Increase to part-charges for Fortisip and Fortisip Multi Fibre nutritional supplements

Medicines Decision

What is happening?

From 1 July 2024 prices for Fortisip and Fortisip Multi Fibre supplied by Nutricia will increase. This means the amount people pay for the part-charge for these products will increase. 

The part-charge is made up of two parts:

  • The difference between the subsidy paid by Pharmac and the price charged by the supplier, which will increase from $0.62 to $1.20 (including GST) and; 
  • An additional margin that pharmacies may to apply to these products.

Pharmacies choose how much margin to apply to these products. As a result, Pharmac is unable to say what the exact part-charge will be.

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 Fortisip and Fortisip Multi Fibre. Talk to your prescriber about the alternative options available if you currently pay a part-charge and would like to move to a fully funded product.

Fortisip and Fortisip Multi Fibre 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 Fortisip and Fortisip Multi Fibre 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 of Fortisip and Fortisip Multi Fibre, Nutricia, has told us that this price increase is needed to sustain ongoing supply. Nutricia is experiencing increases in supply chain costs, which includes global price increases for materials and raw ingredients used in the manufacturing of its products.

We have worked with Nutricia, 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 within our fixed budget. 

Reference pricing

Fortisip and Fortisip Multi Fibre, supplied by Nutricia are currently listed in Section D and Part II of Section H of the Pharmaceutical Schedule and have been available since 1995 and 2006 respectively. 

Since April 2011, Fortisip and Fortisip Multi Fibre 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

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. Nutricia’s sale price for Fortisip and Fortisip Multi Fibre is higher than the referenced price of the Ensure brand oral feed powder. This means people who use Fortisip or Fortisip Multi Fibre must pay the difference in price. This is known as a ‘part-charge’.

Changes from 1 July 2024

From 1 July 2024 the price of Fortisip and Fortisip Multi Fibre will increase. This means that the part-charge paid by people for Fortisip and Fortisip Multi Fibre will also increase. 

Pharmac will continue to fully fund Fortisip and Fortisip Multi Fibre 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. Fortisip and Fortisip Multi Fibre will remain fully funded for use in Health New Zealand Hospitals.

People who are eligible for fully funded Fortisip 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 Fortisip Multi Fibre in the community are: 

  • People being bolus fed through a feeding tube 
  • People who have severe epidermolysis bullosa

The price of fully funded 200 ml bottles of Fortisip and Fortisip Multi Fibre will increase from $1.26 to $1.76 from 1 July 2024 (excluding GST).

The part charge paid by people who receive partial funding for Fortisip and Fortisip Multi Fibre will increase. The difference between the Pharmac subsidy and the amount charged by the supplier will increase from $0.62 to $1.20 (including GST).

Pharmacies can choose to apply an additional margin to the part charge paid by people for Fortisip and Fortisip Multi Fibre. This means that the actual amount paid by people will likely be higher than what we have shared above.

We have created a resource for pharmacies to share to help communicate these changes: [resource title]

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 recently notified of similar changes to the prices for Ensure Plus and TwoCal HN nutritional supplements supplied by Abbott. 

We plan to review the reference pricing arrangements for Fortisip, Fortisip Multi Fibre 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.