Proposal to fully fund Sustagen Formula and Alfamino

Medicines

Consultation Closes 20 Apr

We are seeking feedback on a proposal to fully fund Sustagen Hospital Formula Active (Sustagen Formula) powder and Alfamino.

What we’re proposing

We are seeking feedback on a proposal to fully fund Sustagen Hospital Formula Active (Sustagen Formula) powder and Alfamino through a provisional agreement with Nestle New Zealand Limited (Nestle) from 1 July 2021.

  • Sustagen Formula (vanilla and chocolate flavour) would be funded with full subsidy.
  • Alfamino would be funded as an additional amino acid formula for infants from birth to 1 year of age.

Consultation closes at 5 pm Tuesday 20 April 2021 and feedback can be emailed to consult@pharmac.govt.nz.

What would the effect be?

From 1 July 2021 the list price of Sustagen Formula (vanilla and chocolate flavour) would reduce and the subsidy would increase to enable full funding for people who meet certain eligibility criteria. The additional endorsement for Sustagen Formula would be removed. This would provide more funded powdered oral feed options for people who require a standard supplement.

Alfamino, a new amino acid formula, would be funded from 1 July 2021 for infants who meet eligibility criteria. This would provide an additional fully funded amino acid formula for infants from birth to 1 year of age.

Who we think will be interested

  • People who require nutritional supplementation, their carers and whānau
  • Community and hospital dietitians
  • Paediatricians, gastroenterologists, general practitioners, pharmacists and other clinicians and health professionals involved in the management of people who require nutritional supplementation
  • Pharmaceutical suppliers and wholesalers

About Sustagen Formula and Alfamino

Sustagen Formula

Standard supplements are nutritionally complete (or near nutritionally complete) oral supplements formulated to help improve the daily energy and nutrient intake of people who struggle to meet daily nutritional requirements.

Sustagen Formula (vanilla and chocolate flavour) is currently listed in the Standard Supplements(external link) section of the Special Foods therapeutic group in the Pharmaceutical Schedule with a part subsidy. This means that for most people there is an extra cost to access these products.

Full subsidy for Sustagen Formula is available for people who meet the endorsement criteria. This includes people who have fat malabsorption, fat intolerance or chyle leak.

Alfamino

Amino acid formulas are available for infants and children with allergy or intolerance to cow’s milk protein formula, or with gastrointestinal or malabsorption difficulties from a variety of causes.

There are a number of amino acid formulas currently listed in the Pharmaceutical Schedule, for use in a range of age groups.(external link)

Amino acid formulas are hypoallergenic, nutritionally complete (or near nutritionally complete) and used in infants and/or children to provide adequate nutrient intake to meet daily energy needs important for overall growth and development.

Alfamino is an amino acid formula indicated for use in infants from birth to 1 year of age, with similar macronutrients as some of the currently available amino acid infant formulae.

Why we’re proposing this

Sustagen

There are currently two other fully funded brands of oral feed powders listed in the Pharmaceutical Schedule, Ensure (chocolate and vanilla flavour) and Fortisip (vanilla flavour).

In January 2021, the supplier of Fortisip discontinued its brand of oral feed powder, with Fortisip to be delisted from the Pharmaceutical Schedule from 1 August 2021.

This means all people taking Fortisip powder are required to change to another product. Ensure powder (vanilla and chocolate flavour) remains fully funded.  

This proposal to increase the funding of Sustagen Formula is to ensure continuity of supply to oral feed powders and would provide an additional fully funded option for people who require a standard supplement.

Alfamino

A funding application for Alfamino was reviewed by the Special Foods Subcommittee of the Pharmacology and Therapeutics Advisory Committee (PTAC) in December 2017 [PDF, 564 KB]

The Special Foods Subcommittee recommended that Alfamino be listed as an amino acid formula on the Pharmaceutical Schedule, considering that such a listing should be cost neutral or cost saving when compared to funded products.

PHARMAC has reached a provisional agreement with the supplier to change the list price and increase the subsidy for Sustagen Formula (vanilla and chocolate flavour) and to fund Alfamino.

Details about our proposal

Sustagen

The price for Sustagen Formula (vanilla and chocolate flavour) would reduce in Section D of the Pharmaceutical Schedule, and the subsidy increased to the following prices and subsidies (ex-manufacturer, excluding GST) from 1 July 2021:

Pharmaceutical Formulation Flavour Brand Pack size Current price and subsidy Proposed price and subsidy
Oral feed (powder)  Powder Vanilla Sustagen Hospital Formula Active 840 g OP $9.54* ($26.00) $14.00
Oral feed (powder)  Powder Chocolate Sustagen Hospital Formula Active 840 g OP $9.54* ($26.00) $14.00

* The two prices listed in the schedule indicate a part subsidy. The lower price refers to the subsidy paid by PHARMAC and the price in brackets refers to the manufacturers price. The difference is the price paid by a person (in addition to any mark-ups and GST). 

The price for Sustagen Formula (vanilla and chocolate flavour) would reduce in Part II of Section H of the Pharmaceutical Schedule to the following prices (ex-manufacturer, excluding GST) from 1 July 2021:

Pharmaceutical Formulation Flavour Brand Pack size Current price and subsidy Proposed price
Oral feed (powder)  Powder 23 g protein, 65 g carbohydrate and 2.5 g fat, per 100 g Vanilla Sustagen Hospital Formula Active 840 g $26.00 $14.00
Oral feed (powder)  Powder 23 g protein, 65 g carbohydrate and 2.5 g fat, per 100 g Chocolate Sustagen Hospital Formula Active 840 g $26.00 $14.00

The Special Authority criteria(external link) and Hospital Restrictions(external link) that currently apply to Standard Supplements would continue to apply. 

The endorsement for access to Sustagen Formula would be removed. Patients receiving funded access via the endorsement would continue to be able to access treatment under Special Authority.

Alfamino

Alfamino would be listed in Section D of the Pharmaceutical Schedule from 1 July 2021 at the following price and subsidy (ex-manufacturer, excluding GST):

Pharmaceutical Formulation Brand Pack size Proposed price and subsidy
Amino Acid Formula   Powder Alfamino 400 g OP $43.60

Alfamino would be listed in Part II of Section H of the Pharmaceutical Schedule from 1 July 2021 at the following price (ex-manufacturer, excluding GST):

Chemical Formulation Brand Pack size Proposed price
Amino Acid Formula   Powder 13.3 g protein, 57 g carbohydrate and 24.6 g fat per 100 g Alfamino 400 g $43.60

The Special Authority criteria(external link) and Hospital Restrictions(external link) that currently apply to amino acid formulas would apply to Alfamino. 

To provide feedback

Send us an email: consult@pharmac.govt.nz by 5pm Tuesday 20 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.

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