Decision to retain first-line biologic access for adalimumab in dermatology and rheumatology indications

Medicines

Decision

PHARMAC is pleased to announce the approval of an agreement with AbbVie Limited to reduce the price and subsidy of adalimumab (Humira and HumiraPen) and to retain the same funded access criteria that currently apply to adalimumab.

This was the subject of a consultation letter dated 29 October 2015.

In summary, the effect of the decision is that:

  • the price and subsidy for all presentations of adalimumab (Humira and HumiraPen) currently listed on the Pharmaceutical Schedule will reduce from 1 January 2016.
  • the current Special Authority criteria and Hospital Restrictions for adalimumab (Humira and HumiraPen) will remain unchanged from 1 January 2016. There was a notification on 9 September 2015 of a previous decision by the PHARMAC Board to amend these restrictions from 1 January 2016. This decision reverses the previous decision.
  • new confidential rebates will apply to all presentations of adalimumab (Humira and HumiraPen) from 1 January 2016 which will further reduce the net cost of this treatment.
  • a new strength, injection 10 mg per 0.2 ml prefilled syringe, of adalimumab (Humira) will be listed on the Pharmaceutical Schedule from 1 January 2016 subject to the same Special Authority criteria and Hospital Restrictions as the other funded strengths of adalimumab.
  • adalimumab (Humira and HumiraPen) will have protection from subsidy reduction, delisting and Special Authority/Hospital Restriction amendment until 30 June 2019.

The decision will have no impact on the Special Authority criteria or Hospital Restrictions for etanercept, which will remain the same as they are now.

Details of the decision

  • From 1 January 2016 the prices and subsidies of adalimumab (Humira and HumiraPen) will be reduced in Section B and Part II of Section H of the Pharmaceutical Schedule as follows (all prices are ex-manufacturer and exclude GST):

Chemical and presentation

Brand

Pack size

Current Price/Subsidy

New Price/Subsidy

Adalimumab inj 20 mg per 0.4 ml prefilled syringe

Humira

2

$1,799.92

$1,599.96

Adalimumab inj 40 mg per 0.8 ml prefilled syringe

Humira

2

$1,799.92

$1,599.96

Adalimumab inj 20 mg per 0.4 ml prefilled pen

HumiraPen

2

$1,799.92

$1,599.96

  • A new lower strength of adalimumab, inj 10 mg per 0.2 ml prefilled syringe (Humira), will be listed in Section B and in Part II of Section H of the Pharmaceutical Schedule from 1 January 2016 at a price and subsidy of $1,599.96 per pack of 2.
  • New confidential rebates will apply to all strengths and presentations of Humira and HumiraPen listed on the Pharmaceutical Schedule from 1 January 2016, further reducing their net price to the funder and DHB hospitals.
  • All strengths and presentations of Humira and HumiraPen will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 January 2016 subject to the same Special Authority criteria and Hospital Restrictions that currently apply to them.
  • Humira and HumiraPen will have protection from subsidy reduction, delisting, and Special Authority/Hospital Restriction changes until 30 June 2019.

Feedback received

We appreciate all of the feedback that we received and acknowledge the time people took to respond. All consultation responses received by 12 November 2015 were considered in their entirety in making a decision on the proposed changes. All responses were supportive of the proposal.

More information

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.