Proposal to reinstate monthly dispensing on various pharmaceuticals (remove ‘stat’ dispensing)
PHARMAC is seeking feedback on a proposal to remove the ‘three months dispensed all-at-once’ (‘stat’) dispensing rule from the following pharmaceuticals from 1 March 2015, meaning that they would need to be dispensed monthly unless access exemptions apply:
- Betamethasone valerate cream (Beta Cream), ointment (Beta Ointment), lotion (Betnovate) and scalp application (Beta Scalp)
- Clobetasol propionate cream, ointment and scalp application (Dermol)
- Dexamethasone phosphate injection (Dexamethasone-hameln)
- Hydrocortisone cream (Pharmacy Health), tablets (Douglas) and injection (Solu-Cortef)
- Prednisolone oral liquid (Redipred)
- Sodium valproate tablets (Epilim Crushable, Epilim) and oral liquid (Epilim S/F Liquid, Epilim Syrup)
Feedback sought
PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by Tuesday, 27 January 2015 to:
Geraldine MacGibbon
Senior Therapeutic Group Manager/Team Leader
PHARMAC
PO Box 10 254, Wellington 6143
Email: dispensingconsult@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 withheld. PHARMAC will give due consideration to any such request
Details of the proposal
From 1 March 2015 the ‘three months dispensed all-at-once’ (‘stat’) dispensing rule would be removed from the following pharmaceuticals in Section B of the Pharmaceutical Schedule:
| Chemical | Presentation | Brand | Pack size |
|---|---|---|---|
| Betamethasone valerate | Crm 0.1% | Beta Cream | 50 g OP |
| Betamethasone valerate | Oint 0.1% | Beta Ointment | 50 g OP |
| Betamethasone valerate | Lotn 0.1% | Betnovate | 50 ml OP |
| Betamethasone valerate | Scalp app 0.1% | Beta Scalp | 100 ml OP |
| Clobetasol propionate | Crm 0.05% & Oint 0.05% | Dermol | 30 g OP |
| Clobetasol propionate | Scalp app 0.05% | Dermol | 30 ml OP |
| Dexamethasone phosphate | Inj 4 mg per ml, 1 ml ampoule |
Dexamethasone-hameln | 10 |
| Dexamethasone phosphate | Inj 4 mg per ml, 2 ml ampoule |
Dexamethasone-hameln | 5 |
| Hydrocortisone | Crm 1% | Pharmacy Health | 100 g and 500 g |
| Hydrocortisone | Tab 5 mg and 20 mg | Douglas | 100 |
| Hydrocortisone | Inj 100 mg vial | Solu-Cortef | 1 |
| Prednisolone | Oral liq 5 mg per ml | Redipred | 30 ml OP |
| Sodium valproate | Tab 100 mg | Epilim Crushable | 100 |
| Sodium valproate | Tab 200 mg & 500 mg EC | Epilim | 100 |
| Sodium valproate | Oral liq 200 mg per 5 ml | Epilim S/F Liquid, Epilim Syrup | 300 ml |
Background
PHARMAC has identified several pharmaceuticals for which the cost of stat dispensing to the Pharmaceutical Budget currently outweighs the savings from reduced dispensing fees. The proposal is to remove stat dispensing from those pharmaceuticals. The increased cost associated with additional dispensings has been taken into account in the analysis, with reference to the current Community Pharmacy Services Agreement fee structure (Stage 4 – from 1 August 2014).
Currently, approximately half of the patients on sodium valproate already visit their pharmacy more frequently than once every three months to collect medicines (either sodium valproate or another medicine). For most of the other presentations listed above, the average dispensing frequency is currently less than two dispensings per year.
If this proposal is approved, these medicines could still be dispensed stat for patients who have difficulty getting to and from a pharmacy and meet one of the following Access Exemption Criteria:
a) have limited physical mobility;
b) live and work more than 30 minutes from the nearest pharmacy by their normal form of transport;
c) are relocating to another area; or
d) are travelling extensively and will be out of town when the repeat prescriptions are due.
As part of our usual processes we regularly review funded pharmaceuticals with a view to adding or removing stat dispensing; at this time no further changes to dispensing frequency are proposed (other than temporary changes to manage stock issues).