Decision to award sole supply for fluticasone and fluticasone with salmeterol metered dose inhalers

Medicines

Decision

PHARMAC has made a decision to make changes to the funded brands of fluticasone and fluticasone with salmeterol metered dose inhalers (MDIs), which are used in the management of asthma and chronic obstructive pulmonary disease (COPD).

This decision means that:

  • The Flixotide brand of fluticasone MDI and the Seretide brand of fluticasone with salmeterol MDI, which are currently funded and supplied by GlaxoSmithKline NZ Limited (GSK), will be the only funded brands of fluticasone and fluticasone with salmeterol MDIs from 1 September 2020 until at least 30 June 2023.
  • Most people using fluticasone and fluticasone with salmeterol MDIs (approximately 220,000 people) will be able to remain on their currently funded brand, but a small proportion of people (about 12,000 people) using the Floair and RexAir brands will need to change to the Flixotide and Seretide brands in order to remain on a fully funded brand of fluticasone or fluticasone with salmeterol MDI.
  • From 1 September 2020, the Floair brand of fluticasone MDI and RexAir brand of fluticasone with salmeterol MDI, which are currently funded and supplied by Rex Medical Limited (Rex Medical), will no longer be funded and will be delisted from the Pharmaceutical Schedule.
  • The changes will be implemented over a six-month transition period, starting from 1 March 2020 and ending on 31 August 2020. During the transition period the Floair brand of fluticasone MDI and RexAir brand of fluticasone with salmeterol MDI will remain fully funded and listed on the Pharmaceutical Schedule.

This decision results from a Request for Proposal (RFP) for the supply of fluticasone and fluticasone with salmeterol MDIs. It will release significant funds for PHARMAC to invest in other medicines for the benefit of New Zealanders.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 21 October 2019

There were no changes to the agreement following consultation feedback.

Who we think will be most interested

  • People currently using fluticasone and fluticasone with salmeterol MDIs and their whānau or caregivers.
  • Organisations and groups that support clinicians and individuals with asthma and COPD, such as Asthma New Zealand and Asthma and Respiratory Foundation NZ.
  • Clinicians who treat people with asthma and COPD, general practitioners, respiratory physicians, nurse specialists, nurse practitioners and nurse educators.
  • Hospital and community pharmacists, DHBs and wholesalers.
  • Suppliers of fluticasone and fluticasone with salmeterol MDIs or other inhaled molecules for the treatment of asthma and COPD.

Details about this decision

  • From 1 March 2020, the price and subsidy of the Flixotide brand of fluticasone MDI and the Seretide brand of fluticasone with salmeterol MDI will be reduced in Section B and Part II of Section H of the Pharmaceutical Schedule as follows:

Chemical

Presentation

Brand

Pack size

Price & subsidy

Fluticasone

Aerosol Inhaler 50 mcg per dose

Flixotide

120 dose OP

$7.19

Fluticasone

Aerosol Inhaler 125 mcg per dose

Flixotide

120 dose OP

$13.60

Fluticasone

Aerosol Inhaler 250 mcg per dose

Flixotide

120 dose OP

$24.62

Fluticasone with Salmeterol 

Aerosol Inhaler 50 mcg with salmeterol 25 mcg

Seretide

120 dose OP

$25.79

Fluticasone with Salmeterol 

Aerosol Inhaler 125 mcg with salmeterol 25 mcg

Seretide

120 dose OP

$32.60

  • A confidential rebate will apply to Flixotide and Seretide, which will reduce the net prices to the funder.
  • By 1 September 2020, people currently using the Floair and RexAir brands of fluticasone and fluticasone with salmeterol MDIs will need to change to the Flixotide and Seretide brands of fluticasone and fluticasone with salmeterol MDIs to remain on a funded brand.
  • From 1 September 2020, the Floair and RexAir brands of fluticasone and fluticasone with salmeterol MDIs will be delisted from the Section B and Part II of Section H of the Pharmaceutical Schedule and will no longer be funded.
  • From 1 September 2020, the Flixotide and Seretide brands will be the only funded brands of fluticasone and fluticasone with salmeterol MDIs listed in Section B and Part II of Section H of the Pharmaceutical Schedule. This will apply until at least 30 June 2023, with two optional extension periods of one year each that may be exercised at PHARMAC’s sole discretion.

Support for the changes

PHARMAC has developed a programme of work to support the change to having one funded brand of fluticasone and fluticasone with salmeterol MDIs. This includes providing education to healthcare professionals groups to support affected patients transitioning to a new funded brand of brand of MDI.  We will look to work with consumer organisations to support patients using Floair and RexAir brand MDIs to know that their brand of MDI will no longer be funded from 1 September 2020 and information on what treatment options are available to them.

Our response to what you told us

We are really grateful for the time people took to respond to this consultation. Responses were generally supportive of the proposal and a summary of the main themes raised in feedback and our responses to the feedback received are set out below:

Theme

PHARMAC Comment

Concerns regarding a move to sole supply and brand changes.

We have developed an implementation plan that includes provision of information to healthcare professionals, consumer organisations and patients to support this change.

Request that a Brand Switch Fee be applied to the dispending of fluticasone and fluticasone with salmeterol MDIs.

This transaction does not meet the criteria for a brand switch fee as agreed with DHBs due to the low number of patients impacted.

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 66 00 50.