Olanzapine depot injections: Supply issue
Pharmaco, the supplier, has advised Pharmac that there is a global supply issue affecting the olanzapine depot injection (Zyprexa Relprevv).
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Update 29 February 2024
Supply of the 405 mg olanzapine depot injections is significantly constrained. Together, Pharmac and Te Whatu Ora - Mental Health and Addiction Services have agreed on the following:
- Current supply will be evenly distributed over the next 3 weeks.
- Supply will be distributed around the country proportionally to current usage.
- Clinicians have been asked to identify who is most critically in need of the 405 mg strength injection and who can use a lower strength and who will need to move to a different chemical.
- Clinicians, pharmacies, wholesalers and the supplier will need to work together to ensure those with greatest clinical need can access this product.
We know that this is a difficult situation for everyone involved. We are trying to reduce the impact of this global supply issue on New Zealand. We appreciate the time, energy and resources committed by everyone involved.
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 of olanzapine depot injections is being 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.
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:
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.
A Schedule endorsement ‘for existing olanzapine depot injections patients only’ was applied from 1 December 2023. This means olanzapine depot injections will be restricted to people who are already receiving olanzapine depot injections.
Any new initiations of the olanzapine depot injection after 1 December will need to be applied for using Pharmac’s Named Patient Pharmaceutical Assessment (NPPA) process.
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.
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:
- Aripiprazole clinical guidance [PDF 61 KB]
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.
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)
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 email@example.com
Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.