Proposal to change the funded brand of epoetin alfa
What we’re proposing
PHARMAC is seeking feedback on a proposed change to the funded brand of epoetin alfa [erythropoietin alfa] injections used in the treatment of chronic renal failure and myelodysplasia:
- the funded brand would change from Eprex (supplied by Janssen) to Binocrit (supplied by Novartis) following a transition period starting on 1 February 2019;
- from the end of the transition period, Binocrit would be the only funded brand in both the community and hospital settings.
Consultation closes at 4 pm on Monday 10 September 2018 and feedback can be emailed to procurement@pharmac.govt.nz.
What would the effect be?
For patients
- From 1 February 2019, people would have funded access to a new brand of epoetin alfa (Binocrit);
- From 1 July 2019, the currently funded brand of epoetin alfa, Eprex, would be delisted, so people using this brand of epoetin alfa would need to change to Binocrit to keep accessing a funded treatment.
For community pharmacies
Following the listing of each strength of Binocrit on the Pharmaceutical Schedule, pharmacies could continue to dispense and claim for any listed brand of that strength of epoetin alfa injection for five months. After that, Binocrit would be the only funded brand of epoetin alfa injection.
For hospital pharmacies
Following the listing of Binocrit on the Pharmaceutical Schedule, pharmacies could continue to dispense any listed brand of that strength of epoetin alfa injection for two months. After that a discretionary variant (DV) limit of 1% would apply, meaning that only 1% of total purchases of that strength of erythropoietin injection could be a brand other than Binocrit. Note that epoetin beta is considered to be a (DV) pharmaceutical for epoetin alfa.
For prescribers
Prescribers would continue to be able to prescribe funded epoetin alfa, within the current Special Authority restrictions.
Who we think will be interested
People currently using epoetin alfa, pharmacists, clinicians involved in the management of chronic renal failure and/or myelodysplasia, DHBs and suppliers of epoetin injections.
About epoetin
Epoetin is a growth factor that stimulates the production of red blood cells.
Epoetin is currently funded subject to Special Authority and hospital restrictions as a treatment for chronic renal failure and myelodysplasia.
Why we’re proposing this
As a result of the RFP, PHARMAC has entered into a provisional agreement with Novartis New Zealand Limited for the supply of epoetin alfa and feedback to this consultation will help us to decide if this agreement should be confirmed.
Details about the our proposal
Listing of Binocrit
From 1 February 2019 Novartis’ brand of epoetin alfa (Binocrit) would be listed in Section B (the Community) and Part II of Section H (the Hospital Medicines List) of the Pharmaceutical Schedule as follows:
|
Chemical |
Presentation |
Brand |
Pack size |
|---|---|---|---|
|
Epoetin alfa [erythropoietin alfa] |
Inj 1,000 iu in 0.5 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 2,000 iu in 1 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 3,000 iu in 0.3 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 4,000 iu in 0.4 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 5,000 iu in 0.5 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 6,000 iu in 0.6 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 8,000 iu in 0.8 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 10,000 iu in 1 ml, syringe |
Binocrit |
6 |
|
Epoetin alfa [erythropoietin alfa] |
Inj 40,000 iu in 1 ml, syringe |
Binocrit |
1 |
Special Authority restrictions for epoetin alfa would remain unchanged.
Wastage would continue to be able to be claimed on epoetin alfa.
The price and subsidy would be notified should PHARMAC decide to progress the proposal following consideration of consultation feedback. A confidential rebate would apply that would reduce the net price to the Funder.
Reference pricing of other listed brands of epoetin alfa injections in the community
There would be no period of reference pricing in the community as both the existing funded brand of epoetin alfa and the proposed funded brand of epoetin alfa have confidential net pricing.
Epoetin Sole Supply
In DHB hospitals
From 1 April 2019 until 30 June 2022, Binocrit would be awarded Hospital Supply Status (HSS) for epoetin injections in DHB hospitals. This would result in Binocrit being the only available brand of epoetin in DHB hospitals, subject to a 1% DV limit (i.e. 99% of total volume of erythropoietin purchased by DHB hospitals would be required to be Binocrit).
From 1 April 2019, all other brands of epoetin would be delisted from Part II of Section H of the Pharmaceutical Schedule.
In the community
From 1 July 2019 until 30 June 2022, Binocrit would be awarded Sole Subsidised Supply status for epoetin injections in the community.
From 1 July 2019, all other brands of epoetin would be delisted from Section B of the Pharmaceutical Schedule.
To provide feedback
Send us an email: procurement@pharmac.govt.nz, by 4pm on 10 September 2018.
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.