Decision to change the sole subsidised brand of lidocaine [lignocaine] hydrochloride gel 2%, urethral syringe

Medicines

Decision

The funded brand of lidocaine [lignocaine] hydrochloride gel 2%, urethral syringe will change from Cathejell to Instillagel Lido.

Instillagel Lido will be listed 1 January 2020 and become the sole subsidised brand in the community and hospital settings 1 April 2020, following a 3 month transition period.

Cathejell will be delisted from the Pharmaceutical Schedule 1 April 2020.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 14 November 2019

Following consideration of consultation feedback the decision to change the sole subsidised brand of lidocaine [lignocaine] gel 2%, urethral syringe was approved as consulted on without any changes.

Who we think will be most interested

  • Patients and their carers
  • DHB staff, including nurses, pharmacists and doctors

Details about this decision

The following changes will occur in Section B and Part II of Section H of the Pharmaceutical Schedule.

The sole subsidised brand of lidocaine [lignocaine] hydrochloride gel 2%, urethral syringe would change from Cathejell to Instillagel Lido. The following will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 January 2020 as follows: 

Chemical and presentation

Brand

Pack Size

Price and subsidy
(ex-man., ex. GST)

Lidocaine [lignocaine] hydrochloride gel 2%, 11 ml urethral syringe

Instillagel Lido

10

$42.00

The following restrictions will continue to apply to LIDOCAINE [LIGNOCAINE] Gel 2%, 11 ml urethral syringe in Section B of the Pharmaceutical Schedule:

  1. Up to 5 each available on a PSO
  2. Subsidised only if prescribed for urethral or cervical administration and the prescription is endorsed accordingly.

The supplier, InterPharma, will be offering in-servicing support for Instillagel Lido. For more information, please contact Drew Williams from InterPharma by email at drewwilliams@interpharma.com.au.

Lidocaine Gel 2% Urethral syringe.

Our response to what you told us

We’re really grateful for the time people took to respond to this consultation. Overall, feedback was supportive of the Instillagel Lido brand. A summary of the main themes raised in feedback and our responses to the feedback received is set out below.

Feedback Theme

Comment

Preference for Pfizer brand

Due the sole supply agreement with InterPharma until 30 June 2022, this is not possible at this time.

Preference for Cathejell to remain listed

Due the sole supply agreement with InterPharma until 30 June 2022, this is not possible at this time.

General feedback that Instillagel Lido is preferred to Cathejell

Noted.

Noted a preference for the applicators to be packaged with the syringe

PHARMAC has investigated the potential for applicators to be packaged with the urethral syringe; however, the supplier has confirmed that this is not possible. The supplier has indicated that international practice is to use these syringes without the applicator and therefore there is no combined presentation.

Noted danger of syringe presentation for mistaken use with an infusion line

Instillagel Lido is presented in a non-leur slip, non-parenteral syringe. The syringe tip means that the risk of connecting the syringe to a needle or infusion line is minimised.

Noted there may be more wastage when Instillagel Lido is used without the applicator tip

Instillagel Lido is 1 ml greater than previously supplied brands, this would help to offset any potential wastage.

Noted the Instillagel Lido applicator provides shorter extension than the syringe tip alone and that it is uncertain whether the length of the applicator would be suitable in practice.

The Instillagel Lido applicator is very similar to the Pfizer brand. Due to feedback for the strong preference for the Pfizer brand, PHARMAC staff consider that Instillagel Lido would offer similar suitability with respect to the applicator length.

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.