Proposal to award sole supply of propofol in DHB hospitals

Medicines Consultation Closed

Following a Request for Tender for the supply of propofol to DHB hospitals, issued on 14 October 2015, PHARMAC is seeking feedback on a proposal to:

  • award Hospital Supply Status for propofol injection 10 mg per ml, 20 ml to AFT Pharmaceuticals Limited for its Provive MCT-LCT 1% 10 mg per ml, 20 ml vial from 1 May 2016 until 30 June 2019 with a 10% DV limit; and
  • award Hospital Supply Status for propofol injection 10 mg per ml, 50 ml and 100 ml to Fresenius Kabi New Zealand Limited for its Fresofol 1% MCT/LCT 10 mg per ml, 50 ml vial and 10 mg per ml, 100 ml vial from 1 May 2016 until 30 June 2019 with a 10% DV limit.

Proposal to award sole supply of propofol in DHB hospitals

In summary, this proposal would result in the following:

  • the 50 ml and 100 ml presentations of Fresenius Kabi’s Fresofol 1% MCT/LCT brand being listed, which will replace the currently listed Fresofol 1% brand by 1 May 2016;
  • all listed presentations of propofol would be in a vial presentation;
  • all listed presentations of propofol would be of the MCT-LCT formulation;
  • all currently listed propofol products other than Provive MCT-LCT 1% 20 ml vial being delisted; and
  • a reduction in price across all three volume presentations of propofol.

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Friday, 15 January 2016 to:

Andrew Park
Therapeutic Group Manager
PHARMAC
PO Box 10 254
Wellington 6143

Email: andrew.park@pharmac.govt.nz
Fax:      04 460 4995

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.

Details of the proposal

  • AFT’s Provive MCT-LCT 1% (propofol) 20 ml vial, would remain listed and Fresenius Kabi’s Fresofol 1% MCT/LCT (propofol) 50 ml and 100 ml vials would be listed in pack sizes of 10 vials, in Part II of Section H of the Pharmaceutical Schedule at the following prices from 1 March 2016:
    Chemical Presentation Brand Pack size Current price per pack
    (ex-man, ex GST)    		 Proposed price per pack 
    (ex-man, ex GST)
    Propofol Inj 10 mg per ml, 20 ml vial Provive MCT-LCT 1% 5 $7.60 $5.27
    Propofol Inj 10 mg per ml, 50 ml vial Fresofol 1% MCT/LCT 10 N/A $24.50
    Propofol Inj 10 mg per ml, 100 ml vial Fresofol 1% MCT/LCT 10 N/A $49.00
  • Provive MCT-LCT 1% inj 10 mg per ml, 20 ml vial would be awarded Hospital Supply Status from 1 May 2016 until 30 June 2019 with a 10% DV limit.
  • Fresofol 1% MCT/LCT inj 10 mg per ml, 50 ml vial would be awarded Hospital Supply Status from 1 May 2016 until 30 June 2019 with a 10% DV limit.
  • Fresofol 1% MCT/LCT inj 10 mg per ml, 100 ml vial would be awarded Hospital Supply Status from 1 May 2016 until 30 June 2019 with a 10% DV limit.
  • The following currently listed presentations would be delisted from Part II of Section H of the Pharmaceutical Schedule from 1 May 2016:
    Chemical Presentation Brand Supplier Pack size Current price (ex-man, ex GST)
    Propofol Inj 10 mg per ml, 20 ml ampoule Fresofol 1% Fresenius Kabi 5 $7.60
    Propofol Inj 10 mg per ml, 20 ml vial Diprivan AstraZeneca 5 $42.00
    Propofol Inj 10 mg per ml, 50 ml vial Diprivan AstraZeneca 1 $25.00
    Propofol Inj 10 mg per ml, 50 ml vial Fresofol 1% Fresenius Kabi 1 $4.00
    Propofol Inj 10 mg per ml, 50 ml vial Provive MCT-LCT 1% AFT 1 $4.00
    Propofol Inj 10 mg per ml, 50 ml syringe Diprivan AstraZeneca 1 $47.00
    Propofol Inj 10 mg per ml, 100 ml vial Fresofol 1% Fresenius Kabi 1 $7.60
    Propofol Inj 10 mg per ml, 100 ml vial Provive MCT-LCT 1% AFT 1 $7.60
  • Should the proposal be approved:
    • this would result in the removal of the syringe presentation; and
    • the removal of all non MCT-LCT propofol formulations (LCT and EDTA containing).
  • PHARMAC staff note that:
    • current usage of the syringe presentation is very low, at less than 1% of the current 50 ml propofol market in terms of units, with some use still possible under the proposed DV limit; and
    • current usage of the EDTA containing presentations is low, at less than 2% of the current market in terms of units, with some use still possible under the proposed DV limit. 

Background

Propofol is a short-acting general anaesthetic indicated for induction and maintenance of general anaesthesia, sedation during intensive care and during diagnostic or surgical procedures.

In October 2015, PHARMAC invited tenders for the sole supply of propofol to DHB hospitals, with a 10% DV limit, via a Request for Tenders (RFT) document. This proposal to award tenders for Hospital Supply Status for propofol is the result of this process.

Approximately 350,000 units of propofol are administered to patients in DHB hospitals each year made up of approximately 250,000 x 20 ml, 85,000 x 50 ml and 15,000 x 100 ml presentations.

Advice we have received from clinicians indicated a preference for the vial presentation over ampoules, with this preference being indicted in the RFT document. Should the proposal be approved, the packaging for all three listed presentations would be vials.