Olanzapine depot injections: Supply issue

Reason for supply issue

Pharmaco, the supplier, has advised that there are limits on the amount of olanzapine depot injection that can be made. This is in part due to limited supply of the main active ingredient (API). Pharmaco is working with its global partners to ensure as much stock is allocated to Aotearoa New Zealand as possible

This means New Zealand is only getting the stock that is allotted to us. The duration of the supply issue is uncertain, however supply will likely be restricted for the rest of 2024. We are working closely with Pharmaco to understand when the supply of olanzapine depot injection will likely be resolved. 

Stock situation

Small shipments are continuing to arrive.

Stock of olanzapine depot injections continues to be allocated weekly from the supplier to wholesalers, and from wholesalers to their customers (pharmacies and hospitals). 

The allocation ensures that there is a consistent supply of olanzapine depot injection. It is based on current weekly demand.

This supply issue can change from week to week. Quantities and delivery dates are planned but final volumes and dates are subject to final production, air freight bookings, and arrival of the medicine into New Zealand.

Pharmac is meeting with Pharmaco weekly until the supply issue is resolved. If there are any changes to supply, this medicine notice will be updated.

Schedule listing for olanzapine injections(external link)

Unaffected products

All other presentations of olanzapine are unaffected by this supply issue and remain available. These are olanzapine 10 mg intramuscular injections (brand name Zyprexa, available in hospitals only), olanzapine tablets (brand name Zypine), and olanzapine wafers (brand name Zypine ODT).

Other funded antipsychotic depot injections are available:

Schedule listing of antipsychotic depot injections(external link)

Advice for prescribers

Pharmac’s Mental Health Advisory Committee has advised that, while oral formulations of olanzapine and other antipsychotic depot injections are available, individual clinicians will need to decide on the appropriate treatment course for their patients.

From 1 April 2024, access to funded olanzapine depot injections was restricted to people who are already receiving olanzapine depot injections.

Process for new initiations

Any new initiations of the olanzapine depot injection need to be applied for using Pharmac’s Named Patient Pharmaceutical Assessment (NPPA) process. 

The Health NZ Chief Clinical Officer – Mental Health and Addictions advises that you will need Clinical Director approval before submitting a NPPA application for olanzapine depot injection.

To make an application, you will need to:

• include confirmation of Clinical Director approval 
• indicate that an individual meets the intent of the olanzapine depot Special Authority criteria below  
• demonstrate that funded alternatives have been reasonably trialled or considered.

Special Authority criteria

• The patient has had an initial Special Authority approval for paliperidone depot injection or risperidone depot injection; or
• All of the following:
  • The patient has schizophrenia; and
  • The patient has difficulties adhering to treatment using oral atypical antipsychotic agents; and
  • The patient has been admitted to hospital or treated in respite care, or intensive outpatient or home-based treatment for 30 days or more in the last 12 months.

Named Patient Pharmaceutical Assessment (NPPA) process

Patient leaflet

We have developed a patient leaflet on advice from our mental health clinical advisors. It's available in PDF and Microsoft Word format. Note it is A5 size. 

Aripiprazole as a treatment option

On 12 December we announced our decision to fund the aripiprazole depot injection for those who meet the access criteria.

To assist with the use of aripiprazole depot injection, there is information for prescribers and consumers available:

• Abilify Maintena Datasheet(external link)
• Abilify Maintena Consumer Information(external link)

Aripiprazole depot injection not Medsafe-approved

The aripiprazole depot injection has been listed as a section 29 medicine because it is not yet Medsafe approved. The supplier is working to have an approved product as soon as possible.

Prescribing and supplying an unapproved medicine

Section 29 of the Medicines Act 1981 allows for medicines that are not Medsafe approved to be prescribed and supplied to people. The medicine must be prescribed by someone registered with the Medical Council of New Zealand – such as, a doctor. 

We know supplying a medicine under section 29 is not ideal. In this case, however, this will allow patients to be able to access an appropriate treatment. 

We apologise for any inconvenience this causes. 

Advice for prescribing under section 29 – BPAC website(external link) 

Prescriber and pharmacist requirements for section 29 medicines – Medsafe website (external link)

Medsafe’s section 29 Declaration / Notification Form [DOC](external link)

What patients need to know about unapproved medicines – Healthify website(external link)

Clinical advice about aripiprazole depot injection

Pharmac has received clinical advice on aripiprazole depot injection as an alternative treatment option.

The advice indicates that it would not be clinically appropriate for many people to switch to aripiprazole depot injection from the olanzapine depot injection. However, we understand that listing of aripiprazole depot injection would still reduce demand on olanzapine depot injection during the supply issue.

Advice for people using the depot injection olanzapine (Zyprexa Relprevv)

Pharmac and Pharmaco (the supplier) are working together to make sure supply of the olanzapine depot injection is maintained. Pharmac will continue to seek advice to lessen the impact of this supply issue.

You may need to change your treatment

The person who prescribes your medicine might need to change you to olanzapine tablets or a different medicine. They will work with you to manage any changes. No changes will be made without discussing them with you.

There are other funded medicines available, including the following depot injections:

• Risperidone (Risperdal Consta)
• Paliperidone (Invega Sustenna)
• Haloperidol (Haldol)
• Flupenthixol decanoate (Fluanxol)
• Zuclopenthixol decanoate (Clopixol)

Thank you

We know that changes to your medicines can be stressful.

Your mental health team and Pharmac are working to make sure you are disrupted as little as possible.

Talk to your psychiatrist or a health professional you trust if you have got any questions or concerns. They know you best.

Who to contact

If you have questions about this issue, email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.  

Sign up to our email list for regular emails about supply issues and more(external link)