Consultation on the draft 2024/25 Invitation to Tender (for health care professionals)

Overview

Pharmac | Te Pātaka Whaioranga is seeking feedback from healthcare professionals, medical groups, hospital pharmacies, and other interested parties on the draft 2024/25 Invitation to Tender.

Consultation closes at 4 pm (New Zealand standard time) on Tuesday 3 September 2024

Submit feedback through our online form or email tender@pharmac.govt.nz

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?
• whether Pharmac should delay or avoid a brand change for any of these medicines and, if so, why?
• are there any features of the medicines that we should consider when evaluating them?
• what are the potential benefits, issues, or consequences of dispensing the entire prescription for any of these products all at once?
• are there potential benefits, issues, or consequences if we removed any funding restrictions from the medicine (such as Special Authority criteria)?
• which medicines, indications (uses), or population groups might need an alternative brand if a brand change were to occur and why?
• are the proposed Additional Special Terms for intra-uterine devices [Non-hormonal] (IUDs) appropriate?

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

This consultation document and all the related documents are available for download

We are also seeking feedback from suppliers and people who take medicines.

Industry consultation

Consultation for public input

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

About the 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 from Pharmac’s Tender Clinical Advisory Committee advice on every tender decision we make. The committee is made up of healthcare professionals, including doctors, nurse practitioners, and pharmacists. We’ll 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 decision 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).  For this tender round, Principal Supply Status would be in place until 30 June 2028.

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 an “alternative brand allowance” (ABA) to 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 time period of time in which to change brands
• allowing some patients to avoid switching altogether.

The structure of the tender gives Pharmac the flexibility to fund alternative brands in different ways. For example:

• in hospitals, we expect to continue to use the alternative brand allowance provisions in the Schedule. This lets hospitals purchase alternative brands up to a certain percent of volume, typically 5 percent
• in the community, alternative brands could be funded through listing (or maintaining the listing of) other brands under strict Special Authority criteria, or
• managing case-by case approvals through our Exceptional Circumstances framework.

While Pharmac can fund alternative brands, continued supply of a particular alternative brand cannot always be guaranteed. It is helpful to understand what products 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

The tender can result in substantial price reductions, and we can use the savings to fund new medicines. We also use the savings to fund changes to the tendered products. For example:

• If the product is currently partially funded, it could become fully funded if the tender was awarded.
• The product could be added to the all-at-once (‘stat’) dispensing list, which would mean that people could collect prescriptions all at once, rather than monthly.
• We might change or remove funding restrictions so more people can use it (for example, a Special Authority restriction, endorsement, or prescriber-type restriction). We might consult on this separately before 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.

Additional Special Terms

We have included Additional Special Terms in the draft 2024/25 Invitation to Tender contract for intra-uterine devices [Non-hormonal] (IUDs). This clause would require that potential suppliers offer education, training, and support resources to safely use the supplier’s IUD product. This could include a description of the inserter and IUD materials and insertion instructions. 

Any feedback on these Additional Special Terms will help inform the final contract.

The tender list

See Schedule Two: Products to be tendered (draft, by therapeutic group) for the list of medicines that we are proposing to include in this year’s tender. Medicines have been grouped according to the therapeutic group classification system used in the Pharmaceutical Schedule.

Schedule two Products to be tendered [PDF, 193 KB]

Below is a list of these groups, and the corresponding page numbers in the consultation for health care professionals PDF. Medicines with multiple indications only appear in one group.

Therapeutic group	Pages
Alimentary Tract and Metabolism	8–9
Blood and Blood Forming Organs	9
Cardiovascular System	10–11
Dermatologicals	11
Genito-Urinary System	12
Hormone Preparations	12–13
Infections	13–14
Musculoskeletal System	14
Nervous System	14–17
Oncology and Immunosuppressants	17
Respiratory	17–18
Sensory Organs	18
Various	18

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

Tendered Item
Cladribine Tab 10 mg
Desogestrel Tab 75 mcg
Famotidine Inj 10 mg per ml, 2 ml
Fingolimod Cap 0.5 mg
Fulvestrant Inj 50 mg per ml, 5 ml
Gefitinib Tab 250 mg
Icatibant Inj 10 mg per ml, 3 ml prefilled syringe
Nilotinib Cap 150 mg Cap 200 mg
Nitisinone Cap 2 mg Cap 5 mg Cap 10 mg
Pancreatic enzyme Cap 420 mg
Perindopril arginine with amlodipine Tab perindopril arginine 10 mg with amlodipine 5 mg Tab perindopril arginine 5 mg with amlodipine 10 mg Tab perindopril arginine 5 mg with amlodipine 5 mg
Pirfenidone Cap 267 mg Tab 801 mg
Progesterone Cap 200 mg
Telmisartan with amlodipine Tab 40 mg with amlodipine 10 mg Tab 40 mg with amlodipine 5 mg Tab 80 mg with amlodipine 10 mg Tab 80 mg with amlodipine 5 mg

Information provided for each medicine

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

• the current subsidy paid per unit (e.g. capsule, tablet, injection) as of 1 July 2024. These values are ex-manufacturer excluding GST
• the number of units funded in the community per year in the year ending 30 June 2024 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 2024 by the current listed unit subsidy as of 1 July 2024
• comments specifically relating to the tender item and/or its current listing on the Pharmaceutical Schedule

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	Tender items where there is currently a sole supply or principal supply contract are underlined. The price and subsidy for these items are fixed until 30 June 2025 unless otherwise stated in the comments column, therefore 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 Health New Zealand | Te Whatu Ora 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 tender 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

23 July 2024 – Consultation begins

3 September 2024 – Consultation closes

September 2024 –Tender Clinical Advisory Committee meets

Late October/Early November 2024 – Final Invitation to Tender issued

January 2025 – Earliest tender results announced

April 2025 – Earliest listing of new brands

Providing feedback

Feedback should be provided to the tender analysts via our online form or by emailing tender@pharmac.govt.nz

All feedback received before the closing date will be considered by Pharmac’s Board or its delegate before finalising the 2024/25 Invitation to Tender.

Your feedback may be shared

Feedback we receive is subject to the Official Information Act 1982 (OIA). 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.