Decision to award sole supply of bortezomib in DHB hospitals

Medicines Decision

PHARMAC is pleased to announce the decision to award Hospital Supply Status (HSS) from 1 July 2016 until 30 June 2019 for bortezomib in DHB hospitals to Janssen-Cilag’s brand of bortezomib (Velcade) inj 3.5 mg vial with a 1% discretionary variance (DV) limit.

This decision has been made following a Request for Proposals (RFP) for the supply of bortezomib to DHB hospitals, issued on 16 March 2016, and was the subject of a consultation letter dated 20 May 2016.

The proposal was approved as consulted on. In summary, the effect of the decision is that:  

  • Janssen-Cilag’s brand of bortezomib (Velcade) inj 3.5 mg vial will have HSS from 1 July 2016 until 30 June 2019.
  • A confidential rebate will apply to Velcade inj 3.5 mg vial which will reduce the net price to DHB hospitals.
  • Bortezomib inj 1 mg for ECP (Baxter) will remain listed at $594.77 per 1 mg in Section B of the Pharmaceutical Schedule.
  • Bortezomib inj 1 mg vial (Velcade) will be delisted from 1 September 2016 in Part II of Section H, and from 1 December 2016 in Section B, of the Pharmaceutical Schedule.
  • There will be no changes to current Special Authority and hospital restrictions for bortezomib as a result of this proposal.

Details of the decision

  • Velcade inj 3.5 mg vial will be awarded Hospital Supply Status from 1 July 2016 to 30 June 2019 with a 1% DV limit.
  • Velcade inj 3.5 mg vial will remain listed in Part II of Section H (the Hospital Medicines List or HML) and Velcade inj 3.5 mg vial, and bortezomib inj 1 mg for ECP will remain listed in Section B (as a PCT only - Specialist pharmaceutical) of the Pharmaceutical Schedule at the following price (ex-manufacturer and excluding GST):

Chemical

Presentation

Brand

Pack size

Price

bortezomib

Inj 3.5 mg vial

Velcade

1

$1,892.50

bortezomib

Inj 1 mg for ECP

Baxter

1 mg

$594.77
  • A confidential rebate will apply to Velcade inj 3.5 mg vial which will reduce its net price to the Funder.
  • Velcade inj 3.5 mg vial and Inj 1 mg for ECP will remain listed subject to the current Special Authority criteria and hospital restrictions.
  • Velcade inj 1 mg vials will remain listed on the Pharmaceutical Schedule at the current price and subsidy until the following delisting dates:
  • 1 September 2016 in Part II of Section H of the Pharmaceutical Schedule
  • 1 December 2016 in Section B of the Pharmaceutical Schedule.

Feedback received

We appreciate all of the feedback that we received and acknowledge the time people took to respond. All consultation responses were considered in their entirety in making a decision on the proposed changes. Most responses were supportive of the proposal. The following issue was raised in relation to one specific aspect of the proposal:

Theme

PHARMAC response

One responder was opposed to the delisting of the 1 mg vial because they considered that the visual difference between the 1 mg vial and 3.5 mg vial is important for the compounding process to minimise the risk of potential medication error. The responder noted the two vial types can be used to distinguish between concentrations following reconstitution:

  • the inj 1 mg vial for intravenous  administration (1 mg/ ml); and
  • the inj 3.5 mg vial for subcutaneous administration (2.5 mg/ ml).

We consider that the availability of two vial sizes is not a critical requirement to safely managing potential medication error. Creating any shortcut for identifying a pharmaceutical and its concentration such as using vial type should be discouraged.

We note that the use of the 1 mg vial is extremely low and our clinical advice is that it is not clinically necessary for this strength to remain listed.

More information

If you have any questions about this decision, you can email enquiry@pharmac.govt.nz.