Budesonide with eformoterol (Symbicort Turbuhaler and Vannair) proposal with Astra Zeneca

Medicines Consultation Closed

PHARMAC is seeking feedback on a proposal involving budesonide with eformoterol inhalers (Symbicort Turbuhaler and Vannair), which are already listed in the Pharmaceutical Schedule in the Respiratory System and Allergies Therapeutic Group.

In summary, from 1 March 2016 this proposal would result in:

  • a reduction in expenditure for budesonide with eformorterol inhalers (Symbicort Turbuhaler and Vannair; and
  • removal of the funding restrictions for budesonide with eformoterol in Section B and Part II of Section H of the Pharmaceutical Schedule.

Proposal for budesonide with eformoterol (Symbicort Turbuhaler and Vannair) [PDF, 84 KB]

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Friday, 8 January 2016 to:

Christine Chapman
Senior Therapeutic Group Manager
PHARMAC
PO Box 10254
Wellington 6143

Email: christine.chapman@pharmac.govt.nz
Fax:  04 460 4995

All feedback received before the closing date will be considered by PHARMAC’s Board (or its delegate) prior to making a decision on this proposal.

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 proposal

The price and subsidies for Symbicort Turbuhaler and Vannair in Section B of the Pharmaceutical Schedule from 1 March 2016 would reduce as follows (prices are ex-manufacturer, exclusive of GST):

Pharmaceutical Brand Presentation Pack size Current subsidy and price Proposed price and subsidy
Budesonide witheformoterol Vannair Aerosol inhaler 100 mcg with eformoterol fumarate 6 mcg 120 dose OP $26.49 $18.23
Budesonide with eformoterol Vannair Aerosol inhaler 200 mcg with eformoterol fumarate 6 mcg 120 dose OP $31.25 $21.40
Budesonide with eformoterol Symbicort Turbuhaler 100/6 Powder for inhalation 100 mcg with eformoterol fumarate 6 mcg 120 dose OP $55.00 $37.48*
Budesonide with eformoterol Symbicort Turbuhaler 200/6 Powder for inhalation 200 mcg with eformoterol fumarate 6 mcg 120 dose OP $60.00 $49.69*
Budesonide with eformoterol Symbicort Turbuhaler 400/6 Powder for inhalation 400 mcg with eformoterol fumarate 6 mcg 120 dose OP $60.00 $49.69*
  • A confidential rebate would  apply to Symbicort Turbuhaler reducing its net price.
  • Symbicort Turbuhaler and Vannair would have subsidy and delisting protection until 1 January 2019.
  • The Special Authority criteria for budesonide with eformoterol in Section B of the Pharmaceutical Schedule would be removed as follows (deletions in strikethrough):

Special Authority for Subsidy

Initial application from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

Either:

  1. All of the following:
    1. Patient is a child under the age of 12; and
    2. Has been treated with inhaled corticosteroids of at least 400 mcg per day beclomethasone or budesonide, or 200 mcg per day fluticasone; and
    3. The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product; or
  2. All of the following:
    1. Patient is over the age of 12; and
    2. Has been treated with inhaled corticosteroids of at least 800 mcg per day beclomethasone or budesonide, or 500 mcg per day fluticasone; and
    3. The prescriber considers that the patient would receive additional clinical benefit from switching to a combination product.

Renewal from any relevant practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.

  • The restrictions for budesonide with eformoterol on the Hospital Medicines List (HML) would also be removed. 
  • The dose maximum rule that currently applies to Symbicort Turbuhaler 400/12 would remain.

Background

Symbicort Turbuhaler and Vannair are both listed in the Pharmaceutical Schedule in the Respiratory System and Allergies Therapeutic Group. Budesonide with eformoterol is indicated in the treatment of asthma and chronic obstructive pulmonary disease (COPD).

The proposal to remove the Special Authority relating to access to budesonide and eformoterol would improve patient access to these products and is as a result of a provisional agreement with AstraZeneca which would result in savings to the combined pharmaceutical budget (CPB).