Metoprolol succinate sole supply

Medicines

Consultation Closed

We propose changes to the funded brand of metoprolol succinate long-acting tablets listed in the Pharmaceutical Schedule.

What we’re proposing

This includes awarding Sole Supply in both the community and hospital settings to AstraZeneca’s Betaloc CR(external link) brand of metoprolol succinate long-acting tablets.

Consultation closes at 5 pm on Tuesday, 11 April 2017 and can be emailed to procurement@pharmac.govt.nz.

What would the effect be?

For patients

Patients may have to change brands of current metoprolol succinate long acting tablets. The pack size for all Betaloc CR presentations would be 30 tablets, this would be a change for some patients who currently receive a 90 tablet pack. More information would be available during the transition period from pharmacists and GPs and PHARMAC’s website.

For community pharmacies

Pharmacies could continue to dispense and claim for any listed brand of metoprolol succinate long-acting tablets until 28 February 2018 (see timeline below). After that the only brand that would be fully funded would be Betaloc CR.

For hospital pharmacies

Pharmacies could continue to purchase any brand of metoprolol succinate long-acting tablets until 28 February 2018. After that only 1% of total purchases of metoprolol succinate could be a brand other than Betaloc CR.

For prescribers

GPs, cardiologists and other prescribers should continue to prescribe metoprolol succinate long acting tablets, using generic chemical names, as they usually would.

For DHBs

A cost of approximately $140,000 per year to the Combined Pharmaceutical Budget.

Supply arrangements

To ensure that enough stock of all strengths would be available in the quantities the New Zealand market requires, we have negotiated the following:

From 1 July 2017:

  • AstraZeneca’s Betaloc CR 23.75 mg long-acting tablets would be listed in Section B of the Pharmaceutical Schedule with no restrictions.

From 1 October 2017:

  • AstraZeneca’s Betaloc CR 190 mg long-acting tablets would be listed in Section B of the Pharmaceutical Schedule with no restrictions.
  • The price and subsidy of AstraZeneca’s Betaloc CR 47.5 mg and 95 mg long-acting tablets, currently listed in Section B of the Pharmaceutical Schedule, would be reduced.
  • All four presentations of AstraZeneca’s Betaloc CR would be listed in Part II of Section H (Hospital Medicines List) of the Pharmaceutical Schedule with no restrictions.

From 1 March 2018:

  • Sole Supply Status and Hospital Supply Status, with a 1% DV Limit for hospitals, for metoprolol succinate would be applied to AstraZeneca’s Betaloc CR brand until 30 June 2020.
  • All other brands of metoprolol succinate would be delisted from Section B and Part II of Section H (Hospital Medicines List) of the Pharmaceutical Schedule.

Who we think will be interested

People currently using metoprolol succinate, pharmacists, doctors in general practice, cardiologists, DHBs, and suppliers of metoprolol succinate.

About metoprolol succinate

Metoprolol succinate is a selective beta-blocker (it acts via the beta-1 receptor) indicated for patients with hypertension, angina, heart failure, cardiac arrhythmias (such as supraventricular tachycardia), myocardial infarction and several other minor indications.

Why we’re proposing this

PHARMAC previously issued a Request for Tender (RFT) for the supply of metoprolol succinate and metoprolol tartrate to DHB hospitals and/or community pharmacies, on 20 April 2015. Following evaluation and consultation, in July 2015, PHARMAC notified of its decision to award Sole Supply Status in the Community and Hospital Supply Status in DHB hospitals, to AFT Pharmaceuticals Limited (AFT) for its Metoprolol - AFT CR brand of metoprolol succinate long-acting tablets, from 1 July 2016 until 30 June 2018.

Ongoing disruption to the continuity of supply of Metoprolol - AFT CR has occurred over the past 6-12 months, causing significant inconvenience to patients, pharmacy and wholesalers. PHARMAC has been working with AFT and other suppliers to obtain sufficient stocks of metoprolol succinate to ensure continuity of supply.

PHARMAC currently lists and fully funds multiple brands of metoprolol succinate in Section B of the Pharmaceutical Schedule, without restriction.

To secure continuity of supply of metoprolol succinate in New Zealand, PHARMAC released a Request for Proposals (RFP) for the supply of metoprolol succinate to DHB hospitals and/or to community pharmacies on 16 December 2016. As a result of the RFP PHARMAC has entered into a provisional agreement with AstraZeneca Pty Limited and feedback to this consultation will help us decide if the agreement should be finalised.

Details about our proposal

We propose the following changes in Section B and Section H of the Pharmaceutical Schedule.

Section B proposed changes

From 1 July 2017:

  • Betaloc CR 23.75 mg would be listed at the price and subsidy as set out in the table below.

From 1 October 2017:

  • Betaloc CR 190 mg would be listed at the price and subsidy as set out in the table below.
  • Betaloc CR 47.5 mg and 95 mg would be reduced in price and subsidy as set out in the table below.
Chemical Presentation Brand Pack size Current price and subsidy
(ex-man., ex. GST)
Proposed price and subsidy
(ex-man., ex. GST)
Metoprolol succinate Tab long-acting
23.75 mg
Metoprolol-AFT CR 90 $2.39 $2.39
Myloc CR 30 $0.80 $0.80
Betaloc CR 30 N/A $1.03
Metoprolol succinate Tab long-acting
47.5 mg
Metoprolol-AFT CR 90 $3.48 $3.48
Betaloc CR 30 $7.50 $1.25
Metoprolol succinate Tab long-acting
95 mg
Metoprolol-AFT CR 90 $5.73 $5.73
Myloc CR 30 $1.91 $1.91
Betaloc CR 30 $7.50 $1.99
Metoprolol succinate Tab long-acting
190 mg
Metoprolol-AFT CR 90 $11.54 $11.54
Myloc CR 30 $3.85 $3.85
Betaloc CR 30 N/A $3.00

Section H (Hospital Medicines List) proposed changes

From 1 October 2017:

  • Betaloc CR CR 23.75 mg, 47.5 mg, 95 mg and 190 mg would be listed at the following prices:
Chemical Presentation Brand Pack size Current price and subsidy
(ex-man., ex. GST)
Proposed price and subsidy
(ex-man., ex. GST)
Metoprolol succinate Tab long-acting
23.75 mg
Metoprolol-AFT CR 90 $2.39 $2.39
Betaloc CR 30 N/A $1.03
Metoprolol succinate Tab long-acting
47.5 mg
Metoprolol-AFT CR 90 $3.48 $3.48
Betaloc CR 30 N/A $1.25
Metoprolol succinate Tab long-acting
95 mg
Metoprolol-AFT CR 90 $5.73 $5.73
Betaloc CR 30 N/A $1.99
Metoprolol succinate Tab long-acting
190 mg
Metoprolol-AFT CR 90 $11.54 $11.54
Betaloc CR 30 N/A $3.00

Proposed sole supply in Sections B & H

From 1 March 2018:

  • Betaloc CR 23.75 mg, 47.5 mg, 95 mg and 190 mg would be awarded Sole Supply Status and Hospital Supply Status for metoprolol succinate, with a 1% DV Limit for hospitals, to until 30 June 2020.

To provide your feedback to this proposal

Send us an email: procurement@pharmac.govt.nz  by 11 April 2017.

All feedback received before the closing date will be considered by PHARMAC’s Board (or its delegate) prior to making a decision on this proposal.

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.