Increase to part-charges for Ensure Plus and TwoCal HN nutritional supplements
What is happening?
From 1 April 2024 prices for the Ensure Plus and Two Cal HN nutritional supplements supplied by Abbott will increase. This means the amount people pay for the part-charge for these products will increase.
Based on the price agreed with Abbott, the cost for people who receive partial funding for these products will increase (excluding GST) to:
- $0.84 per 200 ml bottle of Ensure Plus
- $0.80 per 237 ml bottle of Ensure Plus
- $1.40 per bottle for Two Cal HN.
Pharmacies may choose to apply a margin to these products so the total cost on purchase may be higher.
We understand that people will be disappointed that the cost of these products is increasing.
There are fully funded oral feed supplements available, which may be suitable for people using Ensure Plus and Two Cal HN. Talk to your prescriber about the alternative options if you currently pay a part-charge and would like to move to a fully funded product.
Ensure Plus and Two Cal HN will continue to be fully funded in the community for people who meet the criteria for additional subsidy by endorsement, and in Health New Zealand – Te Whatu Ora Hospitals. In these situations, a part-charge is not required.
Who we think will be most interested
- People using Ensure Plus and Two Cal HN who pay a part-charge and their whānau and family
- Healthcare professionals involved in the care of people who require oral feed supplements and other nutritional supplements
- Wholesalers, pharmacies and suppliers of other special foods in New Zealand.
Details about this decision
Reason for price increases
The supplier, Abbott, has told us that this price increase is needed to sustain ongoing supply. Abbott is experiencing increases in supply chain costs, which includes global price increases for materials and raw ingredients used in the manufacturing its products.
We have worked with Abbott, to minimise the impact of any price increase as much as possible but are unable to take on any further costs to our fixed budget.
Pharmac must make very difficult decisions about what medicines are funded for people in New Zealand with our fixed budget.
Reference pricing
Ensure Plus and Two Cal HN, supplied by Abbott are currently listed in Section D and Part II of Section H of the Pharmaceutical Schedule and have been available since 1995.
Since April 2011, Ensure Plus and Two Cal HN have been funded in the community subject to reference pricing, which means they are partially funded for some people in the community. Reference pricing is where Pharmac pays the same amount for medicines that have the same or similar therapeutic effect.
More information on reference pricing – Pharmac website
Our clinical advisors have told us it would be appropriate to reference price these supplements if fully funded alternatives were available. In 2011 we decided to fully fund the Ensure brand of 1 kcal / ml oral feed powder and reference price a range of liquid nutritional supplements to it. Abbott’s sale price for Ensure Plus and Two Cal HN is higher than the referenced price of the Ensure brand oral feed powder. This means people who use Ensure Plus or Two Cal HN must pay the price difference. This is known as a ‘part-charge’.
Changes from 1 April 2024
From 1 April 2024 the price of Ensure Plus and Two Cal HN will increase. This means that the part-charge paid by people for Ensure Plus and Two Cal HN will also increase.
Pharmac will continue to fully fund Ensure Plus and Two Cal HN for people in the community who meet the criteria for additional funding. This additional funding is called ‘additional subsidy by endorsement’ in the Pharmaceutical Schedule. Ensure Plus and Two Cal HN will remain fully funded for use in Health New Zealand Hospitals.
People who are eligible for fully funded Ensure Plus in the community are:
- People being bolus fed through a feeding tube
- People who have severe epidermolysis bullosa
- Children under the age of 18 years receiving exclusive enteral nutrition for the treatment of Crohn's disease
- People with COPD and hypercapnia, defined as CO2 value exceeding 55mmHg
People who are eligible for fully funded Two Cal HN in the community are:
- People being bolus fed through a feeding tube
- People who have severe epidermolysis bullosa
Price changes for people who receive partial funding:
| Ensure Plus 200 ml | Ensure Plus 237 ml | Two Cal HN 200 ml | ||||
| Current | From 1 April 2024 | Current | From 1 April 2024 | Current | Increase from 1 April 2024 | |
| Pharmac subsidy | $0.72 | $0.72 | $0.85 | $0.85 | $0.96 | $0.96 |
|---|---|---|---|---|---|---|
| Part-charge per bottle | $0.54 | $0.84 | $0.48 | $0.80 | $0.94 | $1.40 |
| Total price per bottle | $1.26 | $1.56 | $1.33 | $1.65 | $1.90 | $2.36 |
Pharmacies can choose to apply an additional margin to the part charge paid by people for Ensure Plus and Two Cal HN. This means that the actual amount paid by people may be higher than what we have shared above.
We have created a resource for pharmacies to share these changes:
- Abbott Foods price increase (A5 flier) March 2024 [PDF 110 KB]
Alternatives are available
We understand that increasing part-charges may have a significant impact for some people. For people who want to move from a partially funded supplement to a fully funded supplement, options are available which may be suitable.
If you would like to consider fully funded alternatives, discuss these with your healthcare professional.
We plan to review the reference pricing arrangements for Ensure Plus, Two Cal HN and other liquid supplements later in 2024.
Contact us
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.