Consultation on proposed 2023/24 Invitation to Tender: For consumers

Medicines Tender Closed

Te Pātaka Whaioranga - Pharmac is seeking feedback from consumers, consumer advocacy groups, the public, and other interested parties on the contents of the 2023/24 Invitation to Tender.

We’re particularly interested in feedback on:

  • would a brand change for any of the medicines included in the draft tender list be not appropriate, and why?
  • what are the circumstances that might require delaying or avoiding a brand change for these medicines?
  • are there any particular features of the products that we should be considering when evaluating potential products?
  • what are the potential benefits, issues or consequences of enabling the entire prescription for any of these products to be dispensed all at once?
  • what potential benefits, issues or consequences could occur from removing any existing funding restrictions (eg Special Authority criteria) from the medicine?
  • which medicines, indications (uses), or population groups might need funding for an alternative brand if a brand change were to occur, and why?
  • are the proposed Additional Special Terms included in the draft 2023/24 Tender contract appropriate?

We welcome any other feedback you may wish to provide. Please feel free to contact us if you wish to meet to discuss anything in this consultation.

We are also seeking feedback from healthcare professionals and suppliers.

Please share this consultation with others who you think might be interested. We want to hear feedback from a range of people.

All tender documents and consultations are available from the Pharmac website.

Download a PDF version of this consultation

Consultation closes 5pm (New Zealand standard time) Monday 28 August 2023

Email feedback to tender@pharmac.govt.nz

All feedback received before the closing date will be considered by Pharmac’s Board or its delegate prior to finalising the 2023/24 Invitation to Tender.

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.

About the annual tender

Pharmac’s annual tender is used to contract for supply of medicines. Most of these medicines are already funded in New Zealand and are no longer under patent.

The tender helps to secure the ongoing supply of medicines and generates savings. These savings can be used to fund new medicines. Each year, some of the medicines on the Pharmaceutical Schedule (the list of funded medicines) are included in the annual tender. Although the tender is run annually, the list of medicines included in it changes from year to year. Typically, each medicine is tendered every three years.

Before we run the tender each year, we seek feedback from healthcare professionals, consumer groups, the pharmaceutical industry and the public. This can tell us if:

  • tendering is appropriate for each medicine.
  • there are any potential issues when considering a change in brand for a particular medicine.

We get expert advice on every decision we make from Pharmac’s Tender Clinical Advisory Committee.

The committee is made up of healthcare professionals, including doctors, nurse practitioners, and pharmacists. We also seek additional advice from specialists in particular fields, such as cancer or mental health, as needed.

The feedback and advice we get makes sure our decisions support New Zealanders to live longer, healthier lives.

What the tender means

If we award a tender for a medicine to a pharmaceutical supplier, then that supplier’s brand becomes the principal funded brand of that medicine. It would likely be the only brand of that medicine funded on the Pharmaceutical Schedule (Principal Supply Status) until June 2027.  

If the brand awarded the tender was already the only funded brand, there would be no noticeable difference for most people, although the price that Pharmac pays may change.

If that brand was one of multiple funded brands, we would transition from the various funded brands to the brand that has been awarded the tender (and therefore would have Principal Supply Status) over time. The other brands would be removed from the Pharmaceutical Schedule. Usually, this transition lasts for five months.

If that brand was not already funded, we would transition from the old brand to the new one over time. The new brand is listed on the Pharmaceutical Schedule, and there is then a period of time when both the old and new brands would be available and funded. The old brand is then removed from the Pharmaceutical Schedule. Usually, this transition lasts for five months. We notify of any upcoming changes at least one month before any changes occur.

Access to other brands if a tender is awarded to a new brand

Most people will start on, or transition to, the new brand easily. However, we understand that people’s experiences when taking medicines may be different. We use a mechanism called an “alternative brand allowance”, which lets us support people who may experience, or are at heightened risk of, adverse outcomes from a brand change. This may mean:

  • moving back to the old brand after adverse side effects
  • having a longer period of time in which to change brands
  • allowing some patients to avoid switching altogether.

We are unable to guarantee continued supply of a particular alternative brand. It is helpful to understand what medicines might need access to alternative brands before we run the tender.

We are keen to understand:

  • which medicines, indications, or population groups might need funding for an alternative brand and, if so, why?
  • are there any particular features of the products that we should be considering when evaluating potential products?

Other potential changes

Because the tender can result in substantial price reductions, this allows us to use the savings to fund new medicines. The savings can also be used to fund changes to the tendered products. For example:

  • if the product is currently partially funded, it would become fully funded if the tender was awarded
  • the product could be added to the ‘stat’ dispensing list, which would mean that people could collect prescriptions dispensed as a three-month supply (rather than monthly)
  • if funding criteria apply to a product (for example, a Special Authority restriction, endorsement, or prescriber-type restriction), we might change or remove funding restrictions to enable more people to use it. We might consult on this separately prior to making a decision.

We are interested in your feedback on potential changes for the medicines we are tendering.

You can see the Pharmaceutical Schedule for all dispensing and funding restrictions.(external link)

The tender list

The list of medicines that we are proposing to include in this year’s tender is included in Schedule 2 [XLSX, 35 KB].

Most of the items in the tender have been included in the annual tender before. However, the following products have not been tendered previously:  

Tendered Item

Ferrous fumarate with ascorbic acid

  • Tab long-acting 325 mg (105 mg elemental) with ascorbic acid 500 mg

Perindopril with amlodipine

  • Tab 2 mg – 2.5 mg
  • Tab 4 mg – 5 mg
  • Tab 8 mg – 10 mg

Ramipril with felodipine

  • Tab 2.5 mg with felodipine 2.5 mg

Levodopa with carbidopa and entacapone

  • Tab 100 mg with carbidopa 25 mg and entacapone 200 mg
  • Tab 125 mg with carbidopa 31.25 mg and entacapone 200 mg
  • Tab 150 mg with carbidopa 37.5 mg and entacapone 200 mg

Nepafenac

  • Eye drop 0.3%

β-hCG low-sensitivity urine test kit

  • Test Kit

Additional Special Terms

Additional Special Terms have been included in the draft 2023/24 Tender contract for somatropin injections. This clause would require any potential suppliers to offer education, training and support resources to patients and healthcare professionals, and related products required for the safe handling and use of the supplier’s somatropin product (such as associated devices, needles, needle clippers, sharps bins). The full Additional Special Terms for somatropin can be found in the draft 2023/24 Tender contract on the Pharmac website.

  • Any feedback on these Additional Special Terms would be useful to inform the final contract.

Medicines have been grouped according to the therapeutic group classification system used in the Pharmaceutical Schedule. Below is a list of these groups, and the corresponding page numbers. Medicines with indications that may apply to multiple therapeutic groups only appear in one group.

Therapeutic group

Pages

Alimentary Tract and Metabolism

15-16

Blood and Blood Forming Organs

16

Cardiovascular System

16-19

Dermatologicals

19-20

Genito-Urinary System

20-21

Hormone Preparations

21-22

Infections – Agents for Systemic Use

22-23

Musculoskeletal System

23-24

Nervous System

24-28

Oncology and Immunosuppressants

28-30

Respiratory

30

Sensory Organs

30-31

Various

31

Information provided for each medicine

For each medicine (as defined by chemical name, form, and strength), we have provided:

  • the current subsidy paid per unit (e.g. capsule, tablet, injection) as of 1 July 2023. These values are ex-manufacturer excluding GST
  • the number of units funded in the community per year in the year ending 30 June 2022. These may be partially funded or full funded
  • an estimate of the annual community market value based on the current subsidy paid per unit. This is estimated by multiplying the volume of units used in the year ending 30 June 2022 by the current listed unit subsidy as of 1 July 2023
  • comments specifically relating to the tender item and/or its current listing on the Pharmaceutical Schedule.

Hauora Arotahi – Māori health areas of focus

Pharmac is continually working to develop and implement advances in Hauora Arotahi to support equitable health outcomes for Māori. Pharmac’s Māori health areas of focus, voiced by whānau Māori, are available on our website.

The draft 2023/24 Invitation to Tender includes treatments for mental health, heart health (such as medicines to treat high blood pressure and prevent stroke), respiratory health, and cancer (lung and breast), outlined in tables below.

Chemical Name

Line Item

Cancer – lung and breast

Carboplatin

Injection

Cisplatin

Injections

Epirubicin

Injection

Fluorouracil sodium

Injections

Letrozole

Tablets

 

Chemical Name

Line Item

Mental health

Buspirone hydrochloride

Tablets

Dexamfetamine sulphate

Tablets

Disulfiram

Tablets

Lithium carbonate

Capsules – immediate release and long acting

Lorazepam

Tablets

Methadone hydrochloride

Oral liquid

Moclobemide

Tablets

Varenicline tartrate

Tablets

Zopiclone

Tablets

 

Chemical Name

Line item

Heart health – high blood pressure and stroke

Atenolol

Tablets

Candesartan

Tablets

Clonidine

Injections and Tablets

Dobutamine

Injection

Felodipine

Tablets long-acting

Glyceryl trinitrate

Injections

Lisinopril

Tablets

Perindopril

Tablets

Perindopril with amlodipine

Tablets

Quinapril

Tablets

Ramipril

Capsules or Tablets

Ramipril with felodipine

Tablets

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.

Symbols used in the draft tender list:

Symbol

Explanation

Underlined

Medicine line items where a sole supply or principal supply contract is in force are underlined. The price and subsidy for these medicines are fixed until 30 June 2023 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 Principal Supply Status (community medicines).

H

To be tendered for Principal Supply Status (hospital medicines).

PCT

Pharmaceuticals Te Whatu Ora - Health New Zealand hospitals may claim a subsidy through Section B of the Pharmaceutical Schedule. 

+

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). The supplier of the successful tender bid would be required to hold additional stock.

#

A rebate currently exists.

Key dates

24 July 2023 – Consultation begins

28 August 2023 – Consultation closes

September 2023 –Tender Clinical Advisory Committee meets

November 2023 – Release of final Invitation To Tender

January 2024 – Earliest tender results announced

April 2024 – Earliest listing of new brands