Approval of non-steroidal anti-inflammatory drug (NSAID) funding changes

Hospital devices Medicines

Decision

PHARMAC has approved a proposal to make changes to the funding of various non-steroidal anti-inflammatory drugs.

The decision will result in the following changes to NSAID funding:

From 1 August 2014:

  • Sulindac 100 mg and 200 mg tablets (Aclin) will be fully funded in the community and the restriction will be removed from the Hospital Medicines List (HML) listing.
  • Diclofenac 50 mg dispersible tablets (Voltaren D) will be fully funded in the community by endorsement for patients who cannot swallow whole tablets and in whom ibuprofen oral liquid is ineffective or not tolerated.
  • The “Special Authority for Manufacturers Price” that provides a small group of patients with approvals granted prior to 1 September 2010 with full subsidy for partially funded NSAID preparations will be removed, meaning that all existing approvals will be cancelled.

From 1 November 2014:

  • Ibuprofen 400 mg and 600 mg tablets (Brufen), which are currently partly funded by reference to the subsidy of the equivalent number of ibuprofen 200 mg tablets, will be delisted. Ibuprofen 200 mg tablets and 800 mg long-acting tablets will remain fully funded.

Details of the decision

  • The subsidy for sulindac 100 mg and 200 mg tablets will be increased in Section B of the Pharmaceutical Schedule from 1 August 2014 as follows (prices and subsidies expressed ex-manufacturer, excluding GST):
Chemical Presentation Brand Pack size Current subsidy
(and price)
New subsidy and price
Sulindac Tab 100 mg Aclin 50 $2.66
($8.55)
$8.55
Sulindac Tab 200 mg Aclin 50 $3.36
($15.10)
$15.10
  • The restriction that currently applies to sulindac 100 mg and 200 mg tablets in Part II of Section H of the Pharmaceutical Schedule (the HML) will be removed from 1 August 2014 as follows:

Restricted: for continuation only

  • The following rule will be added to the listing of diclofenac sodium tab 50 mg dispersible (Voltaren D) in Section B of the Pharmaceutical Schedule from 1 August 2014:

Higher subsidy of $8.00 per 20 tab with Endorsement

Additional subsidy by endorsement for a patient who cannot swallow whole tablets and in whom ibuprofen oral liquid is ineffective or not tolerated, and the prescription is endorsed accordingly.

  • The Special Authority for Manufacturers Price (SA1038) that currently applies to all the NSAID preparations that are partly funded in the community (diclofenac tab 50 mg dispersible, ibuprofen tab 400 mg and 600 mg, mefenamic acid cap 250 mg and sulindac tab 100 mg and 200 mg) will be removed from 1 August 2014 as follows:

SA1038 Special Authority for Manufacturers Price

Note: Subsidy for patients with existing approvals prior to 1 September 2010. Approvals valid without further renewal unless notified. No new approvals will be granted from 1 September 2010.

  • Ibuprofen 400 mg and 600 mg tablets (Brufen), which are currently only partly funded, will be delisted from Section B of the Pharmaceutical Schedule from 1 November 2014. Ibuprofen 200 mg tablets and 800 mg long-acting tablets will remain listed and fully funded. No changes will occur to HML listings for ibuprofen 400 mg or 600 mg tablets.

Feedback received

We appreciate all of the feedback that we received and acknowledge the time people took to respond. All consultation responses were considered in their entirety in making a decision on the proposed changes. Most responses were supportive of the proposal, and the following issues were raised in relation to specific aspects of the proposal:

Theme Comment
One responder requested that ibuprofen 600 mg remain listed, because it is not always easy for people to swallow three 200 mg tablets. The responder noted that the 600 mg dose is useful for migraine and sprains/strains. We note that ibuprofen 600 mg tablets are not currently fully funded, and patients taking this strength are already paying close to the full price. Patients will still be able to pay for ibuprofen 600 mg should they choose to do so rather than take three 200 mg tablets.
Ibuprofen at doses of 600 mg will still be an option for prescribers and patients, and will be fully funded if the 200 mg tablet strength is dispensed.
One responder was concerned that General Practitioners might not be adequately made aware of the change for diclofenac 50 mg dispersible tablets, which could result in eligible patients missing out on fully funded treatment. In addition to this notification letter, we will provide information about the changes to the Royal New Zealand College of General Practitioners for inclusion in its ePulse newsletter.

More information

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.