Proposal to fund preoperative carbohydrate 0.5kcal/ml oral feed (preOp) in DHB hospitals

PHARMAC is seeking feedback on a proposal to fund preoperative carbohydrate 0.5kcal/ml oral feed (preOp) in DHB hospitals from 1 August 2014 through a provisional agreement with Nutricia Limited.

In summary, this proposal would result in the listing of preOp in Part II of Section H (Hospital Medicines List; HML) of the Pharmaceutical Schedule from 1 August 2014, restricted to use as part of an Enhanced Recovery After Surgery (ERAS) protocol 2 hours before major abdominal surgery.

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Friday, 23 May 2014 to:

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

• Preoperative carbohydrate 0.5kcal/ml oral feed (preOp) would be listed in Part II of Section H of the Pharmaceutical Schedule (Hospital Medicines List; HML) from 1 August 2014 at a price of $1.70 per 200 ml (ex-manufacturer, excluding GST).

• preOp would be listed on the HML from 1 August 2014 subject to the following restrictions:

Oral feed 0.5 kcal/ml – Restricted

400 ml as part of an Enhanced Recovery After Surgery (ERAS) protocol 2 hours before major abdominal surgery

Background

A funding application was received from Nutricia Limited for preOp 0.5 kcal/ml oral feed which was reviewed by the Special Foods Subcommittee of the Pharmacology and Therapeutics Advisory Committee (PTAC). In summary, the Subcommittee considered that there was moderate quality evidence for the use of 400 ml of 0.5 kcal/ml carbohydrate feed as preoperative metabolic conditioning 2 hours prior to surgery for patients undergoing elective major abdominal surgery, as part of an ERAS protocol, and recommended funding it for this use with a high priority. This proposal is in line with the Subcommittee’s recommendation. Details of the funding application, including a reference to the relevant Subcommittee meeting minutes can be found on the Application Tracker on PHARMAC website at:

https://connect.pharmac.govt.nz/apptracker/s/global-search/preOp(external link)