Decision to fund glyceryl trinitrate ointment (Rectogesic) for chronic anal fissure and to apply reference pricing across brands of lignocaine 1% injections

Medicines

Decision

PHARMAC is pleased to announce the approval of an agreement with Care Pharmaceuticals to fund glyceryl trinitrate 0.2% ointment (Rectogesic) from 1 April 2013.

A decision has also been made to apply reference pricing across funded brands of lignocaine 1% injections from 1 September 2013.

These decisions relate to proposals outlined in a consultation letter dated 12 February 2013. In summary, the effect of the decisions is that:

  • Glyceryl trinitrate 0.2 % w/w ointment will be fully funded in the community from 1 April 2013, subject to Special Authority restrictions for patients with chronic anal fissure; and
  • The subsidy for the Xylocaine brand of lignocaine hydrochloride 1 % injection 5 ml and 20 ml will be reduced to match the subsidy for the Lidocaine-Claris brand of lignocaine hydrochloride 1 % injection 5 ml and 20 ml from 1 September 2013.

After considering feedback to consultation on the lignocaine injections proposal, a separate decision has also been made to increase the maximum number of lignocaine 1% injections available on a PSO from 5 to 25 from 1 July 2013.

Details of the decisions

Glyceryl trinitrate ointment 0.2% w/w (Rectogesic)

  • Rectogesic will be listed in Section B and in Part II of Section H of the Pharmaceutical Schedule from 1 April 2013 as follows (price and subsidy expressed ex-manufacturer, excluding GST):
    Chemical Presentation Brand Pack size Subsidy (and price)
    Glyceryl trinitrate Oint 0.2% Rectogesic 30 g OP $22.00
  • The following Special Authority criteria will apply to glyceryl trinitrate ointment in Section B from 1 April 2013:

Initial Application from any relevant practitioner. Approvals valid without further renewal unless notified where the patient has a chronic anal fissure that has persisted for longer than three weeks

  • No restriction will apply to the prescribing of glyceryl trinitrate ointment in DHB hospitals from 1 July 2013 (when PHARMAC assumes responsibility for hospital medicines).

Lignocaine 1% injections

  • The subsidies for the Xylocaine brand of lignocaine hydrochloride 1 % injection, 5 ml and 20 ml, will be reduced to match the subsidies for the Lidocaine-Claris brand of lignocaine hydrochloride 1 % injection, 5 ml and 20 ml, from 1 September 2013 as follows (prices and subsidies expressed ex-manufacturer, excluding GST) via the application of reference pricing:
    Chemical Presentation Brand name Pack size Current subsidy and price New subsidy (and price)
    Lignocaine hydrochloride Inj 1%, 5 ml Xylocaine 50 $35.00 $17.50 ($35.00)
    Lignocaine hydrochloride Inj 1%, 20 ml Xylocaine >5 $20.00 $12.00 ($20.00)
  • The listing relating to lignocaine hydrochloride inj 1%, 5 ml in Section B of the Pharmaceutical Schedule will be amended from 1 July 2013 as follows (addition in bold):

Lignocaine hydrochloride

Inj 1%, 5 mL – up to 25 inj available on PSO

Feedback received

We appreciate all of the feedback that we received and acknowledge the time people took to respond. All consultation responses received by 26 February 2013 were considered in their entirety in making a decision on the proposed changes. Most responses were supportive of the proposals. One responder considered that the pack size of the lignocaine hydrochloride inj 1%, 5 ml is too large and leaves pharmacies out of pocket when stock expires before being used  (the Xylocaine brand pack size is 50 and the Lidocaine-Claris brand to be listed on 1 July 2013 is 25). The responder requested that either the listing is made OP or the PSO quantity is increased to match the pack size. Following consideration of this response a decision was made to increase the maximum quantity available on a PSO from 5 to 25 on the date that the Lidocaine-Claris brand is listed (i.e. 1 July 2013).

More information

If you have any questions about this decision, you can call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.