Proposal to list Nitrolingual Pump Spray (glyceryl trinitrate oral spray) and Azamun (azathioprine tablets)

In summary, this proposal would result in:

• Nitrolingual Pump Spray being fully funded for patients from 1 May 2015; and
• Azamun being fully funded for patients from 1 February 2015. 

Further details of the proposal can be found on the following pages.

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Wednesday, 5 November 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

• Nitrolingual Pump Spray would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 May 2015 at the following prices and subsidies (ex-manufacturer, excluding GST):

  Chemical	Presentation	Brand	Pack size	Price and subsidy
  Glyceryl trinitrate	Oral pump spray, 400 mcg per dose	Nitrolingual Pump Spray	250 dose OP	$4.45

• There would be no change to the listing of the Glytrin brand of glyceryl trinitrate oral spray on the Pharmaceutical Schedule.
• We propose that Nitrolingual Pump Spray would be available via stat dispensing i.e. up to three months of treatment may be dispensed all at once, and up to 250 doses would be available on a practitioners supply order.
• Azamun would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 February 2015 at the following prices and subsidies (ex-manufacturer, excluding GST):

  Chemical	Presentation	Brand	Pack size	Price and subsidy
  Azathioprine	Tab 25 mg	Azamun	60	$8.28

Background

Nitrolingual Pump Spray

Glyceryl trinitrate is a medicine that is used to treat an attack of angina and comes in tablet and spray forms, both of which are listed on the Pharmaceutical Schedule.

A sole supply arrangement for the Glytrin brand of glyceryl trinitrate spray ended a few months ago. PHARMAC is therefore able to progress a proposal that would result in the listing of a second brand of glyceryl trinitrate spray on the Pharmaceutical Schedule. PHARMAC is aware that some patients have had difficulties using the pump device for the Glytrin brand. This proposal would avoid the requirement of a Named Patient Pharmaceutical Assessment application for exceptional funding for such patients and would reduce the burden on clinicians associated with this.

The listing of two brands of glyceryl trinitrate spray would allow patients and clinicians to choose the device that is most clinically appropriate for them.

Azamun

Azathiprine is an immunosuppressant medicine that is used to prevent rejection following organ transplantation and to treat some autoimmune diseases. Azathioprine is currently listed on the Pharmaceutical Schedule as a 50 mg tablet and a 50 mg vial for injection. 

PHARMAC staff have received clinical advice that a 25 mg tablet preparation is desirable for those patients who require 25mg dose increments and would avoid them having to halve tablets.