New bulk packs take advantage of new technology

Media release Medicines

Twenty years after it was first tendered, new funding decisions for paracetamol are still making a difference.

Pharmacists around the country will now be able to take advantage of new technology, with New Zealand’s most prescribed medicine, paracetamol, being funded in bulk dispensing packs from 1 July 2017.

While there are new bulk dispensing packs, the brand and presentation of paracetamol will not change, and the current blister packaging will also remain available.

PHARMAC Director of Operations, Sarah Fitt, says that changes in the way pharmacists are dispensing medicines has been an important driver for the decision.

“Pharmacists have told PHARMAC that they want to be able to use new technology, like robotics, to dispense common medicines such as paracetamol, so they can focus on providing higher-level clinical services,” says Ms Fitt.

“The new bulk packaging will allow pharmacists to maximise the efficiencies that come from using this new technology and will make a big difference in their day-to-day dispensing activities.”

Paracetamol was the first medicine included in PHARMAC’s annual medicine tender in 1997. It is New Zealand’s most common medicine with over 2.7 million prescriptions being dispensed in 2016.

“The annual medicine tender allows PHARMAC to get the best value we can out of our budget, while also being able to make the most out of advances in medicine and dispensing technology,” says Ms Fitt.

“The focus of the annual tender has changed over the last 20 years from being about savings to putting a greater emphasis on suitability; products that are easy for patients to use, as well as pharmacies to manage and dispense.

“Having seven practising pharmacists on our PTAC Tender Medical Subcommittee helps to ensure that we get the pharmacy view and that we’re fully aware of how our decisions are going to impact them on a practical level.

“We’re looking forward to continuing to enhance our relationship with pharmacy to ensure the ongoing success of the tender.”

Details of the new paracetamol packaging can be found on the PHARMAC website

Background

PHARMAC’s annual tender is an important part of being able to get the greatest health benefits for New Zealanders.

Clinical advice is an important part of the review of the tenders that are received. PHARMAC gets this advice from the Tender Medical Evaluation Subcommittee (TMESC) – made up of a range of health professionals including seven pharmacists. Their role is to evaluate the suitability of tendering for a medicine, and then evaluating the packaging, breakability, usability and even the taste of medicines that are submitted for consideration.

Watch the video below for more information on the TMESC, what they do, and how they take in the pharmacy and patient’s view:

Transcript: Introduction to the Tender Medical Evaluation Subcommittee video

Melissa Copeland: The tender medical subcommittee is made up of quite a number of different people, from different backgrounds, some of those people are involved in acting as the health professional that actual administer the medicines to patients and some of those are pharmacists. So we have different aspects that we're interested in when it comes to medicines and the way that they're used and those view points are represented all around the table. There are a number of pharmacists on the committee some of whom are hospital pharmacists, some are community pharmacists who own their own business; so we're intimately involved in the actual issues that are at play here. And those view points are robustly expressed and we come to some agreement around the benefits and costs of various decisions that we make. But at the end of it all it's the consumer, the patient, that's actually pivotal to the whole decision making. None of this has any value unless we can actually get the right medicine to the right patient in a way that they can actually deal with it.

Geoff Savell: Being able to provide a pharmacy perspective to PHARMAC, it's our expertise of what happens at the coal face, at the counter, that I bring to PHARMAC so that I can say this particular thing that we're looking at, will or won't work. No amount of savings of money will be of any value if the customer takes it off me at the counter, walks out the door and literally throws it in the rubbish.

Melissa Copeland: Medsafe deals with the actual regulatory aspects of medicines and whether they are of equivalent quality from the medicines perspective. What we're looking at in the Tender Committee is the actual aspects of these medicines. We're looking at the packaging, we're looking at how readable the labels are; we're thinking about how easy it is to get into that packaging for someone who might have limited abilities, limited dexterity; we're consider all sorts of things about breakability of tablets; we also consider palatability of medicines. I'd admit that not all them taste fantastic but sometimes that's unavoidable; it is a factor that we consider that we do take seriously and we sit there with our teaspoons and try things, just to make sure we do have a good understanding of what the implications are of these decisions that we're making.

Geoff Savell: Amongst that of course is also the ramifications for pharmacy of things like pack sizes, repackaging costs, and the knock-on effects of having to count and pour verses just putting a label on the box. And that's discussed literally every time we have a new medicine, every time without fail, to ensure this is a practicable  step that reasonably can be expected for pharmacy to deal with. Sometimes there's some wins and sometimes there's some losses, and it's a bit of an averaging, but at the end of the day we try to ensure that pharmacy not inconvenienced or financially impacted by the use of various pack sizes.