Decision to widen funded access to macrogol 3350

Medicines

Decision

We’re pleased to inform you about our decision to remove the Special Authority, quantity restrictions and Hospital Medicines restrictions on macrogol 3350 (Molaxone and Lax-sachets) from 1 March 2018.

What we’re doing

We’re pleased to inform you about our decision to remove the Special Authority, quantity restrictions and Hospital Medicines restrictions on macrogol 3350 (Molaxone and Lax-sachets) from 1 March 2018.

Why are we doing this?

The original listing of macrogol 3350 in October 2007 was the subject of a consultation letter, relevant feedback to this consultation was discussed in the notification of this listing. Over the years PHARMAC has received correspondence from clinicians and patient groups about the funding criteria; this prompted a change to the quantity restriction and rewording of the special authority in October 2014.

The Gastrointestinal Subcommittee, at its March 2017 meeting considered two proposals to widen access to macrogol 3350. Firstly, for all patients (removal of the Restrictions completely) and secondly to widen access to schizophrenic patients co-prescribed clozapine (direct access without a trial of lactulose). It considered the evidence and recommended restrictions be removed with a high priority, The Pharmacology and Therapeutics Advisory Committee endorsed these minutes in November 2017.

Who we think will be most interested

This decision will be of interest to:

  • patients currently unable to access funded macrogol, who are potentially using other laxatives.
  • community and hospital clinicians, internal medicine physicians, gastroenterologists, psychiatrists and general practitioners.
  • hospital and community pharmacists, DHBs, suppliers and wholesalers.

This decision is expected to reduce administrative burden for clinicians. Macrogol 3350 is ranked number three of Special Authority by application volume.

What will the effect of this decision be?

From 1 March 2018 clinicians will no longer be required to apply for Special Authority approvals to access funded macrogol 3350 (Molaxone and Lax-Sachets) for their patients. This decision is expected to improve patient health outcomes.

Currently patients need to meet the following criteria to access funded macrogol 3350:

  1. The patient has problematic constipation despite an adequate trial of other oral pharmacotherapies including lactulose where lactulose is not contraindicated; and
  2. The patient would otherwise require a per rectal preparation.

Molaxone is supplied by Mylan via a sole supply arrangement, as a result of the annual multi-product tender, which ends on 30 June 2020. The incumbent sole supply product (Lax-sachets supplied by AFT Pharmaceuticals) will be delisted from 1 May 2018.

Feedback

If you have any questions, you can email us at enquiry@pharmac.govt.nz or call our toll free number on 0800 66 00 50.