Proposal to widen access to long-acting octreotide for pre-operative treatment in acromegaly

Medicines

Consultation Closes 16 Apr

We are seeking feedback on a proposal to widen access to long-acting octreotide.

What we’re proposing

We are seeking feedback on a proposal to widen access to long-acting octreotide (octreotide LAR, a somatostatin analogue) to include pre-operative treatment for people with acromegaly prior to pituitary surgery.

Consultation closes at 5 pm on Friday 16 April 2021 and feedback can be emailed to consult@pharmac.govt.nz.

As part of PHARMAC’s Annual Tender process, PHARMAC is proposing to widen access to long-acting octreotide. As the Tender process is still in progress, the brands, pricing and timings are still to be determined; however, we are seeking your feedback on the proposed restrictions.

What would the effect be?

This proposal would mean that funded access to long-acting octreotide injection would be widened for people with acromegaly and large pituitary tumours for pre-operative treatment prior to pituitary surgery.

People who meet the proposed restrictions would be able to access funded treatment for up to six months before planned surgery.

Evidence indicates that people with large pituitary tumours who receive long-acting octreotide before surgery have better outcomes three to four months after surgery. We estimate that around nine patients would benefit each year from this proposal.

The date this proposed change would take effect is still to be determined. 

Who we think will be interested

  • People with acromegaly and large pituitary tumours who are waiting for pituitary surgery and their whānau
  • Healthcare professionals involved in the management of people with acromegaly
  • Support and advocacy groups for people with acromegaly
  • Community and Hospital Pharmacists
  • Pharmaceutical wholesalers and suppliers

About long-acting octreotide

Long-acting octreotide depot intramuscular injection is used to treat acromegaly, as well as symptoms of gastro-entero-pancreatic endocrine tumours and neuroendocrine tumours. Octreotide reduces the body’s secretion of some hormones, including growth hormone. Long-acting octreotide injection is administered intramuscularly once every four weeks.

More information about the currently funded brand of long-acting octreotide can be found in the Medsafe datasheet.(external link)

Long-acting octreotide injection is currently listed on the Pharmaceutical Schedule, subject to Special Authority criteria.(external link)

Why we’re proposing this

The Endocrinology Subcommittee of PTAC recommended widening access to long-acting octreotide injection for people with acromegaly and large pituitary tumours in preparation for pituitary surgery in 2014.

More information, including links to the clinical advice received, can be found in the Application Tracker record for this application.(external link)

Long-acting octreotide injection (octreotide LAR) was included in the 2020/21 Invitation to Tender, dated 2 November 2020. As part of the Tender process, PHARMAC included the option to widen access to long-acting octreotide injection to more people.

Details about our proposal

PHARMAC is seeking feedback on the following proposed Special Authority that would apply to the listings of long-acting octreotide in Section B of the Pharmaceutical Schedule if the tenders are progressed (new indication only) as follows:

Special Authority for Subsidy

Initial application (pre-operative acromegaly) only from a relevant specialist or medical practitioner on the recommendation of a relevant specialist. Approvals valid for one year for applications meeting the following criteria:

All of the following:

  1. Patient has acromegaly; and
  2. Patient has a large pituitary tumour, greater than 10 mm at its widest; and
  3. Patient is scheduled to undergo pituitary surgery in the next six months.

Similar restrictions would also apply to Part II of Section H of the Pharmaceutical Schedule. There are no other changes proposed to the restrictions for long-acting octreotide.

The brands, pricing, and dates of any potential access changes are still to be confirmed. Any products listed through the Tender would have Principal Supply Status in the community and DHB hospitals until 30 June 2024.

To provide feedback

Send us an email: consult@pharmac.govt.nz by 5pm Friday 16 April 2021.

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.

Your feedback may be shared

Feedback we receive is subject to the Official Information Act 1982 (OIA). Please be aware that we may need to share your feedback, including your identity, in response to an OIA request. This applies to anyone providing feedback, whether they are providing feedback themselves or for an organisation, in a personal or professional capacity.

We can only keep feedback confidential as allowed under the OIA and other related laws. If you want any part of your feedback treated as confidential, you need to tell us. Please let us know if you want to keep part of your feedback confidential, and why. Is it commercially sensitive, confidential or proprietary, or personal information? Clearly state this and tell us which parts of your feedback you want to keep confidential for these reasons. We will consider your request under our OIA requirements.