Proposal to award sole supply of volatile anaesthetics in DHB hospitals

Hospital devices

Consultation Closed

PHARMAC is now seeking feedback on a proposal to:

  • award Hospital Supply Status to the Baxter brand of sevoflurane solution for inhalation 100%, 250 ml bottle, from 1 September 2016 until 30 June 2019 with a 1% DV limit.
  • award Hospital Supply Status to the Suprane brand of desflurane solution for inhalation 100%, 240 ml bottle, from 1 September 2016 until 30 June 2019 with a 1% DV limit.
  • award Hospital Supply Status to the Aerrane brand of isoflurane solution for inhalation 100%, 250 ml bottle, from 1 September 2016 until 30 June 2019 with a 1% DV limit.

This proposal would also result in the following:

  • a reduction in price across all three volatile anaesthetics currently used in DHB Hospitals; and
  • continued supply of loan vaporisers for the administration of sevoflurane, desflurane and isoflurane as required by DHB hospitals.

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Monday, 18 July 2016 to:

Andrew Park
Therapeutic Group Manager
PHARMAC
PO Box 10 254
Wellington 6143

Email: consult@pharmac.govt.nz
Fax:     04 460 4995

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. 

Details of the proposal

Sevoflurane, Suprane and Aerrane

  • Baxter’s Sevoflurane, Suprane and Aerrane would remain listed, in Part II of Section H of the Pharmaceutical Schedule at the following prices from 1 September 2016:

Pharmaceutical

Presentation

Brand

Pack size

Current price per pack (ex-man, ex GST)

Proposed price per pack (ex-man, ex GST)

Sevoflurane

Soln for inhalation 100%, 250 ml bottle

Baxter

6

$1,365.00*

$840.00

Desflurane

Soln for inhalation 100%, 240 ml bottle

Suprane

6

$1,414.50

$1,350.00

Isoflurane

Soln for inhalation 100%, 250 ml bottle

Aerrane

6

$1,173.00

$1,020.00

*Confidential rebate currently exists
  • Hospital Supply Status would apply to the above three pharmaceuticals from 1 September 2016 until 30 June 2019 (the HHS Period) with a 1% DV limit.
  • As indicated in the RFP document, the HHS Period for each pharmaceutical could be extended for an additional period of 12 or 24 months at PHARMACs discretion.
  • PHARMAC notes that usage of isoflurane is very low. PHARMAC considers that there is unlikely to be an ongoing clinical need for this pharmaceutical, however we would like feedback on this view. Under the terms of the provisional agreement, PHARMAC may, with a 12 month notice period and appropriate communication with affected parties, delist Aerrane from Section H of the Pharmaceutical Schedule.

Vaporisers

  • Baxter would continue to provide and support a sufficient number of vaporisers on loan to DHB Hospitals for the administration of sevoflurane, desflurane and isoflurane as required in each DHB Hospital. The range of supported vaporiser models available on loan and specified in the agreement has been expanded to include new models manufactured by Dräger, GE and Marquet.
  • Some DHBs currently own, or may wish to purchase their own vaporisers as part of anaesthetic machine upgrades. For DHBs that do not require loan vaporisers for a pharmaceutical, or require loan vaporisers for less than 25% of their needs for a pharmaceutical and can commit to purchase their remaining vaporiser requirement within an 18 month period, the following pharmaceutical prices would apply:

Chemical

Presentation

Brand

Pack size

Proposed price per pack (ex-man, ex GST)

Sevoflurane

Soln for inhalation 100%, 250 ml bottle

Baxter

6

$720.00

Desflurane

Soln for inhalation 100%, 240 ml bottle

Suprane

6

$1,230.00

Isoflurane

Soln for inhalation 100%, 250 ml bottle

Aerrane

6

$900.00

  • The above prices would not be recorded in Part II of Section H of the Pharmaceutical Schedule; they would be made available from Baxter directly to DHB Hospitals.

Background

Sevoflurane, desflurane and isoflurane are general anaesthetics used for induction and/or maintenance of general anaesthesia during surgical procedures.

In December 2015, PHARMAC invited proposals for the sole supply of volatile anaesthetics to DHB hospitals, with a 1% DV limit. This proposal is the result of this process.

Volatile anaesthetics require vaporiser devices in combination with anaesthetic machines to deliver the anaesthetic agent to patients. The majority of DHBs are currently using vaporisers provided on loan by the supplier of volatile anaesthetics. 

Several DHBs have already upgraded, or are in the process of upgrading, their anaesthetic machines due to a combination of technological advancement and existing machine age. New generation anaesthetic machines also require new models of vaporisers. PHARMAC is aware that some DHBs have purchased their own vaporisers when upgrading anaesthetic machines.

Over 20,000 bottles of volatile anaesthetics are used in DHB hospitals each year. In 2014/15 financial year this was made up of made up of approximately 13,000 x 250 ml bottles of sevoflurane, 7000 x 240 ml bottles of desflurane and 260 x 250 ml bottles of isoflurane.