Proposal to award sole supply for fluticasone and fluticasone with salmeterol metered dose inhalers
PHARMAC is seeking feedback on a proposal to make changes to the funded brands of fluticasone and fluticasone with salmeterol metered dose inhalers (MDIs), which are used in the treatment of asthma and chronic obstructive pulmonary disease (COPD).
A decision has been made
What we’re proposing
These changes would mean that only the Flixotide and Seretide brands would be funded from 1 September 2020, following a six-month transition period.
These changes would mean that most people using fluticasone and fluticasone with salmeterol MDIs (approximately 220,000 people) would remain on their currently funded brand, but a small proportion of people (about 5%) using the Floair and RexAir brands would need to change to the Flixotide and Seretide brands in order to remain on a fully funded brand.
If the proposal is approved, the following changes would occur:
- The Flixotide brand of fluticasone MDI and the Seretide brand of fluticasone with salmeterol MDI, which are currently funded and supplied by GlaxoSmithKline NZ Limited (GSK), would be the only funded brands of fluticasone and fluticasone with salmeterol MDIs following a six-month transition period starting from 1 March 2020.
- Following the six-month transition period, from 1 September 2020, the Floair brand of fluticasone MDI and RexAir brand of fluticasone with salmeterol MDI, which are currently funded and supplied by Rex Medical Limited (Rex Medical), would no longer be funded and would be delisted from the Pharmaceutical Schedule.
The arrangements outlined above would apply until at least 30 June 2023.
This proposal results from a competitive process for the supply of fluticasone and fluticasone with salmeterol MDIs and would release significant funds for PHARMAC to invest in other medicines for the benefit of New Zealanders.
Consultation closes at 4pm, Wednesday 6 November 2019 and feedback can be emailed to Josh Wiles, Procurement Manager, PHARMAC - josh.wiles@pharmac.govt.nz.
What would the effect be?
For patients
There are currently approximately 220,000 patients using fluticasone and fluticasone with salmeterol MDIs in the community. Most of these patients are currently using the Flixotide and Seretide brands of these treatments and would be unaffected by this proposal and would not need to change brands.
Approximately 12,000 patients currently using the Floair brand of fluticasone MDI and the Rex Air brand of fluticasone with salmeterol MDI would need to change to the Flixotide brand of fluticaonse MDI or the Seretide brand of fluticasone with salmeterol MD (as applicable) before 1 September 2020 in order to stay on a fully funded treatment.
For pharmacies, asthma and COPD clinicians, educators and support organisations
From 1 March 2020, a six-month transition period would begin, requiring your assistance to transition and support patients currently using the Floair and the RexAir brands of fluticasone and fluticasone with salmeterol MDIs to change to the Flixotide and the Seretide brands. Haleraids and placebo MDIs would continue to be available free of charge throughout the transition period and the subsequent sole supply period.
For prescribers
Prescribers would be required to support people needing to change brands as a result of this proposal, and to provide education on best practice inhaler technique for their new brand of inhaler.
Prescribers would continue to be able to prescribe funded fluticasone and fluticasone with salmeterol MDIs.
For DHBs
From 1 March 2020, the confidential net price of Flixotide and Seretide would reduce.
Who we think will be interested
- People currently using fluticasone and fluticasone with salmeterol MDIs and their family, whānau or caregivers.
- Organisations and groups that support clinicians and individuals with asthma and COPD, such as Asthma New Zealand and Asthma and Respiratory Foundation NZ.
- Clinicians who treat people with asthma and COPD, general practitioners, nurse specialists, nurse practitioners and nurse educators.
- Hospital and community pharmacists, DHBs and wholesalers.
- Suppliers of fluticasone and fluticasone with salmeterol MDIs or other inhaled molecules for the treatment of asthma and COPD.
About fluticasone and fluticasone with salmeterol MDIs
Fluticasone is an inhaled corticosteroid used as a prophylactic (preventative) treatment in the management of asthma and is also used to manage chronic obstructive pulmonary disease in some cases. Fluticasone in combination with salmeterol (which is a long-acting beta agonist) provides additional symptom control.
Fluticasone MDI and fluticasone with salmeterol MDI have been fully funded in New Zealand since 1996 and 2006 respectively.Why we’re proposing this
As a result of the RFP and our analysis of the proposals received, including expert advice from PHARMAC’s Respiratory Inhalers Advisory Committee PHARMAC has entered into a provisional agreement with GSK for the supply of the Flixotide brand of fluticasone MDI and the Seretide brand of fluticasone with salmeterol MDI.
This proposal would release significant funds for PHARMAC to invest in other medicines for the benefit of New Zealanders. Feedback to this consultation will help us decide if this agreement should be confirmed.
Details about our proposal
- From 1 March 2020, the price and subsidy of the Flixotide brand of fluticasone MDI and the Seretide brand of fluticasone with salmeterol MDI would be reduced in Section B and Part II of Section H of the Pharmaceutical Schedule.
- A confidential rebate would apply to all strengths of the Flixotide brand of fluticasone MDI and Seretide brand of fluticasone with salmeterol MDI, which would reduce the net prices to the funder.
- From 1 March 2020, people currently using the Floair and RexAir brands of fluticasone and fluticasone with salmeterol MDIs would need to change to the Flixotide and Seretide brands of fluticasone and fluticasone with salmeterol MDIs.
- From 1 September 2020, the Floair and RexAir brands of fluticasone and fluticasone with salmeterol MDIs would be delisted from the Section B and Part II of Section H of the Pharmaceutical Schedule, and would no longer be funded.
From 1 September 2020, the Flixotide and Seretide brands would be the only funded brands of fluticasone and fluticasone with salmeterol MDIs listed in Section B and Part II of Section H of the Pharmaceutical Schedule as follows:
|
Chemical |
Brand |
Strength |
Doses |
|---|---|---|---|
|
Fluticasone |
Flixotide |
50 mcg per dose |
120 dose OP |
|
125 mcg per dose |
120 dose OP |
||
|
250 mcg per dose |
120 dose OP |
||
|
Fluticasone with salmeterol |
Seretide |
50 mcg with salmeterol 25 mcg |
120 dose OP |
|
125 mcg with salmeterol 25 mcg |
120 dose OP |
The proposed arrangements above would apply until at least 30 June 2023, with two optional extension periods of one year each until 30 June 2024 and 30 June 2025 respectively, to be exercised at PHARMAC’s sole discretion.
To provide feedback
Send us an email: josh.wiles@pharmac.govt.nz by 4pm, Wednesday 6 November 2019.
All feedback received before the closing date will be considered by PHARMAC’s Board (or its delegate) prior to making a decision on this proposal.
Feedback we receive is subject to the Official Information Act 1982 (OIA) and we will consider any request to have information withheld in accordance with our obligations under the OIA. Anyone providing feedback, whether on their own account or on behalf of an organisation, and whether in a personal or professional capacity, should be aware that the content of their feedback and their identity may need to be disclosed in response to an OIA request.
We are not able to treat any part of your feedback as confidential unless you specifically request that we do, and then only to the extent permissible under the OIA and other relevant laws and requirements. If you would like us to withhold any commercially sensitive, confidential proprietary, or personal information included in your submission, please clearly state this in your submission and identify the relevant sections of your submission that you would like it withheld. PHARMAC will give due consideration to any such request.