Summaries of the Section H (HML) update

Bromocriptine tab 2.5 mg

restriction added

Clotrimazole (Clomazol) crm 1%, 20 g

price increase

Clozapine (Versacloz) oral liq 50 mg per ml, 100 ml

new listing (p’code 2604965)

Cocaine hydrochloride (Biomed) soln 4%, 2 ml syringe

price increase

Diltiazem hydrochloride (Dilzem) tab 60 mg

to be delisted 1 January 2022

Dimethyl fumarate (Tecfidera) cap 120 mg and 240 mg

amended restriction criteria and addition of note

Empagliflozin (Jardiance) tab 10 mg and 25 mg

amended restriction criteria

Empagliflozin with metformin hydrochloride (Jardiamet) tab 5 mg with 500 mg and 1,000 mg metformin hydrochloride and tab 12.5 mg with 500 mg and 1,000 mg metformin hydrochloride

amended restriction criteria

Fat-modified feed (e.g. Monogen) powder 12.8 g protein, 68.6 g carbohydrate and 12.9 g fat per 100 g, 400 g can

new listing

Fat-modified feed (e.g. Monogen) powder 12.9 g protein, 69.1 g carbohydrate and 12.9 g fat per 100 g, 400 g can

to be delisted 1 December 2021

Fingolimod (Gilenya) cap 0.5 mg

amended restriction criteria and addition of note

Gadoteric acid (e.g. Clariscan)

• Inj 279.30 mg per ml, 10 ml prefilled syringe
• Inj 279.30 mg per ml, 15 ml prefilled syringe
• Inj 279.30 mg per ml, 5 ml vial
• Inj 279.30 mg per ml, 10 ml vial
• Inj 279.30 mg per ml, 20 ml vial

new listing

Glatiramer acetate (Copaxone) inj 40  mg prefilled syringe

amended restriction criteria and addition of note

Glyceryl trinitrate (Nitrolingual Pump Spray) oral pump spray, 400 mcg per dose, 250 dose

price increase

Glycopyrronium bromide (Max Health) inj 200 mcg per ml, 1 ml ampoule

price increase

Influenza vaccine

New listing

• Inj 30 mcg in 0.25 ml syringe (paediatric quadrivalent vaccine) (Afluria Quad Junior (2021 Formulation)) (p’code 2602733)
• Inj 60 mcg in 0.5 ml syringe (quadrivalent vaccine) (Afluria Quad (2021 Formulation)) (p’code 2602725)
• Inj 60 mcg in 0.5 ml syringe (adjuvanted quadrivalent vaccine) (Fluad Quad (2021 Formulation)) (p’code 2602741)

Influenza vaccine

• Inj 30 mcg in 0.25 ml syringe (paediatric quadrivalent vaccine) (Afluria Quad Junior (2020 Formulation))
• Inj 60 mcg in 0.5 ml syringe (quadrivalent vaccine) (Afluria Quad (2020 Formulation) and Influvac Tetra (2020 Formulation))

delisted 1 March 2021

Interferon beta-1-alpha inj 6 million iu in 0.5 ml pen injector (Avonex Pen) and inj 6 million iu in 0.5 ml syringe (Avonex)

amended restriction criteria and addition of note

Interferon beta-1-beta inj 8 million iu per ml, 1 ml vial

amended restriction criteria and addition of note

Ivacaftor (Kalydeco) tab 150 mg, oral granules 50 mg and 75 mg, sachet

New listing

• Tab 150 mg (p’code 2586118)
• Oral granules 50 mg, sachet (p’code 2586134)
• Oral granules 75 mg, sachet (p’code 2586126)

Low-calcium formula (e.g. Locasol) powder 14.6 g protein, 55.2 g carbohydrate and 25.8 g fat per 100 g, 400 g can

new listing

Low-calcium formula (e.g. Locasol) powder 14.6 g protein, 53.7 g carbohydrate and 26.1 g fat per 100 g, 400 g can

to be delisted 1 September 2021

Low-GI enteral feed 1 kcal/ml (Glucerna Select) liquid 5 g protein, 9.6 g carbohydrate and 5.4 g fat per 100 ml, 500 ml bottle

new listing (p’code 2605651)

Low-GI enteral feed 1 kcal/ml (Glucerna Select RTH (Vanilla)) liquid 5 g protein, 9.6 g carbohydrate and 5.4 g fat per 100 ml, 1,000 ml bottle

to be delisted 1 September 2021

Low-GI oral feed 1 kcal/ml (Glucerna Select (Vanilla)) liquid 5 g protein, 9.6 g carbohydrate and 5.4 g fat per 100 ml, 250 ml bottle

to be delisted 1 September 2021

Low-GI oral feed 1 kcal/ml (Resource Diabetic (Vanilla)) liquid 6 g protein, 9.5 g carbohydrate, 4.7 g fat and 2.6 g fibre per 100 ml, can

to be delisted 1 May 2021

Multiple Sclerosis Treatments

amended restriction criteria

Natalizumab (Tysabri) inj 20 mg per ml, 15 ml vial

amended restriction criteria and addition of note

Nitrofurantoin (Macrobid) cap modified-release 100 mg

new listing and addition of HSS (p’code 2493624)

Ocrelizumab (Ocrevus) inj 30 mg per ml, 10 ml vial

amended restriction criteria and addition of note

Olaparib (Lynparza) cap 50 mg

to be delisted 1 July 2021

Omeprazole cap 10 mg (Omeprazole actavis 10), cap 20 mg (Omeprazole actavis 20) and cap 40 mg (Omeprazole actavis 40)

New Pharmacode listing and addition of HSS

• Cap 10 mg (Omeprazole actavis 10) (p’code 2604930)
• Cap 20 mg (Omeprazole actavis 20) (p’code 2604949)
• Cap 40 mg (Omeprazole actavis 40) (p’code 2604957)
• Old Pharmacodes to be delisted 1 August 2021

Phenoxymethylpenicillin [penicillin V] (Cilicaine VK) cap 500 mg

Pharmacode change

• new Pharmacode listing (p’code 2602873)
• 2048868 to be delisted 1 August 2021

Rituximab (Riximyo) inj 10 mg per ml, 10 ml and 50 ml vial

amended restriction criteria

Sodium alginate with sodium bicarbonate and calcium carbonate (Acidex) oral liq 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg per 10 ml, 500 ml

price increase

Terbinafine (Deolate) tab 250 mg

Packsize change

• new 84 tab pack size listing and addition of HSS (p’code 2597160)
• 14 tab pack to be delisted from 1 August 2021

Teriflunomide (Aubagio) tab 14 mg

price decrease, addition of HSS, amended restriction criteria and addition of note

Timolol maleate tab 10 mg

restriction added