Committee considers renewal criteria for ADHD medicines

Update Medicines

At the July Mental Health Advisory Committee meeting, our expert advisors discussed the Special Authority (SA) renewal criteria for stimulant treatments for attention-deficit/hyperactivity disorder (ADHD).

Methylphenidate and dexamfetamine are both controlled drugs. The prescribing of these types of medicines is tighter than others, reflecting the need to minimise the misuse of the treatments. Currently, the Special Authority must be renewed every two years.

The Committee noted that specialists are getting busier. This makes it harder for people to get their Special Authority renewed on time. The Committee and Pharmac acknowledge the problems that any break in treatment can cause people with ADHD.

The Committee considered the benefits and risks of removing the renewal criteria for ADHD stimulants and how any change to the restrictions could be implemented.  

Pharmac is considering what action to take following the Committee’s advice. Any changes to the Special Authority renewal criteria would be publicly consulted on. 

Record of the July Mental Health Advisory Committee [PDF, 137 KB]

Specialist advisory committees

Background information on Special Authority renewal for ADHD treatments

Pharmac currently funds three treatments for ADHD: atomoxetine, methylphenidate and dexamfetamine. Atomoxetine is funded without restrictions. Methylphenidate and dexamfetamine are both funded through Special Authority for people who meet funding criteria.

Special Authority applications

The current renewal criteria for methylphenidate and dexamfetamine requires treatment to remain appropriate and be continuing to provide benefits to the individual.

The Special Authority must be renewed every two years. Renewals can only be made by a paediatrician, psychiatrist, or nurse or medical practitioner (only on recommendation from a paediatrician or psychiatrist). The recommendation must be provided in writing.

While Pharmac sets the renewal period, the Misuse of Drugs Regulations 1975 set out who can prescribe stimulant treatments.

The regulations state that medical and nurse practitioners can only prescribe stimulant treatments on the written recommendation of a specialist.

Recent updates for controlled medicines

Manatū Hauora - Ministry of Health made changes to controlled drugs regulations earlier this year. People can now get a 3-month prescription for their ADHD treatment. Since 1 July 2023, all three months were funded. Before this, only 1 month’s supply was funded for each prescription.

Dispensing remains at one month’s supply. People can only pick up one month’s supply at a time, but they do not need a new prescription each month.

This change has meant fewer visits to a prescriber for prescriptions of ADHD treatments.

Changes to prescribing and dispensing of methylphenidate and dexamfetamine

More changes for the Misuse of Drugs regulations come into effect on 5 October 2023. These changes do not affect ADHD treatments. We are consulting on making sure the Schedule Rules align with these changes. Our proposal does not affect ADHD treatments.

Proposal to amend Pharmaceutical Schedule Rules to align funding with the Misuse of Drugs Amendment Regulations (No 2) 2023