2018/19 invitation to tender (medical)
PHARMAC is seeking feedback from medical groups, DHB hospital pharmacies and other interested parties on:
- A proposal to tender certain pharmaceuticals for sole supply; and
- The draft process and terms and conditions for the 2018/19 Invitation to Tender (2018/19 Tender).
PHARMAC welcomes all feedback on the 2018/19 Tender. Feedback received by the deadline may be considered by the Tender Medical Evaluation Subcommittee of PTAC, and would be considered by the PHARMAC Board (or its Delegate) prior to making a decision on this proposal.
All responses are due by 5pm, Thursday 6 September 2018
Feedback should be provided by submitting an email or letter to the Tender Analysts:
Email: tender@pharmac.govt.nz
Letter:
Tender Analyst
PHARMAC
PO Box 10254
Wellington 6143
DDI:
Heather Milne: (04) 830 2658
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 proposed 2018/19 Tender
In accordance with PHARMAC’s objective (to secure, for eligible people in need of pharmaceuticals, the best health outcomes that are reasonably achievable from pharmaceutical treatment and from within the amount of funding provided), PHARMAC is consulting on a proposal to tender certain pharmaceuticals for Sole Supply Status to community pharmacies and/or Hospital Supply Status for supply to DHB hospital pharmacies.
Attached to this letter (as Schedule Two) is a list of pharmaceuticals that we are considering tendering for Sole Subsidised Supply and/or Hospital Supply Status. Pharmaceuticals are sorted into therapeutic groups and then listed alphabetically in each group by chemical, form and strength. Each pharmaceutical has a ‘C’ and/or ‘H’ next to it to indicate whether it is proposed to be tendered for community and/or hospital supply.
In general, the proposed 2018/19 Tender process would be similar to the 2017/18 Tender. A copy of the draft 2018/19 Invitation to Tender is available on our website: www.pharmac.health.nz, or by contacting PHARMAC.
We are seeking feedback on the approach outlined in the following pages, in particular on:
- The proposed tender process and timeline;
- The actual or potential clinical implications of awarding Sole Subsidised Supply and/or Hospital Supply Status to the pharmaceuticals listed in Schedule Two, including the impact of a brand switch on patients and clinical staff; and
- For hospital pharmaceuticals, your views on the appropriate Discretionary Variance (DV) Limit for each pharmaceutical, in the event you consider a 1% DV Limit to be clinically unacceptable.
Background
Since 1997 PHARMAC has been using the strategy of tendering pharmaceuticals for sole supply of pharmaceuticals for a fixed period of time. Regular tendering has proven to be an effective way to encourage competition among suppliers of pharmaceuticals. As in the past, the community and hospital tender processes would be run in unison, however, the pharmaceutical list for community and hospital supply may be different.
Key Aspects of Awarding a Tender for Community Pharmaceuticals
- For community pharmaceuticals, the tender winning brand would be the only subsidised brand for up to approximately 3 years. The Sole Subsidised Supply period would conclude on 30 June 2022 for all Tenders awarded from the 2018/19 Tender.
- No other brand of the pharmaceutical would be listed (or subsidised) in Section B of the Pharmaceutical Schedule during the Sole Subsidised Supply period.
- Other brands could continue to be marketed, sold and dispensed during the Sole Subsidised Supply Status period, but they would not receive a subsidy.
- Any pharmaceutical that currently carries a manufacturer’s surcharge (that is, the additional patient charge above that of the patient co-payment) would become fully subsidised if a tender was awarded for that pharmaceutical.
Key Aspects of Awarding a Tender for DHB Hospital Pharmaceuticals
- For DHB hospital pharmaceuticals, the Hospital Supply Status brand would be the only brand DHB Hospitals could purchase (subject to any allowance for alternative brands under the agreed DV Limits) for up to approximately 3 years. The Hospital Supply Status period would conclude on 30 June 2022 for all tenders awarded from the 2018/19 Tender.
- No other brand of the pharmaceutical would be listed in Section H of the Pharmaceutical Schedule during the Hospital Supply Status period.
Key Dates and Timeframes for the 2018/19 Tender
The proposed timelines for the 2018/19 Tender are as follows:
Date |
Event |
3 August 2018 |
Consultation with suppliers, medical groups and interested parties on the proposed pharmaceutical list and draft 2018/19 Tender. |
27 August 2018 |
Final date for receipt of Alternative Commercial Proposals (ACPs) to tendering by PHARMAC. |
6 September 2018 |
Final date for all consultation to be received. |
September 2018 |
PHARMAC considers feedback from consultation, negotiates with suppliers over any ACP proposals it considers would meet PHARMAC’s Factors for Consideration, and enters into provisional contracts with suppliers where appropriate. |
September 2018 |
Meeting of the Tender Medical Evaluation Subcommittee of PTAC to consider clinical issues in relation to the proposed Tender list. |
September/October 2018 |
Consultation and decisions on Alternative Commercial Proposals. |
Early November 2018 |
Issuing of the 2018/19 Tender. |
14 December 2018 |
Invitation to Tender closes. |
From end of January 2019 |
Decisions on the first Tender winners announced. |
Contractual obligations for suppliers
Proposed inclusion of the following provisions in the 2018/19 Invitation to Tender
Proposal to modify the transition between funded brands in the Schedule
On 13 July 2018 PHARMAC released a consultation to seek feedback on the proposal to modify the transition between funded brands in the Schedule. The proposal is to remove the reference pricing period during brand changes and would result in the alignment of transition arrangements in the community and DHB hospitals by increasing the transition time in DHB hospitals to five months.
The consultation is available on our website (www.pharmac.govt.nz/news/consultation-2018-07-13-brand-transition) and closes at 5 pm on Friday, 10 August 2018. Feedback can be emailed to consult@pharmac.govt.nz.
If the proposal was to be accepted it would result in changes to Schedule Three and Five in the 2018/19 Tender. Briefly it would result in the Second Transition Period being removed from the 2018/19 Tender which would result in the following changes;
- the Sole Supply Period would be modified to state that it relates to the period beginning on the day after the expiry of the First Transition Period and ending on 30 June 2022.
- the transition period in relation to community supply would be changed from three transition periods to two transition periods, this is the same as the current transition period for hospital supply.
- the subsidy payable for all other brands of the pharmaceutical will remain until the Sole Supply Period begins, this contrasts with the current process which decreases the subsidy to the price of the incoming brand on the first day of the Second Transition Period until the first day of the Sole Supply Period.
Additional Special Terms
PHARMAC proposes to include a new schedule in the 2018/19 Tender relating to special terms for the supply of intra-uterine copper device as follows.
You shall provide the following information when submitting a Tender Bid for the Pharmaceutical intra-uterine copper device (“IUCD Tender Item”):
- the size of the IUCD Tender Item, including length and width measurements as well as the diameter of the inserter;
- a description of the material the inserter is made of;
- the duration of the therapeutic effect of the IUCD Tender Item; and
- the metals which are contained in the IUCD Tender Item.
You shall provide the following Resources at no cost for the IUCD Tender Item:
- the provision of education, training and support to healthcare professionals in respect of the use of the IUCD Tender Item.
For the purposes of this clause “Resources” shall include but not be limited to the:
- provision of training materials (DVDs, pamphlets, leaflets, brochures) to healthcare professionals;
- provision of an information sheet explaining the differences between the current brand of intra-uterine device and your IUCD Tender Item; and
- provision of presentations and/or demonstrations on the use of your IUCD Tender Item to patients and/or healthcare professionals.
Unresolved Tender Bids
PHARMAC would review any unresolved Tender Bids from the 2016/17 Tender and the 2017/18 Tender prior to issuing the 2018/19 Tender, and may close the tender for some of these items, and reissue them as part of the 2018/19 tender. The following Tender Bids remain unresolved, and may potentially be added to the 2018/19 Tender following consultation:
2016/17 Invitation to Tender
Chemical Name |
Line Item |
Amantadine hydrochloride |
Cap 100 mg |
Benzylpenicillin sodium [Penicillin G] |
Inj 3 g |
Bupivacaine hydrochloride with adrenaline |
Inj 2.5 mg per ml with adrenaline 1:400,000, 20 ml sterile pack |
Bupivacaine hydrochloride with adrenaline |
Inj 5 mg per ml with adrenaline 1:200,000, 20 ml sterile pack |
Buprenorphine with naloxone |
Tab sublingual 2 mg with naloxone 0.5 mg |
Buprenorphine with naloxone |
Tab sublingual 8 mg with naloxone 2 mg |
Cetirizine hydrochloride |
Oral liq 1 mg per ml |
Cetrimide |
Solution 20% (pack size of 100 ml or less) |
Chlorhexidine with ethanol |
Soln 2% with ethanol 70%, non-staining (pink) 100 ml |
Chlorhexidine with ethanol |
Soln 2% with ethanol 70%, non-staining pink (pack size less than 50 ml) |
Chlorhexidine with ethanol |
Soln 2% with ethanol 70%, staining (red) 100 ml |
Chlorhexidine with ethanol |
Soln 2% with ethanol 70%, staining red (pack size less than 50 ml) |
Ephedrine |
Inj 3 mg per ml, 10 ml prefilled syringe |
Hyoscine N-butylbromide |
Inj 20 mg, 1 ml |
Iodine supplement |
Tab 150 mcg elemental |
Mebeverine hydrochloride |
Tab 135 mg |
Mercaptopurine |
Tab 50 mg |
Metoclopramide hydrochloride |
Inj 5 mg per ml, 2 ml ampoule |
Tenoxicam |
Inj 20 mg |
Trimethoprim with sulphamethoxazole [Co-trimoxazole] |
Inj 16 mg with sulphamethoxazole 80 mg per ml, 5 ml |
Zinc |
Paste (pack size 50 g or less) |
2017/18 Invitation to Tender
Chemical Name |
Line Item |
Ambrisentan (current access) |
Tab 10 mg |
Ambrisentan (current access) |
Tab 5 mg |
Ambrisentan (widened access) |
Tab 10 mg |
Ambrisentan (widened access) |
Tab 5 mg |
Amoxicillin clavulanate |
Grans for oral liq amoxicillin 400 mg with potassium clavulanate 57 mg per 5 ml |
Baclofen |
Inj 0.05 mg per ml, 1 ml |
Baclofen |
Inj 2 mg per ml, 5 ml |
Benzoyl peroxide |
Soln/Gel 5% |
Budesonide (current access) |
Cap 3 mg modified release |
Budesonide (widened access) |
Cap 3 mg modified release |
Bumetanide |
Tab 1 mg |
Bupivacaine hydrochloride |
Inj 0.25%, 20 ml sterile pack |
Bupivacaine hydrochloride |
Inj 0.5%, 10 ml sterile pack |
Bupivacaine hydrochloride |
Inj 0.5%, 20 ml sterile pack |
Calamine |
Lotn, BP |
Carboplatin |
Inj 10 mg per ml, 15 ml |
Carboplatin |
Inj 10 mg per ml, 45 ml |
Chloramphenicol |
Inj 1 g |
Chlorhexidine gluconate |
Crm 1% obstetric |
Chlorhexidine gluconate |
Lotn 1% obstetric |
Chlorhexidine gluconate |
Mouthwash 0.2% |
Chlorhexidine gluconate |
Soln 4% |
Colchicine |
Tab 500 mcg |
Daptomycin |
Inj 350 mg- 500 mg |
Diclofenac sodium |
Eye drops 0.1% |
Dorzolamide hydrochloride |
Eye drops 2% |
Doxorubicin |
Inj 200 mg |
Efavirenz |
Tab 50 mg |
Efavirenz |
Tab 200 mg |
Efavirenz |
Tab 600 mg |
Epirubicin |
Inj 2 mg per ml, 100 ml |
Febuxostat |
Tab 80 mg |
Febuxostat |
Tab 120 mg |
Ferrous fumarate |
Tab 200 mg |
Ferrous sulphate with ascorbic acid |
Tab long-acting 325 mg (105 mg elemental) with ascorbic acid 500 mg |
Filgrastim |
Inj 120 mg per ml, 0.5 ml prefilled syringe |
Filgrastim |
Inj 300 mcg per ml, 0.5 ml prefilled syringe |
Filgrastim |
Inj 480 mcg per ml, 0.5 ml prefilled syringe |
Furosemide |
Tab 40 mg |
Fusidic acid |
Crm 2% |
Fusidic acid |
Oint 2% |
Hydrocortisone butyrate |
Lipocream 0.1% (pack size greater than 30 g) |
Hydrogen peroxide |
Crm 1% |
Hydrogen peroxide |
Soln 3% (10 vol) |
Ibuprofen |
Tab long-acting 800 mg |
Imipenem with cilastatin |
Inj 500 mg with cilastatin 500 mg |
Irinotecan |
Inj 20 mg per ml, 2 ml |
Irinotecan |
Inj 20 mg per ml, 5 ml |
Lidocaine [lignocaine] hydrochloride with adrenaline |
Inj 2% with adrenaline 1:80,000, 2.2 ml dental cartridge |
Linezolid |
Inj 2 mg per ml, 300 ml |
Metaraminol tartrate |
Inj 0.5 per ml, 20 ml prefilled syringe |
Metaraminol tartrate |
Inj 1 mg per ml, 1 ml |
Metaraminol tartrate |
Inj 1 mg per ml, 10 ml prefilled syringe |
Metaraminol tartrate |
Inj 10 mg per ml 1 ml |
Methadone hydrochloride |
Tab 5 mg |
Methotrexate |
Inj 7.5 mg prefilled syringe |
Methotrexate |
Inj 10 mg prefilled syringe |
Methotrexate |
Inj 15 mg prefilled syringe |
Methotrexate |
Inj 20 mg prefilled syringe |
Methotrexate |
Inj 25 mg prefilled syringe |
Methotrexate |
Inj 30 mg prefilled syringe |
Midodrine |
Tab 2.5 mg |
Midodrine |
Tab 5 mg |
Mitozantrone |
Inj 2 mg per ml, 10 ml |
Mixed salt solution for eye irrigation |
Eye irrigation solution calcium chloride 0.048% with magnesium chloride 0.03%, potassium chloride 0.075%, sodium acetate 0.39%, sodium chloride 0.64% and sodium acetate 0.17%, 450 ml - 550 ml |
Moclobemide |
Tab 150 mg |
Moclobemide |
Tab 300 mg |
Nitrofurantoin |
Tab 50 mg |
Nitrofurantoin |
Tab 100 mg |
Norethisterone |
Tab 5 mg |
Oxaliplatin |
Inj 50 mg |
Oxycodone hydrochloride |
Oral liq 1 mg per ml |
Pizotifen |
Tab 500 mcg |
Povidone iodine |
Antiseptic soln 10% (pack size 15 ml or less) |
Povidone iodine |
Antiseptic soln 10% (pack size greater than 100 ml) |
Povidone iodine |
Antiseptic soln 10% (pack size greater than 15 ml but less than or equal to 100 ml) |
Povidone iodine |
Oint 10% |
Rivastigmine |
Patch 4.6 mg per 24 hour |
Rivastigmine |
Patch 9.5 mg per 24 hour |
Teicoplanin |
Inj 400 mg |
Tobramycin |
Solution for inhalation 60 mg per ml, 5 ml |
Valganciclovir |
Tab 450 mg |
Zoledronic acid |
Inj 4 mg per 100 ml |
Zoledronic acid (current access) |
Inj 4 mg per 5 ml |
Zoledronic acid (widened access) |
Inj 4 mg per 5 ml |
Should any unresolved Tender Bids be declined prior to the release of the 2018/19 Tender, PHARMAC would consider including those pharmaceuticals in the 2018/19 Tender. Currently unresolved Tender Bids have not been included in the draft pharmaceutical list set out in Schedule Two.
Distribution of Consultation Documents
Although this consultation letter has been widely distributed, should you consider that a particular person, group or agency should receive this letter and/or future tender documents, please feel free to contact PHARMAC or refer it on directly (note, all tender documents and consultations are also available from our website at www.pharmac.health.nz/news/consultation). We also invite any person or group to contact PHARMAC should you wish to meet to discuss the proposals contained in this consultation letter.
Schedule Two: Possible pharmaceuticals for tender for sole supply [PDF, 659 KB]
Order of pharmaceuticals in this Schedule
Pharmaceuticals have been listed in groups according to the therapeutic group classification system used in the Pharmaceutical Schedule. Below is a list of these groups, and the corresponding page numbers for your ease of reference. Pharmaceuticals with indications that may apply to multiple therapeutic groups will only appear in one group.
Therapeutic Group |
Page Numbers |
Alimentary Tract and Metabolism |
9 – 11 |
Blood and Blood Forming Organs |
12 |
Cardiovascular System |
12 – 14 |
Dermatologicals |
14 – 16 |
Genito-Urinary System |
16 – 17 |
Hormone Preparations – Systemic excluding contraceptives |
17 – 18 |
Infections – Agents for Systemic Use |
18 – 21 |
Musculoskeletal System |
21 – 22 |
Nervous System |
22 – 27 |
Oncology and Immunosuppressants |
27 – 29 |
Respiratory System and Allergies |
29 – 30 |
Sensory Organs Various |
30 – 32 n/a |
Information provided for each pharmaceutical
For each pharmaceutical (as defined by chemical name, form and strength) we have provided the following information:
- the current ex-manufacturer subsidy per unit of measure as at 1 July 2018
- the number of subsidised or partially subsidised units sold in the community in the year ending 30 June 2018
- an estimate of the annual community market value at current subsidies (estimated by multiplying the volume of units subsidised in the year ending 30 June 2018 by the relevant listed unit subsidy as at 1 July 2018); and
- comments specifically relating to the Tender of the line item and/or its current listing on the Pharmaceutical Schedule.
Explanation of terms, symbols and abbreviations
Most terms and abbreviations used are self-explanatory: “tab” means tablet, “cap” means capsule, “liq” means liquid, “inj” means injection, “suppos” means suppository, “grans” mean granules and “OP” means original pack to be dispensed.
The following table explains the symbols used in the draft pharmaceutical list:
Symbol | Explanation |
---|---|
Underlined | Pharmaceutical line items where a sole supply contract is in force are underlined. The price and subsidy for these pharmaceuticals are fixed until 30 June 2018 unless otherwise stated in the Comments column and a listing of a new brand could only occur after that date. |
C | To be tendered for Sole Subsidised Supply Status (community pharmaceuticals). |
H | To be tendered for Hospital Supply Status (DHB hospital pharmaceuticals). |
PCT | A reference in the Invitation to Tender to allow Pharmaceuticals Cancer Treatments to be listed in Section B of the Pharmaceutical Schedule as part of PHARMAC’s Pharmaceutical Cancer Treatments project. |
+ | PHARMAC has been advised of the existence of a patent. |
* | There is no fully funded product available for this line item (in relation to community supply). |
@ | Additional Stock Pharmaceuticals (ASP) means a Pharmaceutical, marked with an “@”, for which the supplier of the successful Tender Bid would be required to hold additional stock. |
# | A rebate currently exists. |