Decision to list a new presentation of raltegravir and amend arrangements for raltegravir and posaconazole

Medicines Decision

We’re pleased to announce PHARMAC’s decision to approve a multiproduct agreement with Merck Sharpe & Dohme (MSD).

This will result in the listing of a new, once-daily presentation of raltegravir for the treatment of HIV, once it is registered with Medsafe, as well as changes to the contractual arrangements for the currently funded presentations of raltegravir and posaconazole.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 7 December 2018.

No changes were made to the proposal as described in the consultation.

Who we think will be most interested

  • Clinicians who prescribe HIV treatments.
  • People with HIV and organisations who support HIV treatment and prevention.
  • Suppliers of HIV treatments or of other anti-infective agents.
  • Community and hospital pharmacists, and wholesalers.
  • DHBs.

Detail about this decision

Posaconazole (Noxafil)

The confidential rebates that apply to both posaconazole (Noxafil) presentations (tab modified-release 100 mg and oral liq 40 mg per ml) will be changed from 1 February 2019. The effect of this will be to reduce the net cost of posaconazole.

The Noxafil brand of posaconazole will have subsidy and delisting protection until 30 June 2022.

There are no changes to the list price, or to the funding restrictions.

Raltegravir potassium tab 400 mg (Isentress)

The currently listed form of raltegravir potassium tab 400 mg, Isentress, will have subsidy and delisting protection until 30 June 2022.

There are no other changes to the listing: the list price, confidential rebate and funding restrictions will all remain the same as they are now.

Raltegravir potassium tab 600 mg (Isentress HD)

A new, once-daily 600 mg tablet presentation of raltegravir potassium, Isentress HD, will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule after it has received Medsafe approval. A registration application is currently being considered by Medsafe.

If approved by Medsafe, this 600 mg tablet presentation will be listed at a price and subsidy of $1,090.00 per pack of 60 tablets (ex-manufacturer, excluding GST), which is the same list price per tablet as the 400 mg tablet presentation. A confidential rebate will apply to Isentress HD, which reduces the cost of the medicine to the funder.

If listed, the 600 mg tablet presentation will be funded subject to the same funding restrictions as the 400 mg tablet.

Isentress HD will have subsidy and delisting protection until 30 June 2022.

Our response to what you told us

We’re really grateful for the time people took to respond to this consultation. All responders were supportive of the proposal.

One responder considered that the wastage rule should apply to the new 600 mg presentation of raltegravir. We consider that as the pack contains one month’s supply there is unlikely to be any wastage and note that this rule does not currently apply to the 400 mg presentation of raltegravir, which is listed at the same price and is also supplied in a pack size with one month’s supply. 

If you have any questions about this decision, you can email us at; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 66 00 50.