Proposal to fund levetiracetam inj for palliative care
Update on funding decision - May 2024
We are grateful for the feedback provided during the consultation on our proposal to fund levetiracetam injections for palliative care. We have received requests for wider access to levetiracetam injection that we are considering.
We are now proposing to list levetiracetam injection in Section B of the Pharmaceutical Schedule from 1 July 2024. We understand that there is a desire for levetiracetam injection to be available as soon as possible for those that need it.
In the meantime, for individuals with urgent or exceptional circumstances, prescribers can consider submitting a Named Patient Pharmaceutical Assessment application for consideration.
We will publicly notify as soon as possible, once a decision has been made.
What we’re proposing
We are seeking feedback on a proposal to fund levetiracetam injection for people who are receiving palliative care in the community.
If approved, levetiracetam injection 100 mg per ml would be listed in Section B of the Pharmaceutical Schedule subject to an endorsement from 1 June 2024.
We welcome your feedback on this proposal. Consultation closes at 4pm, 1 May, 2024 and feedback can be emailed to consult@pharmac.govt.nz
What would the effect be?
Levetiracetam injection 100 mg per ml would be funded for people in the community who require palliative care services and are unable to take medicines orally (by mouth) to prevent seizures.
We estimate that up to 700 people would access levetiracetam injection in the first year, increasing to about 730 people per year after five years.
If approved, the funding of levetiracetam injection may support improved symptom control at home, reducing the need for acute hospital admissions for management of seizures. This may allow the individual to spend more time with their family/whānau at home.
Who we think will be interested
- Family, whānau and friends of people receiving palliative care services
- Healthcare professionals involved in hospice and palliative care communities
- Hospital and community pharmacists and Te Whatu Ora hospitals
- Pharmaceutical suppliers
About levetiracetam
Levetiracetam is a medicine used to treat epilepsy by preventing seizures. Levetiracetam tablets and oral liquid are listed in Section B and Part II of Section H of the Pharmaceutical Schedule without restriction.
Levetiracetam injection 100 mg per ml is listed in Part II of Section H without any restrictions. It is currently supplied by AFT who was awarded Hospital Sole Supply Status in the 2018/19 Invitation to Tender.
Levetiracetam tablets and oral liquid are approved for people with epilepsy who have multiple types of seizures. Levetiracetam injection 100 mg per ml is Medsafe approved [PDF](external link) for intravenous use as an alternative for people when oral administration is not feasible.
Levetiracetam injection is not Medsafe approved for subcutaneous use. It would need to be prescribed and used in accordance with section 25 of the Medicines Act 1981.
You can read more about section 25 of the Medicines Act 1981 on the Medsafe website(external link)
Why we’re proposing this
The Analgesic Advisory Committee reviewed a funding application for levetiracetam injection for those experiencing seizures in a palliative care setting in May 2022. The Advisory Committee recommended levetiracetam injection be funded in the community with a medium priority. You can find more information about this application on the Application Tracker(external link).
The Committee told us that there remains a very high unmet need for seizure control in the palliative care setting in the community for those who can no longer take oral medications and for whom current treatment options have sedative effects.
The Committee noted that, while levetiracetam is available in oral formulations, there is only one Medsafe approved brand of levetiracetam for intravenous injection. The Committee considered that it can be used subcutaneously and that it may provide a health benefit and be less sedating than other anti-seizure medications.
We understand that levetiracetam injection is administered subcutaneously in a hospital setting for people receiving palliative care. However, we would like to enable hospices and those receiving palliative care in the community to access levetiracetam injection if they need it.
Details about our proposal
Levetiracetam (Levetiracetam-AFT) would be listed in Section B of the Pharmaceutical Schedule from 1 June 2024, as follows:
|
Chemical |
Formulation |
Brand |
Pack size |
Price and subsidy |
|---|---|---|---|---|
|
Levetiracetam |
Inj 100 mg per ml, 5 ml vial |
Levetiracetam- AFT |
10 |
$38.95 |
This listing would be subject to the following endorsement:
Subsidy by endorsement - Subsidised only for people receiving palliative care services where the oral route is unsuitable.
To provide feedback
Consultation closes at 4pm, 1 May, 2024 and feedback can be emailed to consult@pharmac.govt.nz
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.
Your feedback may be shared
Feedback we receive is subject to the Official Information Act 1982 (OIA). Please be aware that we may need to share your feedback, including your identity, in response to an OIA request. This applies to anyone providing feedback, whether they are providing feedback themselves or for an organisation, in a personal or professional capacity.
We can only keep feedback confidential as allowed under the OIA and other related laws. If you want any part of your feedback treated as confidential, you need to tell us. Please let us know if you want to keep part of your feedback confidential, and why. Is it commercially sensitive, confidential or proprietary, or personal information? Clearly state this and tell us which parts of your feedback you want to keep confidential for these reasons. We will consider your request under our OIA requirements.