2018/19 invitation to tender (medical)

Hospital devices Medicines

Tender Closed

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

Linked is a copy of the draft terms and conditions which would form the terms of the 2018/19 tender contract [PDF, 659 KB].

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.