

100 g OP

$45.00

Sodium fusidate [fusidic acid] 250 mg tablets (Fucidin)

Sodium fusidate [fusidic acid] 250 mg tablets (Fucidin) will remain listed in both Section B and Part II of Section H of the Pharmaceutical Schedule subject to the following existing funding endorsement restriction:

Prescriptions must be written by, or on the recommendation of, an infectious disease physician or clinical microbiologist.

From 1 December 2020, a 36 tablet pack will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule, at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical

Formulation

Brand

Pack size

Price and subsidy

Sodium fusidate [fusidic acid]

Tab 250 mg

Fucidin

36

$67.85

From 1 December 2020, the wastage rule will be applied to the 36 tablet pack in Section B of the Pharmaceutical Schedule.

Fucidin will have protection from delisting and subsidy reduction until 31 December 2022. This protection does not preclude other brands of sodium fusidate [fusidic acid] from being listed by PHARMAC during this period.

The 12 tablet pack of Fucidin outlined below will be discontinued by the supplier and will be delisted at a future date to be confirmed, but not before 1 December 2021, to allow sufficient time for stock of the 12 tablet pack to be depleted by wholesalers and pharmacies.

Chemical

Formulation

Brand

Pack size

Price and subsidy

Sodium fusidate [fusidic acid]

Tab 250 mg

Fucidin

12

$34.50

Hydrocortisone butyrate lipocream 0.1% (Locoid Lipocream)

Hydrocortisone butyrate (Locoid Lipocream) lipocream 0.1%, 100 g OP will remain listed in both Section B and Part II of Section H of the Pharmaceutical Schedule at the current price and subsidy below (ex-manufacturer, excluding GST):

Chemical

Formulation

Brand

Pack size

Current price and subsidy

Hydrocortisone butyrate

Lipocream 0.1%

Locoid Lipocream

100 g OP

$6.85

From 1 April 2020, a confidential rebate will apply to Locoid Lipocream 100 g that will reduce the net price to the Funder.

Locoid Lipocream will have protection from delisting and subsidy reduction until 31 December 2022. This protection does not preclude other brands of hydrocortisone butyrate from being listed by PHARMAC during this period.

The 30 g pack of Locoid Lipocream outlined below will be discontinued by the supplier and delisted at a future date to be confirmed but not before 1 October 2020 to allow sufficient time for stock of the 30 g pack to be depleted by wholesalers and pharmacies.

Chemical

Formulation

Brand

Pack size

Current price and subsidy

Hydrocortisone butyrate

Lipocream 0.1%

Locoid Lipocream

30 g OP

$3.42

Our response to what you told us

We appreciate the time people took to respond to this consultation.

All consultation responses received by 3 February 2020 were considered in their entirety in making the decision to accept the proposal. All responses were supportive of the proposal.

There was a concern raised in relation to the pack size changes for topical steroids, as a responder considered that a variety of pack sizes is useful if the prescriber needs to restrict quantities dispensed. We note that the supplier is discontinuing the smaller pack size of hydrocortisone butyrate lipocream 1% (Locoid Lipocream) because most use is of the 100 gram pack. PHARMAC funds a range of potent topical steroids in various pack sizes.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.