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

Medicines Decision

We’re widening access to long-acting octreotide to include treatment for people with acromegaly, prior to pituitary surgery

What we’re doing

From 1 September 2021, access to long-acting octreotide injections will be widened to include treatment for people with acromegaly and large pituitary tumours, prior to pituitary surgery.

Long-acting octreotide injections are currently listed as octreotide LAR (somatostatin analogue).(external link)

This decision resulted in conjunction with PHARMAC’s annual tender process. As a result of this tender process and as notified in the June 2021 tender notification, the funded brand of long-acting octreotide injections will be changing from Sandostatin LAR to Octreotide Depot Teva.

You can read the June 2021 tender notification on the PHARMAC website here.(external link)

What does this mean for people?

The decision means that people with acromegaly and large pituitary tumours would be able to access funded long-acting octreotide treatment (a somatostatin analogue) for up to six months before planned surgery, subject to certain eligibility restrictions.

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.

We haven’t made any changes to the original proposal

This decision was subject to a consultation letter dated 26 March 2021.

We’re grateful for the time people took to respond to this consultation.

All consultation responses received were supportive of the proposal and noted the significant benefits this would have for people with acromegaly requiring pituitary surgery and their whānau.

Who we think will be interested

  • People with acromegaly and large pituitary tumours who require 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

Detail about this decision

Long-acting octreotide injections were included in the 2020/21 Invitation to Tender.

We included an option to widen access through the tender process.

Following evaluation of the tender bids and consultation responses received, we have made the decision to widen access to pre-operative acromegaly.

The following criteria for pre-operative acromegaly will be added to the Special Authority for long-acting octreotide injections in Section B of the Pharmaceutical Schedule from 1 September 2021 (new criteria shown only):

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 12 months 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 will apply for Part II of Section H of the Pharmaceutical Schedule.

No other changes will be made to the restrictions for long-acting octreotide injections as a result of this decision.

As notified in the June 2021 tender notification, Octreotide Depot Teva will have Principal Supply Status in the community and DHB hospitals from 1 March 2022 until 30 June 2024.

This means Octreotide Depot Teva will be the only funded brand of long-acting octreotide injections during this time.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.