Si MPletes

Code Level1 Level2 Level3 TGM
10102 Alimentary Tract and Metabolism Antacids and Antiflatulants Antacids and Reflux Barrier Agents Caro
10104 Alimentary Tract and Metabolism Antacids and Antiflatulants Phosphate Binding Agents Caro
10401 Alimentary Tract and Metabolism Antidiarrhoeals Agents Which Reduce Motility Caro
10404 Alimentary Tract and Metabolism Antidiarrhoeals Rectal and Colonic Anti-inflammatories Caro
10501 Alimentary Tract and Metabolism Local preparations for Anal and Rectal Disorders Antihaemorrhoidal Preparations Caro
10502 Alimentary Tract and Metabolism Local preparations for Anal and Rectal Disorders Management of Anal Fissures Caro
10503 Alimentary Tract and Metabolism Local preparations for Anal and Rectal Disorders Rectal Sclerosants Caro
10507 Alimentary Tract and Metabolism Local preparations for Anal and Rectal Disorders Soothing Agents Caro
10701 Alimentary Tract and Metabolism Antispasmodics and Other Agents Altering Gut Motility Antispasmodics and Other Agents Altering Gut Motility Caro
11001 Alimentary Tract and Metabolism Antiulcerants Antisecretory and Cytoprotective Caro
11002 Alimentary Tract and Metabolism Antiulcerants Helicobacter Pylori Eradication Caro
11003 Alimentary Tract and Metabolism Antiulcerants H2 Antagonists Caro
11007 Alimentary Tract and Metabolism Antiulcerants M1 Antagonists Caro
11010 Alimentary Tract and Metabolism Antiulcerants Proton Pump Inhibitors Caro
11013 Alimentary Tract and Metabolism Antiulcerants Site Protective Agents Caro
11301 Alimentary Tract and Metabolism Diabetes Hyperglycaemic Agents Greg
11303 Alimentary Tract and Metabolism Diabetes Insulin - Short-acting Preparations Greg
11305 Alimentary Tract and Metabolism Diabetes Insulin - Intermediate-acting Preparations Greg
11307 Alimentary Tract and Metabolism Diabetes Insulin - Long-acting Preparations Greg
11309 Alimentary Tract and Metabolism Diabetes Insulin - Rapid Acting Preparations Greg
11311 Alimentary Tract and Metabolism Diabetes Alpha Glucosidase Inhibitors Greg
11312 Alimentary Tract and Metabolism Diabetes Oral Hypoglycaemic Agents Greg
11501 Alimentary Tract and Metabolism Diabetes Management Glucose/Urine Testing Greg
11504 Alimentary Tract and Metabolism Diabetes Management Ketone Testing Greg
11507 Alimentary Tract and Metabolism Diabetes Management Blood Glucose Testing Greg
11509 Alimentary Tract and Metabolism Diabetes Management Insulin Syringes and Needles Greg
11512 Alimentary Tract and Metabolism Diabetes Management Insulin Pumps Greg
11515 Alimentary Tract and Metabolism Diabetes Management Insulin Pump Consumables Greg
12201 Alimentary Tract and Metabolism Digestives Including Enzymes Digestives Including Enzymes Caro
12501 Alimentary Tract and Metabolism Laxatives Bulk-forming Agents Caro
12504 Alimentary Tract and Metabolism Laxatives Faecal Softeners Caro
12507 Alimentary Tract and Metabolism Laxatives Osmotic Laxatives Caro
12510 Alimentary Tract and Metabolism Laxatives Stimulant Laxatives Caro
12802 Alimentary Tract and Metabolism Metabolic Disorder Agents Gaucher's Disease Caro
13101 Alimentary Tract and Metabolism Mouth and Throat Agents Used in Mouth Ulceration Caro
13107 Alimentary Tract and Metabolism Mouth and Throat Oropharyngeal Anti-infectives Caro
13109 Alimentary Tract and Metabolism Mouth and Throat Other Oral Agents Caro
13701 Alimentary Tract and Metabolism Vitamins Vitamin A Caro
13704 Alimentary Tract and Metabolism Vitamins Vitamin B Caro
13707 Alimentary Tract and Metabolism Vitamins Vitamin C Caro
13710 Alimentary Tract and Metabolism Vitamins Vitamin D Caro
13713 Alimentary Tract and Metabolism Vitamins Vitamin E Caro
13719 Alimentary Tract and Metabolism Vitamins Multivitamin Preparations Caro
13810 Alimentary Tract and Metabolism Minerals Calcium Caro
13820 Alimentary Tract and Metabolism Minerals Fluoride Caro
13825 Alimentary Tract and Metabolism Minerals Iodine Caro
13830 Alimentary Tract and Metabolism Minerals Iron Caro
13840 Alimentary Tract and Metabolism Minerals MagnesiumCaro
13850 Alimentary Tract and Metabolism Minerals Zinc Caro
40101 Blood and Blood Forming Organs Antianaemics Hypoplastic and Haemolytic Sue Anne
40103 Blood and Blood Forming Organs Antianaemics Iron Therapy Sue Anne
40104 Blood and Blood Forming Organs Antianaemics Megaloblastic Sue Anne
40401 Blood and Blood Forming Organs Antifibrinolytics, Haemostatics and Local Sclerosants Antifibrinolytics, Haemostatics and Local Sclerosants Sue Anne
40403 Blood and Blood Forming Organs Antifibrinolytics, Haemostatics and Local Sclerosants Vitamin K Sue Anne
40701 Blood and Blood Forming Organs Antithrombotic Agents Antiplatelet Agents Sue Anne
40704 Blood and Blood Forming Organs Antithrombotic Agents Heparin and Antagonist Preparations Sue Anne
40707 Blood and Blood Forming Organs Antithrombotic Agents Oral Anticoagulants Sue Anne
40803 Blood and Blood Forming Organs Blood Colony-stimulating Factors Blood Colony-stimulating Factors Sue Anne
41001 Blood and Blood Forming Organs Fluids and Electrolytes Intravenous Administration Sue Anne
41004 Blood and Blood Forming Organs Fluids and Electrolytes Oral Administration Sue Anne
70101 Cardiovascular System Adrenergic Neurone Blockers Adrenergic Neurone Blockers Katie
70401 Cardiovascular System Alpha Adrenoceptor Blockers Alpha Adrenoceptor Blockers Katie
70701 Cardiovascular System Agents Affecting the Renin-Angiotensin System ACE Inhibitors Katie
70702 Cardiovascular System Agents Affecting the Renin-Angiotensin System ACE Inhibitors with Diuretics Katie
70703 Cardiovascular System Agents Affecting the Renin-Angiotensin System Angiotensin II Antagonists Katie
70705 Cardiovascular System Agents Affecting the Renin-Angiotensin System Angiotensin II Antagonists with Diuretics Katie
71301 Cardiovascular System Antiarrhythmics Antiarrhythmics Katie
71501 Cardiovascular System Antihypotensives Antihypotensives Katie
71601 Cardiovascular System Beta Adrenoceptor Blockers Beta Adrenoceptor Blockers Katie
71901 Cardiovascular System Beta Adrenoceptor Blockers with Diuretics Beta Adrenoceptor Blockers with Diuretics Katie
72201 Cardiovascular System Calcium Channel Blockers Dihydropyridine Calcium Channel Blockers Katie
72202 Cardiovascular System Calcium Channel Blockers Other Calcium Channel Blockers Katie
72801 Cardiovascular System Centrally-Acting Agents Centrally-Acting Agents Katie
73101 Cardiovascular System Diuretics Loop Diuretics Katie
73104 Cardiovascular System Diuretics Potassium Sparing Diuretics Katie
73107 Cardiovascular System Diuretics Potassium Sparing Combination Diuretics Katie
73110 Cardiovascular System Diuretics Thiazide and Related Diuretics Katie
73201 Cardiovascular System Lipid-Modifying Agents Fibrates Katie
73202 Cardiovascular System Lipid-Modifying Agents Other Lipid-Modifying Agents Katie
73203 Cardiovascular System Lipid-Modifying Agents Resins Katie
73204 Cardiovascular System Lipid-Modifying Agents HMG CoA Reductase Inhibitors (Statins) Katie
73208 Cardiovascular System Lipid-Modifying Agents Selective Cholesterol Absorption Inhibitors Katie
73401 Cardiovascular System Nitrates Nitrates Katie
73701 Cardiovascular System Sympathomimetics Sympathomimetics Katie
74001 Cardiovascular System VasodilatorsVasodilatorsKatie
74005 Cardiovascular System VasodilatorsEndothelin Receptor Antagonists Katie
74007 Cardiovascular System VasodilatorsPhosphodiesterase Type 5 Inhibitors Katie
74009 Cardiovascular System VasodilatorsProstacyclin Analogues Katie
100101 Dermatologicals Antiacne Preparations Antiacne Preparations Bronwyn
100401 Dermatologicals Antibacterials Topical Antibacterials Topical Bronwyn
100701 Dermatologicals Antifungals Topical Antifungals Topical Bronwyn
100801 Dermatologicals Antipruritic Preparations Antipruritic Preparations Bronwyn
101001 Dermatologicals Antivirals Topical Antivirals Topical Bronwyn
101101 Dermatologicals Corticosteroids Topical Corticosteroids - Plain Bronwyn
101104 Dermatologicals Corticosteroids Topical Corticosteroids - Combination Bronwyn
101301 Dermatologicals Disinfecting and Cleansing Agents Disinfecting and Cleansing Agents Bronwyn
101401 Dermatologicals Dusting Powders Dusting Powders Bronwyn
101502 Dermatologicals Barrier Creams and Emollients Barrier Creams Bronwyn
101504 Dermatologicals Barrier Creams and Emollients Emollients Bronwyn
101506 Dermatologicals Barrier Creams and Emollients Other Dermatological Bases Bronwyn
101601 Dermatologicals Minor Skin Infections Minor Skin Infections Bronwyn
101701 Dermatologicals Parasiticidal Preparations Parasiticidal Preparations Bronwyn
101901 Dermatologicals Psoriasis and Eczema Preparations Psoriasis and Eczema Preparations Bronwyn
102201 Dermatologicals Scalp Preparations Scalp Preparations Bronwyn
102501 Dermatologicals SunscreensSunscreensBronwyn
102801 Dermatologicals Wart Preparations Wart Preparations Bronwyn
103103 Dermatologicals Other Skin Preparations Antineoplastics Bronwyn
103104 Dermatologicals Other Skin Preparations Antiperspirants Bronwyn
103107 Dermatologicals Other Skin Preparations Wound Management Products Bronwyn
130101 Genito-Urinary System Contraceptives - Non-hormonal Condoms Bronwyn
130105 Genito-Urinary System Contraceptives - Non-hormonal Spermicidal Agents Bronwyn
130107 Genito-Urinary System Contraceptives - Non-hormonal Contraceptive Devices Bronwyn
130802 Genito-Urinary System Contraceptives - Hormonal Combined Oral Contraceptives Bronwyn
130804 Genito-Urinary System Contraceptives - Hormonal Progestogen-only Contraceptives Bronwyn
130805 Genito-Urinary System Contraceptives - Hormonal Emergency Contraceptives Bronwyn
130902 Genito-Urinary System Antiandrogen Oral Contraceptives Antiandrogen Oral Contraceptives Bronwyn
131001 Genito-Urinary System Gynaecological Anti-infectives Gynaecological Anti-infectives Bronwyn
131202 Genito-Urinary System Impotence Treatment Impotence Treatment Bronwyn
131402 Genito-Urinary System Myometrial and Vaginal Hormone Preparations Myometrial and Vaginal Hormone Preparations Bronwyn
131602 Genito-Urinary System Pregnancy Tests - hCG Urine Pregnancy Tests - hCG Urine Bronwyn
131901 Genito-Urinary System Urinary Agents 5-Alpha Reductase Inhibitors Bronwyn
131902 Genito-Urinary System Urinary Agents Alpha-1A Adrenoreceptor Blockers Bronwyn
131904 Genito-Urinary System Urinary Agents Other Urinary Agents Bronwyn
132201 Genito-Urinary System Detection of Substances in Urine Detection of Substances in Urine Bronwyn
140101 Hormone Preparations - Systemic Excluding Contraceptive Hormones Anabolic Agents Anabolic Agents Bronwyn
140404 Hormone Preparations - Systemic Excluding Contraceptive Hormones Calcium Homeostasis Calcium Homeostasis Bronwyn
140701 Hormone Preparations - Systemic Excluding Contraceptive Hormones Corticosteroids and Related Agents for Systemic Use Corticosteroids and Related Agents for Systemic Use Bronwyn
141001 Hormone Preparations - Systemic Excluding Contraceptive Hormones Sex Hormones Non Contraceptive Androgen Agonists and Antagonists Bronwyn
141104 Hormone Preparations - Systemic Excluding Contraceptive Hormones Hormone Replacement Therapy - Systemic OestrogensBronwyn
141109 Hormone Preparations - Systemic Excluding Contraceptive Hormones Hormone Replacement Therapy - Systemic Progestogens Bronwyn
141114 Hormone Preparations - Systemic Excluding Contraceptive Hormones Hormone Replacement Therapy - Systemic Progestogen and Oestrogen Combined Preparations Bronwyn
141201 Hormone Preparations - Systemic Excluding Contraceptive Hormones Other Oestrogen Preparations Other Oestrogen Preparations Bronwyn
141301 Hormone Preparations - Systemic Excluding Contraceptive Hormones Other Progestogen Preparations Other Progestogen Preparations Bronwyn
141401 Hormone Preparations - Systemic Excluding Contraceptive Hormones Thyroid and Antithyroid Agents Thyroid and Antithyroid Agents Bronwyn
141602 Hormone Preparations - Systemic Excluding Contraceptive Hormones Trophic Hormones Growth Hormones Bronwyn
141603 Hormone Preparations - Systemic Excluding Contraceptive Hormones Trophic Hormones GnRH Analogues Bronwyn
141901 Hormone Preparations - Systemic Excluding Contraceptive Hormones Vasopressin Agonists Vasopressin Agonists Bronwyn
142101 Hormone Preparations - Systemic Excluding Contraceptive Hormones Other Endocrine Agents Other Endocrine Agents Bronwyn
Trial Version
Not all rows exported
Code FullID FormulationCode Name Manufacturer Distributor Stamp
10010101 07160110010101 100101 Sectral 155 10556006517998354432
10010102 07160110010102 100101 ACB 200 17720948751633219584
10010201 07160110010201 100102 Sectral 155 10628064112036282368
10010202 07160110010202 100102 ACB 200 17793006345671147520
10010301 07160110010301 100103 Sectral 155 10700121706074210304
10010302 07160110010302 100103 ACB 200 17865063939709075456
10020101 22070310020101 100201 Lamictal 104 7193157901026852864
10020201 22070310020201 100202 Lamictal 104 7265215495064780800
10020301 22070310020301 100203 Lamictal 104 7337273089102708736
10022501 22070210022501 100225 Lamictal 143 479470632594046976
10022525 22070210022525 100225 Arrow-Lamotrigine163 7029388942604500992
10022601 22070210022601 100226 Lamictal 143 551528226631974912
10022626 22070210022626 100226 Mogine 35 7822022477021708288
10022627 22070210022627 100226 Logem 200 17504775969519435776
10022701 22070210022701 100227 Lamictal 143 623585820669902848
10022725 22070210022725 100227 Mogine 35 7894080071059636224
10022727 22070210022727 100227 Logem 200 17576833563557363712
10022801 22070210022801 100228 Lamictal 143 695643414707830784
10022826 22070210022826 100228 Mogine 35 7966137665097564160
10022827 22070210022827 100228 Logem 200 17648891157595291648
10022926 22070210022926 100229 Mogine 35 8038195259135492096
10023025 22070210023025 100230 Lamictal 143 3653655148867092480
10030101 31030610030101 100301 Diamox 157 13825917815120461824
10030102 31030610030102 100301 Glaucomide 200 17937121533747003392
10030201 31030610030201 100302 Diamox 177 4190153051547369472
10040101 22070210040101 100401 Sabril 155 5249060814421229568
10050101 07190110050101 100501 Secadrex 155 10772179300112138240
10060101 13100110060101 100601 Aci-Jel 99 5750671213152174080
10090101 14160310090101 100901 Lucrin Depot 2 10507807226771537920
10090201 14160310090201 100902 Lucrin Depot 2 10579864820809465856
10092525 14160310092525 100925 Eligard 227 12486419082884677632
10092625 14160310092625 100926 Eligard 227 12558476676922605568
10092725 14160310092725 100927 Eligard 227 12630534270960533504
10092825 14160310092825 100928 Eligard 227 12702591864998461440
10092925 14160310092925 100929 Lucrin Depot PDS 2 10240191594128998400
10093025 14160310093025 100930 Lucrin Depot PDS 2 10456364376242782208
10093125 14160310093125 100931 Lucrin Depot PDS 2 10672537158356566016
10100101 28490210100101 101001 Pulmozyme 30 17732192357538856960
10110101 22220110110101 101101 Risperdal 69 18019296833783726080
10110125 22220110110125 101101 Ridal 35 8614656011438915584
10110126 22220110110126 101101 Dr Reddy's Risperidone 178 7705513826896052224
10110127 22220110110127 101101 Apo-Risperidone 10 9169747755256512512
10110201 22220110110201 101102 Risperdal 69 18091354427821654016
10110225 22220110110225 101102 Ridal 35 8686713605476843520
10110227 22220110110227 101102 Apo-Risperidone 10 11940586326484582400
10110301 22220110110301 101103 Risperdal 69 18163412021859581952
10110325 22220110110325 101103 Ridal 35 8758771199514771456
10110327 22220110110327 101103 Apo-Risperidone 10 12156759108598366208
10110401 22220110110401 101104 Risperdal 69 18235469615897509888
10110425 22220110110425 101104 Ridal 35 8830828793552699392
10110427 22220110110427 101104 Apo-Risperidone 10 12372931890712150016
10110501 22220110110501 101105 Risperdal 69 18307527209935437824
10110525 22220110110525 101105 Risperon 200 5460184639140265984
10110526 22220110110526 101105 Apo-Risperidone 10 12589104672825933824
10112525 22220110112525 101125 Risperdal 69 17154605705328590848
10112526 22220110112526 101125 Ridal 35 8542598417400987648
10112527 22220110112527 101125 Apo-Risperidone 10 11508240762257014784
10112625 22220410112625 101126 Risperdal Consta 69 13028131969215496192
10112925 22220110112925 101129 Risperdal Quicklet 69 2499112964120903680
10120101 07150110120101 101201 Gutron 35 2739427723045765120
10120201 07150110120201 101202 Gutron 35 2811485317083693056
10130301 07010110130301 101303 Ismelin 116 8106048320708804608
10150101 07370110150101 101501 Hospira 174 7493327873944584192
10150102 07370110150102 101501 AstraZeneca 144 10700403181050920960
10150125 07370110150125 101501 Aspen Adrenaline 157 6465888133857673216
10150201 07370110150201 101502 Hospira 174 7565385467982512128
10150225 07370110150225 101502 Aspen Adrenaline 157 8507737301730721792
10150301 28010110150301 101503 Medihaler-Epi 1 12686206942721343488
10160101 31030910160101 101601 Eppy N 88 9642269474363015168
10160201 31030910160201 101602 Eppy N 88 9714327068400943104
10170101 31030910170101 101701 Epifrin 5 9786384662438871040
10190301 10110110190301 101903 Logoderm 40 8216367819881709568
10190401 10110110190401 101904 Logoderm 40 8288425413919637504
10200101 01371010200101 102001 One-Alpha 29 15827456687695986688
10200201 01371010200201 102002 One-Alpha 29 6468639111950368768
10200301 01371010200301 102003 One-Alpha 29 6540696705988296704
10210101 01010210210101 102101 Gaviscon 162 6921317944710397952
10210201 01010210210201 102102 Gaviscon Infant 162 6993375538748325888
10210301 01010210210301 102103 Gaviscon Infant 23 7065433132786253824
10220101 01101010220101 102201 Zoton 14 4648985850888060928
10220125 01101010220125 102201 Solox 35 6472861236601028608
10220126 01101010220126 102201 Lanzol Relief 200 9516533722657062912
10222525 01101010222525 102225 Solox 35 7208669811071516672
10222526 01101010222526 102225 Lanzol Relief 200 9300360940543279104
10230101 01010210230101 102301 Gastrobrom 19 7137490726824181760
10240101 22010110240101 102401 Mayne 174 10065406628707958784
10242525 22010110242525 102425 APO-go 174 10137464222745886720
10242526 22010110242526 102425 Apomine 174 10209521816783814656
10250101 28400110250101 102501 Tilade 155 17573459162371719168
10250201 28400110250201 102502 Tilade 155 17645516756409647104
10260101 19130110260101 102601 Progout 200 18009179127784931328
10260102 19130110260102 102601 Allorin 35 9083310748150530048
10260103 19130110260103 102601 Zyloprim 157 9763654458557857792
10260104 19130110260104 102601 Apo-Allopurinol 10 9227425936226385920
10260125 19130110260125 102601 Allohexal 116 16708768033916583936
10260201 19130110260201 102602 Allorin 35 9299483530264313856
10260202 19130110260202 102602 Apo-Allopurinol 10 9371541124302241792
10260203 19130110260203 102602 Progout 200 18081236721822859264
10260205 19130110260205 102602 Zyloprim Z300 157 9835712052595785728
10260225 19130110260225 102602 Allohexal 116 16780825627954511872
10260226 19130110260226 102602 Apo-Allopurinol S2910 14042090597234245632
10270201 31031310270201 102702 Tears Plus 5 12236342859728420864
10290101 07160110290101 102901 Aptin CR 11 3748234039576756224
10310101 07070110310101 103101 Gopten 2 10866460223170674688
10310102 07070110310102 103101 Odrik 105 15493340392782299136
10310201 07070110310201 103102 Gopten 2 3002328649828401152
10310202 07070110310202 103102 Odrik 105 15637455580858155008
10310301 07070110310301 103103 Gopten 2 3074386243866329088
10310302 07070110310302 103103 Odrik 105 15781570768934010880
10320101 22010110320101 103201 Permax 157 10281579410821742592
10320201 22010110320201 103202 Permax 157 10353637004859670528
10330101 28510210330101 103301 Betnesol Aqueous 37 2240091114361061376
10340101 25070110340101 103401 Cellcept 30 16074586219689803776
10340125 25070110340125 103401 Myaccord 35 4149645943668473856
10340126 25070110340126 103401 Ceptolate 200 8286491372966379520
10342625 25070110342625 103426 Cellcept 30 15930471031613947904
10342626 25070110342626 103426 Myaccord 35 4365818725782257664
10342627 25070110342627 103426 Ceptolate 200 7998260996814667776
10342725 25070110342725 103427 Cellcept 30 16002528625651875840
10360101 10310410360101 103601 Hidrosol 200 18153294315860787200
10360201 38010110360201 103602 Aluminium chloride155 10844236894150066176
10370101 19080210370101 103701 Fosamax 72 6591705249424080896
10370201 19080410370201 103702 Fosamax 72 11051115504474259456
10372525 19080210372525 103725 Fosamax 72 6663762843462008832
10380201 01010210380201 103802 Amphogel 14 4721043444925988864
10380401 01010410380401 103804 Alu-Tab 35 5091716302439972864
10390101 01010210390101 103901 Aludrox 14 4793101038963916800
10400101 01010210400101 104001 Mylanta 133 3854931747447767040
10400201 01010210400201 104002 Mylanta 133 3710816559371911168
10400225 01010210400225 104002 Mylanta P 133 3782874153409839104
10400301 01010210400301 104003 Aludrox Plus 14 4865158633001844736
10410101 01010210410101 104101 Gastrogel 19 7569836291051749376
10430101 16190710430101 104301 Valtrex 143 4098968353232650240
10480101 22010110480101 104801 Symmetrel 116 10425694598897598464
10500101 07310410500101 105001 Midamor 72 6108914091714150400
10500125 07310410500125 105001 Apo-Amiloride 10 15703382298059603968
10500401 07310410500401 105004 Biomed 102 6180971685752078336
10510101 07310710510101 105101 Frumil 155 4478383427699081216
10530101 07310710530101 105301 Amizide 200 18225351909898715136
10530102 07310710530102 105301 Hydrozide 35 6757432438055501824
10530103 07310710530103 105301 Moduretic 157 15523204228104323072
10540101 04040110540101 105401 Amicar 31 3675613495585406976
10550101 25040110550101 105501 Cytadren 116 8178105914746732544
10560101 28430210560101 105601 DBL Aminophylline174 846546987573575680
10560401 28430210560401 105604 Biomed 102 14345485437756243968
10570101 07130110570101 105701 Cordarone-X 155 6028465024933036032
10570102 07130110570102 105701 Aratac 200 18297409503936643072
10570201 07130110570201 105702 Cordarone-X 155 6100522618970963968
10570202 07130110570202 105702 Aratac 200 18369467097974571008
10570301 07130110570301 105703 Cordarone-X 155 4622498615774937088
10590101 22050110590101 105901 Tryptanol 72 1950171888349085696
10590103 22050110590103 105901 Amitrip 200 139177281355513856
10590125 22050110590125 105901 Amirol 127 15246777109276786688
10590126 22050110590126 105901 Arrow Amitriptyline163 5452338524164456448
10590201 22050110590201 105902 Amitrip 200 211234875393441792
10590203 22050110590203 105902 Tryptanol 72 2166344670462869504
10590301 22050110590301 105903 Amitrip 200 283292469431369728
10590303 22050110590303 105903 Tryptanol 72 2310459858538725376
10590401 22050110590401 105904 Tryptanol 72 2382517452576653312
10590501 22050110590501 105905 Tryptanol 72 2454575046614581248
10600101 22070210600101 106001 Neurontin 14 9184096381998989312
10600201 22070210600201 106002 Neurontin 14 9256153976036917248
10602525 22070210602525 106025 Neurontin 14 9328211570074845184
10602625 22070210602625 106026 Neurontin 14 9400269164112773120
10610101 07070310610101 106101 Cozaar 72 7765957279609782272
10610125 07070310610125 106101 Lostaar 200 17248376454991839232
10610201 07070310610201 106102 Cozaar 72 7838014873647710208
10610225 07070310610225 106102 Lostaar 200 16816030890764271616
10612525 07070310612525 106125 Cozaar 72 7693899685571854336
10612526 07070310612526 106125 Lostaar 200 17464549237105623040
10612625 07070310612625 106126 Cozaar 72 4691180709115592704
10612626 07070310612626 106126 Lostaar 200 17032203672878055424
10620125 22070210620125 106201 Nupentin 200 16712142435102228480
10620126 22070210620126 106201 Arrow-Gabapentin191 3530160201858547712
10620225 22070210620225 106202 Nupentin 200 17288884662382362624
10622526 22070210622526 106225 Nupentin 200 16640084841064300544
10630101 07320410630101 106301 Lescol 36 6962172498263670784
10630102 07320410630102 106301 Vastin 11 7034230092301598720
10630202 07320410630202 106302 Lescol 36 7106287686339526656
10630203 07320410630203 106302 Vastin 11 7178345280377454592
10640101 31030410640101 106401 Maxitrol 3 6615850524770041856
10640201 31030410640201 106402 Maxitrol 3 6687908118807969792
10650101 28100110650101 106501 Flixotide 143 2773786361902137344
10650201 28100110650201 106502 Flixotide 143 2845843955940065280
10650301 28100110650301 106503 Flixotide 143 2989959144015921152
10650401 28100110650401 106504 Flixotide 143 3062016738053849088
10650501 28100110650501 106505 Flixotide 143 17700954132682113024
10650601 28100110650601 106506 Flixotide 143 2557613579788353536
10650707 28100110650707 106507 Flixotide 143 2629671173826281472
10650801 28100110650801 106508 Flixotide 143 2701728767864209408
10650901 28100110650901 106509 Flixotide 143 17989184508833824768
10651001 28100110651001 106510 Flixotide 143 18061242102871752704
10651101 28100110651101 106511 Flixotide Accuhaler143 2917901549977993216
10652525 28100110652525 106525 Flixotide 143 17773011726720040960
10660101 28240210660101 106601 Serevent 143 8632674807994908672
10660201 28240210660201 106602 Serevent 143 8560617213956980736
10660301 28240210660301 106603 Serevent Accuhaler 143 8704732402032836608
10662525 28240210662525 106625 Serevent 143 7716186786266873856
10670101 31030410670101 106701 Blephamide SOP 5 6759965712845897728
10680525 07070510680525 106805 Hyzaar 72 15032623030511599616
10680526 07070510680526 106805 Arrow-Losartan & Hydrochlorothiazide 163 14960565436473671680
10690101 22050110690101 106901 Asendin 14 4937216227039772672
10690201 22050110690201 106902 Asendin 14 5009273821077700608
10690301 22050110690301 106903 Asendin 14 5081331415115628544
10700101 16030710700101 107001 Augmentin 143 6388752995122675712
10700102 16030710700102 107001 Alpha-Amoxyclav 91 8343543931820048384
10700103 16030710700103 107001 Synermox 35 8415601525857976320
10700125 16030710700125 107001 Curam Duo 116 8723910083844505600
10700201 16030710700201 107002 Augmentin 143 6244637807046819840
10700202 16030710700202 107002 Alpha-Amoxyclav 91 8559716713933832192
10700203 16030710700203 107002 Synermox 35 8631774307971760128
10700225 16030710700225 107002 Curam 36 2732411739348926464
10700301 16030710700301 107003 Augmentin 143 6316695401084747776
10700302 16030710700302 107003 Alpha-Amoxyclav 91 8775889496047616000
10700303 16030710700303 107003 Synermox 35 8847947090085543936
10700325 16030710700325 107003 Curam 36 2948584521462710272
10720101 16030710720101 107201 Amoxil 47 8920004684123471872
10720201 16030710720201 107202 Amoxil 47 8992062278161399808
10720202 16030710720202 107202 Moxlin 200 355350063469297664
10720204 16030710720204 107202 Penamox 35 9136177466237255680
10720205 16030710720205 107202 Apo-Amoxi 10 9208235060275183616
10720225 16030710720225 107202 Ospamox 36 12422177917008609280
10720226 16030710720226 107202 Alphamox 200 6753008003265331200
10720301 16030710720301 107203 Amoxil 47 9352350248351039488
10720302 16030710720302 107203 Moxlin 200 427407657507225600
10720304 16030710720304 107203 Penamox 35 9496465436426895360
10720305 16030710720305 107203 Apo-Amoxi 10 9568523030464823296
10720325 16030710720325 107203 Ospamox 116 9640580624502751232
10720326 16030710720326 107203 Alphamox 200 6969180785379115008
10720401 16030710720401 107204 Amoxil Paediatric Drops 143 6172580213008891904
10720425 16030710720425 107204 Ospamox Paediatric Drops 116 11012210385037033472
10720501 16030710720501 107205 Amoxil 47 9784695812578607104
10720502 16030710720502 107205 Moxlin 200 499465251545153536
10720503 16030710720503 107205 Penamox 35 9928811000654462976
10720525 16030710720525 107205 Ospamox 36 1867158760451997696
10720526 16030710720526 107205 Ranbaxy Amoxicillin10 6300891020947095552
10720527 16030710720527 107205 Amoxicillin Actavis 90 7558356290146140160
10720601 16030710720601 107206 Amoxil 47 10072926188730318848
10720602 16030710720602 107206 Moxlin 200 571522845583081472
10720603 16030710720603 107206 Penamox 35 10217041376806174720
10720625 16030710720625 107206 Ospamox 116 10289098970844102656
10720626 16030710720626 107206 Ranbaxy Amoxicillin10 6517063803060879360
10720627 16030710720627 107206 Amoxicillin Actavis 90 7630413884184068096
10720701 16030710720701 107207 Amoxil 47 10361156564882030592
10720801 16030710720801 107208 Ibiamox 35 10433214158919958528
10720901 16030710720901 107209 Ibiamox 35 10505271752957886464
10721001 16030710721001 107210 Ibiamox 35 10577329346995814400
10740101 01310710740101 107401 Fungilin 157 11231844429755056128
10740201 01310710740201 107402 Fungilin 22 3370162568319467520
10760101 31030610760101 107601 Trusopt 72 9137866316097519616
10770101 16200510770101 107701 Invirase 30 7479134278341623808
10770125 16200510770125 107701 Fortovase 30 7551191872379551744
10772525 16200510772525 107725 Invirase 30 14124528680550006784
10780101 22220110780101 107801 Clozaril 116 18379584803973365760
10780125 22220110780125 107801 Clopine 35 4400693035592056832
10780201 22220110780201 107802 Clozaril 116 77237393316380672
10780225 22220110780225 107802 Clopine 35 4472750629629984768
10782525 22220110782525 107825 Clopine 35 8398483229325131776
10782625 22220110782625 107826 Clopine 35 8470540823363059712
10782725 22220110782725 107827 Clopine 35 18069129999289417728
10800101 22280110800101 108001 Amytal 45 8724148677867732992
10810201 16030110810201 108102 Zinnat 143 16331859845961482240
10820101 10110110820101 108201 Advantan 29 8360483007957565440
10820201 10110110820201 108202 Advantan 29 3928381323206459392
10830101 28240210830101 108301 Foradil 116 7500014004153090048
10830201 28240210830201 108302 Oxis Turbuhaler 144 11204806339316416512
10830301 28240210830301 108303 Oxis Turbuhaler 144 17556838944606257152
10840101 01370710840101 108401 PSM 16 5892178359646945280
10840102 01370710840102 108401 Douglas 35 5964235953684873216
10840103 01370710840103 108401 Apo-Ascorbic Acid 10 6036293547722801152
10840125 01370710840125 108401 Alpha Ascorbic Acid91 6252466329836584960
10840126 01370710840126 108401 Vitala-C 185 14514397911573331968
10840127 01370710840127 108401 Cvite 185 16423395288485462016
10840202 01370710840202 108402 PSM 16 6180408735798657024
10840301 38010110840301 108403 PSM 16 15640286823299678208
10850101 04040110850101 108501 Trasylol 15 3747671089623334912
10860101 16200510860101 108601 Norvir 2 7623249466417479680
10860201 16200510860201 108602 Norvir 2 7695307060455407616
10862525 16200510862525 108625 Norvir 2 16433781275321434112
10870101 22040410870101 108701 Solprin 162 4210147670498476032
10870102 22040410870102 108701 Aspro Clear 30 2004781332365836288
10870103 22040410870103 108701 Disprin 162 4282205264536403968
10870125 22040410870125 108701 Ethics Aspirin 120 4238566747541602304
10870201 22040410870201 108702 HMG 16 2148896520441692160
10870501 22040410870501 108705 Aspec 300 179 11076173374471274496
10870601 22040410870601 108706 Ecotrin 185 2293011708517548032
10870701 22040410870701 108707 SRA 53 2365069302555475968
10872525 04070110872525 108725 Ethics Aspirin EC 120 8719645078240362496
10872526 04070110872526 108725 Cartia 186 757847185537630208
10880101 25070610880101 108801 Prograf 69 4021495664427925504
10880125 25070610880125 108801 Tacrolimus Sandoz116 12759732384782352384
10880201 25070610880201 108802 Prograf 69 4093553258465853440
10882525 25070610882525 108825 Prograf 69 10416095862387113984
10920101 22040510920101 109201 Codcomol 104 4236824021611577344
10940101 07160110940101 109401 Anselol 35 3820291633614684160
10940102 07160110940102 109401 Loten 200 643580439621009408
10940103 07160110940103 109401 Apo-Atenolol 10 3964406821690540032
10940104 07160110940104 109401 Tenormin 65 4036464415728467968
10940105 07160110940105 109401 Global Atenolol 128 4108522009766395904
10940125 07160110940125 109401 Mylan Atenolol 200 14590137770052681728
10940126 07160110940126 109401 Noten 200 17432718375481507840
10940127 07160110940127 109401 Atenolol Tablet USP 200 5378000543010521088
10940201 07160110940201 109402 Tenormin 65 4180579603804323840
10940202 07160110940202 109402 Loten 200 715638033658937344
10940203 07160110940203 109402 Apo-Atenolol 10 4324694791880179712
10940204 07160110940204 109402 Anselol 35 4396752385918107648
10940205 07160110940205 109402 Global Atenolol 128 4468809979956035584
10940225 07160110940225 109402 Mylan Atenolol 200 14662195364090609664
10940226 07160110940226 109402 Atenolol Tablet USP 200 5594173325124304896
10940301 07160110940301 109403 Tenormin 65 4540867573993963520
10942525 07160110942525 109425 Atenolol AFT 127 3254020055565860864
10950101 07190110950101 109501 Tenoretic 65 9729014344724774912
10950102 07190110950102 109501 Loten-C 200 787695627696865280
10950201 07190110950201 109502 Tenoret 50 65 9873129532800630784
10950202 07190110950202 109502 Loten-C 200 859753221734793216
10970101 07130110970101 109701 Fawns and McAllan 130 10420937012084211712
10970202 07130110970202 109702 AstraZeneca 144 10492994606122139648
10970301 07130110970301 109703 AstraZeneca 144 10565052200160067584
10970302 07130110970302 109703 Baxter 12 10637109794197995520
10970401 07130110970401 109704 AstraZeneca 144 10709167388235923456
10970501 31031010970501 109705 Atropt 19 4910728991926648832
10970601 31031010970601 109706 Atropt 157 13897975409158389760
10980101 01101010980101 109801 Somac 200 14487375214297481216
10980125 01101010980125 109801 Dr Reddy's Pantoprazole 178 11140050601998548992
10980126 01101010980126 109801 Pantoprazole Actavis 40 191 14099268500413480960
10980201 01101010980201 109802 Somac 200 14559432808335409152
10980225 01101010980225 109802 Dr Reddy's Pantoprazole 178 13357525861687885824
10980226 01101010980226 109802 Pantoprazole Actavis 20 191 14171326094451408896
10982525 01101010982525 109825 Pantocid IV 179 7791917848653201408
10990101 19070110990101 109901 Ridaura 185 613731997461774336
10990125 19070110990125 109901 Ridaura s29 185 17570677397953445888
11000101 25070111000101 110001 Imuran 157 13524716500295876608
11000102 25070111000102 110001 Azamun 35 16218701407765659648
11000103 25070111000103 110001 Thioprine 200 1003868409810649088
11000125 25070111000125 110001 Imuprine 200 9614762991970942976
11000201 25070111000201 110002 Imuran 157 9331308894330290176
11010101 10170111010101 110101 Derbac-M 168 16385352186164412416
11010125 10170111010125 110101 A-Lices 127 18333731870560223232
11012525 10170111012525 110125 A-Lices 127 3809596684011307008
11012601 10170111012601 110126 Prioderm 19 4169884654200946688
11020101 16200511020101 110201 Crixivan 72 7767364654493335552
11020201 16200511020201 110202 Crixivan 72 7839422248531263488
11030101 31030411030101 110301 Lomide 3 6832023306883825664
11050101 13010511050101 110501 Ortho 69 16629604296228339712
11070101 22160111070101 110701 Navoban 116 13623502122493411328
11080101 28100111080101 110801 Becotide Junior 76 3969191896294621184
11080102 28100111080102 110801 Atomide Junior 35 4041249490332549120
11080125 28100111080125 110801 Beclazone 50 132 5770631747242819584
11080201 28100111080201 110802 Becotide 100 76 4113307084370477056
11080202 28100111080202 110802 Atomide 35 4185364678408404992
11080203 28100111080203 110802 Respocort 100 1 6448723657836462080
11080225 28100111080225 110802 Beclazone 100 132 5842689341280747520
11080301 28100111080301 110803 Becloforte 76 4329479866484260864
11080302 28100111080302 110803 Atomide Forte 35 4401537460522188800
11080303 28100111080303 110803 Respocort Forte 1 6664896439950245888
11080325 28100111080325 110803 Respocort 250 1 6736954033988173824
11080326 28100111080326 110803 Beclazone 250 132 5554458965129035776
11080401 28100111080401 110804 Respocort Junior Autohaler 1 6376666063798534144
11080501 28100111080501 110805 Respocort 100 Autohaler 1 6520781251874390016
11080601 28100111080601 110806 Respocort Forte Autohaler 1 6809011628026101760
11080701 28100111080701 110807 Becodisk Junior 104 4833883024749756416
11080801 28100111080801 110808 Becodisk 200 76 4905940618787684352
11080901 28100111080901 110809 Becodisk Forte 76 4977998212825612288
11081102 28510211081102 110811 Atomase 35 2312148708398989312
11081103 28510211081103 110811 Aldecin 40 2384206302436917248
11081104 28510211081104 110811 Beconase 104 2456263896474845184
11081201 28510211081201 110812 Beconase 100 104 2528321490512773120
11081301 28510211081301 110813 Alanase 200 1075926003848577024
11081302 28510211081302 110813 Atomase Aqueous 35 2672436678588628992
11081303 28510211081303 110813 Beconase Aqueous 104 2744494272626556928
11081304 28510211081304 110813 Aldecin Aqueous 40 2816551866664484864
11081401 28510211081401 110814 Alanase 200 1147983597886504960
11081402 28510211081402 110814 Atomase Forte Aqueous 35 2960667054740340736
11081403 28510211081403 110814 Beconase 100 Aqueous 104 3032724648778268672
11081501 28100111081501 110815 Respocort 100-S 1 6592838845912317952
11081601 28100111081601 110816 Respocort Forte-S 1 6881069222064029696
11082525 28100111082525 110825 Beclazone 50 132 15422707765813968896
11082625 28100111082625 110826 Beclazone 100 132 16647686864458743808
11082725 28100111082725 110827 Beclazone 250 132 17957389931093426176
11090101 16200311090101 110901 Zerit 22 6037982397583065088
11090201 16200311090201 110902 Zerit 22 6110039991620993024
11090301 16200311090301 110903 Zerit 22 6182097585658920960
11090401 16200311090401 110904 Zerit 22 6254155179696848896
11090501 16200311090501 110905 Zerit 22 6326212773734776832
11100101 01150911100101 111001 B-D Micro-Fine 119 15547614485752578048
11100125 01150911100125 111001 ABM 167 1922310263701241856
11100126 01150911100126 111001 SC Profi-Fine 19 5638639774374821888
11100201 01150911100201 111002 B-D Micro-Fine 119 15619672079790505984
11100226 01150911100226 111002 ABM 167 625273571018539008
11100227 01150911100227 111002 SC Profi-Fine 19 6070985338602389504
11102525 01150911102525 111025 B-D Micro-Fine 119 15475556891714650112
11102526 01150911102526 111025 SC Profi-Fine 19 5854812556488605696
11102625 01150911102625 111026 NovoFine 8 120870412753043456
11102626 01150911102626 111026 ABM 167 2642886204080521216
11102627 01150911102627 111026 Fine Ject 19 4002709408755744768
11102725 01150911102725 111027 B-D Micro-Fine 39 13380337429429354496
11120101 28010111120101 111201 Allpyral 39 12758264536759271424
11160101 07311011160101 111601 Neo-Naclex 143 6676983371274387456
11160125 07311011160125 111601 Arrow-Bendrofluazide 163 5427539039399968768
11160201 07311011160201 111602 Neo-Naclex 143 6749040965312315392
11160225 07311011160225 111602 Arrow-Bendrofluazide 163 5643711821513752576
11200101 16030711200101 112001 Penadur LA 14 5153389009153556480
11200201 16030711200201 112002 Penadur LA 14 5225446603191484416
11200202 16030711200202 112002 Bicillin 157 10654825125544722432
11200225 16030711200225 112002 Bicillin LA 14 17529850332190867456
11202525 16030711202525 112025 Pan Benzathine Benzylpenicillin 177 6893156153388171264
11220101 01100211220101 112201 Helidac 14 14663289378160246784
11240101 16030711240101 112401 Diclocil 22 10865559723147526144
11240201 16030711240201 112402 Diclocil 22 10937617317185454080
11240301 16030711240301 112403 Diclocil 22 11009674911223382016
11240401 16030711240401 112404 Diclocil 22 11081732505261309952
11240501 16030711240501 112405 Diclocil 22 11153790099299237888
11240601 16030711240601 112406 Diclocil 22 11225847693337165824
11250101 22050711250101 112501 Serzone 22 15405751097490407424
11250201 22050711250201 112502 Serzone 22 15477808691528335360
11260101 01220111260101 112601 Actigall 116 12033448879543287808
11262525 01220111262525 112625 Ursosan 167 8291564519616937984
11270101 07070211270101 112701 Inhibace Plus 30 7189496527306358784
11270125 07070211270125 112701 Apo-Cilazapril/Hydrochlorothiazide 10 4199509895499743232
11280101 10010111280101 112801 Benoxyl 10 30 5408108469913911296
11280201 10010111280201 112802 Benoxyl 5 30 5480166063951839232
11280301 10010111280301 112803 Panoxyl 30 5552223657989767168
11280401 10010111280401 112804 Panoxyl 30 5624281252027695104
11280503 10010111280503 112805 Panoxyl 30 5696338846065623040
11280505 10010111280505 112805 Benzac W5 200 5768396440103550976
11300101 22010411300101 113001 Cogentin 72 10569809786973454336
11300125 22010411300125 113001 Benztrop 127 10497752192935526400
11300201 22010411300201 113002 Cogentin 218 17952068294814990336
11320101 01310111320101 113201 Difflam 35 5271016962116288512
11330101 22070211330101 113301 Topamax 69 16367036521468919808
11330125 22070211330125 113301 Arrow-Topiramate163 10434133350640779264
11330201 22070211330201 113302 Topamax 69 16439094115506847744
11330301 22070211330301 113303 Topamax 69 16511151709544775680
11330401 22070211330401 113304 Topamax 69 16583209303582703616
11332525 22070211332525 113325 Topamax 69 16655266897620631552
11332625 22070211332625 113326 Topamax 69 16727324491658559488
11360101 16030711360101 113601 Sandoz 116 6088717162623533056
11360102 16030711360102 113601 Benpen 29 11369962881413021696
11370101 07320411370101 113701 Lipitor 14 7250402874415382528
11370125 07320411370125 113701 Lorstat 10 200 7322460468453310464
11370126 07320411370126 113701 Dr Reddy's Atorvastatin 178 7394518062491238400
11370127 07320411370127 113701 Zarator 14 7466575656529166336
11370201 07320411370201 113702 Lipitor 14 7538633250567094272
11370225 07320411370225 113702 Lorstat 20 200 7610690844605022208
11370227 07320411370227 113702 Zarator 14 7754806032680878080
11370301 07320411370301 113703 Lipitor 14 7826863626718806016
11370325 07320411370325 113703 Lorstat 40 200 7898921220756733952
11370327 07320411370327 113703 Zarator 14 8043036408832589824
11372525 07320411372525 113725 Lipitor 14 8115094002870517760
11372526 07320411372526 113725 Lorstat 80 200 8187151596908445696
11372528 07320411372528 113725 Zarator 14 8331266784984301568
11380101 22010111380101 113801 Tasmar 211 10713924975049310208
11400101 22220111400101 114001 Zyprexa 45 149294987354308608
11400125 22220111400125 114001 Dr Reddy's Olanzapine 178 13991989150891376640
11400126 22220111400126 114001 Olanzine 200 14208161933005160448
11400127 22220111400127 114001 Zypine 200 11384437951992692736
11400201 22220111400201 114002 Zyprexa 45 221352581392236544
11400226 22220111400226 114002 Olanzine 200 14640507497232728064
11400227 22220111400227 114002 Zypine 200 11816783516220260352
11400301 22220111400301 114003 Zyprexa 45 293410175430164480
11400326 22220111400326 114003 Olanzine 200 13775816368777592832
11400327 22220111400327 114003 Zypine 200 11168265169878908928
11401525 22220411401525 114015 Zyprexa Relprevv 45 2084499223914479616
11402726 22220111402726 114027 Olanzine-D 200 2931458528348471296
11402727 22220111402727 114027 Zypine ODT 200 11600610734106476544
11402728 22220111402728 114027 Zyprexa Zydis 45 1361966152837758976
11402826 22220111402826 114028 Olanzine-D 200 3075573716424327168
11402827 22220111402827 114028 Zypine ODT 200 12032956298334044160
11402828 22220111402828 114028 Zyprexa Zydis 45 929620588610191360
11410101 31020111410101 114101 Ultrazon N 35 6851777132788449280
11410102 31020111410102 114101 Betnesol-N 104 6923834726826377216
11431001 10220111431001 114310 Diprosone 40 12684220125209952256
11431101 10220111431101 114311 Diprolene 40 12756277719247880192
11431201 10110111431201 114312 Diprosone 72 17828802046225022976
11431301 10110111431301 114313 Diprosone 72 17900859640262950912
11431401 10110111431401 114314 Diprolene 72 17972917234300878848
11431425 10110111431425 114314 Diprosone OV 72 18044974828338806784
11431501 10110111431501 114315 Diprolene 40 8720770978147205120
11431525 10110111431525 114315 Diprosone OV 40 8072252631805853696
11440101 14070111440101 114401 Betnesol 104 11388027857457381376
11440201 14070111440201 114402 Betnesol 104 11460085451495309312
11440701 31020111440701 114407 Ultrazon 35 6995892320864305152
11440702 31020111440702 114407 Betnesol 104 7067949914902233088
11450101 10110411450101 114501 Lotricomb 40 15945103332356390912
11460201 10110411460201 114602 Betnovate-C 143 5415132150192144384
11460301 10110411460301 114603 Betnovate-C 143 5487189744230072320
11472501 10110411472501 114725 Garamycin V 40 16161276114470174720
11480101 10110411480101 114801 Fucicort 29 16233333708508102656
11490101 31030511490101 114901 Betoptic S 19 3496035758978891776
11490201 31030511490201 114902 Betoptic 19 3568093353016819712
11490225 31030511490225 114902 Apo-Betaxolol 10 7768772029376888832
11500101 10110411500101 115001 Diprosalic 40 16305391302546030592
11500201 10110411500201 115002 Diprosalic 40 16377448896583958528
11510101 07320111510101 115101 Bezalip 20 5448963023467184128
11510102 07320111510102 115101 Fibalip 200 5521020617505112064
11510201 07320111510201 115102 Bezalip Retard 191 5593078211543040000
11560101 14110411560101 115601 Progynova 15 4432784481471954944
11560201 14110411560201 115602 Progynova 15 4504842075509882880
11580101 25040411580101 115801 Arimidex 144 3447927727217180672
11580125 25040411580125 115801 DP-Anastrozole 35 3303812539141324800
11580126 25040411580126 115801 Aremed 127 11580303853853081600
11590101 01101311590101 115901 Roter 6 7116875983315009536
11590201 38010111590201 115902 PSM 16 15712344417337606144
11660101 22250111660101 116601 Lexotan 30 5265384164047192064
11660201 22250111660201 116602 Lexotan 30 5337441758085120000
11670101 22010111670101 116701 Parlodel 116 10930097757163094016
11670102 22010111670102 116701 Apo-Bromocriptine 91 10858040163125166080
11670103 22010111670103 116701 Alpha-Bromocriptine10 10785982569087238144
11670301 22010111670301 116703 Apo-Bromcriptine 10 11074212945238949888
11670302 22010111670302 116703 Alpha-Bromocriptine10 11002155351201021952
11670401 22010111670401 116704 Parlodel 116 11146270539276877824
11672525 22010111672525 116725 Apo-Bromocriptine 10 11218328133314805760
11680101 28100111680101 116801 Pulmicort 144 10196000022785425408
11680201 28100111680201 116802 Pulmicort Turbuhaler 144 15904577532779823104
11680325 28100111680325 116803 Budenocort 127 9923542140934160384
11680425 28100111680425 116804 Budenocort 127 7617699131720466432
11680501 28100111680501 116805 Pulmicort 144 10268057616823353344
11680701 28510211680701 116807 Rhinocort Aqueous 11 3104782242816196608
11680702 28510211680702 116807 Eltair 35 3176839836854124544
11680703 28510211680703 116807 Butacort Aqueous 200 1436213974038216704
11680801 28510211680801 116808 Eltair Forte 35 3320955024929980416
11680802 28510211680802 116808 Rhinocort Aqueous 11 3393012618967908352
11680803 28510211680803 116808 Butacort Aqueous 200 1508271568076144640
11680901 01040411680901 116809 Entocort CIR 144 5919535308457639936
11700101 16200111700101 117001 Viramune 17 7065416640111837184
11700125 16200111700125 117001 Nevirapine Alphapharm 200 13581053277079863296
11702525 16200111702525 117025 Viramune Suspension 17 6993359046073909248
11710101 07310111710101 117101 Burinex 29 1154442129188061184
11710201 07310111710201 117102 Burinex 29 1226499723225989120
11720101 16200511720101 117201 Viracept 30 7911479842569191424
11720201 16200511720201 117202 Viracept 30 7983537436607119360
11730101 25010111730101 117301 Myleran 157 4729482196669169664
11740101 28010111740101 117401 Albay 39 12830322130797199360
11740201 28010111740201 117402 Albay 39 12902379724835127296
11770101 01100211770101 117701 Helicosec 144 10340115210861281280
11780101 16030411780101 117801 Zithromax 14 5198959368078360576
11780125 16030411780125 117801 Arrow-Azithromycin163 6741158566452789248
11780126 16030411780126 117801 Apo-Azithromycin 10 2246620014406795264
11782525 16030411782525 117825 Zithromax 14 17642734991991373824
11782625 16030411782625 117826 Apo-Azithromycin 10 2030447232293011456
11790101 10080111790101 117901 PSM 16 17871803945987342336
11790125 10080111790125 117901 ABM 167 4219142775125311488
11790126 10080111790126 117901 healthE 202 2314137724933636096
11790127 10080111790127 117901 Home Essential 179 8059356459923668992
11790128 10080111790128 117901 Pharmacy Health 179 18350929331930267648
11790201 10080111790201 117902 PSM 179 1862684847638577152
11790225 10080111790225 117902 ABM 167 4291200369163239424
11790301 10080111790301 117903 PSM 16 18015919134063198208
11790401 38010111790401 117904 PSM 16 15784402011375534080
11810101 25040411810101 118101 Femara 116 3519985321255108608
11810125 25040411810125 118101 Letara 35 3375870133179252736
11810126 25040411810126 118101 Letraccord 163 514144831287590912
11830101 22220111830101 118301 Seroquel 144 3073544017959452672
11830125 22220111830125 118301 Quetapel 200 17000372811253940224
11830126 22220111830126 118301 Dr Reddy's Quetiapine 178 15955831267308601344
11830201 22220111830201 118302 Seroquel 144 3145601611997380608
11830225 22220111830225 118302 Quetapel 200 17793287820647858176
11830301 22220111830301 118303 Seroquel 144 3289716800073236480
11830325 22220111830325 118303 Quetapel 200 17072430405291868160
11830401 22220111830401 118304 Seroquel 144 3217659206035308544
11832525 22220111832525 118325 Seroquel 144 725755739657732096
11832526 22220111832526 118325 Quetapel 200 7489051873224163328
11850101 38010111850101 118501 Isopropyl alcohol 16 15856459605413462016
11870101 01371011870101 118701 HMG 16 6612754300026224640
11870125 01371011870125 118701 Cal-d-Forte 179 712263632473292800
11880201 14040411880201 118802 Miacalcic 116 1219808095459344384
11880301 19080611880301 118803 Calcitare 155 10916294488187994112
11880401 19080611880401 118804 Calsynar 155 10988352082225922048
11890101 01371011890101 118901 Rocaltrol 30 6684811894064152576
11890125 01371011890125 118901 Calcitriol-AFT 127 5364142298454032384
11890126 01371011890126 118901 Airflow 132 6452386131068583936
11890201 01371011890201 118902 Rocaltrol 30 6756869488102080512
11890225 01371011890225 118902 Calcitriol-AFT 127 5580315080567816192
11890226 01371011890226 118902 Airflow 132 6668558913182367744
11890301 01371011890301 118903 Rocaltrol solution 30 6828927082140008448
11910201 01381011910201 119102 Calforte 200 7269793861482840064
11910202 01381011910202 119102 Oscal-500 105 7341851455520768000
11910203 01381011910203 119102 Cal-Sup 1 7413909049558695936
11910204 01381011910204 119102 Oscal Chewable 105 7485966643596623872
11910205 01381011910205 119102 Osteo~500 59 7558024237634551808
11910225 01381011910225 119102 Calci-Tab 500 127 6981563485331128320
11910226 01381011910226 119102 Arrow-Calcium 163 6232572865955233792
11910301 01381011910301 119103 Caltrate 31 7630081831672479744
11910302 01381011910302 119103 Osteo~600 59 7702139425710407680
11910325 01381011910325 119103 Calci-Tab 600 127 8638888148203470848
11910401 38010111910401 119104 PSM 16 15928517199451389952
11912525 01381011912525 119125 Calci-Tab Effervescent 127 7053621079369056256
11912601 01381011912601 119126 Calcium-Sandoz 1000 116 7918312207824191488
11912625 01381011912625 119126 Calsource 158 7197736267444912128
11912725 01010411912725 119127 Roxane 220 11342765361788354560
11920101 01130911920101 119201 Humalog 45 2287388806053101568
11920201 01130911920201 119202 Humalog 45 2359446400091029504
11930101 22050711930101 119301 Cipramil 134 15549866285566263296
11930125 22050711930125 119301 Celapram 200 16279796870874660864
11930126 22050711930126 119301 Arrow-Citalopram 163 6669100972414861312
11930127 22050711930127 119301 Citalopram - Rex 166 6597043378376933376
11940101 28040111940101 119401 Telfast 155 8978330477442105344
11940201 28040111940201 119402 Telfast 155 9122445665517961216
11940301 28040111940301 119403 Telfast 155 9050388071480033280
11950101 22160111950101 119501 Serc 135 13767617310569267200
11950125 22160111950125 119501 Vergo 16 200 1652386756152000512
11950201 22160111950201 119502 Serc 33 13695559716531339264
11970101 01381011970101 119701 Mayne 12 7774197019748335616
11980101 25010411980101 119801 Leucovorin 31 5822654040399413248
11980102 25010411980102 119801 DBL Leucovorin Calcium 174 17275396953244434432
11980103 25010411980103 119801 Rescuvolin 144 8555558360957583360
11980104 25010411980104 119801 Refolinon 14 14807404566236102656
11980201 25010411980201 119802 Hospira 174 8213903814323863552
11980301 25010411980301 119803 Mayne 12 11034238000987897856
11980401 25010411980401 119804 Leucovorin 31 6254999604626980864
11980402 25010411980402 119804 Mayne 12 6327057198664908800
11980425 25010411980425 119804 Calcium Folinate Ebewe 36 3107070326513598464
11982525 25010411982525 119825 Mayne 174 11106295595025825792
11982625 25010411982625 119826 Baxter 12 9281418554219954176
11982626 25010411982626 119826 Biomed 102 14393064604424994816
11990101 01381011990101 119901 Hospira 174 7060982309717016576
12050101 04100412050101 120501 Calcium Resonium155 15416517515349590016
12090101 16160112090101 120901 Capastat 45 17153198330445037568
12160101 31030912160101 121601 Isopto Carbachol 3 9858442256476798976
12160201 31030912160201 121602 Isopto Carbachol 3 9930499850514726912
12170301 22070212170301 121703 Tegretol 158 2544652536720130048
12170401 22070212170401 121704 Teril 200 2012674726341640192
12170402 22070212170402 121704 Tegretol 116 17423363730552389632
12170501 22070212170501 121705 Tegretol CR 116 17495421324590317568
12170601 22070212170601 121706 Teril 200 2084732320379568128
12170602 22070212170602 121706 Tegretol 116 17639536512666173440
12170701 22070212170701 121707 Tegretol CR 116 17711594106704101376
12210101 14140112210101 122101 Neo-Mercazole 127 18411676249853263872
12210125 14140112210125 122101 AFT 127 4415682677613527040
12230101 16200312230101 122301 Combivir 143 11442920975474098176
12230125 16200312230125 122301 Alphapharm 200 16646034298482196480
12240101 10220112240101 122401 Seborrol 35 12828335313285808128
12280101 16030112280101 122801 Ceclor 45 8938632610121252864
12280125 16030112280125 122801 Clorotir 116 10740072461069451264
12280126 16030112280126 122801 Ranbaxy-Cefaclor 35 10668014867031523328
12280127 16030112280127 122801 Cefaclor Sandoz 36 15785262928980082688
12280201 16030112280201 122802 Ceclor 45 9010690204159180800
12280225 16030112280225 122802 Clorotir 116 11100360431259090944
12280226 16030112280226 122802 Ranbaxy-Cefaclor 35 11172418025297018880
12300101 16030112300101 123001 Mandol 45 9082747798197108736
12300202 16030112300202 123002 Mandol 45 9154805392235036672
12300203 16030112300203 123002 Baxter 12 9226862986272964608
12310101 16030112310101 123101 Mefoxin 72 9298920580310892544
12310125 16030112310125 123101 Mayne 153 10884187649145307136
12320101 16030112320101 123201 Rocephin IM 30 9370978174348820480
12320102 16030112320102 123201 Rocephin IV 30 9443035768386748416
12320201 16030112320201 123202 Rocephin 30 9515093362424676352
12320225 16030112320225 123202 Novartis 116 11460648401448730624
12320226 16030112320226 123202 AFT 127 8722459828007469056
12320227 16030112320227 123202 Veracol 120 12405869960545435648
12320228 16030112320228 123202 Ceftriaxone-AFT 127 6361237716637581312
12320301 16030112320301 123203 Rocephin IM 30 9587150956462604288
12320325 16030112320325 123203 Novartis 116 11532705995486658560
12320326 16030112320326 123203 Rocephin 30 10812130055107379200
12320327 16030112320327 123203 AFT 127 8794517422045396992
12320328 16030112320328 123203 Aspen Ceftriaxone157 16459952950597386240
12320329 16030112320329 123203 Ceftriaxone-AFT 127 3359875537529995264
12330101 16030112330101 123301 Zinacef 104 9659208550500532224
12330125 16030112330125 123301 Mayne 12 11244475619334946816
12330201 16030112330201 123302 Zinacef 143 16403917439999410176
12330225 16030112330225 123302 Mayne 153 10956245243183235072
12330226 16030112330226 123302 m-Cefuroxime 120 5692986435112534016
12330301 16030112330301 123303 Zinacef 143 16475975034037338112
12330325 16030112330325 123303 Mayne 12 11316533213372874752
12330326 16030112330326 123303 Mylan 200 2913421040094806016
12340101 16030112340101 123401 Keflex 45 9875381332614316032
12340201 16030112340201 123402 Keflex 45 9947438926652243968
12340301 16030112340301 123403 Keflex 45 10019496520690171904
12340325 16030112340325 123403 Cefalexin Sandoz 36 7100904477409935360
12340401 16030112340401 123404 Keflex 45 10091554114728099840
12340425 16030112340425 123404 Cefalexin Sandoz 36 7317077259523719168
12342525 16030112342525 123425 Cephalexin ABM 167 7578292634980974592
12350101 16030112350101 123501 Keflin 45 10163611708766027776
12360101 16030112360101 123601 Kefzol 45 10235669302803955712
12360125 16030112360125 123601 Baxter 12 11028302837221163008
12360126 16030112360126 123601 Novartis 116 11604763589524586496
12360127 16030112360127 123601 m-Cefazolin 120 8650402233969541120
12360128 16030112360128 123601 Hospira 174 17528132895028281344
12360129 16030112360129 123601 AFT 127 2954516386694561792
12360201 16030112360201 123602 Kefzol 45 10307726896841883648
12360225 16030112360225 123602 Hospira 174 18248708835407560704
12360226 16030112360226 123602 Novartis 116 11676821183562514432
12360227 16030112360227 123602 m-Cefazolin 120 11748878777600442368
12360228 16030112360228 123602 AFT 127 3170689168808345600
12370101 16030112370101 123701 Velosef 22 10379784490879811584
12370201 16030112370201 123702 Velosef 22 10451842084917739520
12370301 16030112370301 123703 Velosef 22 10523899678955667456
12370401 16030112370401 123704 Velosef 22 10595957272993595392
12380101 01280212380101 123801 Cerezyme 138 4539741674087120896
12382525 01280212382525 123825 Cerezyme 138 9418576032715243520
12390101 38010112390101 123901 David Craig 120 16144689981565173760
12390125 38010112390125 123901 Midwest 152 1198147716392157184
12400101 38010112400101 124001 PSM 179 1216666790738788352
12400125 38010112400125 124001 ABM 167 15424114041185894400
12400126 38010112400126 124001 Midwest 152 4989006523242905600
12440101 10130112440101 124401 Hibitane 65 13332456996574593024
12440201 10130112440201 124402 Hibiclens 144 11276863933354344448
12440225 10130112440225 124402 Orion 141 13476572184650448896
12440301 10130112440301 124403 Hibitane Concentrate 65 13548629778688376832
12440401 10130112440401 124404 Hibitane 65 13620687372726304768
12440402 10130112440402 124404 Multichem 120 13692744966764232704
12440601 10130112440601 124406 Microshield Handrub 133 13764802560802160640
12442525 10130112442525 124425 Orion 78 13260399402536665088
12442526 10130112442526 124425 healthE 202 10466784447939215360
12442601 01310112442601 124426 Rivacol 141 6044533287861354496
12442602 01310112442602 124426 Delta West 14 14735346972198174720
12442625 01310112442625 124426 healthE 202 17654840615013187584
12470101 01131112470101 124701 Glucobay 15 11103178479561080832
12470125 01131112470125 124701 Accarb 200 7062092816461070336
12470201 01131112470201 124702 Glucobay 15 11656504407704469504
12470225 01131112470225 124702 Accarb 200 7278265598574854144
12480101 22260112480101 124801 Avonex 180 11009733185339654144
12482525 22260112482525 124825 Avonex 180 11081790779377582080
12482625 22260112482625 124826 Avonex Pen 180 2282648811425759232
12500101 31030812500101 125001 Xalatan 14 12162086242434940928
12500125 31030812500125 125001 Hysite 14 777003976628371456
12510101 01100212510101 125101 Klacid Hp7 2 3802226657570324480
12510102 01100212510102 125101 Losec Hp7 OAC 144 2641198453731885056
12540101 07070312540101 125401 Atacand 144 16043629469809770496
12540125 07070312540125 125401 Candestar 200 7980248797328441344
12540201 07070312540201 125402 Atacand 144 16187744657885626368
12540225 07070312540225 125402 Candestar 200 8196421579442225152
12540301 07070312540301 125403 Atacand 144 16259802251923554304
12540325 07070312540325 125403 Candestar 200 8412594361556008960
12542525 07070312542525 125425 Atacand 144 16115687063847698432
12542526 07070312542526 125425 Candestar 200 8628767143669792768
12550101 25010112550101 125501 Leukeran 157 4513309414555385856
12550125 25010112550125 125501 Leukeran FC 157 4585367008593313792
12550201 25010112550201 125502 Leukeran 157 4657424602631241728
12570101 31030112570101 125701 Chloroptic-P 5 6924116201803087872
12580101 31030112580101 125801 Chloromyxin 58 6996173795841015808
12580201 31030112580201 125802 Chloromyxin 58 7068231389878943744
12580301 31010112580301 125803 Chloromyxin 58 11317112656000712704
12590102 31030112590102 125901 Chlorsig 177 18267561061777408000
12590103 31030112590103 125901 Chloromycetin 14 3494643777258127360
12590104 31030112590104 125901 Chloroptic 5 7284404171992727552
12590105 31030112590105 125901 Isopto-Fenicol 3 7356461766030655488
12590125 31030112590125 125901 Chlorafast 163 11796476635966865408
12590202 31010112590202 125902 Chloromycetin 14 3350528589182271488
12590402 31030112590402 125904 Chloromycetin 14 3422586183220199424
12590403 31030112590403 125904 Chlorsig 157 13753860221082533888
12590404 31030112590404 125904 Chloroptic 5 7572634548144439296
12590601 16031312590601 125906 Chloromycetin 14 3134355807068487680
12590701 16031312590701 125907 Chloromycetin 14 3206413401106415616
12610101 16031312610101 126101 Chloromycetin 14 3278470995144343552
12730101 22280112730101 127301 Hemineurin 11 8796206271905660928
12730201 22280112730201 127302 Hemineurin 11 8868263865943588864
12730301 22280112730301 127303 Hemineurin 11 8940321459981516800
12750101 01010212750101 127501 Titralac 35 7641893885089677312
12760101 01010212760101 127601 Titralac-Sil 1 7097242004177813504
12800101 16100112800101 128001 Nivaquine 155 11060409676263849984
12800201 16100112800201 128002 Avloclor 65 14487067351041703936
12800301 16100112800301 128003 Nivaquine 155 11132467270301777920
12820101 07311012820101 128201 Chlotride 72 7261835596320997376
12820201 07311012820201 128202 Biomed 102 7333893190358925312
12830101 22220112830101 128301 Largactil 155 8847436916690255872
12830201 22220112830201 128302 Largactil 155 8919494510728183808
12830301 22220112830301 128303 Largactil 155 11204524864339705856
12830401 22220112830401 128304 Largactil 155 8991552104766111744
12830501 22220112830501 128305 Largactil Forte 155 11276582458377633792
12830601 22220112830601 128306 Largactil 155 8775379322652327936
12880101 10040112880101 128801 Aureomycin 31 11170447700460044288
12900101 07311012900101 129001 Hygroton 127 10764326588066562048
12900125 07311012900125 129001 Igroton 127 7139497335544872960
12910101 07320312910101 129101 Questran Light 145 6745999716149886976
12910125 07320312910125 129101 Questran-Lite 22 6818057310187814912
12920101 28450212920101 129201 Brondecon 133 3062298213030559744
12970101 01100312970101 129701 Duomet 200 2228847508455424000
12970102 01100312970102 129701 Tagamet 47 4162514627759964160
12970103 01100312970103 129701 Cytine 35 4234572221797892096
12970104 01100312970104 129701 Apo-Cimetidine 10 4306629815835820032
12970201 01100312970201 129702 Duomet 200 2300905102493351936
12970202 01100312970202 129702 Tagamet 47 4450745003911675904
12970203 01100312970203 129702 Cytine 35 4522802597949603840
12970204 01100312970204 129702 Apo-Cimetidine 10 4594860191987531776
12970301 01100312970301 129703 Tagamet 47 4666917786025459712
12970302 01100312970302 129703 Cytine 35 4738975380063387648
12970304 01100312970304 129703 Apo-Cimetidine 10 4811032974101315584
12970401 01100312970401 129704 Tagamet 47 4883090568139243520
13030101 16031313030101 130301 Dalacin C 14 9423897668993679360
13030125 16031313030125 130301 Clindamycin ABM167 9156255648072073216
13030201 16031313030201 130302 Dalacin C 14 14879462160274030592
13030301 16031313030301 130303 Dalacin C 14 14951519754311958528
13060101 10010113060101 130601 Dalacin-T 14 15023577348349886464
13060301 10010113060301 130603 Dalacin T 14 15095634942387814400
13080101 22070213080101 130801 Frisium 155 9495955263031607296
13090201 10220113090201 130902 Dermovate 143 2413498391712497664
13090202 10220113090202 130902 Dermol 200 2372962696531279872
13090301 10110113090301 130903 Dermol 200 2445020290569207808
13090302 10110113090302 130903 Dermovate 143 2269383203636641792
13090401 10110113090401 130904 Dermol 200 2517077884607135744
13090402 10110113090402 130904 Dermovate 143 2341440797674569728
13100201 10110113100201 131002 Eumovate 143 16548032628075266048
13100301 10110113100301 131003 Eumovate 143 2485555985750425600
13120101 16160113120101 131201 Lamprene 116 8250163508784660480
13130101 07320213130101 131301 Atromid-S 65 5953366181732679680
13140101 14210113140101 131401 Clomid 105 9010408729182470144
13140102 14210113140102 131401 Phenate 200 2589135478645063680
13140103 14210113140103 131401 Serophene 85 9154523917258326016
13150101 22050113150101 131501 Anafranil 116 8322221102822588416
13150125 22050113150125 131501 Clopress 200 8858146159944794112
13150126 22050113150126 131501 Apo-Clomipramine 10 5083573319324663808
13150201 22050113150201 131502 Anafranil 116 8394278696860516352
13150202 22050113150202 131502 Clopress 200 2661193072682991616
13150225 22050113150225 131502 Apo-Clomipramine 10 5299746101438447616
13160101 22250113160101 131601 Rivotril 30 4948498315852382208
13160125 22250113160125 131601 Paxam 200 4876440721814454272
13160201 22250113160201 131602 Rivotril 30 5092613503928238080
13160225 22250113160225 131602 Paxam 200 5020555909890310144
13160301 22070213160301 131603 Rivotril 30 17999824482855813120
13160401 22070113160401 131604 Rivotril 30 8795643321952239616
13170201 07280113170201 131702 Catapres-TTS-1 17 14989218709493514240
13170301 07280113170301 131703 Catapres-TTS-2 17 15061276303531442176
13170401 07280113170401 131704 Catapres-TTS-3 17 15133333897569370112
13180101 07280113180101 131801 Catapres 17 14917161115455586304
13180501 07280113180501 131805 Catapres 17 15205391491607298048
13180801 07280113180801 131808 Dixarit 17 11793969749455536128
13180825 07280113180825 131808 Clonidine BNM 185 18119570095213641728
13200101 13100113200101 132001 Canesten 15 17656757063780401152
13200102 13100113200102 132001 Gyne Lotremin 40 17728814657818329088
13200103 13100113200103 132001 Fungizid 35 17800872251856257024
13200125 13100113200125 132001 Clotrihexal 116 17069056004106223616
13200201 13100113200201 132002 Canesten 1 15 17872929845894184960
13200225 13100113200225 132002 Clotrihexal 116 17213171192182079488
13200301 13100113200301 132003 Canesten 15 17944987439932112896
13200302 13100113200302 132003 Clocreme 200 2733250666720919552
13200303 13100113200303 132003 Gyne Lotremin 40 18089102628007968768
13200304 13100113200304 132003 Clotrimaderm 1% 127 18161160222045896704
13200325 13100113200325 132003 Clomazol 120 17584699469742473216
13200401 13100113200401 132004 Canesten 3 15 18233217816083824640
13200402 13100113200402 132004 Clotrimaderm 2% 127 18305275410121752576
13200425 13100113200425 132004 Clomazol 120 1134748776422965248
13200601 10070113200601 132006 Canesten 15 13620405897749594112
13200701 10070113200701 132007 Canesten 15 13692463491787522048
13200702 10070113200702 132007 Clocreme 200 2805308260758847488
13200704 10070113200704 132007 Lotremin 40 13836578679863377920
13200705 10070113200705 132007 AFT 127 13908636273901305856
13200725 10070113200725 132007 Clomazol 120 13548348303711666176
13240101 10190113240101 132401 Egopsoryl TA 35 9657801175616978944
13320101 22040713320101 133201 Douglas 35 5461803120256352256
13320102 22040713320102 133201 PSM 179 13069295485536174080
13320103 22040713320103 133201 Alpha-codeine phosphate 10 5605918308332208128
13320201 22040713320201 133202 Douglas 35 5677975902370136064
13320202 22040713320202 133202 PSM 179 13141353079574102016
13320301 22040713320301 133203 Douglas 35 5894148684483919872
13320302 22040713320302 133203 PSM 179 13213410673612029952
13320401 28470213320401 133204 PSM 16 16795443635045793792
13320501 38010113320501 133205 Douglas 35 16288805169641029632
13320602 28470213320602 133206 PSM 16 16867501229083721728
13410101 19130113410101 134101 Abbott 2 9659771500453953536
13412525 19130113412525 134125 Colgout 151 9587713906416025600
13450101 07320313450101 134501 Colestid 14 6890114904225742848
13460101 16031313460101 134601 Colymycin-M 154 15261072959461130240
13460125 16031313460125 134601 Colistin-Link 154 5444121873770086400
13470101 31010113470101 134701 Colymycin-S Otic 58 11461227844076568576
13570101 01150113570101 135701 Clinitest 15 11781267091619840000
13590101 14070113590101 135901 Acthargel 155 11348640052415561728
13600101 14070113600101 136001 Douglas 35 11604200639571165184
13600201 14070113600201 136002 Douglas 35 11676258233609093120
13610101 16031313610101 136101 Trisul 200 2877365854796775424
13610102 16031313610102 136101 Bactrim 30 15405188147536986112
13610103 16031313610103 136101 Septrin 104 15477245741574914048
13610125 16031313610125 136101 Deprim 127 6368781465915752448
13610201 16031313610201 136102 Trisul 200 2949423448834703360
13610203 16031313610203 136102 Trimel 35 15621360929650769920
13610204 16031313610204 136102 Bactrim 30 15693418523688697856
13610205 16031313610205 136102 Septrin 104 15765476117726625792
13610206 16031313610206 136102 Apo-Sulfatrim 10 15837533711764553728
13610301 16031313610301 136103 Apo-Sulfatrim DS 10 15909591305802481664
13610401 16031313610401 136104 Trisul 200 3021481042872631296
13630101 10080113630101 136301 Eurax 158 2760825318833913856
13630125 10080113630125 136301 Itch-Soothe 127 9241805349294440448
13630201 10080113630201 136302 Eurax 158 2832882912871841792
13670101 07311013670101 136701 Prothiazide 200 3093538636910559232
13670102 07311013670102 136701 Navidrex 116 8466336290898444288
13690101 25010113690101 136901 Cycloblastin 14 11460946369099857920
13690125 25010113690125 136901 Procytox 226 970144189163503616
13690126 25010113690126 136901 Endoxan 12 17125405975029743616
13690201 25010113690201 136902 Cytoxan 22 11533003963137785856
13690202 25010113690202 136902 Cycloblastin 14 15167692536425742336
13690225 25010113690225 136902 Endoxan 12 9299218547962019840
13690301 25010113690301 136903 Cycloblastin 14 15239750130463670272
13690401 25010113690401 136904 Cytoxan 22 11749176745251569664
13690402 25010113690402 136904 Cycloblastin 14 15311807724501598208
13692525 25010113692525 136925 Endoxan 12 9227160953924091904
13692625 25010113692625 136926 Baxter 12 9875679300265443328
13692626 25010113692626 136926 Biomed 102 12325637497554993152
13700101 31031013700101 137001 Cyclogyl 3 11803997295500853248
13710101 25010413710101 137101 Cytosar U 14 15383865318539526144
13710102 25010413710102 137101 Hospira 174 8358019002399719424
13710103 25010413710103 137101 Pfizer 14 9544111673304940544
13710201 25010413710201 137102 Cytosar U 14 15455922912577454080
13710202 25010413710202 137102 Pharmacia 14 15527980506615382016
13710225 25010413710225 137102 Pfizer 14 7598556634280886272
13710226 25010413710226 137102 Hospira 174 8574191784513503232
13710301 25010413710301 137103 Cytosar U 14 15600038100653309952
13710302 25010413710302 137103 Hospira 174 8430076596437647360
13710325 25010413710325 137103 Pharmacia 14 15672095694691237888
13710326 25010413710326 137103 Pfizer 14 7166211070053318656
13710401 25010413710401 137104 Hospira 174 8502134190475575296
13710402 25010413710402 137104 Pharmacia 14 15744153288729165824
13710425 25010413710425 137104 Pfizer 14 7382383852167102464
13712625 25010413712625 137126 Baxter 12 5102078100020133888
13712626 25010413712626 137126 Biomed 102 14537179792500850688
13712725 25010413712725 137127 Baxter 12 5174135694058061824
13712726 25010413712726 137127 Biomed 102 14609237386538778624
13720101 14210113720101 137201 Danocrine 50 9226581511296253952
13720102 14210113720102 137201 D-Zol 200 3165596230948487168
13720125 14210113720125 137201 Azol 200 2492588462121680896
13720201 14210113720201 137202 Danocrine 50 9370696699372109824
13720202 14210113720202 137202 D-Zol 200 3237653824986415104
13720225 14210113720225 137202 Azol 200 10217960568526995456
13730101 19160113730101 137301 Dantrium 14 9928300827259174912
13730201 19160113730201 137302 Dantrium 14 10000358421297102848
13740101 16160113740101 137401 Dapsone 154 17297313518520893440
13742525 16160113742525 137425 Dapsone 154 16937025548331253760
13750101 16100113750101 137501 Maloprim 104 14631182539117559808
13780101 35040813780101 137801 Desferal 116 1003635313345560576
13780102 35040813780102 137801 Hospira 174 9006537348741070848
13790101 22050113790101 137901 Pertofran 116 8610451478974300160
13810101 31020113810101 138101 Sofradex 155 17216544493856096256
13810201 31020113810201 138102 Sofradex 155 10072416015335030784
13830101 14070113830101 138301 Douglas 35 11748315827647021056
13830201 14070113830201 138302 Douglas 35 11820373421684948992
13830301 31030413830301 138303 Maxidex 3 6904080900921753600
13830501 14070113830501 138305 Biomed 102 11892431015722876928
13830601 31030413830601 138306 Maxidex 3 6976138494959681536
13850101 14070113850101 138501 Hospira 174 9760284455418724352
13850125 14070113850125 138501 Dexamethasone-hameln 201 13822577498795278336
13850201 14070113850201 138502 Hospira 174 9832342049456652288
13850225 14070113850225 138502 Dexamethasone-hameln 201 13606404716681494528
13890101 22310113890101 138901 PSM 179 640206038435364864
13890125 22310113890125 138901 PSM S29 90 15844698129531142144
13900101 22040713900101 139001 Palfium 35 6110321466597703680
13910101 22040713910101 139101 Doloxene 45 6182379060635631616
13920101 22040713920101 139201 Capadex 145 4138101071576825856
13920201 22040713920201 139202 Apo-Paradex 10 6326494248711487488
13920202 22040713920202 139202 Di-Gesic 45 6398551842749415424
13920203 22040713920203 139202 Paradex 179 11148230968509202432
13930101 04100113930101 139301 Mayne 153 14700425383388381184
13930125 04100113930125 139301 Biomed 102 14196022225122885632
13930201 38010113930201 139302 PSM 16 16360862763678957568
13932525 04100113932525 139325 Biomed 102 14628367789350453248
13940101 04100413940101 139401 Pedialyte 2 16556702277260279808
13940102 04100413940102 139401 Plasma-Lyte Oral 12 16628759871298207744
13940103 04100413940103 139401 Pedialyte - Fruit 2 3901072752907386880
13940125 04100413940125 139401 Pedialyte - Bubblegum2 3973130346945314816
13940126 04100413940126 139401 Pedialyte - Plain 2 4333418317134954496
13970103 22250113970103 139701 D-Pam 35 5409499352123047936
13970104 22250113970104 139701 Pro-Pam 200 3309711419024343040
13970125 22250113970125 139701 Arrow-Diazepam 163 9226036153528877056
13970201 22250113970201 139702 Pro-Pam 200 3381769013062270976
13970203 22250113970203 139702 D-Pam 35 5625672134236831744
13970225 22250113970225 139702 Arrow-Diazepam 163 9153978559490949120
13970302 22250113970302 139703 D-Pam 35 5697729728274759680
13970303 22250113970303 139703 Pro-Pam 200 3453826607100198912
13970401 22070113970401 139704 Stesolid 191 2560989080485625856
13970501 22070113970501 139705 Stesolid 191 2633046674523553792
13970601 22070113970601 139706 Hospira 174 7781558250096295936
13970602 22070113970602 139706 Diazemuls 29 9083873698103951360
14000101 31030114000101 140001 Brolene 155 11420697646453489664
14010101 19040114010101 140101 Diclax 35 17585825369649315840
14010102 19040114010102 140101 Voltaren 116 8682509073012228096
14010103 19040114010103 140101 Apo-Diclo 10 17729940557725171712
14010104 19040114010104 140101 Flameril 116 17801998151763099648
14010125 19040114010125 140101 Diclohexal 36 15240596754417057792
14010126 19040114010126 140101 Diclofenac Sandoz 36 16533698294983950336
14010201 19040114010201 140102 Voltaren 116 8754566667050156032
14010202 19040114010202 140102 Diclax 35 17946113339838955520
14010203 19040114010203 140102 Apo-Diclo 10 18018170933876883456
14010204 19040114010204 140102 Flameril 116 18090228527914811392
14010225 19040114010225 140102 Diclohexal 36 15456769536530841600
14010226 19040114010226 140102 Diclofenac Sandoz 36 16749871077097734144
14010301 19040114010301 140103 Diclax SR 35 18162286121952739328
14010302 19040114010302 140103 Voltaren SR 116 8826624261088083968
14010303 19040114010303 140103 Apo-Diclo SR 10 18306401310028595200
14010304 19040114010304 140103 Flameril Retard 116 18378458904066523136
14010501 19040114010501 140105 Voltaren 116 4144841077855092736
14010601 19040114010601 140106 Voltaren 116 4216898671893020672
14010701 19040114010701 140107 Voltaren 116 4288956265930948608
14010801 19040114010801 140108 Voltaren 116 4361013859968876544
14010901 19040114010901 140109 Voltaren 116 4433071454006804480
14011001 31030414011001 140110 Voltaren Ophtha 116 4505129048044732416
14011101 19040114011101 140111 Voltaren D 116 11047740003776987136
14011201 19040114011201 140112 Diclax SR 35 508457057637105664
14011202 19040114011202 140112 Voltaren SR 116 8898681855126011904
14011203 19040114011203 140112 Apo-Diclo SR 10 652572245712961536
14011204 19040114011204 140112 Flameril Retard 116 724629839750889472
14011301 19040114011301 140113 Anfenax SR 35 796687433788817408
14050101 07130114050101 140501 Merbentyl 19 10781224982273851392
14050201 07130114050201 140502 Merbentyl Dospan 19 10853282576311779328
14050301 07130114050301 140503 Merbentyl 105 10925340170349707264
14070101 13140214070101 140701 Janssen-Cilag 69 4758729205968011264
14080101 16010114080101 140801 Hetrazan 31 10668594309659361280
14090301 10110114090301 140903 Nerisone 29 1046077561689341952
14090401 10110114090401 140904 Nerisone 29 16620090222113193984
14090501 10110114090501 140905 Nerisone 29 16692147816151121920
14100101 10110414100101 141001 Nerisone C 15 7025465885116596224
14110101 19040114110101 141101 Dolobid 72 868745027826745344
14110201 19040114110201 141102 Dolobid 72 940802621864673280
14110202 19040114110202 141102 Ansal 200 3525884201138126848
14120101 07130114120101 141201 Lanoxin PG 157 13380601312220020736
14120201 07130114120201 141202 Lanoxin 157 13452658906257948672
14120301 07130114120301 141203 Lanoxin 157 9691596864519929856
14120401 07130114120401 141204 Lanoxin 157 9547481676444073984
14120501 07130114120501 141205 Lanoxin 157 9619539270482001920
14180101 22160114180101 141801 Dramamine 14 10576819173600526336
14200101 10150214200101 142001 DP Barrier Cream 35 3172617712203464704
14200102 10150214200102 142001 Barrier Cream 555 16 3244675306241392640
14200201 10150214200201 142002 DP Barrier Cream 35 3316732900279320576
14200202 10150214200202 142002 555 Barrier Cream 16 3388790494317248512
14200301 10150214200301 142003 PSM 16 3460848088355176448
14200401 38010114200401 142004 PSM 16 16432920357716885504
14202525 10150214202525 142025 healthE Dimethicone 5% 202 13390231934567710720
14230101 10140114230101 142301 Prantal 40 15350069629636575232
14240101 01040114240101 142401 Lomotil 55 13113749840158785536
14240102 01040114240102 142401 Diastop 200 3597941795176054784
14250101 31030914250101 142501 Propine 5 10002557444552654848
14250103 31030914250103 142501 Dipoquin 200 3669999389213982720
14270101 04070114270101 142701 Persantin 17 8863760266316218368
14270301 04070114270301 142703 Persantin 17 8935817860354146304
14270401 04070114270401 142704 Pytazen SR 35 9007875454392074240
14270501 04070114270501 142705 Persantin PL 17 9079933048430002176
14280101 07130114280101 142801 Rythmodan Retard155 15844076905461448704
14280201 07130114280201 142802 Pyramide 200 3742056983251910656
14280202 07130114280202 142802 Rythmodan 155 15627904123347664896
14280401 07130114280401 142804 Rythmodan 155 15772019311423520768
14280501 07130114280501 142805 Rythmodan 155 15699961717385592832
14280601 07130114280601 142806 Diso Durules 11 1226218248249278464
14310102 19010114310102 143101 Ubretid 155 11492755240491417600
14310201 19010114310201 143102 Ubretid 155 11564812834529345536
14320101 22340114320101 143201 Antabuse 191 17533214837771862016
14360101 22160114360101 143601 Motilium 69 14055847686720978944
14360125 22160114360125 143601 Prokinex 132 7542571701217787904
14370101 22050114370101 143701 Prothiaden 107 3031035798918004736
14370102 22050114370102 143701 Dopress 200 3814114577289838592
14370201 22050114370201 143702 Prothiaden 107 3175150986993860608
14370202 22050114370202 143702 Dopress 200 3886172171327766528
14380101 22050114380101 143801 Anten 200 3958229765365694464
14380201 22050114380201 143802 Sinequan 14 3391323769107644416
14380202 22050114380202 143802 Anten 200 4030287359403622400
14380301 22050114380301 143803 Anten 200 4102344953441550336
14380401 22050114380401 143804 Anten 200 4174402547479478272
14380402 22050114380402 143804 Sinequan 14 3679554145259356160
14410101 14130114410101 144101 Duphaston 177 17595139332648206336
14430101 13100114430101 144301 Ecostatin 22 18377333004159680512
14430102 13100114430102 144301 Gyno-Pevaryl 143 7962214607609659392
14430125 13100114430125 144301 Pevaryl Ovules 200 16351854464912588800
14430201 13100114430201 144302 Gyno- Pervaryl 143 7890157013571731456
14430301 13100114430301 144303 Ecostatin 22 219100781578551296
14430601 10070114430601 144306 Pevaryl 200 4246460141517406208
14430701 10070114430701 144307 Pevaryl 200 4318517735555334144
14431002 10070114431002 144310 Pevaryl 211 5596453712240312320
14431003 10070114431003 144310 Ecreme 200 4462632923631190016
14431004 10070114431004 144310 Ecostatin 22 14268924244090945536
14431102 10070114431102 144311 Pevaryl 200 4534690517669117952
14460101 04100414460101 144601 Gastrolyte (Natural) 155 11636870428567273472
14460102 04100414460102 144601 Gastrolyte (Fruit) 2 16844932653411991552
14460103 04100414460103 144601 Gastrolyte (Orange) 2 16916990247449919488
14460125 04100414460125 144601 Enerlyte 120 16412587089184423936
14462525 04100414462525 144625 Electral 163 4211577035614584832
14462526 04100414462526 144625 Enerlyte 120 2377238697251700736
14480101 13190414480101 144801 Cetiprin Novum 14 15816210882767093760
14530101 28450214530101 145301 PSM 16 16146925288704442368
14530201 28450214530201 145302 PSM 16 16218982882742370304
14530301 38010114530301 145303 PSM 16 16504977951754813440
14560101 13140214560101 145601 DBL Ergometrine 174 7763794540237946880
14580601 22130114580601 145806 Medihaler-Ergotamine 1 12182350241734852608
14590101 22130114590101 145901 Migril 104 12254407835772780544
14600101 22130114600101 146001 Ergodryl 58 12326465429810708480
14620301 22130114620301 146203 Cafergot 127 2103585646261043200
14650301 10010114650301 146503 Stiemycin 30 5984569222217334784
14650401 16030414650401 146504 Emu-V 14 15888268476805021696
14650501 16030414650501 146505 Eryc 58 6181816110682210304
14660201 16030414660201 146602 Eromycin 45 6253873704720138240
14660301 16030414660301 146603 Eromycin 45 6325931298758066176
14660401 16030414660401 146604 Eromycin 45 6397988892795994112
14660501 16030414660501 146605 Eromycin 45 6470046486833922048
14680101 16160114680101 146801 Myambutol 145 18366092696788926464
14680201 16160114680201 146802 Apo-Ethambutol 10 17441428706596749312
14680202 16160114680202 146802 Myambutol 145 18438150290826854400
14750801 13080214750801 147508 Brevinor 21 14 17250043314619547648
14750901 13080214750901 147509 Brevinor 28 52 11315688788442742784
14750902 13080214750902 147509 Norimin 14 15664776245785133056
14751001 13080214751001 147510 Synphasic 28 14 4287277311675334656
14751101 13080214751101 147511 Brevinor 1/21 14 17394158502695403520
14751201 13080214751201 147512 Brevinor 1/28 14 17322100908657475584
14760101 13080214760101 147601 Ovulen 0.5/50 55 11675976758632382464
14760201 13080214760201 147602 Ovulen 1/50 55 11748034352670310400
14770101 13080214770101 147701 Mercilon 21 40 10022887414550233088
14770201 13080214770201 147702 Mercilon 28 40 10094945008588161024
14770301 13080214770301 147703 Marvelon 21 40 9878772226474377216
14770401 13080214770401 147704 Marvelon 28 40 9950829820512305152
14780101 14120114780101 147801 NZ Medical and Scientific 6 2164937295579316224
14790101 13080214790101 147901 Femodene 21 15 6737235508964884480
14790102 13080214790102 147901 Minulet 21 14 5585734573381124096
14790201 13080214790201 147902 Femodene 28 15 1262250343803125760
14790202 13080214790202 147902 Minulet 28 14 5657792167419052032
14790301 13080214790301 147903 Melodene 15 15702819348106182656
14810101 22070214810101 148101 Zarontin 14 2846125430916775936
14810201 22070214810201 148102 Zarontin 58 18143939670931668992
14840101 13080414840101 148401 Femulen 14 4503450093789118464
14870101 19080614870101 148701 Didronel 14 7096108407689576448
14870125 19080614870125 148701 Etidrate 200 4606748111707045888
14870126 19080614870126 148701 Arrow-Etidronate 163 3164757303576494080
14920101 28340114920101 149201 Atrovent 17 12399930398732189696
14920201 28340114920201 149202 Atrovent Forte 17 12471987992770117632
14920301 28340114920301 149203 Atrovent Respules 17 12544045586808045568
14920302 28340114920302 149203 Ipratropium Steri-Neb 132 12616103180845973504
14920325 28340114920325 149203 Ipra 500 200 16135681682798804992
14920326 28340114920326 149203 Univent 166 10047108556198510592
14920401 28340114920401 149204 Atrovent Respules 17 12688160774883901440
14920501 28510214920501 149205 Atrovent Nasal 17 3537127807043764224
14920601 28510214920601 149206 Atrovent Nasal Aqueous 17 3609185401081692160
14920625 28510214920625 149206 Apo-Ipravent 10 2168033520323133440
14920626 28510214920626 149206 Univent 166 11604797674385047552
14920701 28340114920701 149207 Ipratropium Steri-Neb 132 12760218368921829376
14920725 28340114920725 149207 Ipra 250 200 16063624088760877056
14920726 28340114920726 149207 Univent 166 9830935774084726784
14922525 28340114922525 149225 Atrovent 17 12327872804694261760
14980101 04010414980101 149801 Douglas 35 10431806784036405248
14980102 04010414980102 149801 PSM 16 10503864378074333184
14980103 04010414980103 149801 Apo-Folic Acid 10 10575921972112261120
14980125 04010414980125 149801 Healtheries 10 10287691595960549376
14980201 04010414980201 149802 Abbott 2 10647979566150189056
14980301 04010414980301 149803 Biomed 102 10720037160188116992
14982525 04010414982525 149825 Apo-Folic Acid 10 10215634001922621440
14982526 04010414982526 149825 Apo-Folic Acid (s29) 10 10651922414847393792
14990101 04010314990101 149901 Fergon 143 8898963330102722560
14990201 04010314990201 149902 Fergon 143 8610732953951010816
15010101 01383015010101 150101 Ferrograd F 2 154124042423500800
15080101 10310715080101 150801 Elase 58 8667567809502380032
15080301 10310715080301 150803 Elase 58 8739625403540307968
15090101 10150415090101 150901 Ungvita 30 741232465330307072
15100102 07130115100102 151001 Tabco 200 4678805705744973824
15100103 07130115100103 151001 Tambocor 211 13449330684560670720
15100202 07130115100202 151002 Tabco 200 4750863299782901760
15100203 07130115100203 151002 Tambocor 211 13521388278598598656
15100301 07130115100301 151003 Tambocor 211 13377273090522742784
15100401 07130115100401 151004 Tambocor CR 211 13233157902446886912
15100501 07130115100501 151005 Tambocor CR 211 13305215496484814848
15110101 16030715110101 151101 Floxapen 143 7385753855306235904
15110201 16030715110201 151102 Floxapen 143 7457811449344163840
15120101 16030715120101 151201 Floxapen 143 7529869043382091776
15120102 16030715120102 151201 Flucloxin 35 11658193257564733440
15120104 16030715120104 151201 Staphlex 200 4822920893820829696
15120105 16030715120105 151201 HSSL 115 11802308445640589312
15120125 16030715120125 151201 AFT 127 10086509555379863552
15120201 16030715120201 151202 Floxapen 143 7601926637420019712
15120202 16030715120202 151202 Flucloxin 35 11946423633716445184
15120204 16030715120204 151202 Staphlex 200 4894978487858757632
15120205 16030715120205 151202 HSSL 115 12090538821792301056
15120225 16030715120225 151202 AFT 127 10302682337493647360
15120301 16030715120301 151203 Flucloxin 35 12162596415830228992
15120302 16030715120302 151203 Staphlex 200 5111151269972541440
15120325 16030715120325 151203 AFT 127 8055313555668336640
15120401 16030715120401 151204 Flucloxin 35 12306711603906084864
15120402 16030715120402 151204 Staphlex 200 5183208864010469376
15120425 16030715120425 151204 AFT 127 13531690702550859776
15120501 16030715120501 151205 Floxapen 143 7673984231457947648
15120502 16030715120502 151205 Flucloxin 35 12522884386019868672
15120601 16030715120601 151206 Floxapen 143 7746041825495875584
15120602 16030715120602 151206 Flucloxin 35 12666999574095724544
15120701 16030715120701 151207 Floxapen 143 7818099419533803520
15120702 16030715120702 151207 Flucloxin 35 12811114762171580416
15130101 16040115130101 151301 Alcobon 30 12829742688169361408
15150101 14070115150101 151501 Florinef 157 12240650746286047232
15160101 31010115160101 151601 Locorten-Vioform 127 11533285438114496512
15160125 31010115160125 151601 Locacorten-Viaform ED's 127 16708494255521267712
15170101 28510215170101 151701 Rhinalar 52 3681242995119620096
15180301 10220115180301 151803 Synalar Gel 65 13044508095399591936
15180401 10110115180401 151804 Synalar 16 9441346918526484480
15180501 10110115180501 151805 Synalar 16 9513404512564412416
15210101 01050115210101 152101 Ultraproct 29 1982826284182405120
15210201 01050115210201 152102 Ultraproct 29 1910768690144477184
15270101 31030415270101 152701 FML 5 7120253683035537408
15270102 31030415270102 152701 Flucon 3 7192311277073465344
15290101 10310315290101 152901 Efudix 211 4258576759655497728
15290201 25010415290201 152902 Mayne 12 7335863515195899904
15290202 25010415290202 152902 Pharmacia 14 15960326070842949632
15290301 25010415290301 152903 Mayne 153 2054883878220333056
15290302 25010415290302 152903 Adrucil 14 16032383664880877568
15290401 25010415290401 152904 Pharmacia 14 16104441258918805504
15290402 25010415290402 152904 Mayne 153 2126941472258260992
15292525 25010415292525 152925 Hospira 174 8646249378551431168
15292625 25010415292625 152926 Mayne 153 9209360960182026240
15292626 25010415292626 152926 Fluorouracil Ebewe36 4332049425158373376
15292725 25010415292725 152927 Mayne 175 15880949027898916864
15292825 25010415292825 152928 Baxter 12 5246193288095989760
15292826 25010415292826 152928 Biomed 102 14681294980576706560
15320101 22220415320101 153201 Depixol 14 13316362345367207936
15320125 22220415320125 153201 Fluanxol 134 13865582697092481024
15320201 22220415320201 153202 Depixol 14 13460477533443063808
15320225 22220415320225 153202 Fluanxol 134 13937640291130408960
15320301 22220415320301 153203 Depixol Conc 14 13604592721518919680
15320325 22220415320325 153203 Fluanxol 134 14009697885168336896
15330101 22220415330101 153301 Modecate 22 13748707909594775552
15330102 22220415330102 153301 Baxter 12 13820765503632703488
15330201 22220415330201 153302 Modecate 22 13892823097670631424
15330202 22220415330202 153302 Baxter 12 13964880691708559360
15330301 22220415330301 153303 Mayne 12 14036938285746487296
15330401 22220415330401 153304 Modecate 22 14108995879784415232
15330402 22220415330402 153304 Baxter 12 14181053473822343168
15350101 22220115350101 153501 Anatensol 22 1230158897923227648
15350201 22220115350201 153502 Anatensol 22 1302216491961155584
15360101 19040115360101 153601 Froben 107 1156975403978457088
15360201 19040115360201 153602 Froben 107 1229032998016385024
15360301 19040115360301 153603 Froben SR 107 1301090592054312960
15370101 25040115370101 153701 Eulexin 40 1374837035952504832
15370102 25040115370102 153701 Flutol 35 1446894629990432768
15370103 25040115370103 153701 Flutamin 200 5255266458048397312
15370125 25040115370125 153701 Flutamin S29 90 12366773526084976640
15420301 10040115420301 154203 Soframycin 155 15555846529309736960
15422501 10040115422501 154225 Soframycin 105 11386620482573828096
15440101 07310115440101 154401 Frusid 35 1298557317263917056
15440102 07310115440102 154401 Lasix 105 1370614911301844992
15440103 07310115440103 154401 Diurin 40 200 5327324052086325248
15440105 07310115440105 154401 Apo-Frusemide 10 1514730099377700864
15440201 07310115440201 154402 Lasix 105 1586787693415628800
15440202 07310115440202 154402 Diurin 500 200 5399381646124253184
15440203 07310115440203 154402 Frusid Forte 35 1730902881491484672
15440225 07310115440225 154402 Urex Forte 157 11808305182058479616
15440301 07310115440301 154403 Lasix 155 11081222331866021888
15440401 07310115440401 154404 Mayne 174 6145576207430713344
15440402 07310115440402 154404 Frusid 35 1947075663605268480
15440403 07310115440403 154404 Lasix 105 2019133257643196416
15440425 07310115440425 154404 Frusemide-Claris 127 12189697178431651840
15440501 07310115440501 154405 Frusid 35 2091190851681124352
15440601 07310115440601 154406 Lasix 155 11009164737828093952
15460101 16031315460101 154601 Fucidin 29 16125764087916265472
15460201 16031315460201 154602 Fucidin 29 16197821681954193408
15460301 16031315460301 154603 Fucidin 29 16269879275992121344
15460401 31030115460401 154604 Fucithalmic 29 7716749736220295168
15460801 10040115460801 154608 Fucidin 29 11458678076611756032
15460825 10040115460825 154608 Foban 127 11963081234877251584
15460901 10040115460901 154609 Fucidin 29 11530735670649683968
15460925 10040115460925 154609 Foban 127 11242505294497972224
15461001 10040115461001 154610 Fucidin 29 11602793264687611904
15490101 10170115490101 154901 Quellada 49 7640188542554996736
15490201 10170115490201 154902 Benhex 179 1072551602662932480
15530101 07320115530101 155301 Lopid 125 5665135805580967936
15530102 07320115530102 155301 Apo-Gemfibrozil 10 5737193399618895872
15530103 07320115530103 155301 Gemizol 200 5809250993656823808
15532525 07320115532525 155325 Lipazil 35 5881308587694751744
15540101 16031315540101 155401 Hospira 174 7709500656058368000
15540201 16031315540201 155402 Mayne 12 16413994464067977216
15540202 16031315540202 155402 Cidomycin 155 16276422469689016320
15540225 16031315540225 155402 APP Pharmaceuticals 90 15753198970890878976
15540301 16031315540301 155403 Pfizer 14 12237468759635263488
15540302 16031315540302 155403 Baxter 12 16630167246181761024
15540303 16031315540303 155403 Cidomycin 155 16348480063726944256
15540501 31030115540501 155405 Genoptic 5 2198999066296188928
15540701 10040115540701 155407 Garamycin 40 11674850858725539840
15540801 10040115540801 155408 Garamycin 40 11746908452763467776
15670101 01131215670101 156701 Semi-Daonil 105 11872677189818253312
15670102 01131215670102 156701 Apo-Glibenclamide 10 11944734783856181248
15670104 01131215670104 156701 Gliben 200 5543496834200109056
15670201 01131215670201 156702 Gliben 200 5615554428238036992
15670202 01131215670202 156702 Daonil 155 9112038787961061376
15670204 01131215670204 156702 Apo-Glibenclamide 10 12232965160007892992
15680101 01131215680101 156801 Diamicron 46 12305022754045820928
15680125 01131215680125 156801 Apo-Gliclazide 10 12521195536159604736
15680126 01131215680126 156801 Nidem 10 12590783627081547776
15690101 01131215690101 156901 Glipid 200 5687612022275964928
15690102 01131215690102 156901 Minidiab 14 11441510302055661568
15700101 01130115700101 157001 Eli Lilly 45 3818883159219503104
15700301 01130115700301 157003 Novo 8 3890940753257431040
15700401 01130115700401 157004 Glucagen Hypokit 8 3962998347295358976
15700402 01130115700402 157004 Novo Hypokit 8 4035055941333286912
15720101 01150115720101 157201 Clinistix 15 11709209497581912064
15720102 01150115720102 157201 Diastix 15 11637151903543984128
15720201 01150115720201 157202 Tes-Tape 45 10592296998784729088
15720202 01150115720202 157202 Diabur 5000 164 1837037639409074176
15720303 01150715720303 157203 Accutrend 164 207860474207797248
15720304 01150715720304 157203 Advantage 20 5138457641248358400
15720305 01150715720305 157203 BM-Test Glycemie 1-44 164 279918068245725184
15720306 01150715720306 157203 Glucocard 6 5282572829324214272
15720307 01150715720307 157203 Glucofilm 15 11925382279695695872
15720308 01150715720308 157203 Glucostix 15 11997439873733623808
15720309 01150715720309 157203 Glucopat 6 5498745611437998080
15720310 01150715720310 157203 Glucometer Elite 15 12069497467771551744
15720311 01150715720311 157203 Glucometer Esprit 15 12141555061809479680
15720313 01150715720313 157203 Exactech 71 5714918393551781888
15720314 01150715720314 157203 Medisense-2 (new) 71 5786975987589709824
15720315 01150715720315 157203 Precision Plus 71 5859033581627637760
15720325 01150715720325 157203 Ascensia Glucodisc15 12213612655847407616
15720401 01150415720401 157204 Keto-Diastix 15 11853324685657767936
15721001 01150415721001 157210 Keto-Diabur 5000 164 351975662283653120
15740101 01250715740101 157401 PSM 16 631973994878205952
15740201 01250715740201 157402 PSM 16 704031588916133888
15740301 01250715740301 157403 PSM 179 784321226511220736
15740401 01250715740401 157404 PSM 16 848146776991989760
15740501 01250715740501 157405 PSM 16 920204371029917696
15740601 38010115740601 157406 PSM 179 1288724384776716288
15740602 38010115740602 157406 David Craig 120 16649093139830669312
15740625 38010115740625 157406 MidWest 152 10020075963318009856
15740626 38010115740626 157406 ABM 167 15279998853110038528
15740627 38010115740627 157406 healthE 202 9719752058772389888
15740701 01250715740701 157407 Fleet Glycerin Suppositories 12 18017374887458373632
15740801 01250715740801 157408 Fleet Glycerin Suppositories 12 1064319559105773568
15750101 10150415750101 157501 QV 35 813290059368235008
15770102 07340115770102 157701 Nitrocor 1 2307363633794908160
15770103 07340115770103 157701 Nitroderm TTS 158 3193170883061481472
15770104 07340115770104 157701 Nitro-Dur 40 2451478821870764032
15770105 07340115770105 157701 Minitran 1 2523536415908691968
15770201 07340115770201 157702 Anginine 143 2053210421522857984
15770225 07340115770225 157702 Lycinate 157 11880362776096407552
15770301 07340115770301 157703 Nitrobid 105 2667651603984547840
15770401 07340115770401 157704 Nitrolingual 35 2739709198022475776
15770502 07340115770502 157705 Nitroderm TTS 158 3265228477099409408
15770503 07340115770503 157705 Nitrocor 1 2883824386098331648
15770504 07340115770504 157705 Nitro-Dur 40 2955881980136259584
15770505 07340115770505 157705 Minitran 1 3027939574174187520
15770601 07340115770601 157706 Nitrolingual Pumpspray 35 3099997168212115456
15772525 07340115772525 157725 Glytrin 127 3964688296667250688
15772625 01050215772625 157726 Rectogesic 224 7879220171410243584
15790201 16040115790201 157902 Griseostatin 40 12901800282207289344
15790301 16040115790301 157903 Grisovin 500 104 12973857876245217280
15800101 28430215800101 158001 Nuelin 35 10289999470867251200
15800301 28430215800301 158003 Nuelin-SR 35 10362057064905179136
15800401 28430215800401 158004 Nuelin-SR 35 10434114658943107072
15800501 28430215800501 158005 Theostat 200 5831727210351820800
15800502 28430215800502 158005 Theo-Dur 11 14705773407945883648
15800601 28430215800601 158006 Nuelin-SR 35 10506172252981035008
15800701 28430215800701 158007 Theostat 200 5903784804389748736
15800702 28430215800702 158007 Theo-Dur 11 14921946190059667456
15800801 28430215800801 158008 Nuelin-SR 35 10578229847018962944
15800901 28430215800901 158009 Nuelin-SR 35 10650287441056890880
15801101 28430215801101 158011 Theo-Dur 1 15138118972173451264
15801201 28430215801201 158012 Nuelin-SR Sprinkle 35 9929711500677611520
15801202 28430215801202 158012 Theo-24 55 15282234160249307136
15801301 28430215801301 158013 Nuelin-SR Sprinkle 35 10001769094715539456
15801302 28430215801302 158013 Nuelin-24 35 10073826688753467392
15801401 28430215801401 158014 Nuelin-24 35 10145884282791395328
15801501 28430215801501 158015 Nuelin 35 10217941876829323264
15830101 22220115830101 158301 Serenace 157 13105341874741182464
15830201 22220115830201 158302 Serenace 157 13177399468779110400
15830301 22220115830301 158303 Serenace 157 13249457062817038336
15830401 22220115830401 158304 Serenace 157 13321514656854966272
15830601 22220115830601 158306 Serenace 157 13393572250892894208
15890101 04070415890101 158901 Hospira 174 7205097497792872448
15890102 04070415890102 158901 Monoparin 108 12449419417098387456
15890103 04070415890103 158901 Multiparin 108 12521477011136315392
15890125 04070415890125 158901 Pfizer 14 18358775446906077184
15890203 04070415890203 158902 Hospira 174 7277155091830800384
15890301 04070415890301 158903 Hospira 174 7349212685868728320
15890402 04070415890402 158904 Multiparin 108 12737649793250099200
15890403 04070415890403 158904 Mayne 12 12809707387288027136
15890404 04070415890404 158904 Leo 29 12881764981325955072
15890425 04070415890425 158904 Pfizer 14 344658412400803840
15890501 04070415890501 158905 Baxter 12 12953822575363883008
15890601 04070415890601 158906 Hospira 174 7421270279906656256
15890602 04070415890602 158906 Monoparin 51 13097937763439738880
15890603 04070415890603 158906 Minihep (10s) 29 13169995357477666816
15890701 04070415890701 158907 Multiparin 108 13242052951515594752
15890702 04070415890702 158907 Leo 29 13314110545553522688
15940101 16230115940101 159401 Hiprex 35 14805989494771154944
15980201 28100115980201 159802 Ipradol 105 5626516559166963712
15980301 28100115980301 159803 Ipradol 105 5698574153204891648
16000101 31031016000101 160001 Isopto Homatropine 3 11876054889538781184
16000201 31031016000201 160002 Isopto Homatropine 3 11948112483576709120
16030101 19110116030101 160301 Hyalase 108 8434792401809178624
16040101 07400116040101 160401 Alphapress 200 5975842398427676672
16040102 07400116040102 160401 Apresoline 127 2391816022412754944
16040125 07400116040125 160401 Hydralazine 90 9844195884315705344
16040126 07400116040126 160401 Onelink 220 12039139951728656384
16040201 07400116040201 160402 Alphapress 200 6047899992465604608
16040301 07400116040301 160403 Apresoline 127 2319758428374827008
16060101 01040416060101 160601 Colifoam 49 343462143749783552
16060201 01040416060201 160602 Colifoam 157 2847517412637540352
16110101 10110416110101 161101 Micreme H 200 6119957586503532544
16110102 10110416110102 161101 Daktacort 69 16665679272735670272
16120201 10110416120201 161202 Pimafucort 29 2991632600713396224
16120301 10110416120301 161203 Pimafucort 29 3063690194751324160
16130101 10110116130101 161301 DP Lotn HC 35 9585462106602340352
16130102 10110116130102 161301 BK Lotn HC 1 9657519700640268288
16140101 10110116140101 161401 Locoid 29 4299082768022765568
16140201 10110116140201 161402 Locoid 29 4154967579946909696
16140601 10220116140601 161406 Locoid 29 4515255550136549376
16140701 10110116140701 161407 Locoid Lipocream 29 4227025173984837632
16142525 10110116142525 161425 Locoid Crelo 29 4371140362060693504
16150201 10110416150201 161502 Locoid C 29 4443197956098621440
16170101 14070116170101 161701 Douglas 35 12180661391874588672
16170201 14070116170201 161702 Douglas 35 12252718985912516608
16170501 10110116170501 161705 Cortaid 16 10017807670829907968
16170502 10110116170502 161705 PSM 16 10089865264867835904
16170601 10110116170601 161706 Pharmacia 14 16176498852956733440
16170602 10110116170602 161706 Apo-Hydrocortisone10 10233980452943691776
16170603 10110116170603 161706 PSM 16 10306038046981619712
16170604 10110116170604 161706 Douglas 35 10378095641019547648
16170625 10110116170625 161706 m-Hydrocortisone 120 4435315557239095296
16170626 10110116170626 161706 ABM 167 17719261001284583424
16171601 14070116171601 161716 Solu-Cortef 14 16248556446994661376
16171701 14070116171701 161717 Solu-Cortef 14 16320614041032589312
16171801 14070116171801 161718 Solu-Cortef 14 16392671635070517248
16171901 10110116171901 161719 Douglas 35 10450153235057475584
16171902 10110116171902 161719 PSM 179 12853122703422390272
16171903 10110116171903 161719 Cortef 14 16464729229108445184
16171904 10110116171904 161719 Egocort 35 10666326017171259392
16171925 10110116171925 161719 Lemnis Fatty Cream HC 29 12256099984167927808
16171926 10110116171926 161719 Pharmacy Health 179 10001787786413211648
16190101 01050716190101 161901 Anusol 182 5257234583862116352
16190201 01050716190201 161902 Anusol 182 5329292177900044288
16190402 38010116190402 161904 PSM 16 16721150733868597248
16200101 10070116200101 162001 Daktarin 182 8756814068817330176
16200201 10070116200201 162002 Daktarin 182 8972986850931113984
16200301 10070116200301 162003 Daktarin 182 8900929256893186048
16200302 10070116200302 162003 Micreme 200 6192015180541460480
16200303 10070116200303 162003 AFT 127 14701269808318513152
16200325 10070116200325 162003 Multichem 120 16286536877152927744
16200401 10070116200401 162004 Daktarin 182 8828871662855258112
16200501 13100116200501 162005 Gyno-Daktarin-7 69 291158375616479232
16200601 13100116200601 162006 Gyno-Daktarin-7 69 363215969654407168
16200602 13100116200602 162006 Micreme 200 6264072774579388416
16200603 13100116200603 162006 Micozole 127 507331157730263040
16240101 01370416240101 162401 Neo-Cytamen 143 3710535084395200512
16240125 01370416240125 162401 Goldshield 153 13833200980142850048
16240126 01370416240126 162401 Neo-B12 153 16984591520860471296
16240127 01370416240127 162401 ABM Hydroxocobalamin 167 4258835144888025088
16250101 19070116250101 162501 Plaquenil 143 1147750501421416448
16260101 25010716260101 162601 Hydrea 22 12740183068040495104
16290101 22160116290101 162901 Scopoderm TTS 158 4177270073804718080
16290201 31031016290201 162902 Isopto Hyoscine 3 14320221959084834816
16290301 22160116290301 162903 Hospira 174 7997731032210079744
16300101 31031316300101 163001 Poly-Tears 3 3597708698710966272
16310101 01070116310101 163101 Buscopan 17 10362956465416699904
16310125 01070116310125 163101 Gastrosoothe 127 10435014059454627840
16310201 01070116310201 163102 Buscopan 17 10507071653492555776
16320101 01050116320101 163201 Proctosedyl 155 16132307281613160448
16320401 01050116320401 163204 Proctosedyl 155 16204364875651088384
16320501 01050116320501 163205 Proctosedyl 155 16060249687575232512
16330101 31031316330101 163301 Tears Naturale 3 12308400453766348800
16330202 31031316330202 163302 Isopto Tears 3 12452515641842204672
16330203 31031316330203 163302 Methopt 157 13970033003196317696
16330301 31031316330301 163303 Methopt Forte 19 12596630829918060544
16340101 01050116340101 163401 Xyloproct 11 503952358498107392
16340201 01050116340201 163402 Xyloproct 11 576009952536035328
16390301 31030116390301 163903 Stoxil 47 7860864924296151040
16420101 22050116420101 164201 Imipramin 29 3751611739297284096
16420125 22050116420125 164201 Tofranil 127 1815355270109331456
16420201 22050116420201 164202 Imipramin 29 3895726927373139968
16420225 22050116420225 164202 Tofranil 127 1959470458185187328
16430101 07311016430101 164301 Natrilix 46 7622123566510637056
16430102 07311016430102 164301 Napamide 35 7694181160548564992
16430103 07311016430103 164301 Naplin 200 6336130368617316352
16430125 07311016430125 164301 Dapa-Tabs 200 2192830806064365568
16450102 19040216450102 164501 Indocid 72 15045181652324057088
16450103 19040216450103 164501 Rheumacin 200 6480245556693172224
16450201 19040216450201 164502 Rheumacin 200 6552303150731100160
16450202 19040216450202 164502 Indocid 72 15261354434437840896
16450301 19040216450301 164503 Indocid-R 72 15333412028475768832
16450302 19040216450302 164503 Rheumacin SR 200 6624360744769028096
16450401 19040216450401 164504 Indocid 72 15477527216551624704
16450402 19040216450402 164504 Arthrexin 200 6696418338806956032
16480101 01130316480101 164801 Actrapid 8 7693336735618433024
16480102 01130316480102 164801 Humulin R 45 7765394329656360960
16480201 01130316480201 164802 Actrapid Penfill 8 7837451923694288896
16480202 01130316480202 164802 Humulin R 45 7909509517732216832
16480204 01130316480204 164802 Actrapid 8 7981567111770144768
16480301 01130316480301 164803 Actrapid Penfill 8 8053624705808072704
16480302 01130316480302 164803 Humulin R 45 8125682299846000640
16482501 01130316482501 164825 Velosulin 8 8197739893883928576
16482502 01130316482502 164825 Actrapid 8 8269797487921856512
16490201 01130516490201 164902 Humulin N 45 2558390934509191168
16490203 01130516490203 164902 Protaphane Penfill 8 2630448528547119104
16490301 01130516490301 164903 Protaphane Penfill 8 2702506122585047040
16490302 01130516490302 164903 Humulin N 45 2774563716622974976
16490325 01130516490325 164903 Humulin NPH 45 2270160558357479424
16490401 01130516490401 164904 Humulin N 45 2846621310660902912
16490402 01130516490402 164904 Protaphane 8 11895812013978288128
16490425 01130516490425 164904 Humulin NPH 45 2486333340471263232
16492501 01130516492501 164925 Insulatard 8 2990736498736758784
16492503 01130516492503 164925 Protaphane 8 3134851686812614656
16530101 01150916530101 165301 VAN 39 13599589943612538880
16550101 01130516550101 165501 Humulin L 45 3206909280850542592
16550102 01130516550102 165501 Monotard 8 3278966874888470528
16550201 01130516550201 165502 Humulin U 45 3351024468926398464
16550202 01130516550202 165502 Ultratard 8 3423082062964326400
16760101 01383016760101 167601 Ferrum H 157 8062427395900047360
16760125 01383016760125 167601 Ferrosig 145 6765390703217344512
16780101 13100116780101 167801 Gyno-Travogen Ovule 38 579388751768190976
16790101 16160116790101 167901 PSM 179 424033256321581056
16790201 16160116790201 167902 Rifinah 155 15916134499499376640
16790301 16160116790301 167903 Rifinah 155 15988192093537304576
16820101 07370116820101 168201 Isuprel 103 13437469153120223232
16860101 10150416860101 168601 QV 35 885347653406162944
16860201 10150416860201 168602 QV 35 957405247444090880
16860202 10150416860202 168602 QV Spray Pack 35 1029462841482018816
16880101 10010116880101 168801 Roaccutane 30 6056626816255262720
16880125 10010116880125 168801 Oratane 35 6633087568558686208
16880126 10010116880126 168801 Isotane 10 200 6561029974520758272
16880201 10010116880201 168802 Roaccutane 30 6128684410293190656
16880202 10010116880202 168802 Oratane 35 6200742004331118592
16880225 10010116880225 168802 Isotane 20 200 5336050875875983360
16960101 16040116960101 169601 Nizoral 69 13045915470283145216
16960201 10070116960201 169602 Nizoral 69 14845384996394369024
16960301 10220116960301 169603 Nizoral 69 13188623283475447808
16960302 10220116960302 169603 Sebizole 35 13260680877513375744
16960325 10220116960325 169603 Ketopine 127 12612162531172024320
16970101 19040116970101 169701 Orudis 155 11708928022605201408
16970302 19040116970302 169703 Kefen SR 200 6768475932844883968
16970303 19040116970303 169703 Oruvail SR 155 1397108743484735488
16970505 19040116970505 169705 Oruvail 155 11780985616643129344
16970601 19040116970601 169706 Oruvail EC 155 11853043210681057280
16970701 19040116970701 169707 Orudis 155 11925100804718985216
16970801 19040116970801 169708 Oruvail SR 155 1325051149446807552
16980101 28040116980101 169801 Zasten 36 150139412284440576
16980201 28040116980201 169802 Zasten 36 222197006322368512
16980202 28040116980202 169802 Asmafen 200 6840533526882811904
16990101 07160116990101 169901 Trandate 157 5089770166858809344
16990102 07160116990102 169901 Hybloc 200 6912591120920739840
16990201 07160116990201 169902 Trandate 157 5161827760896737280
16990202 07160116990202 169902 Hybloc 200 6984648714958667776
16990301 07160116990301 169903 Hybloc 200 7056706308996595712
16990302 07160116990302 169903 Albetol 35 4973213138221531136
16990303 07160116990303 169903 Trandate 157 5233885354934665216
16990401 07160116990401 169904 Albetol 35 5117328326297387008
16990402 07160116990402 169904 Trandate 157 5305942948972593152
16990403 07160116990403 169904 Hybloc 200 7128763903034523648
16990501 07160116990501 169905 Trandate 157 5017712572820881408
16992525 07160116992525 169925 Trandate 157 4945654978782953472
17150101 22020117150101 171501 EMLA 144 9056600312176967680
17150201 22020117150201 171502 EMLA 144 9128657906214895616
17160101 31030517160101 171601 Betagan 5 7984944811490672640
17160201 31030517160201 171602 Betagan 5 8057002405528600576
17160225 31030517160225 171602 Alcon-Levobunolol 3 8129059999566528512
17170201 22010117170201 171702 Madopar 250 30 11290385727352733696
17170601 22010117170601 171706 Madopar 125 30 11362443321390661632
17170701 22010117170701 171707 Madopar HBS 30 11434500915428589568
17170801 22010117170801 171708 Madopar 62.5 30 11506558509466517504
17170901 22010117170901 171709 Madopar Rapid 30 13490996677695242240
17180201 13080217180201 171802 Triphasil 21 14 5729849761456979968
17180301 13080217180301 171803 Biphasil 21 14 5801907355494907904
17180401 13080217180401 171804 Biphasil 28 14 5873964949532835840
17180501 13080217180501 171805 Triphasil 28 14 5946022543570763776
17180502 13080217180502 171805 Triquilar ED 15 12684783075163373568
17180503 13080217180503 171805 Trifeme 14 6018080137608691712
17180601 13080217180601 171806 Microgynon 50 15 1334307937841053696
17180701 13080217180701 171807 Microgynon 50 ED 15 1406365531878981632
17180801 13080217180801 171808 Microgynon 30 15 1622538313992765440
17180802 13080217180802 171808 Nordette 21 14 6090137731646619648
17180901 13080217180901 171809 Microgynon 30 ED 15 1478423125916909568
17180902 13080217180902 171809 Nordette 28 14 6162195325684547584
17180903 13080217180903 171809 Monofeme 14 6234252919722475520
17180904 13080217180904 171809 Levlen ED 15 1694595908030693376
17180925 13080217180925 171809 Ava 30 ED 163 4333464496623321088
17181001 13080217181001 171810 Nordiol 21 14 6306310513760403456
17181101 13080217181101 171811 Nordiol 28 14 6378368107798331392
17181201 13080217181201 171812 Loette 14 15774876942144110592
17181202 13080217181202 171812 Microgynon 20 ED 15 15846934536182038528
17181225 13080217181225 171812 Ava 20 ED 163 15918992130219966464
17190101 07130117190101 171901 Xylocard 144 9907769646633713664
17190201 07130117190201 171902 Xylocard 144 9979827240671641600
17190401 22020117190401 171904 Xylocaine 144 9200715500252823552
17190601 22020117190601 171906 Xylocaine 0.5% 144 9272773094290751488
17190701 22020117190701 171907 Xylocaine 144 9344830688328679424
17190725 22020117190725 171907 Lidocaine-Claris 120 18080719951357804544
17190801 22020117190801 171908 Xylocaine 144 9416888282366607360
17191001 22020117191001 171910 Xylocaine 144 9488945876404535296
17192525 22020117192525 171925 Xylocaine 144 9561003470442463232
17192625 22020117192625 171926 Xylocaine 144 9633061064480391168
17192725 22020117192725 171927 Xylocaine Viscous144 9705118658518319104
17200201 16031317200201 172002 Lincocin 14 16536786823146373120
17200301 16031317200301 172003 Lincocin 14 16608844417184301056
17210101 14140117210101 172101 Tertroxin 143 3782592678433128448
17230101 22010117230101 172301 Sindopa 200 11650673697542373376
17230102 22010117230102 172301 Sinemet 72 11722731291580301312
17230201 22010117230201 172302 Sinemet 72 11794788885618229248
17230301 22010117230301 172303 Sinemet CR 72 11866846479656157184
17240101 13080417240101 172401 Microlut 15 839758602783686656
17240102 13080417240102 172401 Microval 14 6522483295874187264
17242525 13080517242525 172425 Postinor-2 15 12111984796092071936
17242526 13080517242526 172425 Next Choice 163 408869891462922240
17242625 14130117242625 172426 Mirena 15 767701008745758720
17242725 13080517242725 172427 Postinor-1 15 17445374853828837376
17242825 13080417242825 172428 Jadelle 15 16243780168483602432
17280101 01040117280101 172801 Imodium 69 13257865028234641408
17280102 01040117280102 172801 Dicap 200 7272879091110379520
17280125 01040117280125 172801 Diamide Relief 200 5888316874810195968
17280201 01040117280201 172802 Apo-Loperamide 69 13401980216310497280
17280225 01040117280225 172802 Nodia 120 13041692246120857600
17290101 22280117290101 172901 Dormonoct 105 9084436648057372672
17300101 22250117300101 173001 Ativan 14 6594540889912115200
17300201 22250117300201 173002 Ativan 157 13465629844930822144
17300202 22250117300202 173002 Lorapam 200 7344936685148307456
17300401 22250117300401 173004 Lorapam 200 7416994279186235392
17300402 22250117300402 173004 Lorzem 35 6202132886540255232
17300403 22250117300403 173004 Ativan 157 13537687438968750080
17300501 22250117300501 173005 Ativan 14 6666598483950043136
17310101 22280117310101 173101 Noctamid 15 3712208541092675584
17320101 22220117320101 173201 Loxapac 31 1734562056188723200
17320201 22220117320201 173202 Loxapac 31 1806619650226651136
17320301 22220117320301 173203 Loxapac 31 1878677244264579072
17330101 16031017330101 173301 Tetralysal 14 16680902011222228992
17600101 22050117600101 176001 Ludiomil 127 2175643240298971136
17600201 22050117600201 176002 Ludiomil 127 2247700834336899072
17620101 16010117620101 176201 Vermox 112 10740651903697289216
17620201 16010117620201 176202 Mindol 200 10812709497735217152
17620202 16010117620202 176202 Vermox 112 10884767091773145088
17620225 16010117620225 176202 De-Worm 120 10596536715621433344
17660101 14130117660101 176601 Provera 14 12666489400700436480
17660102 14130117660102 176601 Farlutal 14 16752959605260156928
17660201 14130117660201 176602 Provera 14 12738546994738364416
17660202 14130117660202 176602 Farlutal 14 16825017199298084864
17660301 14130117660301 176603 Provera 14 16897074793336012800
17660401 14130117660401 176604 Farlutal 14 16969132387373940736
17660501 14110917660501 176605 Provera 14 12450316618586652672
17660601 14110917660601 176606 Provera 14 12522374212624580608
17660701 14110917660701 176607 Provera 14 12594431806662508544
17660801 13080417660801 176608 Depo-Provera 14 12378259024548724736
17662525 13080417662525 176625 Depo-Provera 14 17105928126543691776
17690101 19040117690101 176901 Ponstan 14 2918183024954703872
17690102 19040117690102 176901 Mefic 58 1949608938395664384
17720101 25040117720101 177201 Megostat 22 1591009818066288640
17720125 25040117720125 177201 Megace 22 1663067412104216576
17720126 25040117720126 177201 Apo-Megestrol 10 16303168090034667520
17730101 25010117730101 177301 Alkeran 157 4225079038403674112
17730201 25010117730201 177302 Alkeran 157 4297136632441602048
17732525 25010117732525 177325 Alkeran 157 4153021444365746176
17800101 22250117800101 178001 Equanil 14 6738656077987971072
17810101 25010417810101 178101 Puri-nethol 157 3417846188592857088
17810201 25010417810201 178102 Puri-nethol 157 5471206143697092608
17920101 14100117920101 179201 Proviron 38 15927656281846841344
17930101 07370117930101 179301 Aramine 72 4469091454932746240
17940101 01131217940101 179401 Glucophage 200 7633167061300019200
17940103 01131217940103 179401 Metomin 200 7705224655337947136
17940104 01131217940104 179401 Glucomet 35 12737368318273388544
17940105 01131217940105 179401 Apo-Metformin 10 12809425912311316480
17940106 01131217940106 179401 3M 1 12881483506349244416
17940125 01131217940125 179401 Arrow-Metformin 163 2633875706290896896
17940126 01131217940126 179401 Apotex 10 5902945877017755648
17940201 01131217940201 179402 Glucophage 200 7777282249375875072
17940203 01131217940203 179402 Metomin 200 7849339843413803008
17940204 01131217940204 179402 Glucomet 35 13097656288463028224
17940205 01131217940205 179402 Apo-Metformin 10 13169713882500956160
17940206 01131217940206 179402 3M 1 13241771476538884096
17940225 01131217940225 179402 Diabex 200 15199214435282452480
17940226 01131217940226 179402 Arrow-Metformin 163 2705933300328824832
17940227 01131217940227 179402 Apotex 10 6119118659131539456
17950101 22040717950101 179501 Methatabs 179 13285468267649957888
17950102 22040717950102 179501 Pallidone 35 6614724624863199232
17950201 22040717950201 179502 AFT 127 3856323729168531456
17950225 22040717950225 179502 Martindale 12 4741227179877072896
17950301 22040717950301 179503 PSM 16 6758839812939055104
17950401 38010117950401 179504 PSM 16 16793208327906525184
17950402 38010117950402 179504 Douglas 35 16865265921944453120
17950425 38010117950425 179504 AFT 127 18162302614627155968
17950501 22040717950501 179505 Biodone 102 6830897406976983040
17950502 22040717950502 179505 Methaforte 16 6902955001014910976
17950525 22040717950525 179505 PSM Methaforte 16 6975012595052838912
17950601 22040717950601 179506 GlaxoWellcome 143 3134074332091777024
17950602 22040717950602 179506 Biodone Forte 102 7119127783128694784
17950625 22040717950625 179506 PSM Methaforte 16 7191185377166622720
17950701 22040717950701 179507 Biodone Extra Forte 102 7263242971204550656
17950725 22040717950725 179507 PSM Methaforte 16 7335300565242478592
17970101 25010417970101 179701 Ledertrexate 31 7912324267499323392
17970102 25010417970102 179701 Baxter 12 7984381861537251328
17970103 25010417970103 179701 Methoblastin 14 2818540883199131648
17970125 25010417970125 179701 Trexate 166 7586502688305577984
17970201 25010417970201 179702 Methoblastin 14 12810604588776292352
17970225 25010417970225 179702 Trexate 166 7802675470419361792
17970401 25010417970401 179704 Hospira 174 8718306972589359104
17970501 25010417970501 179705 Mayne 12 8272612237688963072
17970701 25010417970701 179707 Hospira 174 13774964247266066432
17970703 25010417970703 179707 Pharmacia 14 17041189981411868672
17970901 25010417970901 179709 Mayne 12 8488785019802746880
17971001 25010417971001 179710 Hospira 174 13847021841303994368
17971002 25010417971002 179710 Pharmacia 14 17113247575449796608
17971101 25010417971101 179711 Mayne 12 8704957801916530688
17971125 25010417971125 179711 Methotrexate Ebewe36 2242379198058463232
17971201 25010417971201 179712 Mayne 12 8777015395954458624
17971202 25010417971202 179712 Pharmacia 14 17185305169487724544
17972525 25010417972525 179725 Baxter 12 5318250882133917696
17972526 25010417972526 179725 Biomed 102 14753352574614634496
17972625 25010417972625 179726 Baxter 12 5390308476171845632
17972626 25010417972626 179726 Biomed 102 14825410168652562432
17972825 25010417972825 179728 DBL Methotrexate116 15721371407801647104
17972925 25010417972925 179729 Methotrexate Sandoz 116 11329268856557404160
17990101 22220117990101 179901 Nozinan 155 11997158398756913152
17990201 22220117990201 179902 Nozinan 155 12069215992794841088
17990301 22220117990301 179903 Nozinan 155 12141273586832769024
18000101 10190118000101 180001 Oxsoralen 200 15195558559120097280
18010101 07311018010101 180101 Enduron 2 7838296348624420864
18050101 07280118050101 180501 Hydromet 72 15277449085645225984
18060101 07280118060101 180601 Douglas 35 15349506679683153920
18060103 07280118060103 180601 Aldomet 72 15421564273721081856
18060104 07280118060104 180601 Prodopa 200 7921397437451730944
18060201 07280118060201 180602 Prodopa 200 7993455031489658880
18060202 07280118060202 180602 Aldomet 72 15637737055834865664
18060204 07280118060204 180602 Douglas 35 15709794649872793600
18060301 07280118060301 180603 Douglas 35 15781852243910721536
18060303 07280118060303 180603 Aldomet 72 15853909837948649472
18060304 07280118060304 180603 Prodopa 200 8065512625527586816
18090101 22310118090101 180901 Ritalin 116 12038798003612418048
18090125 22310118090125 180901 Rubifen 127 12110855597650345984
18092525 22310118092525 180925 Ritalin SR 116 12182913191688273920
18092526 22310118092526 180925 Rubifen SR 127 11750567627460706304
18092625 22310118092625 180926 Rubifen 127 11678510033422778368
18092725 22310118092725 180927 Rubifen 127 12471143567839985664
18100101 14070118100101 181001 Depo-Medrol 14 17257362763525652480
18100201 14070118100201 181002 Depo-Medrol 14 17329420357563580416
18100301 14070118100301 181003 Depo-Medrol 14 17401477951601508352
18100401 14070118100401 181004 Depo-Medrol 14 17473535545639436288
18100501 14070118100501 181005 Depo-Medrol 14 13026777370890076160
18110101 14070118110101 181101 Medrol 14 12882662182814220288
18110201 14070118110201 181102 Medrol 14 12954719776852148224
18120101 14070118120101 181201 Solu-Medrol 14 13170892558965932032
18120201 14070118120201 181202 Solu-Medrol 14 13242950153003859968
18120301 14070118120301 181203 Solu-Medrol 14 17545593139677364224
18120401 14070118120401 181204 Solu-Medrol 14 13315007747041787904
18120402 14070118120402 181204 Baxter 12 13405640490519363584
18120501 14070118120501 181205 Solu-Medrol 14 1862353894638616576
18120502 14070118120502 181205 Baxter 12 13549755678595219456
18130101 22130418130101 181301 Deseril 116 4719622875902902272
18140101 22160118140101 181401 Maxolon 143 8250444983761371136
18140102 22160118140102 181401 Metamide 200 8137570219565514752
18140201 22160118140201 181402 Maxolon 143 8106329795685515264
18140301 22160118140301 181403 Maxolon 143 8034272201647587328
18140302 22160118140302 181403 Pfizer 14 1934411488676544512
18140325 22160118140325 181403 AstraZeneca 144 13551444528455483392
18140501 22160118140501 181405 Maxolon 143 8178387389723443200
18150101 22130118150101 181501 Paramax 143 1416219355087110144
18160601 14070118160601 181606 Depo-Medrol with Lidocaine 14 8766682185676619776
18170101 07160118170101 181701 Betaloc CR 144 1560334543162966016
18170125 07160118170125 181701 Metoprolol - AFT CR 127 9006483472671309824
18170126 07160118170126 181701 Myloc CR 200 8001917972488650752
18170201 07160118170201 181702 Betaloc CR 144 1632392137200893952
18170226 07160118170226 181702 Myloc CR 200 8218090754602434560
18170301 07160118170301 181703 Betaloc CR 144 1704449731238821888
18170326 07160118170326 181703 Myloc CR 200 8434263536716218368
18172525 07160118172525 181725 Betaloc CR 144 1488276949125038080
18172527 07160118172527 181725 Myloc CR 200 7785745190374866944
18180101 07160118180101 181801 Lopresor 116 4124329688438931456
18180102 07160118180102 181801 Mycol 200 8281685407641370624
18180201 07160118180201 181802 Lopresor 116 4196387282476859392
18180202 07160118180202 181802 Mycol 200 8353743001679298560
18180301 07160118180301 181803 Slow-Lopresor 116 11099544593631281152
18180401 07160118180401 181804 Betaloc 144 1776507325276749824
18180425 07160118180425 181804 Lopresor 116 10123964418980052992
18200102 16130118200102 182001 Trichozole 200 8425800595717226496
18200103 16130118200103 182001 Flagyl 155 12213331180870696960
18200202 16130118200202 182002 Trichozole 200 8497858189755154432
18200203 16130118200203 182002 Flagyl 155 12285388774908624896
18200301 16130118200301 182003 Flagyl-S 155 2150584270790328320
18200401 16130118200401 182004 Flagyl 155 2294699458866184192
18200501 16130118200501 182005 Flagyl 155 2222641864828256256
18220101 14210118220101 182201 Metopirone 226 15371522201006112768
18230101 07130118230101 182301 Mexitil 17 1946794188628557824
18230201 07130118230201 182302 Mexitil 17 2018851782666485760
18230301 07130118230301 182303 Mexitil PL 17 2090909376704413696
18232525 07130118232525 182325 Mexiletine Hydrochloride USP 154 17222495050785619968
18232625 07130118232625 182326 Mexiletine Hydrochloride USP 154 17438667832899403776
18240101 22050118240101 182401 Tolvon 40 4174962198898016256
18250102 01310718250102 182501 Daktarin 69 3442220162357395456
18250125 01310718250125 182501 Decozol 127 1165756103837876224
18260101 28530218260101 182601 Breath-A-Tech (with mask) 132 8322524568031854592
18260125 28530218260125 182601 Space Chamber 132 9115158102449061888
18270101 28530218270101 182701 Personal Best 90 4329761341460971520
18270103 28530218270103 182701 Assess 74 10774426701879312384
18270104 28530218270104 182701 Mini Wright 39 10846484295917240320
18270108 28530218270108 182701 Breath-Alert 132 10704326238538825728
18270125 28530218270125 182701 Air-O-Breath PocketPeak 140 4617991717612683264
18270126 28530218270126 182701 Vitalograph 136 4690049311650611200
18270201 28530218270201 182702 Breath-Alert 132 10776383832576753664
18270202 28530218270202 182702 Personal Best 90 4834164499726467072
18270203 28530218270203 182702 Mini Wright 39 10918541889955168256
18270225 28530218270225 182702 Air-O-Breath PocketPeak 140 4978279687802322944
18270226 28530218270226 182702 Vitalograph 136 5050337281840250880
18280101 16031018280101 182801 Mino-tabs 157 12672996310513614848
18280201 16031018280201 182802 Minomycin 157 12745053904551542784
18292525 28530218292525 182925 Space Chamber 132 12359693770713726976
18292526 28530218292526 182925 Space Chamber Plus 132 8466358281130999808
18292625 28530218292625 182926 Volumatic 143 3533486224532570112
18300101 22040718300101 183001 RA-Morph 14 2438814646942040064
18300201 22040718300201 183002 RA-Morph 14 2510872240979968000
18300301 22040718300301 183003 RA-Morph 14 2582929835017895936
18300401 22040718300401 183004 RA-Morph 14 2654987429055823872
18300501 38010118300501 183005 PSM 16 16937323515982381056
18300502 38010118300502 183005 Douglas 35 17009381110020308992
18310101 22040718310101 183101 MST Continus 35 7695588535432118272
18310102 22040718310102 183101 LA-Morph 35 4148212180505853952
18310125 22040718310125 183101 Arrow-Morphine LA163 6282108063809798144
18310201 22040718310201 183102 MST Continus 35 7839703723507974144
18310202 22040718310202 183102 LA-Morph 35 4220269774543781888
18310301 22040718310301 183103 MST Continus 35 7983818911583830016
18310302 22040718310302 183103 LA-Morph 35 4292327368581709824
18310401 22040718310401 183104 MST Continus 35 8127934099659685888
18310402 22040718310402 183104 LA-Morph 35 4364384962619637760
18310501 22040718310501 183105 MST Continus 35 8272049287735541760
18310601 22040718310601 183106 Baxter 12 8344106881773469696
18310701 22040718310701 183107 DBL Morphine Sulphate 174 11799019806361911296
18310802 22040718310802 183108 AstraZeneca 144 10844518369126776832
18310901 22040718310901 183109 Baxter 12 8632337257925181440
18311002 22040718311002 183110 AstraZeneca 144 10916575963164704768
18311102 22040718311102 183111 AstraZeneca 144 10988633557202632704
18311201 22040718311201 183112 RMS 12 8992625228114821120
18311301 22040718311301 183113 RMS 12 9064682822152749056
18311325 22040718311325 183113 Martindale 12 8615214563345825792
18311401 22040718311401 183114 RMS 12 9136740416190676992
18311425 22040718311425 183114 Martindale 12 4669169585839144960
18311501 22040718311501 183115 RMS 12 9208798010228604928
18311525 22040718311525 183115 Martindale 12 10722007485025091584
18311601 38010118311601 183116 Douglas 35 17081438704058236928
18311701 22040718311701 183117 Kapanol 143 3278189520167632896
18311801 22040718311801 183118 Kapanol 143 3350247114205560832
18311901 22040718311901 183119 Kapanol 143 3422304708243488768
18311925 22040718311925 183119 m-Eslon 120 4813284773915000832
18312001 22040718312001 183120 Sevredol 35 9497028386380316672
18312101 22040718312101 183121 Sevredol 35 9569085980418244608
18312201 22040718312201 183122 Kapanol 143 3206131926129704960
18312225 22040718312225 183122 m-Eslon 120 5389745526218424320
18312525 22040718312525 183125 m-Eslon 120 10866122673100947456
18312625 22040718312625 183126 m-Eslon 120 10794065079063019520
18312725 22040718312725 183127 m-Eslon 120 11586698613480226816
18320225 28530218320225 183202 EZ-fit Paediatric Mask 132 16536808813378928640
18350101 10040118350101 183501 Bactroban 143 1920622513352605696
18380101 07160118380101 183801 Corgard 22 6054077048790450176
18380102 07160118380102 183801 Apo-Nadolol 10 6126134642828378112
18380201 07160118380201 183802 Corgard 22 6198192236866306048
18380202 07160118380202 183802 Apo-Nadolol 10 6270249830904233984
18390101 16230118390101 183901 Negram 50 14878047088809082880
18410101 22330118410101 184101 Narcan Neonatal 127 8840427530063183872
18410125 22330118410125 184101 Mayne 12 8768369936025255936
18410201 35040418410201 184102 Narcan 53 138944184890425344
18410202 35040418410202 184102 Hospira 174 9078594942778998784
18430101 31031718430101 184301 Albalon 5 12884861206069772288
18430102 31031718430102 184301 Naphcon Forte 19 4144554105320243200
18490101 22040418490101 184901 Acupan 35 2064737701428461568
18490201 22040418490201 184902 Acupan 35 1992680107390533632
18520101 16031318520101 185201 Neosulf 200 8569915783793082368
18520102 16031318520102 185201 Mycifradin 14 17617650733715292160
18530601 38010118530601 185306 Douglas 35 17153496298096164864
18540101 10040118540101 185401 Spersin 19 11891023640839323648
18570202 19010118570202 185702 AstraZeneca 144 10772460775088848896
18570301 19010118570301 185703 AstraZeneca 144 8218354637393100800
18590101 16010118590101 185901 Yomesan 15 10956824685811073024
18600101 01370418600101 186001 Apo-Nicotinamide 10 4234853696774602752
18600201 01370418600201 186002 Apo-Nicotinamide 10 4306911290812530688
18600301 38010118600301 186003 PSM 16 17225553892134092800
18610101 07320218610101 186101 Apo-Nicotinic Acid 10 6025423775770607616
18610102 07320218610102 186101 PSM 16 6097481369808535552
18610202 07320218610202 186102 PSM 16 6241596557884391424
18610302 07320218610302 186103 PSM 16 6385711745960247296
18610401 07320218610401 186104 PSM 16 6457769339998175232
18610425 07320218610425 186104 Niacin-Odan 10 6601884528074031104
18620101 07400118620101 186201 Ronicol Timespan 30 4973494613198241792
18630101 07220118630101 186301 Adalat Retard 15 13187778858545315840
18630125 07220118630125 186301 Adalat 10 15 13980412392962523136
18630201 07220118630201 186302 Adalat Retard 15 13259836452583243776
18630202 07220118630202 186302 Apo-Nifedipine Retard 10 13331894046621171712
18630203 07220118630203 186302 Nyefax Retard 35 13403951640659099648
18630204 07220118630204 186302 Alpha-Nifedipine 10 13476009234697027584
18630301 07220118630301 186303 Adalat Oros 15 13548066828734955520
18630325 07220118630325 186303 Arrow-Nifedipine XR 163 3714739616859815936
18630326 07220118630326 186303 Adefin XL 200 16495969652988444672
18630401 07220118630401 186304 Adalat Oros 15 13620124422772883456
18630425 07220118630425 186304 Arrow-Nifedipine XR 163 3786797210897743872
18630426 07220118630426 186304 Adefin XL 200 16568027247026372608
18630501 07220118630501 186305 Adalat 15 13692182016810811392
18630601 07220118630601 186306 Adalat 15 13764239610848739328
18630602 07220118630602 186306 Nical 200 8641973377831010304
18630603 07220118630603 186306 Nyefax 35 13908354798924595200
18640101 16130118640101 186401 Naxogin 14 17689708327753220096
18650102 22280118650102 186501 Insoma 200 8714030971868938240
18650104 22280118650104 186501 Nitrados 35 9300609430171156480
18670101 16230118670101 186701 Nifuran 57 14950104682847010816
18670201 16230118670201 186702 Nifuran 57 15022162276884938752
18670301 16230118670301 186703 Furadantin 14 17761765921791148032
18710101 13080418710101 187101 Noriday 28 14 1847164141500891136
18710201 14130118710201 187102 Primolut N 15 4216611699358171136
18730101 13080218730101 187301 Norinyl-1/21 14 17466216096733331456
18730201 13080218730201 187302 Norinyl-1/28 14 17538273690771259392
18740101 16230118740101 187401 Noroxin 72 15166277464960794624
18740125 16230118740125 187401 Arrow-Norfloxacin163 15238335058998722560
18750101 13080218750101 187501 Ovral 14 6810713672025899008
18760101 22050118760101 187601 Allegron 45 4256014897562779648
18760125 22050118760125 187601 Norpress 200 17072711880268578816
18760201 22050118760201 187602 Allegron 45 4328072491600707584
18760202 22050118760202 187602 Norpress 200 8786088565906866176
18760301 22050118760301 187603 Allegron 45 4472187679676563456
18810201 10070118810201 188102 Mycostatin 22 14917442590432296960
18810301 10070118810301 188103 Mycostatin 22 14989500184470224896
18810401 01310718810401 188104 Mycostatin 22 3514277756395323392
18810501 01310718810501 188105 Mycostatin 22 3586335350433251328
18810502 01310718810502 188105 Nilstat 157 11303902023792984064
18810601 16040118810601 188106 Nilstat 145 18221977508713070592
18810701 13100118810701 188107 Mycostatin 22 651446345806118912
18810702 13100118810702 188107 Nilstat 145 18149919914675142656
18810801 13100118810801 188108 Mycostatin 22 795561533881974784
18810901 13100118810901 188109 Nilstat 157 12168593152248119296
18811301 10070118811301 188113 Nilstat 145 17933747132561358848
18811302 10070118811302 188113 Mycostatin 157 11952420370134335488
18811401 10070118811401 188114 Nilstat 145 18005804726599286784
18811402 10070118811402 188114 Mycostatin 22 15277730560621936640
18812501 16040118812501 188125 Mycostatin 22 13190030658359001088
18812502 16040118812502 188125 Nilstat 157 12817111498589470720
18812601 16040118812601 188126 Nilstat 157 12889169092627398656
18860101 14120118860101 188601 Organon 19 2236994889617244160
18860201 14120118860201 188602 Organon 19 2309052483655172096
18860501 14110418860501 188605 Estraderm TTS 25116 8970739449163939840
18860525 14110418860525 188605 Estradot 116 10341535779884367872
18860601 14110418860601 188606 Estraderm TTS 50116 9042797043201867776
18860625 14110418860625 188606 Estradot 50 mcg 116 15915860721104060416
18860701 14110418860701 188607 Estraderm TTS 100 116 9114854637239795712
18860725 14110418860725 188607 Estradot 116 10557708561998151680
18860801 14110418860801 188608 Femtran 1 1228188573086253056
18860802 14110418860802 188608 Climara 50 15 4288669293396099072
18860803 14110418860803 188608 Femtran 50 35 2208852889504317440
18860901 14110418860901 188609 Femtran 1 1444361355200036864
18860902 14110418860902 188609 Climara 100 15 4360726887434027008
18860903 14110418860903 188609 Femtran 100 35 2280910483542245376
18861001 14110418861001 188610 Estrofem 8 1660534137313820672
18861101 14110418861101 188611 Estrofem 8 1732591731351748608
18880102 14110418880102 188801 Premarin 14 6882771266063826944
18880202 14110418880202 188802 Premarin 14 6954828860101754880
18880302 14110418880302 188803 Premarin 14 7026886454139682816
18880501 13140218880501 188805 Premarin 14 7098944048177610752
19030101 28450219030101 190301 Alupent 17 16291040476780298240
19060101 16130119060101 190601 Tiberal 30 16072334419876118528
19060125 16130119060125 190601 Arrow-Ornidazole 163 6065935281696014336
19080101 19160119080101 190801 Norflex 35 7241357192253669376
19080201 19160119080201 190802 Norflex 35 7169299598215741440
19090101 22010419090101 190901 Disipal 29 11938904073694085120
19100101 13220119100101 191001 Hemastix 13 13941872311385718784
19110101 22250119110101 191101 Serepax 14 7171001642215538688
19110102 22250119110102 191101 Ox-Pam 35 6562420856729894912
19110103 22250119110103 191101 Benzotran 200 8930203753982722048
19110201 22250119110201 191102 Benzotran 200 9002261348020649984
19110202 22250119110202 191102 Ox-Pam 35 6778593638843678720
19110203 22250119110203 191102 Serepax 14 7243059236253466624
19110301 22250119110301 191103 Serepax 14 7315116830291394560
19110302 22250119110302 191103 Ox-Pam 35 6994766420957462528
19110303 22250119110303 191103 Benzotran 200 9074318942058577920
19120101 07160119120101 191201 Captol 40 200 9146376536096505856
19120102 07160119120102 191201 Trasicor 116 9186912231277723648
19120201 07160119120201 191202 Captol 80 200 9218434130134433792
19120202 07160119120202 191202 Trasicor 116 9258969825315651584
19120401 07160119120401 191204 Captol SR 200 9290491724172361728
19120402 07160119120402 191204 Slow Trasicor 116 6702595395131801600
19140101 13190419140101 191401 Ditropan 105 9442472818433327104
19140102 13190419140102 191401 Apo-Oxybutynin 10 9514530412471255040
19140201 13190419140201 191402 Ditropan 105 9586588006509182976
19140202 13190419140202 191402 Apo-Oxybutynin 10 9658645600547110912
19150101 22040719150101 191501 Proladone 107 9713201168494100480
19160101 28510419160101 191601 Drixine 40 2004164506342653952
19160601 28510419160601 191606 Drixine 40 2076222100380581888
19160701 28510419160701 191607 Drixine 40 2148279694418509824
19160801 28510419160801 191608 Drixine 40 2220337288456437760
19170101 14010119170101 191701 Anapolon 52 10452421527545577472
19220101 13140219220101 192201 Syntocinon 116 2088679567123283968
19220125 13140219220125 192201 Oxytocin BNM 185 2881641855517196288
19220201 13140219220201 192202 Syntocinon 116 2160737161161211904
19220225 13140219220225 192202 BNM 185 10670062157682442240
19220301 13140219220301 192203 Syntometrine 179 3787994579060391936
19250101 01220119250101 192501 Viokase 14 7387174424329322496
19250201 01220119250201 192502 Viokase 14 7459232018367250432
19250301 01220119250301 192503 Viokase 14 7531289612405178368
19250401 01220119250401 192504 Pancrex V 6 12321679255694999552
19250501 01220119250501 192505 Pancrex V Forte 6 12393736849732927488
19250601 01220119250601 192506 Pancrex V 6 12465794443770855424
19250702 01220119250702 192507 Pancrex 6 12537852037808783360
19250802 01220119250802 192508 Pancrex V 6 12609909631846711296
19250901 01220119250901 192509 Combizym 29 12681967225884639232
19251001 01220119251001 192510 Combizym Compositum 29 12754024819922567168
19251101 01220119251101 192511 Cotazym ECS 40 9734657038398521344
19251201 01220119251201 192512 Creon 17 12898140007998423040
19251301 01220119251301 192513 Creon Forte 17 12970197602036350976
19251325 01220119251325 192513 Creon 25000 2 3983337113385959424
19251401 01220119251401 192514 Pancrease 69 13042255196074278912
19251501 01220119251501 192515 Panzytrat 15 7097523479154524160
19252525 01220119252525 192525 Creon 10000 17 13186370384150134784
19270101 22040719270101 192701 Baxter 12 9785258762532028416
19280101 07400119280101 192801 Hospira 174 7637443062020440064
19290201 22040419290201 192902 Panadol 186 2653299678707187712
19290202 22040419290202 192902 PSM Paracetamol Elixir Paediatric 16 2725357272745115648
19290203 22040419290203 192902 Pamol 133 3926989341485694976
19290204 22040419290204 192902 Panadol Colourfree47 2869472460820971520
19290205 22040419290205 192902 Douglas 35 2941530054858899456
19290206 22040419290206 192902 PSM Paracetamol Junior Suspension 16 3013587648896827392
19290207 22040419290207 192902 Paracare Junior 179 1050871432386445312
19290225 22040419290225 192902 Junior Parapaed 127 4166509153503674368
19290226 22040419290226 192902 Ethics Paracetamol 120 531296113169268736
19290301 22040419290301 192903 Pamol 133 3999046935523622912
19290302 22040419290302 192903 Panadol 186 3229760431010611200
19290303 22040419290303 192903 PSM Paracetamol Double Strength 16 3301818025048539136
19290304 22040419290304 192903 Douglas 35 3373875619086467072
19290305 22040419290305 192903 Paracare Double Strength 179 1122929026424373248
19290325 22040419290325 192903 Six Plus Parapaed127 1860666144289980416
19290401 22040419290401 192904 Panadol 186 3517990807162322944
19290501 22040419290501 192905 Panadol 186 3590048401200250880
19290601 22040419290601 192906 HMG 16 3662105995238178816
19290625 22040419290625 192906 Paracare 179 5656090123419254784
19290701 38010119290701 192907 PSM 16 17297611486172020736
19290801 22040419290801 192908 Pamol 133 4071104529561550848
19290802 22040419290802 192908 Panadol 186 3806221183314034688
19290803 22040419290803 192908 Apo-Paracetamol 10 3878278777351962624
19290804 22040419290804 192908 Douglas 35 3950336371389890560
19290805 22040419290805 192908 Disprol 162 4354262858574331904
19290825 22040419290825 192908 Pacimol 120 2437126896593403904
19290826 22040419290826 192908 Pharmacare 179 978813838348517376
19290827 22040419290827 192908 Parafast 163 12600380164568776704
19310101 22040719310101 193101 Panadeine 143 9043078518178578432
19310102 22040719310102 193101 Apo-Paracodeine 10 5823833816376016896
19310103 22040719310103 193101 Pamol Plus 104 5895891410413944832
19310105 22040719310105 193101 Codral Pain 104 5967949004451872768
19310125 22040719310125 193101 Codalgin 145 6040006598489800704
19310126 22040719310126 193101 ParaCode 163 10518855119607431168
19310127 22040719310127 193101 Paracetamol + Codeine (Relieve) 200 8649314816969670656
19420301 19070119420301 194203 D-Penamine 200 9362549318210289664
19420325 19070119420325 194203 Distamine 200 16784481504116867072
19420401 19070119420401 194204 D-Penamine 200 9434606912248217600
19420425 19070119420425 194204 Distamine 200 16856539098154795008
19440101 22040719440101 194401 Fortral 143 8754848142026866688
19440201 22040719440201 194402 Fortral 143 8826905736064794624
19440301 22040719440301 194403 Fortral 143 8682790547988938752
19490102 07220219490102 194901 Pexid (Sigma) 19 1497228073286762496
19490125 07220219490125 194901 Pexsig 157 11736247588020551680
19500101 22220119500101 195001 Neulactil 155 12544330360319639552
19500201 22220119500201 195002 Neulactil 155 12616387954357567488
19530101 22040719530101 195301 PSM 179 496090850359508992
19530102 22040719530102 195301 Douglas 35 10145546732721668096
19530201 22040719530201 195302 PSM 179 568148444397436928
19530202 22040719530202 195302 Douglas 35 10289661920797523968
19530301 22040719530301 195303 DBL Pethidine Hydrochloride 174 13096056499044614144
19530302 22040719530302 195303 AstraZeneca 144 11060691151240560640
19530401 22040719530401 195304 Mayne 174 12760503142433423360
19530501 22040719530501 195305 DBL Pethidine Hydrochloride 174 14176920409613533184
19530502 22040719530502 195305 AstraZeneca 144 11132748745278488576
19550101 22050419550101 195501 Nardil 154 12904618330509279232
19560401 22070119560401 195604 Gardenal Sodium 155 12357446368946552832
19560501 38010119560501 195605 PSM 16 17369669080209948672
19560525 38010119560525 195605 MidWest 152 10164191151393865728
19562525 22280119562525 195625 Martindale 201 1292144965450727424
19660101 07040119660101 196601 Dibenyline 185 2065579927335337984
19660125 07040119660125 196601 BNM 185 11102407721910009856
19700101 16030719700101 197001 Compocillin VK 2 12883172356209508352
19700201 16030719700201 197002 Compocillin VK 2 12955229950247436288
19700301 16030719700301 197003 Compocillin V 2 13027287544285364224
19700401 16030719700401 197004 Compocillin V 2 13099345138323292160
19702525 16030719702525 197025 Cilicaine VK 157 12456823528399831040
19702625 16030719702625 197026 Cilicaine VK 157 12528881122437758976
19702725 16030719702725 197027 AFT 127 8127371149706264576
19702825 16030719702825 197028 AFT 127 8199428743744192512
19710101 07040119710101 197101 Regitine 116 10823144962594439168
19720101 31031719720101 197201 Isopto Frin 3 13028976394145628160
19720102 31031719720102 197201 Prefrin 5 13101033988183556096
19730101 31031719730101 197301 Prefrin-Z 5 13173091582221484032
19730102 31031719730102 197301 Zincfrin 3 13245149176259411968
19780101 22070219780101 197801 Dilantin Infatab 14 3303505775397175296
19780201 22070219780201 197802 Dilantin 14 3087332993283391488
19780301 22070219780301 197803 Dilantin 14 3159390587321319424
19780401 22070219780401 197804 Dilantin 14 3231448181359247360
19780501 22070219780501 197805 Dilantin Forte 14 3566701371296055296
19780601 22070119780601 197806 Dilantin 14 13048733518585135104
19780625 22070119780625 197806 Hospira 174 7853615844134223872
19780701 22070119780701 197807 Dilantin 14 13120791112623063040
19780725 22070119780725 197807 Hospira 174 7925673438172151808
19850101 19010119850101 198501 Mayne 12 8290412231431028736
19860101 04040319860101 198601 Konakion 30 11296497912491540480
19860201 04040319860201 198602 Konakion 30 11368555506529468416
19860302 04040319860302 198603 Konakion MM 30 11440613100567396352
19862525 04040319862525 198625 Konakion MM 30 11512670694605324288
19870101 31030919870101 198701 Isopto Carpine 3 10146672632628510720
19870102 31030919870102 198701 PV Carpine 5 10218730226666438656
19870103 31030919870103 198701 Pilopt 19 10290787820704366592
19870201 31030919870201 198702 Isopto Carpine 3 10362845414742294528
19870202 31030919870202 198702 PV Carpine 5 10434903008780222464
19870203 31030919870203 198702 Pilopt 19 10506960602818150400
19870301 31030919870301 198703 Isopto Carpine 3 10579018196856078336
19870302 31030919870302 198703 PV Carpine 5 10651075790894006272
19870303 31030919870303 198703 Pilopt 19 10723133384931934208
19870401 31030919870401 198704 Isopto Carpine 3 10795190978969862144
19870402 31030919870402 198704 PV Carpine 5 10867248573007790080
19870403 31030919870403 198704 Pilopt 19 10939306167045718016
19870501 31030919870501 198705 Isopto Carpine 3 11011363761083645952
19870502 31030919870502 198705 PV Carpine 5 11083421355121573888
19870503 31030919870503 198705 Pilopt 19 11155478949159501824
19870601 31030919870601 198706 Isopto Carpine 3 11227536543197429760
19870602 31030919870602 198706 PV Carpine 5 11299594137235357696
19870603 31030919870603 198706 Pilopt 19 11371651731273285632
19870701 31030919870701 198707 Minims 87 11443709325311213568
19870801 31030919870801 198708 Ocusert Pilo 40 5 11515766919349141504
19890101 07190119890101 198901 Viskaldix 36 10017244720876486656
19900101 22220119900101 199001 Orap 69 2311022808492146688
19900201 22220119900201 199002 Orap 69 2383080402530074624
19902525 22220119902525 199025 Orap Forte 69 8902886387590627328
19910401 07160119910401 199104 Visken 36 6774652989169729536
19910402 07160119910402 199104 Pindol 200 9506664506286145536
19910403 07160119910403 199104 Apo-Pindolol 10 6918768177245585408
19910404 07160119910404 199104 Vypen 35 6990825771283513344
19910501 07160119910501 199105 Apo-Pindolol 10 7062883365321441280
19910503 07160119910503 199105 Pindol 200 9578722100324073472
19910504 07160119910504 199105 Visken 116 7206998553397297152
19910505 07160119910505 199105 Vypen 35 7279056147435225088
19910601 07160119910601 199106 Apo-Pindolol 10 7351113741473153024
19910603 07160119910603 199106 Pindol 200 9650779694362001408
19910604 07160119910604 199106 Visken 36 7495228929549008896
19930102 10170119930102 199301 Lyban 155 12429503962984480768
19940101 22220419940101 199401 Piportil 155 12501561557022408704
19940201 22220419940201 199402 Piportil 155 12573619151060336640
19950101 01100719950101 199501 Gastrozepin 17 6540415231011586048
19960301 19040219960301 199603 Feldene 14 15621642404627480576
19960401 19040219960401 199604 Candyl D 35 15693699998665408512
19960402 19040219960402 199604 Piram-D 200 9722837288399929344
19960501 19040219960501 199605 Douglas 35 15837815186741264384
19960601 19040219960601 199606 Candyl D 35 15909872780779192320
19960602 19040219960602 199606 Piram-D 200 9794894882437857280
19960701 19040219960701 199607 Douglas 35 16053987968855048192
19960702 19040219960702 199607 Feldene 14 16126045562892976128
19980101 16030719980101 199801 Pondocillin 29 13315517920437075968
20000101 22130420000101 200001 Sandomigran 116 5728429192433893376
20000201 22130420000201 200002 Sandomigran 116 5656371598395965440
20040101 31030120040101 200401 Neosporin 104 7932922518334078976
20080101 10040120080101 200801 Ponoxylan 155 12645676745098264576
20100201 31031320100201 201002 Liquifilm Tears 5 12668688423955988480
20100225 31031320100225 201002 Vistil 127 3293909237909946368
20100301 31031320100301 201003 Liquifilm Forte 5 12740746017993916416
20100325 31031320100325 201003 Vistil Forte 127 3510082020023730176
20130101 04100420130101 201301 Phosphate-Sandoz116 5584314004358037504
20160101 04100420160101 201601 Chlorvescent 151 17061105435525775360
20160201 04100420160201 201602 K-SR 200 9866952476475785216
20160202 04100420160202 201602 Slow K 116 9331027419353579520
20160203 04100420160203 201602 Span-K 157 2137637521373265920
20160301 04100120160301 201603 Pharmacia 14 17833823515829075968
20160302 04100120160302 201603 AstraZeneca 144 2785313641807740928
20160401 04100120160401 201604 Pharmacia 14 17905881109867003904
20160402 04100120160402 201604 AstraZeneca 144 2857371235845668864
20160501 38010120160501 201605 PSM 16 17441726674247876608
20310101 07040120310101 203101 Hyprosin 200 9939010070513713152
20310201 07040120310201 203102 Hyprosin 200 10011067664551641088
20310202 07040120310202 203102 Minipress 14 6702313920155090944
20310203 07040120310203 203102 Pratsiol 35 6774371514193018880
20310225 07040120310225 203102 Apo-Prazo 10 8131364575938347008
20310226 07040120310226 203102 Apo-Prazosin 10 13450750154072129536
20310301 07040120310301 203103 Pratsiol 35 6846429108230946816
20310302 07040120310302 203103 Minipress 14 6918486702268874752
20310303 07040120310303 203103 Hyprosin 200 10083125258589569024
20310325 07040120310325 203103 Apo-Prazo 10 9644574050734833664
20310326 07040120310326 203103 Apo-Prazosin 10 13666922936185913344
20310401 07040120310401 203104 Hyprosin 200 10155182852627496960
20310402 07040120310402 203104 Minipress 14 7134659484382658560
20310403 07040120310403 203104 Pratsiol 35 7206717078420586496
20310425 07040120310425 203104 Apo-Prazo 10 10725437961303752704
20310426 07040120310426 203104 Apo-Prazosin 10 13883095718299697152
20320101 31030420320101 203201 Pred Mild 5 7264368871111393280
20320201 31030420320201 203202 Pred Forte 5 7336426465149321216
20330101 31030420330101 203301 Predmycin-P 5 7408484059187249152
20340101 01040420340101 203401 Predsol 104 487577331825639424
20340201 01040420340201 203402 Predsol 104 559634925863567360
20342525 14070120342525 203425 Redipred 157 2890598477237059584
20350101 31030420350101 203501 Blephamide 5 7480541653225177088
20360101 14070120360101 203601 PSM 16 13693870866671075328
20380101 14070120380101 203801 Origen Prednisone104 13765928460709003264
20380102 14070120380102 203801 Apo-Prednisone 10 13837986054746931200
20380103 14070120380103 203801 Douglas 35 13910043648784859136
20380125 14070120380125 203801 Apo-Prednisone S2910 4498710099161776128
20380202 14070120380202 203802 Douglas 35 13982101242822787072
20380203 14070120380203 203802 Apo-Prednisone 10 14054158836860715008
20380204 14070120380204 203802 Deltasone 14 17977938703904931840
20380301 14070120380301 203803 Douglas 35 14198274024936570880
20380302 14070120380302 203803 Apo-Prednisone 10 14270331618974498816
20380304 14070120380304 203803 Deltasone 14 18049996297942859776
20380401 14070120380401 203804 Douglas 35 14486504401088282624
20380403 14070120380403 203804 Apo-Prednisone 10 14630619589164138496
20380404 14070120380404 203804 Deltasone 14 18122053891980787712
20380501 14070120380501 203805 Deltasone 14 18194111486018715648
20380601 14070120380601 203806 Deltasone 14 18266169080056643584
20410101 22070220410101 204101 Mysoline 65 201880230464323584
20410125 22070220410125 204101 Apo-Primidone 10 17135133354400677888
20420101 19130120420101 204201 Benemid 72 9731829094491881472
20420125 19130120420125 204201 Probenecid-AFT 127 6116590881899282432
20440101 07130120440101 204401 Procainamide Durules 11 2162966970742341632
20450101 14111420450101 204501 Prempak-C 14 7603347206443106304
20450201 14111420450201 204502 Prempak-C 14 7675404800481034240
20460101 16030720460101 204601 Cilicaine 145 2929428829883596800
20460201 16030720460201 204602 Cilicaine 157 12600938716475686912
20470101 25010720470101 204701 Natulan 127 12812240662078423040
20490101 22010420490101 204901 Kemadrin 157 12010961667732013056
20500201 14111420500201 205002 Menoprem 14 7819519988556890112
20500202 14111420500202 205002 Provette 14 18410284268132499456
20500301 14111420500301 205003 Premia 2.5 Continuous 14 7891577582594818048
20500401 14111420500401 205004 Premia 5 Continuous 14 7963635176632745984
20500411 14111420500411 205004 Menoprem Continuous 14 7747462394518962176
20500412 14111420500412 205004 Provette Continuous14 18338226674094571520
20500501 14111420500501 205005 Premia 5 14 8035692770670673920
20520101 14130120520101 205201 Gestone 6 3245801206148235264
20520201 14130120520201 205202 Gestone 6 3317858800186163200
20522525 14130120522525 205225 Utrogestan 19 1400233555530874880
20530101 14111420530101 205301 Nuvelle 15 4576899669547810816
20540101 22160120540101 205401 Avomine 155 3663793745586814976
20560101 14111420560101 205601 Estrapak 116 9403085013391507456
20560201 14111420560201 205602 Trisequens 8 15260791484484419584
20560301 14111420560301 205603 Kliogest 8 15332849078522347520
20560325 14111420560325 205603 Cliane 15 5728147717457182720
20560401 14111420560401 205604 Kliovance 8 15476964266598203392
20570101 31030120570101 205701 Brolene 155 3735851339624742912
20580101 31010120580101 205801 Vosol Otic 34 11605343032152424448
20580201 31010120580201 205802 Vosol 131 11677400626190352384
20590101 22070120590101 205901 AFT 127 5081302827813306368
20600101 07160120600101 206001 Inderal 65 7567286523586936832
20600102 07160120600102 206001 Angilol 35 7639344117624864768
20600103 07160120600103 206001 Cardinol 200 10227240446665424896
20600104 07160120600104 206001 Apo-Propranolol 10 7783459305700720640
20600201 07160120600201 206002 Inderal 65 7855516899738648576
20600202 07160120600202 206002 Angilol 35 7927574493776576512
20600203 07160120600203 206002 Apo-Propranolol 10 7999632087814504448
20600204 07160120600204 206002 Cardinol 200 10299298040703352832
20600401 07160120600401 206004 Inderal 65 8143747275890360320
20600501 07160120600501 206005 Angilol 35 8215804869928288256
20600502 07160120600502 206005 Cardinol 160 200 10371355634741280768
20600503 07160120600503 206005 Inderal 65 8359920058004144128
20600601 07160120600601 206006 Angilol LA 35 8431977652042072064
20600602 07160120600602 206006 Cardinol LA 200 10443413228779208704
20600603 07160120600603 206006 Inderal LA 65 8576092840117927936
20602525 07160120602525 206025 Roxane 220 15608521932373229568
20620101 14140120620101 206201 Abbott 2 3678146770375802880
20620125 14140120620125 206201 PTU 127 11052556964218273792
20630101 04070420630101 206301 Artex 108 13386168139591450624
20660101 28510420660101 206601 Sudomyl 16 2292394882494365696
20660202 28510420660202 206602 Sudafed 104 2364452476532293632
20680101 16010120680101 206801 Combantrin 14 11028882279849000960
20680201 16010120680201 206802 Combantrin 14 11100939873886928896
20680301 16010120680301 206803 Combantrin 14 11172997467924856832
20680401 16010120680401 206804 Combantrin 14 11245055061962784768
20690101 16160120690101 206901 Zinamide 72 17801716676786388992
20690125 16160120690125 206901 AFT-Pyrazinamide127 17081140736407109632
20700101 19010120700101 207001 Mestinon 211 5524396118202384384
20710101 01370420710101 207101 PSM 16 4378968884850458624
20710201 01370420710201 207102 PSM 16 4451026478888386560
20710202 01370420710202 207102 Apo-Pyridoxine 10 4523084072926314496
20710225 01370420710225 207102 Healtheries 59 4595141666964242432
20710226 01370420710226 207102 PyridoxADE 185 8862389175316381696
20710301 01370420710301 207103 PSM 16 4667199261002170368
20710302 01370420710302 207103 Apo-Pyridoxine 10 4739256855040098304
20710303 01370420710303 207103 Douglas 35 4811314449078026240
20710401 01370420710401 207104 PSM 16 4883372043115954176
20710402 01370420710402 207104 Apo-Pyridoxine 10 4955429637153882112
20710403 01370420710403 207104 Douglas 35 5027487231191810048
20710501 38010120710501 207105 PSM 16 17513784268285804544
20730101 16100120730101 207301 Fansidar 30 14775297727193415680
20770101 07130120770101 207701 Kinidin Durules 11 2235024564780269568
20780101 07130120780101 207801 Douglas 35 2307082158818197504
20780201 07130120780201 207802 Douglas 35 2379139752856125440
20790101 16120420790101 207901 Quinoc F 35 1291865689497272320
20790102 16120420790102 207901 Apo-Quinine 10 1363923283535200256
20790103 16120420790103 207901 Quinoc S 35 1435980877573128192
20790104 16120420790104 207901 Q 200 200 1508038471611056128
20790202 16120420790202 207902 Quinoc S 35 1580096065648984064
20790204 16120420790204 207902 PSM 16 1652153659686912000
20790205 16120420790205 207902 Q 300 200 1724211253724839936
20790206 16120420790206 207902 Apo-Quinine 10 1796268847762767872
20790207 16120420790207 207902 Quinoc F 35 1868326441800695808
20800301 01100320800301 208003 Zantac 143 3433831988149092352
20800325 01100320800325 208003 Peptisoothe 127 14372507035520466944
20800401 01100320800401 208004 Zantac 143 15306734577851039744
20800501 01100320800501 208005 Zantac 143 4070823054584840192
20800502 01100320800502 208005 Apo-Ranitidine 10 5171320944290955264
20800503 01100320800503 208005 Zanidin 200 10659586010892992512
20800525 01100320800525 208005 Arrow-Ranitidine 163 2201530142063329280
20800601 01100320800601 208006 Zantac 143 4142880648622768128
20800602 01100320800602 208006 Apo-Ranitidine 10 5387493726404739072
20800603 01100320800603 208006 Zanidin 200 10731643604930920448
20800625 01100320800625 208006 Arrow-Ranitidine 163 13595086343985168384
20802501 01100320802501 208025 Zantac-C 143 3361774394111164416
20802502 01100320802502 208025 Douglas 35 5603666508518522880
20802601 01100320802601 208026 Zantac-C 143 3998765460546912256
20802602 01100320802602 208026 Douglas 35 5747781696594378752
20870101 01370420870101 208701 PSM 16 5099544825229737984
20880101 16160120880101 208801 Rifadin 105 17873774270824316928
20880201 16160120880201 208802 Rifadin 155 4240254497890238464
20880301 16160120880301 208803 Rifadin 155 4024081715776454656
20880401 16160120880401 208804 Rifadin 155 4096139309814382592
20880501 16160120880501 208805 Rifadin 155 4168196903852310528
20900101 16031020900101 209001 Reverin 105 14036093860816355328
20960102 28300120960102 209601 Volmax 143 2569983085600833536
20960201 28300120960201 209602 Volmax 143 2642040679638761472
20960301 28300120960301 209603 Ventolin 143 14770863396798595072
20960325 28300120960325 209603 Salapin 127 10310260171632279552
20960326 28300120960326 209603 Broncolin 90 14744105681825038336
20960401 28300120960401 209604 Ventolin 143 8056214055691485184
20960501 28300120960501 209605 Ventolin 143 7984156461653557248
20960601 28301020960601 209606 Ventolin 143 8200329243767341056
20960602 28301020960602 209606 Asmol 200 10803701198968848384
20960603 28301020960603 209606 Salbuvent 35 1196083933066821632
20960604 28301020960604 209606 Respolin 1 6953126816101957632
20960901 28301020960901 209609 Ventolin Forte 143 8344444431843196928
20960902 28301020960902 209609 Salbuvent Forte 35 14958802919334346752
20961101 28301020961101 209611 Respolin Autohaler 1 7025184410139885568
20961201 28301020961201 209612 Ventodisk 76 16760242770282545152
20961302 28301020961302 209613 Ventodisk 75 17985221868927320064
20961401 28301020961401 209614 Respax 14 107936857475514368
20961402 28301020961402 209614 Ventolin Nebules 143 8416502025881124864
20961403 28301020961403 209614 Asmol 200 10875758793006776320
20961425 28301020961425 209614 Pharmacia 14 2485837460727136256
20961426 28301020961426 209614 Asthalin 166 10488153456425041920
20961501 28301020961501 209615 Respax 14 179994451513442304
20961502 28301020961502 209615 Ventolin Nebules 143 8488559619919052800
20961503 28301020961503 209615 Asmol 200 10947816387044704256
20961525 28301020961525 209615 Pharmacia 14 900570391892721664
20961526 28301020961526 209615 Asthalin 166 10560211050462969856
20961601 28301020961601 209616 Airomir 1 6016378093608894464
20961625 28301020961625 209616 Ventolin 143 8272386837805268992
20961626 28301020961626 209616 Salamol 132 15030860513372274688
20961627 28301020961627 209616 Respigen 200 17144487999329796096
20961701 28301020961701 209617 Salbutamol Turbuhaler 11 17120530740472184832
21140101 10040121140101 211401 Silvazine 87 12107196422953107456
21142525 10040121142525 211425 Flamazine 87 9870336773266079744
21250101 01010221250101 212501 Gaviscon 162 7786009073165533184
21252525 01010221252525 212525 Acidex 127 6777202756634542080
21252625 01010221252625 212526 Gaviscon Double Strength 162 6849260350672470016
21260101 19070121260101 212601 Myocrisin 155 4312312091928166400
21260201 19070121260201 212602 Myocrisin 155 4384369685966094336
21260301 19070121260301 212603 Myocrisin 155 4456427280004022272
21280101 04100121280101 212801 AstraZeneca 144 10484230398937137152
21280102 04100121280102 212801 Mayne 12 15132770947615948800
21280125 04100121280125 212801 Pharmalab 153 14123964631084957696
21280201 04100121280201 212802 Mayne 12 15204828541653876736
21280225 04100121280225 212802 Biomed 102 14340137413198741504
21280301 38010121280301 212803 PSM 16 17585841862323732480
21282525 38010121282525 212825 David Craig 120 18306417802703011840
21282526 38010121282526 212825 Biomed 102 16072632387527245824
21282527 38010121282527 212825 ABM 167 15496171635223822336
21282528 38010121282528 212825 Midwest 152 6069870433811824640
21282625 04100121282625 212826 Biomed 102 14268079819160813568
21282725 04100421282725 212827 Sodibic 157 18025799345550393344
21320101 35040821320101 213201 Calcium Disodium Versenate 35 571289749117992960
21330201 01310121330201 213302 Orabase 22 10016118820969644032
21330203 01310121330203 213302 Stomahesive 22 10088176415007571968
21330701 01310121330701 213307 Stomahesive 143 8466617765875154944
21350101 04100421350101 213501 PSM 16 17349335811677487104
21350201 04100121350201 213502 AstraZeneca 144 10556287992975065088
21350301 04100121350301 213503 AstraZeneca 144 8848847590108692480
21350302 04100121350302 213503 Pfizer 14 8410332666137673728
21350325 04100121350325 213503 Multichem 120 12828367199123013632
21350401 04100121350401 213504 Pfizer 14 8986793418441097216
21350402 04100121350402 213504 AstraZeneca 144 8920905184146620416
21350425 04100121350425 213504 Multichem 120 13044539981236797440
21350501 04100121350501 213505 Pharmacia 14 396167233627226112
21350502 04100121350502 213505 AstraZeneca 144 10628345587012993024
21350503 04100121350503 213505 Baxter 12 15781289293957300224
21350525 04100121350525 213505 Multichem 120 14804852599748034560
21350601 04100121350601 213506 Baxter 12 15853346887995228160
21350701 38010121350701 213507 PSM 16 17657899456361660416
21350901 04100121350901 213509 Baxter 12 15925404482033156096
21352525 04100121352525 213525 Biomed 102 14051907037047029760
21352625 28490221352625 213526 Biomed 102 1983136346461437952
21400101 01250721400101 214001 Microlax 14 468224827665154048
21400102 01250721400102 214001 Fleet 12 1208434747181629440
21400125 01250721400125 214001 Micolette 127 14298225129459548160
21420101 13190421420101 214201 Citravescent 200 11019873981082632192
21420102 13190421420102 214201 Ural 157 2637610747290451968
21440201 28400121440201 214402 Intal Spincaps 35 2714098273676689408
21440301 28400121440301 214403 Intal Forte CFC Free51 14140335259710914560
21440302 28400121440302 214403 Vicrom S 51 13552851903339036672
21440401 28400121440401 214404 Vicrom 51 13624909497376964608
21440501 28400121440501 214405 Intal 155 17861689538523430912
21440601 01040421440601 214406 Nalcrom 35 2786155867714617344
21440701 31030421440701 214407 Opticrom 155 12789791933174120448
21440725 31030421440725 214407 Cromolux 127 10848441426614681600
21440726 31030421440726 214407 Rexacrom 166 13270561089000570880
21440801 31030421440801 214408 Opticrom 155 12861849527212048384
21440901 28510221440901 214409 Rynacrom 155 17717574350447575040
21441201 28510221441201 214412 Rynacrom Forte 155 17789631944485502976
21441225 28510221441225 214412 Rex 166 10632268644500897792
21441301 28400121441301 214413 Vicrom 155 10004911498947723264
21441325 28400121441325 214413 Intal Forte CFC Free 155 10076969092985651200
21490101 01382021490101 214901 F-Tab 206 8206542583975903232
21490125 01382021490125 214901 PSM 179 8278600178013831168
21490201 01382021490201 214902 Hi-Fluor 200 8350657772051759104
21490301 38010121490301 214903 Sodium fluoride 120 17729957050399588352
21580101 01150421580101 215801 Ketur-Test 164 5468062639953281024
21580102 01150421580102 215801 Ketostix 15 11493036715468128256
21582525 01150421582525 215825 Ketostix 15 11565094309506056192
21582526 01150421582526 215825 Accu-Chek Ketur-Test 164 18147138150256869376
21600101 04100421600101 216001 Resonium-A 155 4528484874041950208
21640101 04040121640101 216401 Fibro-vein 6 3819728683661262848
21640201 04040121640201 216402 Fibro-vein 6 3891786277699190784
21640301 04040121640301 216403 STD 6 3963843871737118720
21640401 04040121640401 216404 Fibro-vein 6 4035901465775046656
21660101 22070221660101 216601 Epilim Crushable 162 4714550828763971584
21660201 22070221660201 216602 Epilim 162 4786608422801899520
21660202 22070221660202 216602 Valpro 200 11163989169158488064
21660301 22070221660301 216603 Epilim 162 4858666016839827456
21660302 22070221660302 216603 Valpro 200 11236046763196416000
21660401 22070221660401 216604 Epilim S/F Liquid 162 4570435640688115712
21660402 22070221660402 216604 Epilim Syrup 162 4642493234726043648
21660501 22070221660501 216605 Epilim IV 162 4498378046650187776
21690101 07160121690101 216901 Sotacor 22 8648150434155855872
21690102 07160121690102 216901 Mylan 200 12828915855425273856
21690125 07160121690125 216901 Apo-Sotalol 10 2955600505159548928
21690201 07160121690201 216902 Sotacor 22 8792265622231711744
21690202 07160121690202 216902 Mylan 200 12900973449463201792
21690225 07160121690225 216902 Apo-Sotalol 10 3027658099197476864
21690301 07160121690301 216903 Sotacor 157 11664189993982623744
21710101 16031321710101 217101 Trobicin 14 540282421703081984
21730101 16031321730101 217301 Rovamycin 155 13005964715287904256
21730201 16031321730201 217302 Rovamycin 155 13078022309325832192
21760101 07310421760101 217601 Spirotone 200 11452219545310199808
21760102 07310421760102 217601 Aldactone 55 6325086873827934208
21760125 07310421760125 217601 Spiractin 200 9655055695082422272
21760201 07310421760201 217602 Spirotone 200 11524277139348127744
21760203 07310421760203 217602 Aldactone 55 6469202061903790080
21760225 07310421760225 217602 Spiractin 200 9871228477196206080
21760301 07310421760301 217603 Biomed 102 6541259655941718016
21830101 25040121830101 218301 PSM 16 1951297788255928320
21880101 10310721880101 218801 Varidase 31 8811682997578235904
21910101 01101321910101 219101 Carafate 151 7188933577352937472
21930101 19040121930101 219301 Clinoril 72 2021666532433592320
21930102 19040121930102 219301 Daclin 200 13791014918008340480
21930103 19040121930103 219301 Saldac 35 2165781720509448192
21930125 19040121930125 219301 Aclin 200 16850101457574166528
21930201 19040121930201 219302 Daclin 200 13863072512046268416
21930202 19040121930202 219302 Clinoril 72 2309896908585304064
21930203 19040121930203 219302 Saldac 35 2381954502623232000
21930225 19040121930225 219302 Aclin 90 4179776960316047360
21940101 31030121940101 219401 Acetopt 19 8077037706409934848
21940102 31030121940102 219401 Bleph 10 5 8149095300447862784
21940201 38010121940201 219402 PSM 16 17802014644437516288
22050101 01040422050101 220501 Salazopyrin 14 4672600062117806080
22050102 01040422050102 220501 Colizine 200 11740449921461911552
22050201 01040422050201 220502 Salazopyrin EN 14 4744657656155734016
22050202 01040422050202 220502 Colizine EC 200 11812507515499839488
22050301 01040422050301 220503 Salazopyrin 14 612340015741009920
22050401 01040422050401 220504 Salazopyrin 14 4600542468079878144
22060101 19130122060101 220601 SPZ 116 9475142607429435392
22060102 19130122060102 220601 Anturan 116 9547200201467363328
22060201 19130122060201 220602 SPZ 116 9619257795505291264
22120101 22070222120101 221201 Ospolot 15 850398576805675008
22120201 22070222120201 221202 Ospolot 15 922456170843602944
22130101 10250122130101 221301 R V Paque 200 11884565109537767424
22130201 10250122130201 221302 Eversun 15+ 30 14990063134423646208
22130202 10250122130202 221302 Aquasun 30+ 112 4233517790146854912
22130203 10250122130203 221302 Aquasun 15+ 112 12647924146865438720
22130204 10250122130204 221302 Hamilton Sunscreen 167 2873991453611130880
22130205 10250122130205 221302 Elizabeth Arden Suncare 90 12719981740903366656
22130206 10250122130206 221302 UV Triplegard SPF 15+ 162 12792039334941294592
22130225 10250122130225 221302 Aquasun Oil Free Faces SPF30+ 112 4161460196108926976
22130401 10250122130401 221304 Aquasun 15 112 4305575384184782848
22130402 10250122130402 221304 Eversun 15+ 90 12936154523017150464
22130403 10250122130403 221304 Le Tan SPF 15+ 131 13008212117055078400
22130404 10250122130404 221304 UV Triplegard SPF 15+ 162 13080269711093006336
22130405 10250122130405 221304 Aquasun 30+ 112 4377632978222710784
22130406 10250122130406 221304 Aquasun Sensitive SPF 30+ 112 4449690572260638720
22130425 10250122130425 221304 Marine Blue Lotion SPF 30+ 167 5753463972686725120
22132526 10250122132526 221325 Marine Blue Lotion SPF 50+ 167 15828650757323751424
22180101 25040122180101 221801 Nolvadex 65 2023355382293856256
Trial Version
Code Name
1001 Acebutolol
1002 Lamotrigine
1003 Acetazolamide
1004 Vigabatrin
1005 Acebutolol with hydrochlorothiazide
1006 Acetic acid with hydroxyquinoline and ricinoleic acid
1009 Leuprorelin
1010 Dornase alfa
1011 Risperidone
1012 Midodrine
1013 Guanethidine sulphate
1015 Adrenaline
1016 Adrenaline borate
1017 Adrenaline hydrochloride
1019 Alclometasone dipropionate
1020 Alfacalcidol
1021 Alginic acid
1022 Lansoprazole
1023 Milk dextrin
1024 Apomorphine hydrochloride
1025 Nedocromil
1026 Allopurinol
1027 Polyvinyl alcohol with povidone
1029 Alprenolol
1031 Trandolapril
1032 Pergolide
1033 Betamethasone
1034 Mycophenolate mofetil
1036 Aluminium chloride
1037 Alendronate sodium
1038 Aluminium hydroxide
1039 Aluminium hydroxide with magnesium hydroxide
1040 Simethicone
1041 Polysiloxane
1043 Valaciclovir
1048 Amantadine hydrochloride
1050 Amiloride hydrochloride
1051 Amiloride hydrochloride with furosemide
1053 Amiloride hydrochloride with hydrochlorothiazide
1054 Aminocaproic acid
1055 Aminoglutethimide
1056 Aminophylline
1057 Amiodarone hydrochloride
1059 Amitriptyline
1060 Gabapentin (Neurontin)
1061 Losartan potassium
1062 Gabapentin
1063 Fluvastatin
1064 Dexamethasone with neomycin sulphate and polymyxin B sulphate
1065 Fluticasone
1066 Salmeterol
1067 Prednisolone acetate with sulphacetamide
1068 Losartan potassium with hydrochlorothiazide
1069 Amoxapine
1070 Amoxicillin clavulanate
1072 Amoxicillin
1074 Amphotericin B
1076 Dorzolamide hydrochloride
1077 Saquinavir
1078 Clozapine
1080 Amylobarbitone sodium
1081 Cefuroxime axetil
1082 Methylprednisolone aceponate
1083 Eformoterol fumarate
1084 Ascorbic acid
1085 Aprotinin
1086 Ritonavir
1087 Aspirin
1088 Tacrolimus
1092 Aspirin with paracetamol and codeine
1094 Atenolol
1095 Atenolol with chlorthalidone
1097 Atropine sulphate
1098 Pantoprazole
1099 Auranofin
1100 Azathioprine
1101 Malathion
1102 Indinavir
1103 Lodoxamide
1105 Applicator
1107 Tropisetron
1108 Beclomethasone dipropionate
1109 Stavudine [d4T]
1110 Insulin pen needles
1112 Allergy treatment set
1116 Bendroflumethiazide [Bendrofluazide]
1120 Benzathine benzylpenicillin
1122 Bismuth subcitrate, metronidazole and tetracycline
1124 Dicloxacillin
1125 Nefazodone
1126 Ursodeoxycholic acid
1127 Cilazapril with hydrochlorothiazide
1128 Benzoyl peroxide
1130 Benztropine mesylate
1132 Benzydamine hydrochloride
1133 Topiramate
1136 Benzylpenicillin sodium (penicillin G)
1137 Atorvastatin
1138 Tolcapone
1140 Olanzapine
1141 Betamethasone sodium phosphate with neomycin
1143 Betamethasone dipropionate
1144 Betamethasone sodium phosphate
1145 Betamethasone dipropionate with clotrimazole
1146 Betamethasone valerate with clioquinol
1147 Betamethasone valerate with gentamicin
1148 Betamethasone valerate with fusidic acid
1149 Betaxolol
1150 Betamethasone dipropionate with salicylic acid
1151 Bezafibrate
1156 Oestradiol valerate
1158 Anastrozole
1159 Bismuth subnitrate
1166 Bromazepam
1167 Bromocriptine mesylate
1168 Budesonide
1170 Nevirapine
1171 Bumetanide
1172 Nelfinavir
1173 Busulphan
1174 Wasp venom allergy treatment
1177 Omeprazole, amoxycillin and metronidazole
1178 Azithromycin
1179 Calamine
1181 Letrozole
1183 Quetiapine
1185 Isopropyl alcohol
1187 Cholecalciferol
1188 Calcitonin
1189 Calcitriol
1191 Calcium carbonate
1192 Insulin lispro
1193 Citalopram hydrobromide
1194 Fexofenadine hydrochloride
1195 Betahistine dihydrochloride
1197 Calcium chloride
1198 Calcium folinate
1199 Calcium gluconate
1205 Calcium polystyrene sulphonate
1209 Capreomycin sulphate
1216 Carbachol
1217 Carbamazepine
1221 Carbimazole
1223 Zidovudine [AZT] with lamivudine
1224 Castor oil with resorcinol, salicylic acid and undecylenic alkanolamide
1228 Cefaclor monohydrate
1230 Cefamandole nafate
1231 Cefoxitin sodium
1232 Ceftriaxone
1233 Cefuroxime sodium
1234 Cefalexin monohydrate
1235 Cephalothin sodium
1236 Cefazolin
1237 Cephradine
1238 Imiglucerase
1239 Compound hydroxybenzoate
1240 Propylene glycol
1244 Chlorhexidine gluconate
1247 Acarbose
1248 Interferon beta-1-alpha
1250 Latanoprost
1251 Omeprazole, amoxycillin and clarithromycin
1254 Candesartan cilexetil
1255 Chlorambucil
1257 Chloramphenicol with prednisolone
1258 Chloramphenicol with polymyxin b sulphate
1259 Chloramphenicol
1261 Chloramphenicol sodium succinate
1273 Chlormethiazole edisylate
1275 Calcium carbonate with aminoacetic acid
1276 Calcium carbonate with aminoacetic acid and dimethicone
1280 Chloroquine
1282 Chlorothiazide
1283 Chlorpromazine hydrochloride
1288 Chlortetracycline
1290 Chlortalidone [Chlorthalidone]
1291 Cholestyramine
1292 Choline theophyllinate
1297 Cimetidine
1303 Clindamycin
1306 Clindamycin phosphate
1308 Clobazam
1309 Clobetasol propionate
1310 Clobetasone butyrate
1312 Clofazimine
1313 Clofibrate
1314 Clomiphene citrate
1315 Clomipramine hydrochloride
1316 Clonazepam
1317 Clonidine
1318 Clonidine hydrochloride
1320 Clotrimazole
1324 Coal tar with allantoin, menthol, phenol and sulphur
1332 Codeine phosphate
1341 Colchicine
1345 Colestipol hydrochloride
1346 Colistin sulphomethate
1347 Colistin sulphate with neomycin and hydrocortisone
1357 Copper
1359 Corticotrophin
1360 Cortisone acetate
1361 Co-trimoxazole
1363 Crotamiton
1367 Cyclopenthiazide
1369 Cyclophosphamide
1370 Cyclopentolate hydrochloride
1371 Cytarabine
1372 Danazol
1373 Dantrolene
1374 Dapsone
1375 Dapsone with pyrimethamine
1378 Desferrioxamine mesylate
1379 Desipramine hydrochloride
1381 Dexamethasone with framycetin and gramicidin
1383 Dexamethasone
1385 Dexamethasone phosphate
1389 Dexamphetamine sulphate
1390 Dextromoramide acid tartrate
1391 Dextropropoxyphene
1392 Dextropropoxyphene with paracetamol
1393 Dextrose
1394 Dextrose with electrolytes
1397 Diazepam
1400 Dibromopropamidine isethionate
1401 Diclofenac sodium
1405 Dicyclomine hydrochloride
1407 Dienoestrol
1408 Diethylcarbamazine citrate
1409 Diflucortolone valerate
1410 Diflucortolone valerate with chlorquinaldol
1411 Diflunisal
1412 Digoxin
1418 Dimenhydrinate
1420 Dimethicone
1423 Diphemanil methylsulphate
1424 Diphenoxylate hydrochloride with atropine sulphate
1425 Dipivefrin hydrochloride
1427 Dipyridamole
1428 Disopyramide phosphate
1431 Distigmine bromide
1432 Disulfiram
1436 Domperidone
1437 Dothiepin hydrochloride
1438 Doxepin hydrochloride
1441 Dydrogesterone
1443 Econazole nitrate
1446 Compound electrolytes
1448 Emepronium carrageenate
1453 Ephedrine hydrochloride
1456 Ergometrine maleate
1458 Ergotamine tartrate
1459 Ergotamine tartrate with cyclizine
1460 Ergotamine tartrate with diphenhydramine
1462 Ergotamine tartrate with caffeine
1465 Erythromycin
1466 Erythromycin estolate
1468 Ethambutol
1475 Ethinyloestradiol with norethisterone
1476 Ethinyloestradiol with ethynodiol diacetate
1477 Ethinyloestradiol with desogestrel
1478 Ethinyloestradiol
1479 Ethinyloestradiol with gestodene
1481 Ethosuximide
1484 Ethynodiol diacetate
1487 Etidronate disodium
1492 Ipratropium bromide
1498 Folic acid
1499 Ferrous gluconate
1501 Ferrous sulphate with folic acid
1508 Fibrinolysin
1509 Fish liver oil
1510 Flecainide acetate
1511 Flucloxacillin magnesium
1512 Flucloxacillin
1513 Flucytosine
1515 Fludrocortisone acetate
1516 Flumetasone pivalate
1517 Flunisolide
1518 Fluocinolone acetonide
1521 Fluocortolone caproate with fluocortolone pivalate and cinchocaine
1527 Fluorometholone
1529 Fluorouracil sodium
1532 Flupenthixol decanoate
1533 Fluphenazine decanoate
1535 Fluphenazine hydrochloride
1536 Flurbiprofen
1537 Flutamide
1542 Framycetin sulphate with gramicidin
1544 Furosemide [Frusemide]
1546 Fusidic acid
1549 Gamma benzene hexachloride
1553 Gemfibrozil
1554 Gentamicin sulphate
1567 Glibenclamide
1568 Gliclazide
1569 Glipizide
1570 Glucagon hydrochloride
1572 Glucose oxidase
1574 Glycerol
1575 Glycerol with paraffin and cetyl alcohol
1577 Glyceryl trinitrate
1579 Griseofulvin
1580 Theophylline
1583 Haloperidol
1589 Heparin sodium
1594 Hexamine hippurate
1598 Hexoprenaline sulphate
1600 Homatropine hydrobromide
1603 Hyaluronidase
1604 Hydralazine hydrochloride
1606 Hydrocortisone acetate
1611 Hydrocortisone with miconazole
1612 Hydrocortisone with natamycin and neomycin
1613 Hydrocortisone with wool fat and mineral oil
1614 Hydrocortisone butyrate
1615 Hydrocortisone butyrate with chlorquinaldol
1617 Hydrocortisone
1619 Zinc oxide
1620 Miconazole nitrate
1624 Hydroxocobalamin
1625 Hydroxychloroquine
1626 Hydroxyurea
1629 Hyoscine hydrobromide
1630 Hypromellose with Dextran
1631 Hyoscine N-butylbromide
1632 Hydrocortisone with cinchocaine
1633 Hypromellose
1634 Hydrocortisone with lidocaine [Lignocaine], aluminium and zinc
1639 Idoxuridine
1642 Imipramine hydrochloride
1643 Indapamide
1645 Indomethacin
1648 Insulin neutral
1649 Insulin isophane
1653 Insulin syringes, non-disposable
1655 Insulin zinc suspension
1676 Iron polymaltose
1678 Isoconazole nitrate
1679 Isoniazid
1682 Isoprenaline
1686 Isopropyl myristate with mineral and pine needle oils
1688 Isotretinoin
1696 Ketoconazole
1697 Ketoprofen
1698 Ketotifen
1699 Labetalol
1715 Lidocaine [Lignocaine] with prilocaine
1716 Levobunolol
1717 Levodopa with benserazide
1718 Ethinyloestradiol with levonorgestrel
1719 Lidocaine [Lignocaine] hydrochloride
1720 Lincomycin hydrochloride
1721 Liothyronine
1723 Levodopa with carbidopa
1724 Levonorgestrel
1728 Loperamide hydrochloride
1729 Loprazolam mesylate
1730 Lorazepam
1731 Lormetazepam
1732 Loxapine succinate
1733 Lymecycline
1760 Maprotiline hydrochloride
1762 Mebendazole
1766 Medroxyprogesterone acetate
1769 Mefenamic acid
1772 Megestrol acetate
1773 Melphalan
1780 Meprobamate
1781 Mercaptopurine
1792 Mesterolone
1793 Metaraminol tartrate
1794 Metformin hydrochloride
1795 Methadone hydrochloride
1797 Methotrexate
1799 Levomepromazine maleate
1800 Methoxsalen
1801 Methyclothiazide
1805 Methyldopa with hydrochlorothiazide
1806 Methyldopa
1809 Methylphenidate hydrochloride
1810 Methylprednisolone acetate
1811 Methylprednisolone
1812 Methylprednisolone sodium succinate
1813 Methysergide dimaleate
1814 Metoclopramide hydrochloride
1815 Metoclopramide hydrochloride with paracetamol
1816 Methylprednisolone acetate with lidocaine [Lignocaine]
1817 Metoprolol succinate
1818 Metoprolol tartrate
1820 Metronidazole
1822 Metyrapone
1823 Mexiletine hydrochloride
1824 Mianserin hydrochloride
1825 Miconazole
1826 Spacer device autoclavable
1827 Peak flow meter
1828 Minocycline hydrochloride
1829 Spacer device
1830 Morphine hydrochloride
1831 Morphine sulphate
1832 Mask for spacer device
1835 Mupirocin
1838 Nadolol
1839 Nalidixic acid
1841 Naloxone hydrochloride
1843 Naphazoline hydrochloride
1849 Nefopam hydrochloride
1852 Neomycin sulphate
1853 Neomycin
1854 Neomycin with bacitracin and polymyxin b sulphate
1857 Neostigmine metilsulfate
1859 Niclosamide
1860 Nicotinamide
1861 Nicotinic acid
1862 Nicotinyl alcohol tartrate
1863 Nifedipine
1864 Nimorazole
1865 Nitrazepam
1867 Nitrofurantoin
1871 Norethisterone
1873 Norethisterone with mestranol
1874 Norfloxacin
1875 Ethinyloestradiol with norgestrel
1876 Nortriptyline hydrochloride
1881 Nystatin
1886 Oestradiol
1888 Oestrogens
1903 Orciprenaline sulphate
1906 Ornidazole
1908 Orphenadrine citrate
1909 Orphenadrine hydrochloride
1910 Ortho-tolidine
1911 Oxazepam
1912 Oxprenolol
1914 Oxybutynin
1915 Oxycodone pectinate
1916 Oxymetazoline hydrochloride
1917 Oxymetholone
1922 Oxytocin
1925 Pancreatic enzyme
1927 Papaveretum
1928 Papaverine hydrochloride
1929 Paracetamol
1931 Paracetamol with codeine
1942 Penicillamine
1944 Pentazocine
1949 Perhexiline maleate
1950 Pericyazine
1953 Pethidine hydrochloride
1955 Phenelzine sulphate
1956 Phenobarbitone sodium
1966 Phenoxybenzamine hydrochloride
1970 Phenoxymethylpenicillin (Penicillin V)
1971 Phentolamine mesylate
1972 Phenylephrine hydrochloride
1973 Phenylephrine hydrochloride with zinc sulphate
1978 Phenytoin sodium
1985 Physostigmine salicylate
1986 Phytomenadione
1987 Pilocarpine hydrochloride
1989 Pindolol with clopamide
1990 Pimozide
1991 Pindolol
1993 Piperonyl butoxide
1994 Pipothiazine palmitate
1995 Pirenzepine dihydrochloride
1996 Piroxicam
1998 Pivampicillin
2000 Pizotifen
2004 Polymyxin b sulphate with neomycin and gramicidin
2008 Polynoxylin
2010 Polyvinyl alcohol
2013 Phosphorus
2016 Potassium chloride
2031 Prazosin
2032 Prednisolone acetate
2033 Prednisolone acetate with neomycin and polymyxin b sulphate
2034 Prednisolone sodium phosphate
2035 Prednisolone acetate with phenylephrine and sulphacetamide
2036 Prednisolone
2038 Prednisone
2041 Primidone
2042 Probenecid
2044 Procainamide hydrochloride
2045 Oestrogens with norgestrel
2046 Procaine penicillin
2047 Procarbazine hydrochloride
2049 Procyclidine hydrochloride
2050 Oestrogens with medroxyprogesterone
2052 Progesterone
2053 Oestradiol with levonorgestrel
2054 Promethazine theoclate
2056 Oestradiol with norethisterone
2057 Propamidine isethionate
2058 Acetic acid with 1, 2- propanediol diacetate and benzethonium
2059 Paraldehyde
2060 Propranolol
2062 Propylthiouracil
2063 Protamine sulphate
2066 Pseudoephedrine hydrochloride
2068 Pyrantel embonate
2069 Pyrazinamide
2070 Pyridostigmine bromide
2071 Pyridoxine hydrochloride
2073 Pyrimethamine with sulphadoxine
2077 Quinidine bisulphate
2078 Quinidine sulphate
2079 Quinine sulphate
2080 Ranitidine
2087 Riboflavine
2088 Rifampicin
2090 Rolitetracycline
2096 Salbutamol
2114 Silver sulphadiazine
2125 Sodium alginate
2126 Sodium aurothiomalate
2128 Sodium bicarbonate
2132 Sodium calcium edetate
2133 Sodium carboxymethylcellulose
2135 Sodium chloride
2140 Sodium citrate with sodium lauryl sulphoacetate
2142 Sodium citro-tartrate
2144 Sodium cromoglycate
2149 Sodium fluoride
2158 Sodium nitroprusside
2160 Sodium polystyrene sulphonate
2164 Sodium tetradecyl sulphate
2166 Sodium valproate
2169 Sotalol
2171 Spectinomycin hydrochloride
2173 Spiramycin
2176 Spironolactone
2183 Stilboestrol
2188 Streptodornase
2191 Sucralfate
2193 Sulindac
2194 Sulphacetamide sodium
2205 Sulphasalazine
2206 Sulphinpyrazone
2212 Sulthiame
2213 Sunscreens, proprietary
2218 Tamoxifen citrate
2220 Tar with triethanolamine lauryl sulphate and fluorescein
2221 Tar with cade oil
2224 Temazepam
2237 Tetrabenazine
2238 Tetrabromophenol
2239 Tetracosactrin
2241 Tetracycline hydrochloride
2250 Thiamine hydrochloride
2252 Thioguanine
2255 Thioridazine hydrochloride
2257 Thiotepa
2260 Thiothixene
2262 Thymol glycerin
2263 Levothyroxine
2266 Timolol
2268 Timolol maleate with pilocarpine
2269 Tinidazole
2270 Tioconazole
2274 Tobramycin
2275 Tocainide hydrochloride
2277 Tolbutamide
2285 Tranylcypromine sulphate
2286 Tretinoin
2291 Triamcinolone hexacetonide
2293 Triamterene with hydrochlorothiazide
2295 Triazolam
2298 Trifluoperazine hydrochloride
2300 Trimethoprim
2301 Trimipramine maleate
2302 Trioxsalen
2304 Tripotassium dicitratobismuthate
2305 Tropicamide
2310 Tyloxapol
2312 Urea
2314 Vancomycin hydrochloride
2316 Vasopressin
2317 Verapamil hydrochloride
2318 Vidarabine
2319 Vinblastine sulphate
2320 Vincristine sulphate
2321 Vitamin A acetate
2322 Vitamin A with vitamins D and C
2328 Vitamin B complex
2330 Vitamins
2331 Warfarin sodium
2332 Water
2339 Wool fat with mineral oil
2340 Xylometazoline hydrochloride
2354 Zinc sulphate
2362 Acipimox
2363 Acitretin
2364 Baclofen
2367 Calcium carbimide
2373 Famotidine
2374 Fenoterol hydrobromide
2375 Fenoterol hydrobromide with ipratropium bromide
2377 Isosorbide dinitrate
2381 Mebeverine hydrochloride
2383 Morphine tartrate
2384 Olsalazine
2385 Povidone iodine
2387 Triamcinolone acetonide with gramicidin, neomycin and nystatin
2388 Tolciclate
2389 Triamcinolone acetonide
2390 Triamcinolone acetonide with lidocaine [Lignocaine] and nystatin
2394 Ciclopirox olamine
2398 Felodipine
2404 Terbutaline sulphate
2413 Alpha tocopheryl acetate
2414 Charcoal
2419 Chenodeoxycholic acid
Trial Version
Code ChemicalCode Name Units ATCCode Weight
100101 1001 Tab 400 mgtab 71601 400
100102 1001 Cap 100 mgcap 71601 100
100103 1001 Cap 200 mgcap 71601 200
100201 1002 Tab 25 mg tab 220703 25
100202 1002 Tab 50 mg tab 220703 50
100203 1002 Tab 100 mgtab 220703 100
100225 1002 Tab dispersible 5 mg tab 220702 5
100301 1003 Tab 250 mgtab 310306 250
100302 1003 Sodium inj 500 mg inj 310306 500
100401 1004 Tab 500 mgtab 220702 500
100501 1005 Tab 200 mg with hydrochlorothiazide 12.5 mg tab 71901 200
100601 1006 Jelly with glacial acetic acid 0.94%, hydroxyquinoline sulphate 0.025%, glycerol 5% and ricinoleic acid 0.75% with applicator g 131001
100901 1009 Inj 3.75 mginj 141603 3.75
100902 1009 Inj 11.25 mginj 141603 11.25
100925 1009 Inj 7.5 mg inj 141603 7.5
100926 1009 Inj 22.5 mginj 141603 22.5
100927 1009 Inj 30 mg inj 141603 30
100928 1009 Inj 45 mg inj 141603 45
100929 1009 Inj 3.75 mg prefilled syringe inj 141603 3.75
100930 1009 Inj 11.25 mg prefilled syringe inj 141603 11.25
100931 1009 Inj 30 mg prefilled syringe inj 141603 30
101001 1010 Nebuliser soln, 2.5 mg per 2.5 ml ampoule amp 284902 2.5
101101 1011 Tab 1 mg tab 222201 1
101102 1011 Tab 2 mg tab 222201 2
101103 1011 Tab 3 mg tab 222201 3
101104 1011 Tab 4 mg tab 222201 4
101105 1011 Oral liq 1 mg per ml ml 222201 1
101125 1011 Tab 0.5 mgtab 222201 0.5
101126 1011 Inj 25 mg vial inj 222204 25
101127 1011 Inj 37.5 vialinj 222204 37
101128 1011 Inj 50 mg vial inj 222204 50
101129 1011 Tab orodispersible 0.5 mg tab 222201
101130 1011 Tab orodispersible 1 mg tab 222201 1
101201 1012 Tab 2.5 mgtab 71501 2.5
101202 1012 Tab 5 mg tab 71501 5
101303 1013 Inj 10 mg per ml 1 ml inj 70101 10
101501 1015 Inj 1 in 1,000, 1 ml ampoule inj 73701
101502 1015 Inj 1 in 10,000, 10 ml ampoule inj 73701
101503 1015 Aerosol inhaler dose 280101
101601 1016 Eye drops 0.5% ml 310309
101602 1016 Eye drops 1% ml 310309
101701 1017 Eye drops 1% ml 310309
101903 1019 Crm 0.05%g 101101
101904 1019 Oint 0.05%g 101101
102001 1020 Cap 0.25 mcg cap 13710 0.25
102002 1020 Cap 1 mcg cap 13710 1
102003 1020 Oral drops 2 mcg per ml ml 13710
102101 1021 Tab 500 mg with magnesium trisil 25 mg, aluminium hydroxide gel, dried 100 mg, and sodium bicarbonate 170 mg -- peppermint flavour tab 10102 500
102102 1021 Powder 1 g with magnesium trisil 50 mg, aluminium hydroxide gel, dried, 200 mg and sodium bicarbonate 340 mg per 2 g g 10102 25
102103 1021 Sodium alginate 225 mg and magnesium alginate 87.5 mg per sachet sach 10102 225
102201 1022 Cap 30 mg cap 11010 30
102225 1022 Cap 15 mg cap 11010 15
102301 1023 Tab. 1.3 g dried milk with glucose and dextrins, 130 mg magnesium trisilicate, 100 mg magnesium hydroxide, 65 mg magnesium carbonate, 65 mg calcium carbonate tab 10102 130
102401 1024 Inj 10 mg per ml, 1 ml inj 220101 10
102425 1024 Inj 10 mg per ml, 2 ml inj 220101
102501 1025 Aerosol inhaler, 2 mg per dose dose 284001 2
102502 1025 Aerosol inhaler, 2 mg per dose CFC-free dose 284001 2
102601 1026 Tab 100 mgtab 191301 100
102602 1026 Tab 300 mgtab 191301 300
102702 1027 Eye drops 1.4% with povidone 0.6% ml 310313
102901 1029 Tab long-acting 260 mg tab 71601 260
103101 1031 Cap 0.5 mgcap 70701 0.5
103102 1031 Cap 1 mg cap 70701 1
103103 1031 Cap 2 mg cap 70701 2
103201 1032 Tab 0.25 mg tab 220101 0.25
103202 1032 Tab 1 mg tab 220101 1
103301 1033 Metered aqueous nasal spray 0.02% with naphazoline nitrate 0.02% dose 285102
103401 1034 Cap 250 mgcap 250701 250
103426 1034 Tab 500 mgtab 250701 500
103427 1034 Powder for oral liq 1 g per 5 ml ml 250701
103601 1036 Soln 20% ml 103104
103602 1036 powder g 380101
103701 1037 Tab 10 mg tab 190802 10
103702 1037 Tab 40 mg tab 190804 40
103725 1037 Tab 70 mg tab 190802 70
103802 1038 Gel ml 10102
103804 1038 Tab 600 mgtab 10104 600
103901 1039 Gel ml 10102
104001 1040 Tab aluminium hydroxide 200 mg with magnesium hydroxide 200 mg and activated simethicone 20 mg tab 10102 200
104002 1040 Oral liq aluminium hydroxide 200 mg with magnesium hydroxide 200 mg and activated simethicone 20 mg per 5 ml ml 10102 200
104003 1040 Oral liq aluminium hydroxide 215 mg with magnesium hydroxide 80 mg and activated simethicone 25 mg per 5 ml ml 10102 215
104101 1041 Tab aluminium hydroxide 250 mg with magnesium trisil 120 mg, magnesium hydroxide 120 mg and polysiloxane 10 mg tab 10102 250
104301 1043 Tab 500 mgtab 161907 500
104801 1048 Cap 100 mgcap 220101 100
105001 1050 Tab 5 mg tab 73104 5
105004 1050 Oral liq 1 mg per ml ml 73104
105101 1051 Tab 5 mg with furosemide 40 mg tab 73107 5
105301 1053 Tab 5 mg with hydrochlorothiazide 50 mg tab 73107 5
105401 1054 Tab 500 mgtab 40401 500
105501 1055 Tab 250 mgtab 250401 250
105701 1057 Tab 100 mgtab 71301 100
105702 1057 Tab 200 mgtab 71301 200
105703 1057 Inj 50 mg per ml, 3 ml ampoule inj 71301 150
105901 1059 Tab 10 mg tab 220501 10
105902 1059 Tab 25 mg tab 220501 25
105903 1059 Tab 50 mg tab 220501 50
105904 1059 Cap 75 mg cap 220501 75
105905 1059 Oral liq 10 mg per 5 ml ml 220501 2
106001 1060 Cap 300 mgcap 220702 300
106002 1060 Cap 400 mgcap 220702 400
106025 1060 Cap 100 mgcap 220702 100
106026 1060 Tab 600 mgtab 220702
106101 1061 Tab 50 mg tab 70703 50
106102 1061 Tab 12.5 mg tab 70703 12.5
106125 1061 Tab 100 mgtab 70703 100
106126 1061 Tab 25 mg tab 70703 25
106201 1062 Cap 300 mgcap 220702 300
106202 1062 Cap 400 mgcap 220702 400
106225 1062 Cap 100 mgcap 220702 100
106301 1063 Cap 20 mg cap 73204 20
106302 1063 Cap 40 mg cap 73204 40
106401 1064 Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin b sulphate 6,000 u per ml ml 310304
106402 1064 Eye oint 0.1% with neomycin sulphate 0.35% and polymyxin b sulphate 6,000 u per g g 310304
106501 1065 Aerosol inhaler, 25 mcg per dose dose 281001 25
106505 1065 Powder for inhalation, 50 mcg per dose, 4 doses per disk disk 281001
106509 1065 Aerosol inhaler, 125 mcg per dose CFC-free dose 281001 125
106511 1065 Powder for inhalation, 50 mcg per dose dose 281001 50
106602 1066 Powder for inhalation, 50 ug per dose, 4 doses per disk disk 282402
106603 1066 Powder for inhalation, 50 mcg per dose, breath activated dose 282402 50
106625 1066 Aerosol inhaler CFC-free, 25 mcg per dose dose 282402
106701 1067 Eye oint 0.2% with sulphacetamide sodium 10% g 310304
106901 1069 Tab 25 mg tab 220501 25
106902 1069 Tab 50 mg tab 220501 50
106903 1069 Tab 100 mgtab 220501 100
107001 1070 Tab amoxicillin 500 mg with potassium clavulanate 125 mg tab 160307 500
107002 1070 Grans for oral liq amoxicillin 125 mg with potassium clavulanate 31.25 mg per 5 ml ml 160307
107003 1070 Grans for oral liq amoxicillin 250 mg with potassium clavulanate 62.5 mg per 5 ml ml 160307
107201 1072 Tab chewable 250 mg tab 160307 250
107202 1072 Cap 250 mgcap 160307 250
107203 1072 Cap 500 mgcap 160307 500
107204 1072 Drops 125 mg per 1.25 ml ml 160307 100
107205 1072 Grans for oral liq 125 mg per 5 ml ml 160307
107207 1072 Sachets 3 gsach 160307
107208 1072 Inj 1 g inj 160307 1000
107209 1072 Inj 500 mg inj 160307 500
107210 1072 Inj 250 mg inj 160307 250
107401 1074 Lozenges 10 mg tab 13107 10
107601 1076 Eye drops 2% ml 310306
107701 1077 Cap 200 mgcap 162005 200
107725 1077 Tab 500 mgtab 162005 500
107801 1078 Tab 25 mg tab 222201 25
107802 1078 Tab 100 mgtab 222201 100
107825 1078 Tab 50 mg tab 222201 50
107826 1078 Tab 200 mgtab 222201 200
107827 1078 Suspension 50 mg per ml ml 222201 100
108001 1080 Inj 500 mg inj 222801 500
108102 1081 Tab 250 mgtab 160301 250
108201 1082 Crm 0.1% g 101101
108202 1082 Oint 0.1% g 101101
108301 1083 Powder for inhalation, 12 mcg per dose, and monodose device dose 282402 12
108401 1084 Tab 100 mgtab 13707 100
108402 1084 Tab 50 mg tab 13707 50
108403 1084 Powder g 380101
108425 1084 Tab 250 mgtab 13707 250
108501 1085 Inj 10,000 mcg per ml 50 ml inj 40401 10000
108601 1086 Cap 100 mgcap 162005 100
108625 1086 Tab 100 mgtab 162005 100
108702 1087 Tab 300 mgtab 220404 300
108705 1087 Tab EC 300 mg tab 220404 300
108706 1087 Tab EC 650 mg tab 220404 650
108707 1087 Tab SR 650 mg tab 220404 650
108725 1087 Tab 100 mgtab 40701
108801 1088 Cap 1 mg cap 250706 1
108802 1088 Cap 5 mg cap 250706 5
108825 1088 Cap 0.5 mgcap 250706 0.5
109201 1092 Tab aspirin 250 mg with paracetamol 250 mg and codeine phosphate 8 mg tab 220405 250
109401 1094 Tab 50 mg tab 71601 50
109402 1094 Tab 100 mgtab 71601 100
109403 1094 Inj 0.5 mg per ml, 10 ml inj 71601 5
109425 1094 Oral liq 25 mg per 5 ml ml 71601
109501 1095 Tab 100 mg with chlorthalidone 25 mg tab 71901 100
109502 1095 Tab 50 mg with chlorthalidone 12.5 mg tab 71901 50
109701 1097 Tab 600 mcg tab 71301 600
109702 1097 Inj 400 mcg, 1 ml inj 71301 400
109703 1097 Inj 600 mcg per ml, 1 ml ampoule inj 71301 600
109704 1097 Inj 1200 mcg, 1 ml inj 71301 1200
109705 1097 Eye drops 0.5% ml 310310
109706 1097 Eye drops 1% ml 310310
109801 1098 Tab EC 40 mg tab 11010 40
109802 1098 Tab EC 20 mg tab 11010 20
109825 1098 Inj 40 mg inj 11010
109901 1099 Tab 3 mg tab 190701 3
110001 1100 Tab 50 mg tab 250701 50
110002 1100 Inj 50 mg inj 250701 50
110101 1101 Liq 0.5% ml 101701
110125 1101 Shampoo 1% ml 101701
110126 1101 Crm shampoo 1% g 101701
110201 1102 Cap 200 mgcap 162005 200
110202 1102 Cap 400 mgcap 162005 400
110301 1103 Eye drops 0.1% ml 310304
110501 1105 Applicator dev 130105
110701 1107 Cap 5 mg cap 221601 5
110804 1108 Aerosol inhaler, 50 mcg per dose, breath activated dose 281001 50
110807 1108 Powder for inhalation, 100 mcg per dose, 8 doses per disk disk 281001 100
110811 1108 Metered aerosol nasal spray 50 mcg per dose dose 285102
110812 1108 Metered aerosol nasal spray 100 mcg per dose dose 285102
110813 1108 Metered aqueous nasal spray, 50 mcg per dose dose 285102 50
110815 1108 Aerosol inhaler with spacer, 100 mcg per dose dose 281001 100
110816 1108 Aerosol inhaler with spacer, 250 mcg per dose dose 281001 250
110901 1109 Cap 15 mg cap 162003 15
110902 1109 Cap 20 mg cap 162003 20
110903 1109 Cap 30 mg cap 162003 30
110904 1109 Cap 40 mg cap 162003 40
110905 1109 Powder for oral soln 1 mg per ml ml 162003
111001 1110 29 g x 12.7 mm dev 11509
111002 1110 31 g x 8 mmdev 11509
111025 1110 31 g x 5 mmdev 11509
111026 1110 31 g x 6 mmdev 11509
111027 1110 32 g x 4 mmdev 11509
111201 1112 Extract of inhaled allergens txpk 280101
111601 1116 Tab 2.5 mgtab 73110 2.5
111602 1116 Tab 5 mg tab 73110 5
112001 1120 Inj 600,000 u inj 160307 600000
112002 1120 Inj 1.2 mega u per 2.3 ml inj 160307 1200000
112025 1120 Injection 1.2 mega u inj 160307
112201 1122 Bismuth subcitrate tab 120 mg x 56, metronidazole tab 400 mg x 42 and tetracycline cap 250 mg x 112 txpk 11002 120
112401 1124 Cap 250 mgcap 160307 250
112402 1124 Cap 500 mgcap 160307 500
112403 1124 Grans for oral liq 62.5 mg per 5 ml ml 160307 12.5
112404 1124 Grans for oral liq 125 mg per 5 ml ml 160307 25
112405 1124 Inj 500 mg inj 160307 500
112406 1124 Inj 1 g inj 160307 1000
112501 1125 Tab 100 mgtab 220507 100
112502 1125 Tab 200 mgtab 220507 200
112601 1126 Cap 300 mgcap 12201 300
112625 1126 Cap 250 mgcaps 12201
112801 1128 Lotn 10% ml 100101
112802 1128 Lotn 5% ml 100101
112803 1128 Gel 10% g 100101
112804 1128 Gel 2.5% g 100101
112805 1128 Gel 5% g 100101
113001 1130 Tab 2 mg tab 220104 2
113201 1132 Soln 0.15%ml 13101
113301 1133 Tab 25 mg tab 220702 25
113302 1133 Tab 50 mg tab 220702 50
113303 1133 Tab 100 mgtab 220702 100
113304 1133 Tab 200 mgtab 220702 200
113325 1133 Sprinkle cap 15 mg cap 220702
113326 1133 Sprinkle cap 25 mg cap 220702
113601 1136 Inj 600 mg (1 million units) vial inj 160307 600
113701 1137 Tab 10 mg tab 73204 10
113702 1137 Tab 20 mg tab 73204 20
113703 1137 Tab 40 mg tab 73204 40
113725 1137 Tab 80 mg tab 73204 80
113801 1138 Tab 100 mgtab 220101 100
114001 1140 Tab 5 mg tab 222201 5
114002 1140 Tab 10 mg tab 222201 10
114003 1140 Tab 2.5 mgtab 222201 2.5
114015 1140 Inj 210 mg vial inj 222204 210
114016 1140 Inj 300 mg vial inj 222204 300
114017 1140 Inj 405 mg vial inj 222204 405
114101 1141 Ear/Eye drops 0.1% with neomycin sulphate 0.5% ml 310201
114310 1143 Scalp lotn 0.05% ml 102201
114311 1143 Scalp lotn propylene glycol base 0.05% ml 102201
114312 1143 Crm 0.05%g 101101
114313 1143 Oint 0.05%g 101101
114314 1143 Crm 0.05% in propylene glycol base g 101101
114315 1143 Oint 0.05% in propylene glycol base g 101101
114401 1144 Tab 500 mcg tab 140701 500
114407 1144 Ear/Eye drops 0.1% ml 310201
114501 1145 Crm 0.05% with clotrimazole 1% g 101104
114602 1146 Crm 0.1% with clioquinol 3% g 101104
114603 1146 Oint 0.1% with clioquinol 3% g 101104
114725 1147 Crm 0.05% with gentamicin sulphate 0.1% g 101104
114801 1148 Crm 0.1% with fusidic acid 2% g 101104
114901 1149 Eye drops 0.25% ml 310305
114902 1149 Eye drops 0.5% ml 310305
115001 1150 Lotn 0.05% with salicylic acid 2% ml 101104
115002 1150 Oint 0.05% with salicylic acid 3% g 101104
115101 1151 Tab 200 mgtab 73201 200
115601 1156 Tab 1 mg tab 141104 1
115602 1156 Tab 2 mg tab 141104 2
115801 1158 Tab 1 mg tab 250404 1
115901 1159 Tab 300 mg with frangula bark 25 mg, magnesium carbonate 400 mg and sodium bicarbonate 200 mg tab 11013 300
115902 1159 Bismuth subnitrate g 380101
116601 1166 Tab 1.5 mgtab 222501
116602 1166 Tab 3 mg tab 222501
116701 1167 Tab 2.5 mgtab 220101 2.5
116703 1167 Tab 10 mg tab 220101 10
116704 1167 Cap 10 mg cap 220101 10
116725 1167 Cap 5 mg cap 220101 5
116805 1168 Nebuliser soln, 500 mcg per ml, 2 ml neb 281001 1000
116809 1168 Cap 3 mg cap 10404 3
117001 1170 Tab 200 mgtab 162001 200
117025 1170 Oral suspension 10 mg per ml ml 162001 10
117101 1171 Tab 1 mg tab 73101 1
117102 1171 Inj 500 mcg per ml, 4 ml vial inj 73101 2000
117201 1172 Tab 250 mgtab 162005 250
117202 1172 Powder 50 mg per g g 162005 50
117301 1173 Tab 2 mg tab 250101 2
117401 1174 Treatment kit (Yellow jacket venom) - 1 vial 550 mcg freeze dried vespula venom, 1 diluent 9 ml, 1 diluent 1.8 ml txpk 280101
117402 1174 Treatment kit (Paper wasp venom) - 1 vial 550 mcg freeze dried polister venom, 1 diluent 9 ml, 1 diluent 1.8 ml txpk 280101
117701 1177 Omeprazole cap 40 mg x 7, amoxycillin cap 500 mg x 21, metronidazole tab 400 mg x 21 txpk 11002 40
117801 1178 Tab 500 mgtab 160304 500
117826 1178 Tab 250 mgtab 160304 250
117901 1179 Crm, aqueous, BP g 100801
117902 1179 Lotn, BP ml 100801
117903 1179 Lotn, oily BPml 100801
117904 1179 Calamine g 380101
118101 1181 Tab 2.5 mgtab 250404 2.5
118301 1183 Tab 25 mg tab 222201 25
118302 1183 Tab 100 mgtab 222201 100
118303 1183 Tab 200 mgtab 222201 200
118304 1183 Tab 150 mgtab 222201 150
118325 1183 Tab 300 mgtab 222201 300
118501 1185 purified ml 380101
118701 1187 Tab 1.25 mg (50,000 iu) tab 13710 50000
118802 1188 Inj 100 iu per ml, 1 ml inj 140404 100
118803 1188 Inj 160 iu per ml, 2 ml inj 190806 320
118804 1188 Inj 400 iu per 2 ml, 2 ml inj 190806 400
118901 1189 Cap 0.25 mcg cap 13710 0.25
118902 1189 Cap 0.5 mcg cap 13710 0.5
118903 1189 Oral liq 1 mcg per ml ml 13710 1
119102 1191 Tab 1.25 g (500 mg elemental) tab 13810 1250
119103 1191 Tab 1.5 g (600 mg elemental) tab 13810 1500
119104 1191 powder g 380101
119125 1191 Tab dispersible 2.5 g tab 13810 2500
119126 1191 Tab eff 1.75 g (1 g elemental) tab 13810 1000
119127 1191 Oral liq 1,250 mg per 5 ml (500 mg elemental per 5 ml) ml 10104 1250
119201 1192 Inj 100 u per ml, 3 ml inj 11309 300
119202 1192 Inj 100 u per ml, 10 ml ml 11309
119301 1193 Tab 20 mg tab 220507 20
119401 1194 Cap 60 mg cap 280401 60
119402 1194 Tab 120 mgtab 280401 120
119403 1194 Tab 60 mg tab 280401 60
119501 1195 Tab 16 mg tab 221601 16
119502 1195 Tab 4 mg tab 221601 4
119701 1197 Inj 10%, 10 ml inj 13810 10
119801 1198 Tab 15 mg tab 250104 15
119803 1198 Inj 15 mg inj 250104 15
119804 1198 Inj 50 mg inj 250104 50
119825 1198 Inj 300 mg inj 250104 300
119826 1198 Inj 1 mg for ECP mg 250104 1
119827 1198 Inj 100 mg inj 250104 100
119828 1198 Inj 1 g inj 250104 1000
119901 1199 Inj 10%, 10 ml inj 13810 10
120501 1205 Powder g 41004
120901 1209 Inj 1 g inj 161601
121601 1216 Eye drops 1.5% ml 310309
121602 1216 Eye drops 3% ml 310309
121704 1217 Tab 200 mgtab 220702 200
121706 1217 Tab 400 mgtab 220702 400
122101 1221 Tab 5 mg tab 141401 5
122301 1223 Tab 300 mg with lamivudine 150 mg tab 162003 300
122401 1224 Soln 2.5% with resorcinol 0.5%, salicylic acid 1.5% and undecylenic alkanolamide 0.25% ml 102201
122801 1228 Cap 250 mgcap 160301 250
123001 1230 Inj 500 mg inj 160301 500
123002 1230 Inj 1 g inj 160301 1000
123101 1231 Inj 1 g inj 160301 1000
123201 1232 Inj 250 mg inj 160301 250
123202 1232 Inj 500 mg vial inj 160301 500
123203 1232 Inj 1 g vial inj 160301 1000
123301 1233 Inj 250 mg inj 160301 250
123302 1233 Inj 750 mg inj 160301 750
123303 1233 Inj 1.5 g inj 160301 1500
123401 1234 Tab 500 mgtab 160301 500
123402 1234 Cap 250 mgcap 160301 250
123425 1234 Cap 500 mgcap 160301 500
123501 1235 Inj 1 g inj 160301 1000
123601 1236 Inj 500 mg vial inj 160301 500
123602 1236 Inj 1 g vial inj 160301 1000
123701 1237 Cap 250 mgcap 160301 250
123702 1237 Cap 500 mgcap 160301 500
123703 1237 Inj 500 mg inj 160301 500
123704 1237 Inj 1 g inj 160301 1000
123801 1238 Inj 40 iu per ml, 200 iu vial inj 12802 200
123825 1238 Inj 40 iu per ml, 400 iu vial inj 12802 400
123901 1239 Soln ml 380101
124001 1240 Liq ml 380101
124401 1244 Obstetric crm 1% ml 101301
124402 1244 Soln 4% ml 101301
124403 1244 Soln 5% ml 101301
124404 1244 Soln 20% ml 101301
124406 1244 Handrub 0.5% with ethanol 70% ml 101301
124425 1244 Handrub 1% with ethanol 70% ml 101301
124426 1244 Mouthwash 0.2% ml 13101 0.2
124701 1247 Tab 50 mg tab 11311 50
124702 1247 Tab 100 mgtab 11311 100
124801 1248 Inj 6 million iu per vial inj 222601 6000000
124825 1248 Inj 6 million iu prefilled syringe inj 222601
124826 1248 Injection 6 million iu per 0.5 ml pen injector inj 222601
125001 1250 Eye drops 50 mcg per ml, 2.5 ml ml 310308
125101 1251 Omeprazole cap 20 mg x 14, amoxycillin cap 500 mg x 28 and clarithromycin tab 500 mg x 14 txpk 11002 20
125401 1254 Tab 4 mg tab 70703 4
125402 1254 Tab 8 mg tab 70703 8
125403 1254 Tab 16 mg tab 70703 16
125425 1254 Tab 32 mg tab 70703 32
125501 1255 Tab 2 mg tab 250101 2
125502 1255 Tab 5 mg tab 250101 5
125701 1257 Eye oint 1% with prednisolone 0.5% g 310301
125801 1258 Eye drops 0.5% with polymyxin B sulphate 5,000 u per ml ml 310301
125802 1258 Eye oint 1% with polymyxin B sulphate 5,000 u per g g 310301
125803 1258 Ear drops 0.5% with polymyxin B sulphate 5000 u per ml ml 310101
125901 1259 Eye drops 0.5% ml 310301
125902 1259 Ear drops 0.5% ml 310101
125904 1259 Eye oint 1%g 310301
125906 1259 Cap 250 mgcap 160313 250
125907 1259 Oral liq palmitate 125 mg per 5 ml ml 160313
126101 1261 Inj 1.2 g inj 160313
127301 1273 Cap 192 mgcap 222801 192
127303 1273 Infusion 0.8% 500 ml ml 222801
127501 1275 Tab 420 mg with aminoacetic acid 180 mg tab 10102 420
127601 1276 Tab 420 mg with aminoacetic acid 180 mg and dimethicone 21 mg tab 10102 420
128001 1280 Tab 200 mgtab 161001 200
128002 1280 Tab 250 mgtab 161001 250
128201 1282 Tab 500 mgtab 73110 500
128301 1283 Tab 10 mg tab 222201 10
128302 1283 Tab 25 mg tab 222201 25
128303 1283 Tab 50 mg tab 222201 50
128304 1283 Tab 100 mgtab 222201 100
128801 1288 Oint 3% g 100401
129001 1290 Tab 25 mg tab 73110 25
129101 1291 Powder for oral liq 4 g sach 73203
129201 1292 Oral liq 50 mg with guaiphenesin 25 mg per 5 ml ml 284502 10
129701 1297 Tab 200 mgtab 11003 200
129702 1297 Tab 400 mgtab 11003 400
129703 1297 Tab 800 mgtab 11003 800
130301 1303 Cap hydrochloride 150 mg cap 160313 150
130302 1303 Grans palmitate hydrochloride for oral liq 75 mg per 5 ml ml 160313 15
130303 1303 Inj phosphate 150 mg per ml, 4 ml inj 160313 150
130601 1306 Soln 1% ml 100101
130603 1306 Lotn 1% ml 100101
130801 1308 Tab 10 mg tab 220702 10
130902 1309 Scalp app 0.05% ml 102201
130903 1309 Crm 0.05%g 101101
130904 1309 Oint 0.05%g 101101
131002 1310 Crm 0.05%g 101101
131003 1310 Oint 0.05%g 101101
131201 1312 Cap 50 mg cap 161601 50
131301 1313 Cap 500 mgcap 73202 500
131401 1314 Tab 50 mg tab 142101 50
131501 1315 Tab 10 mg tab 220501 10
131502 1315 Tab 25 mg tab 220501 25
131601 1316 Tab 500 mcg tab 222501 0.5
131602 1316 Tab 2 mg tab 222501 2
131603 1316 Oral drops 2.5 mg per ml ml 220702 2
131702 1317 Patch 2.5 mg, 100 mcg per day patch 72801 2.5
131703 1317 Patch 5 mg, 200 mcg per day patch 72801 5
131704 1317 Patch 7.5 mg, 300 mcg per day patch 72801 7.5
131801 1318 Tab 150 mcg tab 72801 150
131808 1318 Tab 25 mcgtab 72801 25
132001 1320 Pessaries 100 mg with applicator pess 131001
132003 1320 Vaginal crm 1% with applicators g 131001
132004 1320 Vaginal crm 2% with applicators g 131001
132006 1320 Soln 1% ml 100701
132007 1320 Crm 1% g 100701
132401 1324 Soln 5% with sulphur 0.5%, menthol 0.75%, phenol 0.5% and allantoin crm 2.5% g 101901
133201 1332 Tab 15 mg tab 220407 15
133202 1332 Tab 30 mg tab 220407 30
133203 1332 Tab 60 mg tab 220407 60
133204 1332 Syrup 25 mg per 5 ml ml 284702 5
133205 1332 Powder g 380101
133206 1332 Linctus BP ml 284702
134101 1341 Tab 600 mcg tab 191301 600
134125 1341 Tab 500 mcg tab 191301
134501 1345 Grans for oral liq 5 g sach 73203
134601 1346 Inj 150 mg inj 160313 150
134701 1347 Ear drops 3 mg with neomycin sulphate 3.3 mg and hydrocortisone acetate 10 mg per ml ml 310101
135701 1357 Tab, diagnostic tab 11501
135901 1359 Inj in 16 gelatin 40 iu per ml, 5 ml inj 140701 200
136001 1360 Tab 5 mg tab 140701 5
136002 1360 Tab 25 mg tab 140701 25
136101 1361 Oral liq trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml ml 160313
136102 1361 Tab trimethoprim 80 mg and sulphamethoxazole 400 mg tab 160313 80
136103 1361 Tab trimethoprim 160 mg and sulphamethoxazole 800 mg tab 160313 160
136104 1361 Oral liq sugar-free trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml ml 160313
136301 1363 Crm 10% g 100801
136302 1363 Lotn 10% ml 100801
136701 1367 Tab 0.5 mgtab 73110 0.5
136901 1369 Tab 50 mg tab 250101 50
136902 1369 Inj 1 g inj 250101 1000
136903 1369 Inj 200 mg inj 250101 200
136904 1369 Inj 500 mg inj 250101 500
136925 1369 Inj 2 g inj 250101 2000
136926 1369 Inj 1 mg for ECP mg 250101 1
137001 1370 Eye drops 1% ml 310310
137101 1371 Inj 20 mg per ml, 5 ml vial inj 250104 100
137103 1371 Inj 500 mg inj 250104 500
137126 1371 Inj 1 mg for ECP mg 250104 1
137127 1371 Inj 100 mg intrathecal syringe for ECP mg 250104 100
137201 1372 Cap 100 mgcap 142101 100
137202 1372 Cap 200 mgcap 142101 200
137301 1373 Cap 25 mg cap 191601 25
137302 1373 Cap 50 mg cap 191601 50
137401 1374 Tab 100 mgtab 161601 100
137425 1374 Tab 25 mg tab 161601 25
137501 1375 Tab 100 mg with pyrimethamine 12.5 mg tab 161001 100
137801 1378 Inj 500 mg inj 350408 500
137901 1379 Tab 25 mg tab 220501 25
138101 1381 Ear/Eye drops 500 mcg with framycetin sulphate 5 mg and gramicidin 50 mcg per ml ml 310201
138102 1381 Ear/Eye oint 500 mcg with framycetin sulphate 5 mg and gramicidin 50 mcg per g g 310201
138301 1383 Tab 1 mg tab 140701 1
138302 1383 Tab 4 mg tab 140701 4
138303 1383 Eye drops 0.1% ml 310304
138306 1383 Eye oint 0.1% g 310304
138901 1389 Tab 5 mg tab 223101 5
139001 1390 Tab 5 mg tab 220407 5
139101 1391 Cap napsylate 100 mg cap 220407 100
139201 1392 Cap hydrochloride 32.5 mg with paracetamol 325 mg cap 220407 32.5
139202 1392 Tab napsylate 50 mg with paracetamol 325 mg tab 220407 50
139301 1393 Inj 50%, 10 ml inj 41001 10
139302 1393 Dextrose g 380101
139325 1393 Inj 50%, 90 ml inj 41001 90
139401 1394 Soln with electrolytes ml 41004
139701 1397 Tab 2 mg tab 222501 2
139702 1397 Tab 5 mg tab 222501 5
139703 1397 Tab 10 mg tab 222501 10
139704 1397 Rectal tubes 5 mg tube 220701 5
139705 1397 Rectal tubes 10 mg tube 220701 10
140001 1400 Eye oint 0.15% g 310301
140101 1401 Tab EC 25 mg tab 190401 25
140102 1401 Tab EC 50 mg tab 190401 50
140106 1401 Suppos 12.5 mg supp 190401 12.5
140107 1401 Suppos 25 mg supp 190401 25
140108 1401 Suppos 50 mg supp 190401 50
140109 1401 Suppos 100 mg supp 190401 100
140110 1401 Eye drops 0.1% ml 310304
140111 1401 Tab 50 mg dispersible tab 190401 50
140113 1401 Cap long-acting 100 mg cap 190401 100
140501 1405 Tab 10 mg tab 71301 10
140701 1407 Crm 100 mcg per g with applicator g 131402
140801 1408 Tab 50 mg tab 160101 50
140903 1409 Oint 0.1% g 101101
140904 1409 Crm 0.1% g 101101
140905 1409 Fatty oint 0.1% g 101101
141001 1410 Crm 0.1% with chlorquinaldol 1% g 101104
141101 1411 Tab 250 mgtab 190401 250
141102 1411 Tab 500 mgtab 190401 500
141201 1412 Tab 62.5 mcg tab 71301
141202 1412 Tab 250 mcg tab 71301 250
141204 1412 Inj 25 mcg per ml, 2 ml inj 71301 50
141801 1418 Tab 50 mg tab 221601 50
142001 1420 Crm 5% 400 g g 101502
142002 1420 Crm 5% g 101502
142003 1420 Crm 10% BPC g 101502
142004 1420 Fluid 350 ml 380101
142025 1420 Crm 5% pump bottle ml 101502
142301 1423 Powder 2%g 101401
142401 1424 Tab 2.5 mg with atropine sulphate 25 mcg tab 10401 2.5
142501 1425 Eye drops 0.1% ml 310309
142701 1427 Tab 25 mg tab 40701 25
142802 1428 Cap 100 mgcap 71301 100
142805 1428 Cap 150 mgcap 71301 150
143101 1431 Tab 5 mg tab 190101 5
143201 1432 Tab 200 mgtab 223401 200
143601 1436 Tab 10 mg tab 221601 10
143701 1437 Tab 75 mg tab 220501 75
143702 1437 Cap 25 mg cap 220501 25
143801 1438 Cap 10 mg cap 220501 10
143802 1438 Cap 25 mg cap 220501 25
143803 1438 Cap 50 mg cap 220501 50
143804 1438 Cap 75 mg cap 220501 75
144101 1441 Tab 10 mg tab 141301 10
144301 1443 Pessaries 150 mg with applicators pess 131001
144302 1443 Vaginal crm 1% with applicator(s) g 131001
144303 1443 Vaginal crm 1.5% with applicator g 131001
144306 1443 Soln 1% ml 100701
144307 1443 Foaming soln 1%, 10 ml sachets ea 100701
144310 1443 Crm 1% g 100701
144311 1443 Powder 1%g 100701
144601 1446 Powder for soln for oral use 5 g sach 41004 5
144625 1446 Powder for oral soln sach 41004 4.4
144801 1448 Tab 200 mgtab 131904 200
145301 1453 Tab 15 mg tab 284502 15
145302 1453 Tab 30 mg tab 284502 30
145303 1453 Powder g 380101
145806 1458 Aerosol inhaler 360 mcg per dose dose 221301
145901 1459 Tab 2 mg with caffeine 100 mg and cyclizine hydrochloride 50 mg tab 221301 2
146001 1460 Cap 1 mg with caffeine citrate 100 mg and diphenhydramine hydrochloride 25 mg cap 221301 1
146203 1462 Tab 1 mg with caffeine 100 mg tab 221301 1
146503 1465 Soln 2% ml 100101
146504 1465 Tab 250 mgtab 160304 250
146505 1465 Cap 250 mgcap 160304 250
146602 1466 Tab 500 mgtab 160304 500
146605 1466 Cap 250 mgcap 160304 250
146801 1468 Tab 100 mgtab 161601 100
146802 1468 Tab 400 mgtab 161601 400
147508 1475 Tab 35 mcg with norethisterone 500 mcg tab 130802 35
147509 1475 Tab 35 mcg with norethisterone 500 mcg and 7 inert tab tab 130802 35
147510 1475 Tab ethinyloestradiol 35 mcg with norethisterone 500 mcg (7) and tab ethinyloestradiol 35 mcg with norethisterone 1 mg (9) and tab ethinyloestradiol 35 mcg with norethisterone 500 mcg (5) and 7 inert tab 130802 35
147511 1475 Tab 35 mcg with norethisterone 1 mg tab 130802 35
147512 1475 Tab 35 mcg with norethisterone 1 mg and 7 inert tab tab 130802 35
147601 1476 Tab 50 mcg with ethynodiol diacetate 0.5 mg tab 130802 50
147602 1476 Tab 50 mcg with ethynodiol diacetate 1 mg tab 130802 50
147701 1477 Tab 20 mcg with desogestrel 150 mcg tab 130802 20
147702 1477 Tab 20 mcg with desogestrel 150 mcg and 7 inert tab tab 130802 20
147703 1477 Tab 30 mcg with desogestrel 150 mcg tab 130802 30
147704 1477 Tab 30 mcg with desogestrel 150 mcg and 7 inert tab tab 130802 30
147801 1478 Tab 10 mcgtab 141201 0.01
147901 1479 Tab 30 mcg with gestodene 75 mcg tab 130802 30
147902 1479 Tab 30 mcg with gestodene 75 mcg and 7 inert tab tab 130802 30
147903 1479 Tab 20 mcg with gestodene 75 mcg and 7 inert tab tab 130802 20
148101 1481 Cap 250 mgcap 220702 250
148401 1484 Tab 500 mcg tab 130804 500
148701 1487 Tab 200 mgtab 190806 200
149204 1492 Nebuliser soln, 250 mcg per 2 ml, 2 ml neb 283401 125
149205 1492 Aerosol nasal spray, 20 mcg per dose dose 285102
149206 1492 Aqueous nasal spray, 0.03% ml 285102
149801 1498 Tab 5 mg tab 40104 5
149825 1498 Tab 0.8 mgtab 40104
149901 1499 Tab 300 mgtab 40103 300
150101 1501 Tab long-acting 325 mg (105 mg elemental) with folic acid 350 mcg tab 13830 325
150801 1508 Oint 10 u with desoxyribonuclease 6666 u per g g 103107
150803 1508 Powder for soln 25 u with desoxyribonuclease 1500 u g 103107
150901 1509 Oint 1,800 iu vitamin A per g g 101504
151001 1510 Tab 50 mg tab 71301 50
151002 1510 Tab 100 mgtab 71301 100
151201 1512 Cap 250 mgcap 160307 250
151202 1512 Cap 500 mgcap 160307 500
151205 1512 Inj 250 mg vial inj 160307 250
151206 1512 Inj 500 mg vial inj 160307 500
151207 1512 Inj 1 g vial inj 160307 1000
151301 1513 Tab 500 mgtab 160401 500
151501 1515 Tab 100 mcg tab 140701 100
151601 1516 Ear drops 0.02% with clioquinol 1% ml 310101
151701 1517 Metered nasal spray, 25 mcg per dose dose 285102
151803 1518 Gel 0.02% g 102201
151804 1518 Crm 0.025%g 101101
151805 1518 Oint 0.025%g 101101
152101 1521 Suppos 630 mcg, with fluocortolone pivalate 610 mcg, and cinchocaine hydrochloride 1 mg supp 10501 630
152102 1521 Oint 950 mcg, with fluocortolone pivalate 920 mcg, and cinchocaine hydrochloride 5 mg per g g 10501
152701 1527 Eye drops 0.1% ml 310304
152901 1529 Crm 5% g 103103
152902 1529 Inj 250 mg per 10 ml inj 250104 250
152903 1529 Inj 500 mg per 10 ml inj 250104 500
152904 1529 Inj 500 mg per 20 ml inj 250104 500
152928 1529 Inj 1 mg for ECP mg 250104 1
153301 1533 Inj 12.5 mg per 0.5 ml, 0.5 ml inj 222204 12.5
153501 1535 Tab 1 mg tab 222201 1
153502 1535 Tab 5 mg tab 222201 5
153601 1536 Tab 50 mg tab 190401 50
153602 1536 Tab 100 mgtab 190401 100
153701 1537 Tab 250 mgtab 250401 250
154203 1542 Oint 1.5% with gramicidin 0.005% g 100401
154225 1542 Crm 1.5% with gramicidin 0.005% g 100401
154401 1544 Tab 40 mg tab 73101 40
154402 1544 Tab 500 mgtab 73101 500
154406 1544 Inj 10 mg per ml, 25 ml ampoule inf 73101 250
154601 1546 Tab 250 mgtab 160313 250
154603 1546 Inj 500 mg sodium fusidate per 10 ml inj 160313 500
154604 1546 Eye drops 1% g 310301
154608 1546 Crm 2% g 100401
154609 1546 Oint 2% g 100401
154610 1546 Gel 2% g 100401
154901 1549 Lotn 1% ml 101701
154902 1549 Crm 1% g 101701
155301 1553 Cap 300 mgcap 73201 300
155325 1553 Tab 600 mgtab 73201 600
155405 1554 Eye drops 0.3% ml 310301
155407 1554 Crm 0.1% g 100401
155408 1554 Oint 0.1% g 100401
156701 1567 Tab 2.5 mgtab 11312 2.5
156702 1567 Tab 5 mg tab 11312 5
156801 1568 Tab 80 mg tab 11312 80
156901 1569 Tab 5 mg tab 11312 5
157001 1570 Inj 1 mg inj 11301 1
157003 1570 Inj 10 mg inj 11301 10
157004 1570 Inj 1 mg syringe kit kit 11301 1
157201 1572 Urine diagnostic test with peroxidase strip 11501
157202 1572 Urine diagnostic test strip 11501
157203 1572 Blood diagnostic test with peroxidase test 11507
157204 1572 Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid strip 11504
157210 1572 Urine diagnostic test with peroxidase, sodium nitroprusside and aminoacetic acid stick 11504
157401 1574 Suppos 1 gsupp 12507
157402 1574 Suppos 2 gsupp 12507
157403 1574 Suppos 3.6 g supp 12507
157404 1574 Suppos 4 gsupp 12507
157405 1574 Suppos 8 gsupp 12507
157406 1574 Liquid ml 380101
157407 1574 Suppos 1.27 g supp 12507
157408 1574 Suppos 2.55 g supp 12507
157501 1575 Lotn 5% with paraffin liq 5% and cetyl alcohol 2% ml 101504
157701 1577 Patch 50 mg, 10 mg per day patch 73401 10
157702 1577 Tab 600 mcg tab 73401 600
157703 1577 Oint 2% g 73401 2
157704 1577 Oral spray aerosol 400 mcg per dose dose 73401
157705 1577 Patch 25 mg, 5 mg per day patch 73401 5
157706 1577 Oral pump spray 400 mcg per dose dose 73401
157725 1577 Oral spray, 400 mcg per dose dose 73401
157726 1577 Oint 0.2% g 10502
157902 1579 Tab 330 mgtab 160401 330
157903 1579 Tab 500 mgtab 160401 500
158001 1580 Tab 125 mgtab 284302 125
158301 1583 Tab 500 mcg tab 222201 0.5
158302 1583 Tab 1.5 mgtab 222201 1.5
158303 1583 Tab 5 mg tab 222201 5
158901 1589 Inj 1,000 iu per ml, 5 ml inj 40704 99
158905 1589 Inj 10,000 iu per ml, 0.5 ml inj 40704 1000
158906 1589 Inj 25,000 iu per ml, 0.2 ml inj 40704 2500
159401 1594 Tab 1 g tab 162301
160001 1600 Eye drops 2% ml 310310
160002 1600 Eye drops 5% ml 310310
160301 1603 Inj 1,500 iu per ml inj 191101 1500
160401 1604 Tab 25 mg tab 74001 25
160402 1604 Tab 50 mg tab 74001 50
160403 1604 Inj 20 mg ampoule inj 74001 20
160601 1606 Aerosol rectal foam 10% g 10404 10
160602 1606 Rectal foam 10%, CFC-Free (14 applications) g 10404
161101 1611 Crm 1% with miconazole nitrate 2% g 101104
161202 1612 Crm 1% with natamycin 1% and neomycin sulphate 0.5% g 101104
161203 1612 Oint 1% with natamycin 1% and neomycin sulphate 0.5% g 101104
161301 1613 Lotn 1% with wool fat hydrous 3% and mineral oil ml 101101
161401 1614 Oint 0.1% g 101101
161402 1614 Crm 0.1% g 101101
161406 1614 Scalp lotn 0.1% ml 102201
161407 1614 Lipocream 0.1% g 101101
161425 1614 Milky emul 0.1% ml 101101
161502 1615 Crm 0.1% with chlorquinaldol 3% g 101104
161701 1617 Tab 5 mg tab 140701 5
161702 1617 Tab 20 mg tab 140701 20
161705 1617 Crm 0.5% g 101101
161706 1617 Powder g 101101
161716 1617 Inj 100 ml vial inj 140701 100
161719 1617 Crm 1% g 101101
161901 1619 Oint zinc oxide with balsam peru g 10507
161902 1619 Suppos zinc oxide with balsam peru supp 10507
161904 1619 Zinc oxide g 380101
162001 1620 Lotn 2% ml 100701
162002 1620 Tinct 2% ml 100701
162003 1620 Crm 2% g 100701
162004 1620 Powder 2%g 100701
162005 1620 Pessaries 100 mg pess 131001
162006 1620 Vaginal crm 2% with applicator g 131001
162501 1625 Tab 200 mgtab 190701 200
162601 1626 Cap 500 mgcap 250107 500
162901 1629 Patch 1.5 mg patch 221601
162902 1629 Eye drops 0.25% ml 310310
163001 1630 Eye drops 0.3% with dextran 0.1% ml 310313
163101 1631 Tab 10 mg tab 10701 10
163102 1631 Inj 20 mg, 1 ml inj 10701 20
163201 1632 Oint 5 mg with cinchocaine hydrochloride 5 mg per g g 10501
163204 1632 Suppos 5 mg with cinchocaine hydrochloride 5 mg per g supp 10501 5
163205 1632 Oint 5 mg with cinchocaine hydrochloride 5 mg per g, 2 g ea 10501
163301 1633 Eye drops 0.3% ml 310313
163302 1633 Eye drops 0.5% ml 310313
163303 1633 Eye drops 1% ml 310313
163401 1634 Oint 0.25% with lidocaine [lignocaine] hydrochloride 5% aluminium subacet 3.5% and zinc oxide 18% g 10501
163402 1634 Suppos 0.25% with lidocaine [lignocaine] hydrochloride 5% aluminium subacet 3.5% and zinc oxide 18% supp 10501
163903 1639 Eye oint 0.5% g 310301
164201 1642 Tab 10 mg tab 220501 10
164202 1642 Tab 25 mg tab 220501 25
164301 1643 Tab 2.5 mgtab 73110 2.5
164501 1645 Cap 25 mg cap 190402 25
164502 1645 Cap 50 mg cap 190402 50
164504 1645 Suppos 100 mg supp 190402 100
164801 1648 Inj human 100 u per ml ml 11303 100
164802 1648 Inj human 100 u per ml, 1.5 ml inj 11303 150
164803 1648 Inj human 100 u per ml, 3 ml inj 11303 300
164825 1648 Inj animal (pork) 100 u per ml, 10 ml ml 11303 1000
164902 1649 Inj human 100 u per ml, 1.5 ml inj 11305 150
164903 1649 Inj human 100 u per ml, 3 ml inj 11305 300
164904 1649 Inj human 100 u per ml ml 11305
164925 1649 Inj animal (pork) 100 u per ml ml 11305 1000
165301 1653 Syringe 1 ml dev 11509
165501 1655 Inj human 100 u per ml ml 11305
165502 1655 Inj crystalline human 100 u per ml ml 11305
167901 1679 Tab 100 mgtab 161601 100
167902 1679 Tab 100 mg with rifampicin 150 mg tab 161601 100
167903 1679 Tab 150 mg with rifampicin 300 mg tab 161601 150
168601 1686 Synthetic bath oil, 1 ltr ml 101504
168602 1686 Synthetic bath oil ml 101504
168801 1688 Cap 10 mg cap 100101 10
168802 1688 Cap 20 mg cap 100101 20
169601 1696 Tab 200 mgtab 160401 200
169602 1696 Crm 2% g 100701
169603 1696 Shampoo 2% ml 102201
169701 1697 Cap 50 mg cap 190401 50
169705 1697 Suppos 100 mg supp 190401
169706 1697 Tab EC 100 mg tab 190401 100
169707 1697 Cap 100 mgcap 190401 100
169801 1698 Tab 1 mg tab 280401 1
169802 1698 Oral liq 1 mg per 5 ml ml 280401 0.2
169901 1699 Tab 50 mg tab 71601 50
169902 1699 Tab 100 mgtab 71601 100
169903 1699 Tab 200 mgtab 71601 200
169904 1699 Tab 400 mgtab 71601 400
169925 1699 Inj 5 mg per ml, 5 ml inj 71601
171501 1715 Crm 2.5% with prilocaine 2.5% g 220201 2.5
171502 1715 Crm 2.5% with prilocaine 2.5% (5 g tubes) tube 220201 2.5
171601 1716 Eye drops 0.25% ml 310305
171602 1716 Eye drops 0.5% ml 310305
171702 1717 Cap 200 mg with benserazide 50 mg cap 220101 200
171706 1717 Cap 100 mg with benserazide 25 mg cap 220101 100
171707 1717 Cap long-acting 100 mg with benserazide 25 mg cap 220101 100
171708 1717 Cap 50 mg with benserazide 12.5 mg cap 220101 50
171709 1717 Tab dispersible 50 mg with benserazide 12.5 mg tab 220101 50
171802 1718 Tab ethinyloestradiol 30 mcg with levonorgestrel 50 mcg (6) and ethinyloestradiol 40 mcg with levonorgestrel 75 mcg (5), and ethinyloestradiol 30 mcg with levonorgestrel 125 mcg (10) tab 130802 50
171803 1718 Tab 50 mcg with ethinyloestradiol 50 mcg and levonorgestrel 125 mcg with ethinyloestradiol 50 mcg tab 130802 50
171804 1718 Tab ethinyloestradiol 50 mcg with levonorgestrel 50 mcg (11) and ethinyloestradiol 50 mcg with levonorgestrel 125 mcg (10) and 7 inert tab tab 130802 50
171805 1718 Tab ethinyloestradiol 30 mcg with levonorgestrel 50 mcg (6) and tab ethinyloestradiol 40 mcg with levonorgestrel 75 mcg (5), and tab ethinyloestradiol 30 mcg with levonorgestrel 125 mcg (10) and 7 ine tab 130802 50
171806 1718 Tab 125 mcg with ethinyloestradiol 50 mcg tab 130802 125
171807 1718 Tab 50 mcg with levonorgestrel 125 mcg and 7 inert tab tab 130802 125
171808 1718 Tab 30 mcg with levonorgestrel 150 mcg tab 130802 150
171810 1718 Tab 50 mcg with levonorgestrel 250 mcg tab 130802 250
171901 1719 Inj 10% 5 ml inj 71301 10
171902 1719 Inj twin pack 100 mg per 5ml inj 71301 20
171904 1719 Inj 0.5%, 5 ml inj 220201 2
171906 1719 Inj 0.5%, 20 ml vial inj 220201 10
171907 1719 Inj 1%, 20 ml ampoule inj 220201 20
171908 1719 Inj 1%, 50 ml vial inj 220201 50
171927 1719 Oral (viscous) soln 2% ml 220201
172002 1720 Cap 500 mgcap 160313 500
172101 1721 Tab 20 mcgtab 141401 20
172301 1723 Tab 100 mg with carbidopa 25 mg tab 220101 100
172302 1723 Tab 250 mg with carbidopa 25 mg tab 220101 250
172303 1723 Tab long-acting 200 mg with carbidopa 50 mg tab 220101 200
172401 1724 Tab 30 mcgtab 130804 30
172425 1724 Tab 750 mcg tab 130805 750
172426 1724 Levonorgestrel - releasing intrauterine system 20 mcg/24 hr dev 141301
172427 1724 Tab 1.5 mgtab 130805 1
172428 1724 Subdermal implant (2 x 75 mg rods) pack 130804
172801 1728 Cap 2 mg cap 10401 2
172802 1728 Tab 2 mg tab 10401 2
172901 1729 Tab 1 mg tab 222801 1
173001 1730 Tab 500 mcg tab 222501 500
173002 1730 Tab 2.5 mgtab 222501 2.5
173004 1730 Tab 1 mg tab 222501 1
173005 1730 Tab sublingual 1 mg tab 222501 1
173101 1731 Tab 1 mg tab 222801 1
173201 1732 Tab 10 mg tab 222201 10
173202 1732 Cap 25 mg cap 222201 25
173203 1732 Cap 50 mg cap 222201 50
173301 1733 Cap 300 mgcap 160310 300
176001 1760 Tab 25 mg tab 220501 25
176002 1760 Tab 75 mg tab 220501 75
176202 1762 Tab 100 mgtab 160101 100
176601 1766 Tab 100 mgtab 141301 100
176602 1766 Tab 200 mgtab 141301 200
176603 1766 Tab 400 mgtab 141301 400
176604 1766 Tab 500 mgtab 141301 500
176605 1766 Tab 2.5 mgtab 141109 2.5
176606 1766 Tab 5 mg tab 141109 5
176607 1766 Tab 10 mg tab 141109 10
176608 1766 Inj 150 mg per ml, 1 ml syringe inj 130804 150
176901 1769 Cap 250 mgcap 190401 250
177201 1772 Tab 160 mgtab 250401 160
177301 1773 Tab 2 mg tab 250101 2
177302 1773 Tab 5 mg tab 250101 5
177325 1773 Inj 50 mg inj 250101 50
178001 1780 Tab 400 mgtab 222501 400
178101 1781 Tab 10 mg tab 250104 10
178102 1781 Tab 50 mg tab 250104 50
179201 1792 Tab 25 mg tab 141001
179401 1794 Tab immediate-release 500 mg tab 11312 500
179501 1795 Tab 5 mg tab 220407 5
179503 1795 Linctus BPC 2 mg per 5 ml ml 220407 0.4
179504 1795 Powder g 380101
179701 1797 Tab 2.5 mgtab 250104 2.5
179702 1797 Tab 10 mg tab 250104 10
179704 1797 Inj 2.5 mg per ml, 2 ml inj 250104 2.5
179725 1797 Inj 1 mg for ECP mg 250104 1
179726 1797 Inj 5 mg intrathecal syringe for ECP mg 250104 5
179729 1797 Inj 7.5 mg prefilled syringe inj 250104 7
179901 1799 Tab 25 mg tab 222201 25
179902 1799 Tab 100 mgtab 222201 100
180001 1800 Cap 10 mg cap 101901 10
180101 1801 Tab 5 mg tab 73110 5
180601 1806 Tab 125 mgtab 72801 125
180602 1806 Tab 250 mgtab 72801 250
180603 1806 Tab 500 mgtab 72801 500
180925 1809 Tab sustained-release 20 mg tab 223101 20
181101 1811 Tab 4 mg tab 140701 4
181102 1811 Tab 100 mgtab 140701 100
181204 1812 Inj 500 mg inj 140701 500
181205 1812 Inj 1 g inj 140701 1000
181301 1813 Tab 1 mg tab 221304 1
181401 1814 Tab 10 mg tab 221601 10
181405 1814 Suppos 10 mg supp 221601 10
181501 1815 Tab 5 mg with paracetamol 500 mg tab 221301 5
181606 1816 Inj 40 mg per ml with lidocaine [lignocaine] 1 ml inj 140701 40
181701 1817 Tab long-acting 47.5 mg tab 71601 47.5
181725 1817 Tab long-acting 23.75 mg tab 71601
181801 1818 Tab 50 mg tab 71601 50
181802 1818 Tab 100 mgtab 71601 100
182001 1820 Tab 200 mgtab 161301 200
182002 1820 Tab 400 mgtab 161301 400
182003 1820 Oral liq benzoate 200 mg per 5 ml ml 161301 40
182004 1820 Suppos 1 gsupp 161301 1000
182005 1820 Suppos 500 mg supp 161301 500
182201 1822 Cap 250 mgcap 142101 250
182301 1823 Cap 50 mg cap 71301 50
182302 1823 Cap 200 mgcap 71301 200
182325 1823 Cap 150 mgcap 71301 150
182326 1823 Cap 250 mgcap 71301 250
182401 1824 Tab 30 mg tab 220501 30
182501 1825 Oral gel 20 mg per g g 13107
182601 1826 230 ml (autoclavable) dev 285302
182701 1827 Low range dev 285302
182702 1827 Normal range dev 285302
182801 1828 Tab 50 mg tab 160310 50
182802 1828 Cap 100 mgcap 160310 100
182925 1829 230 ml (single patient) dev 285302
182926 1829 800 ml dev 285302
183005 1830 Powder g 380101
183112 1831 Suppos 5 mg supp 220407 5
183113 1831 Suppos 10 mg supp 220407 10
183114 1831 Suppos 20 mg supp 220407 20
183115 1831 Suppos 30 mg supp 220407 30
183116 1831 Morphine sulphate g 380101
183202 1832 Size 2 dev 285302
183501 1835 Oint 2% g 100401
183801 1838 Tab 40 mg tab 71601 40
183802 1838 Tab 80 mg tab 71601 80
183901 1839 Tab 500 mgtab 162301 500
184301 1843 Eye drops 0.1% ml 310317
184901 1849 Tab 30 mg tab 220404 30
185201 1852 Tab 500 mgtab 160313 500
185306 1853 Powder g 380101
185401 1854 Oint 5 mg with polymyxin B sulphate 5000 u with bacitracin 400 u per g g 100401
185702 1857 Inj 2.5 mg per ml, 1 ml (Polyamp Luer Fit) inj 190101 2.5
185703 1857 Inj 2.5 mg per ml, 1 ml ampoule inj 190101 2
185901 1859 Tab 500 mgtab 160101 500
186001 1860 Tab 25 mg tab 13704 25
186002 1860 Tab 50 mg tab 13704 50
186003 1860 Nicotinamide g 380101
186101 1861 Tab 25 mg tab 73202 25
186102 1861 Tab 50 mg tab 73202 50
186103 1861 Tab 100 mgtab 73202 100
186104 1861 Tab 500 mgtab 73202 500
186305 1863 Cap 5 mg cap 72201 5
186306 1863 Cap 10 mg cap 72201 10
186401 1864 Tab 500 mgtab 161301 500
186501 1865 Tab 5 mg tab 222801 5
186701 1867 Tab 50 mg tab 162301 50
186702 1867 Tab 100 mgtab 162301 100
187101 1871 Tab 350 mcg tab 130804 0.35
187102 1871 Tab 5 mg tab 141301 5
187301 1873 Tab 1 mg with mestranol 50 mcg tab 130802 1
187302 1873 Tab 1 mg with mestranol 50 mcg and 7 inert tab tab 130802 1
187401 1874 Tab 400 mgtab 162301 400
187501 1875 Tab 50 mcg with norgestrel 500 mcg tab 130802 500
187601 1876 Tab 10 mg tab 220501 10
187602 1876 Tab 25 mg tab 220501 25
188102 1881 Paste 100,000 u per g g 100701
188103 1881 Topical powder 100,000 u per g g 100701
188104 1881 Pastilles 100,000 u tab 13107 100000
188105 1881 Oral liq 100,000 u per ml ml 13107 100000
188106 1881 Oral powder 5,520 u per mg (for reconstitution) g 160401
188107 1881 Pessaries 100,000 u pess 131001
188108 1881 Vaginal crm 100,000 u per 4 g with applicator g 131001
188109 1881 Vaginal crm 100,000 u per 5 g with applicator(s) g 131001
188113 1881 Crm 100,000 u per g g 100701
188114 1881 Oint 100,000 u per g g 100701
188125 1881 Tab 500,000 u tab 160401 500000
188126 1881 Cap 500,000 u cap 160401 500000
188601 1886 Implant 50 mg unit 141201 50
188602 1886 Implant 100 mg unit 141201 100
188605 1886 TDDS 25 mcg per day patch 141104 25
188608 1886 TDDS 3.9 mg (releases 50 mcg of oestradiol per day) patch 141104 49
188609 1886 TDDS 7.8 mg (releases 100 mcg of oestradiol per day) patch 141104 99
188610 1886 Tab 2 mg tab 141104 2
188611 1886 Tab 1 mg tab 141104 1
188801 1888 Conjugated, equine tab 300 mcg tab 141104 0.3
188802 1888 Conjugated, equine tab 625 mcg tab 141104 0.625
188803 1888 Conjugated, equine tab 1.25 mg tab 141104 1.25
188805 1888 Conjugated, equine vaginal crm 625 mcg per g with applicator g 131402
190301 1903 Aerosol inhaler 750 mcg per dose dose 284502 750
190601 1906 Tab 500 mgtab 161301 500
190801 1908 Tab 100 mgtab 191601 100
190901 1909 Tab 50 mg tab 220104 50
191001 1910 Compound diagnostic sticks test 132201
191101 1911 Tab 10 mg tab 222501 10
191102 1911 Tab 15 mg tab 222501 15
191103 1911 Tab 30 mg tab 222501 30
191201 1912 Tab 40 mg tab 71601 40
191202 1912 Tab 80 mg tab 71601 80
191401 1914 Tab 5 mg tab 131904 5
191501 1915 Suppos 30 mg supp 220407
191601 1916 Nasal drops, 0.025% ml 285104 0.025
191606 1916 Nasal spray, 0.05% ml 285104 0.05
191607 1916 Metered nasal spray, 0.05% ml 285104 0.05
191608 1916 Nasal drops, 0.05% ml 285104 0.05
191701 1917 Tab 50 mg tab 140101 50
192201 1922 Inj 5 iu per ml, 1 ml ampoule inj 131402 5
192202 1922 Inj 10 iu per ml, 1 ml ampoule inj 131402 10
192203 1922 Inj 5 iu with ergometrine maleate 500 mcg per ml, 1 ml inj 131402 500
192501 1925 Tab 325 mgtab 12201 325
192502 1925 Cap 305 mgcap 12201 305
192503 1925 Powder g 12201
192504 1925 Tab EC 1,900 BP u lipase, 1,700 BP u amylase, 110 BP u protease tab 12201
192505 1925 Tab EC 5,600 BP u lipase, 5,000 BP u amylase, 330 BP u protease tab 12201
192506 1925 Cap 8,000 BP u lipase, 9,000 BP u amylase, 430 BP u protease cap 12201
192507 1925 Grans EC g 12201
192508 1925 Powder, strong g 12201
192509 1925 Tab EC 7,400 FIP u lipase, 7,000 FIP u amylase, 420 FIP u protease tab 12201
192510 1925 Tab EC 13,500 FIP u lipase, 13,000 FIP u amylase, 760 FIP u protease tab 12201
192511 1925 Cap 8,000 USP u lipase, 30,000 USP u amylase, 30,000 USP u protease cap 12201 8000
192512 1925 Cap EC 8,000BP u lipase, 9,000BP u amylase, 210BP u protease cap 12201 8000
192513 1925 Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease cap 12201 25000
192514 1925 Cap EC 5,000 BP u lipase, 3,000 BP u amylase, 350 BP u protease cap 12201 5000
192515 1925 Cap EC 25,000 BP u lipase, 22,500 BP u amylase, 1,250 BP u protease cap 12201 25000
192525 1925 Cap EC 10,000 BP u lipase, 9,000 BP u amylase and 210 BP u protease cap 12201 10000
192904 1929 Suppos 125 mg supp 220404 125
192905 1929 Suppos 250 mg supp 220404 250
192906 1929 Suppos 500 mg supp 220404 500
192907 1929 Powder g 380101
192908 1929 Tab 500 mgtab 220404 500
193101 1931 Tab paracetamol 500 mg with codeine phosphate 8 mg tab 220407 500
194203 1942 Tab 125 mgtab 190701 125
194204 1942 Tab 250 mgtab 190701 250
194401 1944 Tab 25 mg tab 220407 25
194402 1944 Tab 50 mg tab 220407 50
194901 1949 Tab 100 mgtab 72202 100
195001 1950 Tab 2.5 mgtab 222201 2.5
195002 1950 Tab 10 mg tab 222201 10
195301 1953 Tab 50 mg tab 220407 50
195302 1953 Tab 100 mgtab 220407 100
195304 1953 Inj 50 mg per ml, 1.5 ml inj 220407 75
195501 1955 Tab 15 mg tab 220504 15
195605 1956 Powder g 380101
195625 1956 Inj 200 mg per ml, 1 ml ampoule inj 222801
196601 1966 Cap 10 mg cap 70401 10
197001 1970 Tab 250 mgtab 160307 250
197002 1970 Tab 500 mgtab 160307 500
197003 1970 Oral 125 mg per 5 ml ml 160307
197025 1970 Cap potassium salt 250 mg cap 160307 250
197026 1970 Cap potassium salt 500 mg cap 160307 500
197201 1972 Eye drops 0.12% ml 310317
197301 1973 Eye drops 0.12% with zinc sulphate 0.25% ml 310317
197801 1978 Tab 50 mg tab 220702 50
197802 1978 Cap 30 mg cap 220702 30
197803 1978 Cap 100 mgcap 220702 100
198601 1986 Tab 10 mg tab 40403 10
198602 1986 Inj 1 mg per 0.5 ml, 0.5 ml inj 40403 1
198625 1986 Inj 2 mg per 0.2 ml inj 40403 2
198701 1987 Eye drops 0.5% ml 310309
198702 1987 Eye drops 1% ml 310309
198703 1987 Eye drops 2% ml 310309
198704 1987 Eye drops 3% ml 310309
198705 1987 Eye drops 4% ml 310309
198706 1987 Eye drops 6% ml 310309
198707 1987 Eye drops 2% single dose dose 310309
198708 1987 Eye inserts dev 310309
198901 1989 Tab 10 mg with clopamide 5 mg tab 71901 10
199001 1990 Tab 2 mg tab 222201 2
199002 1990 Tab 10 mg tab 222201 10
199025 1990 Tab 4 mg tab 222201
199104 1991 Tab 5 mg tab 71601 5
199105 1991 Tab 10 mg tab 71601 10
199106 1991 Tab 15 mg tab 71601 15
199301 1993 2% with pyrethrins I and II 0.165% shampoo ml 101701
199501 1995 Tab 50 mg tab 11007 50
199605 1996 Cap 10 mg cap 190402 10
199607 1996 Cap 20 mg cap 190402 20
199801 1998 Tab 500 mgtab 160307 500
200001 2000 Tab 500 mcg tab 221304 500
200002 2000 Tab 1 mg tab 221304 1
200401 2004 Eye drops 5,000 u with neomycin sulphate 2700 mcg and gramicidin 25 mcg per ml ml 310301
200801 2008 Gel g 100401
201002 2010 Eye drops 1.4% ml 310313
201003 2010 Eye drops 3% ml 310313
201301 2013 Tab eff 500 mg (16 mmol) tab 41004 300
201601 2016 Tab eff 548 mg (14 m eq) with chloride 285 mg (8 m eq) tab 41004 548
201605 2016 Potassium chloride g 380101
203101 2031 Tab 0.5 mgtab 70401 0.5
203102 2031 Tab 1 mg tab 70401 1
203103 2031 Tab 2 mg tab 70401 2
203104 2031 Tab 5 mg tab 70401 5
203201 2032 Eye drops 0.12% ml 310304
203202 2032 Eye drops 1% ml 310304
203301 2033 Eye drops 0.5% with neomycin sulphate 0.5% and polymyxin B sulphate 5,000 u per ml ml 310304
203401 2034 Suppos 5 mg supp 10404
203402 2034 Enema 20 mg 100 ml en 10404 20
203501 2035 Eye drops 0.2% with sulphacetamide sodium 10% and phenylephrine hydrochloride 0.12% ml 310304
203601 2036 Tab 5 mg tab 140701 5
203801 2038 Tab 1 mg tab 140701 1
203802 2038 Tab 2.5 mgtab 140701 2.5
203803 2038 Tab 5 mg tab 140701 5
203804 2038 Tab 20 mg tab 140701 20
203805 2038 Tab 10 mg tab 140701 10
203806 2038 Tab 50 mg tab 140701 50
204101 2041 Tab 250 mgtab 220702 250
204201 2042 Tab 500 mgtab 191301 500
204501 2045 Tab 625 mcg conjugated equine (28) and 150 mcg norgestrel tab (12) tab 141114
204502 2045 Tab 1.25 mg conjugated equine (28) and 150 mcg norgestrel tab (12) tab 141114 1
204601 2046 Inj 1 mega uinj 160307 1000000
204602 2046 Inj 1.5 g in 3.4 ml syringe inj 160307 1500000
204701 2047 Cap 50 mg cap 250107 50
204901 2049 Tab 5 mg tab 220104 5
205002 2050 Tab 625 mcg conjugated equine (28) and 10 mg medroxyprogesterone acetate tab (14) tab 141114
205003 2050 Tab 625 mcg conjugated equine with 2.5 mg medroxyprogesterone acetate tab (28) tab 141114
205004 2050 Tab 625 mcg conjugated equine with 5 mg medroxyprogesterone acetate tab (28) tab 141114
205005 2050 Tab 625 mcg conjugated equine (14) and 5 mg medroxyprogesterone acetate tab (14) tab 141114
205225 2052 Cap 100 mgcap 141301 100
205301 2053 Tab 2 mg with 75 mcg levonorgestrel (36) and tab 2 mg oestradiol (48) tab 141114 2
205401 2054 Tab 25 mg tab 221601 25
205601 2056 TDDS 50 mcg 10, and 1 mg norethisterone tab 12 txpk 141114
205602 2056 Tab 2 mg with 1 mg norethisterone acetate (10), and 2 mg oestradiol tab (12) and 1 mg oestradiol tab (6) tab 141114 2
205603 2056 Tab 2 mg with 1 mg norethisterone acetate tab 141114 2
205604 2056 Tab 1 mg with 0.5 mg norethisterone acetate tab 141114 1
205701 2057 Eye drops 0.1% ml 310301
205801 2058 Ear drops 2% with 1,2 - propanediol diacetate 3% and benzethonium chloride 0.02% ml 310101
205802 2058 Ear drops 2% with 1, 2-Propanediol diacetate 3% and benzethonium chloride 0.02% ml 310101
205901 2059 Inj 5 ml inj 220701
206001 2060 Tab 10 mg tab 71601 10
206002 2060 Tab 40 mg tab 71601 40
206005 2060 Tab 160 mgtab 71601 160
206201 2062 Tab 50 mg tab 141401 50
206601 2066 Tab 60 mg tab 285104 60
206801 2068 Tab 125 mgtab 160101 125
206802 2068 Tab 250 mgtab 160101 250
206804 2068 Sachets 2.5 g sach 160101
206901 2069 Tab 500 mgtab 161601 500
207001 2070 Tab 60 mg tab 190101 60
207101 2071 Tab 10 mg tab 13704 10
207102 2071 Tab 25 mg tab 13704 25
207103 2071 Tab 50 mg tab 13704 50
207104 2071 Tab 100 mgtab 13704 100
207105 2071 Pyridoxine hydrochloride g 380101
207301 2073 Tab 25 mg with sulphadoxine 500 mg tab 161001
207801 2078 Tab 200 mgtab 71301 200
207802 2078 Tab 300 mgtab 71301 300
207901 2079 Tab 200 mgtab 161204 200
207902 2079 Tab 300 mgtab 161204 300
208005 2080 Tab 150 mgtab 11003 150
208006 2080 Tab 300 mgtab 11003 300
208025 2080 Cap 150 mgcap 11003 150
208026 2080 Cap 300 mgcap 11003 300
208701 2087 Tab 10 mg tab 13704 10
208801 2088 Tab 450 mgtab 161601 450
208802 2088 Tab 600 mgtab 161601 600
208803 2088 Cap 150 mgcap 161601 150
208804 2088 Cap 300 mgcap 161601 300
209001 2090 Inj 275 mg and 10 ml diluent inj 160310 275
209603 2096 Oral liq 400 mcg per ml ml 283001 0.4
209605 2096 Infusion 1 mg per ml, 5 ml inf 283001 5
209606 2096 Aerosol Inhaler, 100 mcg per dose dose 283010 100
209614 2096 Nebuliser soln, 1 mg per ml, 2.5 ml neb 283010 2.5
209615 2096 Nebuliser soln, 2 mg per ml, 2.5 ml neb 283010 5
209616 2096 Aerosol inhaler, 100 mcg per dose CFC free dose 283010 100
211401 2114 Crm 1% with chlorhexidine digluconate 0.2% g 100401
211425 2114 Crm 1% g 100401
212501 2125 Oral liq 500 mg with sodium bicarbonate 267 mg per 10 ml (aniseed) ml 10102 500
212525 2125 Oral liq 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg per 10 ml ml 10102
212526 2125 Tab 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg - peppermint flavour tab 10102
212601 2126 Inj 10 mg in 0.5 ml ampoule inj 190701 20
212801 2128 Inj 8.4%, 10 ml inj 41001 8.4
212802 2128 Inj 8.4%, 100 ml inj 41001 8.4
212803 2128 Powder g 380101
212825 2128 Powder BPg 380101
212826 2128 Inj 8.4%, 50 ml inj 41001
212827 2128 Cap 840 mgtab 41004
213302 2133 With pectin and gelatin paste g 13101
213307 2133 With pectin and gelatin powder g 13101
213501 2135 Tab 300 mgtab 41004 300
213502 2135 Inj 0.9%, 2 ml inj 41001 0.18
213503 2135 Inj 0.9%, 5 ml inj 41001 0.45
213504 2135 Inj 0.9%, 10 ml inj 41001 0.9
213505 2135 Inj 0.9%, 20 ml inj 41001 1.8
213506 2135 Inj 20%, 10 ml inj 41001 20
213507 2135 Powder g 380101
213509 2135 Inf 0.9% ml 41001
213525 2135 Inj 23.4%, 20 ml inj 41001
213526 2135 Soln 7% ml 284902 7
214001 2140 Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml en 12507 450
214201 2142 Grans eff 4 g sachets sach 131904
214402 2144 Powder for inhalation, 20 mg per dose dose 284001
214405 2144 Nebuliser soln, 10 mg per ml, 2 ml neb 284001 20
214406 2144 Cap 100 mgcap 10404 100
214407 2144 Eye drops 2% ml 310304
214408 2144 Eye oint 4%g 310304
214409 2144 Nasal drops, 2% ml 285102
214412 2144 Nasal spray, 4% ml 285102
214413 2144 Aerosol inhaler, 5 mg per dose CFC-free dose 284001 5
214901 2149 Tab 1.1 mg (0.5 mg elemental) tab 13820 1.1
214902 2149 Tab 20 mg tab 13820 20
214903 2149 Sodium fluoride g 380101
215801 2158 Urine diagnostic strips, buffered strip 11504
215825 2158 Test strip strip 11504
216001 2160 Powder g 41004
216401 2164 Inj 0.5% 2 ml inj 40401 0.5
216402 2164 Inj 1% 2 ml inj 40401 1
216403 2164 Inj 3% 1 ml inj 40401 3
216404 2164 Inj 3% 2 ml inj 40401 3
216601 2166 Tab 100 mgtab 220702 100
216602 2166 Tab 200 mg EC tab 220702 200
216603 2166 Tab 500 mg EC tab 220702 500
216901 2169 Tab 80 mg tab 71601 80
216902 2169 Tab 160 mgtab 71601 160
217101 2171 Inj 2 g inj 160313
217301 2173 Tab 250 mgtab 160313 250
217302 2173 Tab 500 mgtab 160313 500
217601 2176 Tab 25 mg tab 73104 25
217602 2176 Tab 100 mgtab 73104 100
218301 2183 Tab 1 mg tab 250401 1
218801 2188 Powder 25,000 u with streptokinase 100,000u g 103107
219101 2191 Tab 1 g tab 11013 1000
219301 2193 Tab 100 mgtab 190401 100
219302 2193 Tab 200 mgtab 190401 200
219401 2194 Eye drops 10% ml 310301
219402 2194 Sulphacetamide sodium g 380101
220501 2205 Tab 500 mgtab 10404 500
220502 2205 Tab EC 500 mg tab 10404 500
220503 2205 Suppos 500 mg supp 10404 500
220504 2205 Enema 3 g per 100 ml en 10404 3000
220601 2206 Tab 100 mgtab 191301 100
220602 2206 Tab 200 mgtab 191301 200
221201 2212 Tab 50 mg tab 220702 50
221202 2212 Tab 200 mgtab 220702 200
221301 2213 Oint g 102501
221302 2213 Crm g 102501
221304 2213 Lotn ml 102501
221325 2213 Lotn, g 102501
221801 2218 Tab 10 mg tab 250401 10
221802 2218 Tab 20 mg tab 250401 20
222002 2220 Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ml 101901
222101 2221 Bath emul 7.5% coal tar, 2.5% cade oil, 7.5% compound ml 101901
222401 2224 Cap 10 mg cap 222801 10
222402 2224 Cap 20 mg cap 222801 20
222425 2224 Tab 10 mg tab 222801 10
223701 2237 Tab 25 mg tab 220107 25
223801 2238 Blue diagnostic strips test 132201
223901 2239 Inj 250 mcg per ml, 1 ml ampoule inj 140701 0.25
224101 2241 Cap 250 mgcap 160310 250
224103 2241 Ear/eye oint 1% g 310201
225001 2250 Tab 10 mg tab 13704 10
225002 2250 Tab 25 mg tab 13704 25
225003 2250 Tab 50 mg tab 13704 50
225004 2250 Thiamine hydrochloride g 380101
225201 2252 Tab 40 mg tab 250104 40
225501 2255 Tab 10 mg tab 222201 10
225502 2255 Tab 25 mg tab 222201 25
225503 2255 Tab 50 mg tab 222201 50
225504 2255 Tab 100 mgtab 222201 100
225506 2255 Oral liq 1%ml 222201
225507 2255 Oral liq 3%ml 222201
225701 2257 Inj 15 mg inj 250101 15
225702 2257 Eye drops 15 mg ml 310317 15
226001 2260 Tab 2 mg tab 222201 2
226002 2260 Tab 10 mg tab 222201 10
226201 2262 Compound, BPC ml 13109
226202 2262 Compound BP ml 380101
226301 2263 Tab 50 mcgtab 141401 0.05
226302 2263 Tab 100 mcg tab 141401 0.1
226325 2263 Tab 25 mcgtab 141401 0.03
226601 2266 Tab 10 mg tab 71601 10
226602 2266 Eye drops 0.25% ml 310305
226604 2266 Eye drops 0.5% ml 310305
226605 2266 Eye drops 0.25%, gel forming ml 310305
226606 2266 Eye drops 0.5%, gel forming ml 310305
226801 2268 Eye drops 0.5% with pilocarpine 2% ml 310305
226802 2268 Eye drops 0.5% with pilocarpine 4% ml 310305
226901 2269 Tab 500 mgtab 161301 500
227002 2270 Vaginal oint 6.5% with applicator g 131001
227003 2270 Lotn 1% ml 100701
227004 2270 Crm 1% g 100701
227404 2274 Eye drops 0.3% ml 310301
227405 2274 Eye oint 0.3% g 310301
227501 2275 Tab 400 mgtab 71301 400
227701 2277 Tab 500 mgtab 11312 500
228501 2285 Tab 10 mg tab 220504 10
228601 2286 Liq 0.05% g 100101
228602 2286 Lotn 0.05%ml 100101
228603 2286 Crm 0.05%g 100101
228604 2286 Gel 0.025%g 100101
228625 2286 Cap 10 mg cap 250107 10
228626 2286 Crm 0.5 mg per g g 100101
229501 2295 Tab 125 mcg tab 222801 125
229502 2295 Tab 250 mcg tab 222801 250
229801 2298 Tab 1 mg tab 222201 1
229802 2298 Tab 2 mg tab 222201 2
229803 2298 Tab 5 mg tab 222201 5
230001 2300 Tab 100 mgtab 160313 100
230002 2300 Tab 300 mgtab 160313 300
230101 2301 Tab 10 mg tab 220501 10
230103 2301 Cap 50 mg cap 220501 50
Trial Version
Pharmacode BrandCodeQuantity Multiple Specified Stamp
200034 22410301 3.5 0 TRUE 14007372418075590656
200069 18630601 100 0 TRUE 14079430012113518592
200131 22860201 50 0 TRUE 14151487606151446528
200182 18430101 15 0 TRUE 18177163613788176384
200190 22380102 100 0 TRUE 18249221207826104320
200212 21760102 100 0 TRUE 14223545200189374464
200220 21760203 100 0 TRUE 14295602794227302400
200247 11081103 200 0 TRUE 14367660388265230336
200255 18060103 100 0 TRUE 14439717982303158272
200263 18060303 100 0 TRUE 14511775576341086208
200271 17730101 25 0 TRUE 14583833170379014144
200298 17730201 25 0 TRUE 14655890764416942080
200301 18760301 500 0 TRUE 14727948358454870016
200328 18760101 250 0 FALSE 14760566470404472832
200336 18760201 250 0 FALSE 14832624064442400768
200379 19030101 300 0 TRUE 18321278801864032256
200417 10380401 100 0 TRUE 14800005952492797952
200506 10530101 500 0 TRUE 14872063546530725888
200549 10800101 1 1 TRUE 12331260400019439616
200573 13150101 100 0 TRUE 15016178734606581760
200581 13150201 100 0 TRUE 15088236328644509696
200603 19170101 100 0 TRUE 15160293922682437632
200638 27070101 50 0 TRUE 15232351516720365568
200689 15770201 100 0 TRUE 15304409110758293504
200751 22060102 100 0 TRUE 15376466704796221440
200891 10970501 15 0 TRUE 18393336395901960192
200905 10970601 15 0 TRUE 90988985244975104
200980 20420101 100 0 TRUE 15448524298834149376
200999 11280201 30 0 TRUE 13193884446614355968
201022 19110103 500 0 TRUE 15520581892872077312
201030 19110201 500 0 TRUE 15592639486910005248
201049 19110303 100 0 TRUE 15664697080947933184
201103 23740201 300 0 TRUE 163046579282903040
201111 23740501 20 0 TRUE 15736754674985861120
201200 27160302 100 0 TRUE 15808812269023789056
201286 17180401 84 28 TRUE 756388133607571456
201308 38122525 10 TRUE 9456204619152621568
201316 11670401 100 0 TRUE 15880869863061716992
201324 11670101 30 0 TRUE 15952927457099644928
201413 17170801 100 0 TRUE 16024985051137572864
201421 17170601 100 0 TRUE 16097042645175500800
201448 17170201 100 0 TRUE 16169100239213428736
201472 11730101 100 0 TRUE 16241157833251356672
201499 11890101 100 0 TRUE 16313215427289284608
201502 11890201 100 0 TRUE 16385273021327212544
201510 12050101 300 0 TRUE 1370902983348322304
201529 12090101 1 1 TRUE 12403317994057367552
201588 12170402 200 0 FALSE 13149227781852233728
201642 20350101 5 0 TRUE 235104173320830976
201669 12610101 1 1 TRUE 4837552095051644928
201677 12580101 10 0 TRUE 16745560991516852224
201685 12580201 4 0 TRUE 16817618585554780160
201693 12590104 10 0 TRUE 16889676179592708096
201707 12590404 3.5 0 TRUE 16961733773630636032
201715 12570101 3.5 0 TRUE 307161767358758912
201731 11300201 1 1 FALSE 18024125888852918272
201758 11300101 100 0 TRUE 17105848961706491904
201766 15890101 10 1 TRUE 7813041666046033920
201782 10550101 100 0 TRUE 17249964149782347776
201804 10030101 50 0 FALSE 17322021743820275712
201820 11980103 10 0 TRUE 17394079337858203648
201839 11431201 15 0 TRUE 8029214448159817728
201847 11431001 100 0 TRUE 451276955434614784
201855 13240101 30 0 TRUE 523334549472542720
201863 13240101 75 0 TRUE 8677732794501169152
201871 13240101 500 0 TRUE 667449737548398592
201928 10160101 7.5 0 TRUE 17466136931896131584
201936 10160201 7.5 0 TRUE 17538194525934059520
201960 10740101 20 0 TRUE 17610252119971987456
201979 10740201 12 0 TRUE 17682309714009915392
202029 11472501 15 0 TRUE 17754367308047843328
202045 10210201 100 0 TRUE 17826424902085771264
202096 10360101 50 0 TRUE 17898482496123699200
202118 11000201 1 1 TRUE 6960153794915074048
202126 11000101 100 0 TRUE 18042597684199555072
202185 12800201 100 0 TRUE 18114655278237483008
202193 12920101 500 0 TRUE 18186712872275410944
202215 13200701 20 0 TRUE 739507331586326528
202223 13200601 20 0 TRUE 811564925624254464
202231 13200301 35 0 TRUE 883622519662182400
202258 13200101 6 0 TRUE 18258770466313338880
202266 13180501 5 1 TRUE 4870202092838453248
202274 13180101 100 0 TRUE 18402885654389194752
202320 12820101 100 0 TRUE 100538243732209664
202371 12440301 500 0 TRUE 172595837770137600
202436 10260104 250 0 FALSE 8786676804627726336
202452 24690101 100 0 TRUE 316711025845993472
202479 24690201 100 0 TRUE 388768619883921408
202487 10260202 100 0 FALSE 8858734398665654272
202525 12830601 10 1 TRUE 4366080409549668352
202576 12830201 100 0 TRUE 604941401997705216
202584 12830301 100 0 TRUE 676998996035633152
202592 12830401 100 0 TRUE 749056590073561088
202614 12550101 25 0 TRUE 821114184111489024
202622 12550201 25 0 TRUE 893171778149416960
202665 23640102 100 0 TRUE 965229372187344896
202681 60470201 10 1 TRUE 8113075299521921024
202746 10150301 1 0 TRUE 1109344560263200768
202770 17180801 63 21 TRUE 18194044415809421312
202800 17180601 63 21 TRUE 18266102009847349248
202827 17180701 84 28 TRUE 828445727645499392
202878 10530103 500 0 FALSE 15595261822142251008
202967 11160101 500 0 TRUE 1397574936414912512
202975 11160201 500 0 TRUE 1469632530452840448
203017 17180802 63 21 TRUE 18338159603885277184
203033 17180902 84 28 TRUE 900503321683427328
203041 17181001 63 21 TRUE 18410217197923205120
203068 17181101 84 28 TRUE 972560915721355264
203084 10200101 100 0 TRUE 1685805312566624256
203092 10200201 100 0 TRUE 1757862906604552192
203106 15670202 100 0 TRUE 17248916315201077248
203122 20600502 250 0 TRUE 1901978094680408064
203149 13610102 100 0 TRUE 1974035688718336000
203211 20600103 500 0 FALSE 826994372296835072
203238 20600502 50 0 FALSE 2046093282756263936
203270 24190101 100 0 TRUE 2118150876794191872
203300 24830701 56 0 TRUE 2190208470832119808
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603325 23940401 20 0 TRUE 16520401900869255168
603333 23940301 20 0 TRUE 16592459494907183104
603341 10150101 5 1 TRUE 5518720439179804672
603716 23730101 60 0 TRUE 2696863428911300608
603724 23730201 30 0 TRUE 2768921022949228544
603791 29360102 454 0 TRUE 16664517088945111040
603961 88610101 1 1 TRUE 658211640851824640
604321 32910501 30 0 TRUE 7668926477970178048
604585 23200101 5 0 TRUE 2985093805063012352
604593 23200201 5 0 TRUE 3057151399100940288
606642 20600503 250 0 TRUE 3129208993138868224
606650 27970102 90 0 TRUE 3201266587176796160
606669 27970202 30 0 FALSE 3273324181214724096
606685 27970202 90 0 TRUE 3345381775252652032
606693 27970302 30 0 FALSE 3417439369290579968
606707 27970302 90 0 TRUE 3489496963328507904
607541 27160901 100 0 TRUE 16736574682983038976
607568 27161001 100 0 TRUE 16808632277020966912
607576 27160302 250 0 TRUE 3561554557366435840
608505 14790101 63 21 TRUE 540215351493787648
608513 14790201 84 28 TRUE 2269597608404058112
608599 27830101 100 0 TRUE 3633612151404363776
608602 27830201 100 0 TRUE 3705669745442291712
608637 16200302 20 0 TRUE 16880689871058894848
608750 13610201 100 0 FALSE 3777727339480219648
609498 23980101 30 0 TRUE 3849784933518147584
609501 23980202 30 0 TRUE 3921842527556075520
609625 23750301 100 0 TRUE 12241653500890578944
609641 23620101 30 0 FALSE 12342303894808821760
609668 23980102 30 0 FALSE 1141827432282587136
609676 23980201 30 0 FALSE 1069769838244659200
609684 19251101 250 0 TRUE 4210072903707787264
609706 25290301 100 0 TRUE 4282130497745715200
609757 23830101 50 1 FALSE 1339661459956695040
609765 25390101 100 0 TRUE 4354188091783643136
609781 60120701 21 0 TRUE 4426245685821571072
609935 20960604 400 0 TRUE 4498303279859499008
610097 24550101 90 0 FALSE 6745296028708110336
612634 15800501 100 0 TRUE 4570360873897426944
612642 15800701 100 0 TRUE 4642418467935354880
612650 14431003 15 0 TRUE 16952747465096822784
612669 14431003 30 0 TRUE 4714476061973282816
612685 15670104 100 0 TRUE 4786533656011210752
612960 14790102 63 21 TRUE 612272945531715584
613428 14790202 84 28 TRUE 2341655202441986048
615137 23830101 5 1 TRUE 1411719053994622976
615641 20800301 300 0 TRUE 4930648844087066624
615986 16860201 200 0 TRUE 5002706438124994560
615994 16860202 200 0 TRUE 5074764032162922496
616001 16860101 1000 0 TRUE 5146821626200850432
616133 20960102 56 0 TRUE 5218879220238778368
616168 17690101 20 0 TRUE 11199748585828646912
616222 63040101 30 0 FALSE 5362994408314634240
616249 63040101 90 0 TRUE 5435052002352562176
616575 15890102 10 1 TRUE 330573668448993280
616796 19290805 1000 0 TRUE 5579167190428418048
616842 19980101 12 0 TRUE 5651224784466345984
616923 17690102 30 0 FALSE 5723282378504273920
617962 24680201 100 0 TRUE 4896561784602755072
618268 10190301 100 0 TRUE 5795339972542201856
618438 11431501 30 0 TRUE 17024805059134750720
618675 15740602 100 0 FALSE 5867397566580129792
618683 15740602 200 0 FALSE 5939455160618057728
619124 22550701 50 0 TRUE 6011512754655985664
619272 15540101 5 1 TRUE 14670034881996652544
619310 29050204 454 0 TRUE 17096862653172678656
619515 60470201 100 1 FALSE 8041017705483993088
619523 15120102 50 0 FALSE 6227685536769769472
619647 11880401 1 1 TRUE 730269234889752576
619671 14920301 20 0 TRUE 6371800724845625344
619779 23391904 250 0 TRUE 17168920247210606592
619787 23391904 1000 0 TRUE 6443858318883553280
Trial Version
Scope Effective Expiry RestrictionCode
0101021038 6/1/2012 522
010102104010/1/2003 522
010102104110/1/2003 522
010102127510/1/2003 522
010102127501 10/1/2003 3/31/2007 656
010102127501 4/1/2007 860
010102127610/1/2003 522
010102212510/1/2003 522
0101041038 6/1/2012 522
010104119127 12/1/2012 1281
010401142410/1/2003 522
010401142401 5/16/1994 7/31/1999 38
01040114240102 12/1/2002 6/30/2005 421
01040114240102 10/1/2005 6/30/2008 421
01040114240102 10/1/2008 ######## 29
0104011728 7/1/1996 10030
010401172810/1/2003 522
010401172801 5/16/1994 7/31/1999 40
01040117280102 11/1/1999 6/30/2001 400
01040117280102 12/1/2001 6/30/2004 421
01040117280125 3/1/2011 6/30/2013 421
01040117280125 8/1/2014 6/30/2016 421
01040117280225 6/1/2006 6/30/2007 421
01040117280225 10/1/2007 6/30/2010 421
010404116809 3/1/1999 8/31/1999 459
010404116809 9/1/1999 1/31/2000 488
010404116809 2/1/2000 4/30/2004 512
010404116809 5/1/2004 6/30/2008 698
010404116809 7/1/2008 8/31/2011 913
010404116809 9/1/2011 1155
01040416060201 1/1/2007 6/30/2009 421
01040416060201 1/1/2010 6/30/2012 421
01040416060201 2/1/2013 6/30/2015 421
010404203410/1/2003 522
010404214406 5/16/1994 6/30/2008 23
010404214406 1/1/1999 6/30/2008 227
010404220510/1/2003 522
010404220501 12/1/2011 10
01040422050101 11/1/1999 6/30/2002 421
01040422050101 11/1/2002 6/30/2005 421
01040422050101 10/1/2006 6/30/2009 421
01040422050101 11/1/2013 6/30/2016 421
01040422050201 11/1/1999 6/30/2002 421
01040422050201 11/1/2002 6/30/2005 421
01040422050201 10/1/2006 6/30/2009 421
01040422050201 11/1/2013 6/30/2016 421
010404220504 6/13/1995 24
01040423845/16/1994 6/30/2008 24
01040423840101 11/1/2002 6/30/2005 421
01040423840201 11/1/2002 6/30/2005 421
010404253301 5/16/1994 24
010404253302 5/16/1994 6/30/2009 24
010404253303 5/16/1994 6/30/2009 24
01040425330301 12/1/2006 6/30/2009 421
01040425330301 10/1/2009 6/30/2012 421
01040425330301 10/1/2012 6/30/2015 421
01040425330302 2/1/2004 6/30/2006 421
010404253304 5/16/1994 6/30/2009 24
01040425330501 10/1/2011 6/30/2014 421
01050115210101 4/1/2005 6/30/2007 421
01050115210101 10/1/2007 6/30/2010 421
01050115210201 4/1/2005 6/30/2007 421
01050115210201 10/1/2007 6/30/2010 421
01050116320101 12/1/2001 6/30/2004 421
01050116320401 12/1/2001 6/30/2004 421
010502157710/1/2003 522
0105021577 4/1/2013 1329
010503605710/1/2003 522
01050360570101 12/1/2002 6/30/2005 421
010701163110/1/2003 522
01070116310101 1/1/2009 6/30/2011 421
01070116310125 9/1/2007 6/30/2008 421
01070116310125 1/1/2009 6/30/2011 421
01070116310125 10/1/2011 6/30/2014 421
010701163102 7/1/1996 3/31/2001 10006
010701163102 4/1/2001 10005
01070116310201 1/1/2006 6/30/2008 421
01070116310201 1/1/2009 6/30/2011 421
01070116310201 12/1/2011 6/30/2014 421
0107012381 5/9/1995 6/30/2008 24
010701238110/1/2003 522
01070123810101 1/1/2009 6/30/2011 421
01070123810101 10/1/2011 6/30/2014 421
01100125465/16/1994 6/30/2008 24
011001254610/1/2003 522
01100125460101 12/1/2002 6/30/2005 421
01100125460101 10/1/2006 6/30/2009 421
011002280925 10/1/2009 2/22/2011 137
011002280925 10/1/2009 9/13/2011 992
011002280925 2/23/2011 4/30/2011 1089
011002280925 5/1/2011 9/13/2011 137
011002280925 9/14/2011 ######## 1164
011002280925 9/14/2011 ######## 1166
011002280925 11/1/2011 137
011002280925 11/1/2011 992
01100228092526 6/1/2012 6/30/2014 421
011003 3/1/1996 3/31/1996 286
01100312975/16/1994 ######## 21
01100312975/16/1994 4/30/2005 27
011003129710/1/2003 522
0110031297 5/1/2005 22
011003129701 5/16/1994 ######## 26
01100312970104 9/1/1998 8/31/2001 400
011003129702 5/16/1994 ######## 37
01100312970204 9/1/1998 8/31/2001 400
01100312970304 9/1/1998 8/31/2001 400
011003129704 5/16/1994 ######## 26
01100320805/16/1994 ######## 21
01100320805/16/1994 22
011003208010/1/2003 522
011003208003 5/16/1994 ######## 30
011003208003 5/16/1994 2/28/2002 31
011003208003 3/1/2002 6/30/2008 624
01100320800325 4/1/2008 6/30/2010 421
01100320800325 10/1/2011 6/30/2014 421
011003208005 5/16/1994 ######## 30
01100320800502 9/1/1998 8/31/2001 400
01100320800525 1/1/2004 6/30/2005 421
01100320800525 10/1/2005 6/30/2008 421
01100320800525 10/1/2011 6/30/2014 421
01100320800602 9/1/1998 8/31/2001 400
01100320800625 1/1/2004 6/30/2005 421
01100320800625 10/1/2005 6/30/2008 421
01100320800625 10/1/2011 6/30/2014 421
011003208025 5/16/1994 ######## 30
01100323735/16/1994 ######## 21
01100323735/16/1994 22
011003237310/1/2003 522
011003237301 5/16/1994 ######## 42
01100323730103 2/1/2005 6/30/2007 421
01100323730104 9/1/1998 8/31/2001 400
01100323730203 1/1/2005 6/30/2007 421
01100323730204 9/1/1998 8/31/2001 400
01100324905/16/1994 ######## 21
01100324905/16/1994 22
011003249001 5/16/1994 ######## 30
01100719955/16/1994 21
01100719955/16/1994 22
011007199501 5/16/1994 32
011010102210/1/1995 ######## 270
0110101022 1/1/1998 8/31/1998 382
0110101022 9/1/1998 ######## 423
011010102210/1/2003 522
01101010220125 4/1/2013 6/30/2015 421
01101010222525 4/1/2013 6/30/2015 421
0110101098 7/1/1997 8/31/1998 350
011010109810/1/2003 522
01101010980125 6/1/2008 6/30/2010 421
01101010980125 10/1/2010 6/30/2013 421
01101010980126 8/1/2014 6/30/2016 421
01101010980225 6/1/2008 6/30/2010 421
01101010980225 10/1/2010 6/30/2013 421
01101010980226 8/1/2014 6/30/2016 421
01101010982525 5/1/2009 6/30/2010 421
01101010982525 10/1/2011 6/30/2014 421
011010263912/1/1995 6/30/1996 278
011010263912/1/1995 ######## 280
011010263910/1/2003 522
0110102639 8/1/2006 5020
011010263901 1/29/1995 ######## 35
01101026390126 5/1/2009 6/30/2011 421
01101026390127 1/1/2012 6/30/2014 421
01101026390325 5/1/2009 6/30/2011 421
01101026390325 10/1/2011 6/30/2014 421
01101026390426 5/1/2009 6/30/2011 421
01101026390427 1/1/2012 6/30/2014 421
01101026390526 5/1/2009 6/30/2011 421
01101026390527 1/1/2012 6/30/2014 421
011010263925 7/1/2011 745
01101026392525 10/1/2011 6/30/2014 421
01101311595/16/1994 6/30/1999 21
011013219101 5/16/1994 6/30/1999 21
011013230401 5/16/1994 6/30/1999 21
01101339972525 4/1/2013 29
01101339972525 4/1/2013 429
011301157001 7/1/1996 10005
011301157003 7/1/1996 1/31/1997 10005
011301157004 3/1/1997 10005
0113013996 4/1/2013 1320
01130139962525 4/1/2013 29
01130139962525 4/1/2013 429
011301399626 4/1/2013 6/30/2014 10
01130139962625 4/1/2013 29
01130139962625 4/1/2013 429
01130139962725 7/1/2014 29
0113031648 7/1/1996 533
011303164825 9/1/1995 9/30/1996 269
011303164825 10/1/1996 ######## 11
011303164825 11/1/2004 8/31/2006 750
0113051649 7/1/1996 533
0113051655 7/1/1996 533
011305388225 11/1/2008 533
011305388226 11/1/2008 533
011305398211/1/2002 533
0113056300 7/1/1996 533
011305630005 7/1/1996 9/30/1996 269
011305630005 10/1/1996 ######## 11
011305630005 11/1/2004 8/31/2006 750
0113073857 7/1/2006 533
0113073857 7/1/2006 7/31/2010 834
0113073857 8/1/2010 1/31/2012 1022
011309 11/1/2002 8/31/2006 641
011309 4/1/2004 8/31/2006 684
0113091192 5/1/1999 ######## 464
0113091192 5/1/1999 533
011309378311/1/2002 533
0113093908 8/1/2010 533
0113111247 9/1/1999 8/31/2008 490
011311124710/1/2003 522
0113111247 9/1/2008 8/31/2010 925
0113111247 3/1/2013 5/31/2013 1298
01131112470101 8/1/2009 6/30/2012 421
01131112470125 3/1/2013 5/30/2015 421
01131112470201 8/1/2009 6/30/2012 421
01131112470225 3/1/2013 6/30/2015 421
011312156710/1/2003 522
01131215670104 11/1/1999 6/30/2002 421
01131215670104 11/1/2002 6/30/2005 421
01131215670201 11/1/1999 6/30/2002 421
01131215670201 11/1/2002 6/30/2005 421
011312156810/1/2003 522
01131215680125 5/1/2003 6/30/2005 421
01131215680125 2/1/2006 6/30/2008 421
01131215680125 10/1/2008 6/30/2011 421
01131215680125 10/1/2011 6/30/2014 421
011312156910/1/2003 522
01131215690102 4/1/2003 6/30/2005 421
01131215690102 10/1/2005 6/30/2008 421
01131215690102 10/1/2008 6/30/2011 421
01131215690102 1/1/2013 6/30/2015 421
0113121794 4/1/2004 522
01131217940103 11/1/2000 6/30/2003 421
01131217940103 11/1/2003 6/30/2006 421
01131217940105 1/1/2013 6/30/2015 421
01131217940125 1/1/2008 6/30/2009 421
01131217940126 5/1/2010 6/30/2012 421
01131217940126 1/1/2013 6/30/2015 421
01131217940203 11/1/2000 6/30/2003 421
01131217940203 11/1/2003 6/30/2006 421
01131217940205 1/1/2013 6/30/2015 421
01131217940226 1/1/2008 6/30/2009 421
01131217940227 5/1/2010 6/30/2012 421
01131217940227 1/1/2013 6/30/2015 421
011312227710/1/2003 522
01131222770101 10/1/2003 6/30/2006 421
0113123800 9/1/2004 7/31/2005 738
0113123800 8/1/2005 ######## 781
0113123800 1/1/2006 3/31/2007 819
0113123800 4/1/2007 6/30/2009 859
0113123800 7/1/2009 ######## 959
0113123800 6/1/2012 522
01131238002526 12/1/2009 6/30/2012 421
01131238002526 10/1/2012 6/30/2015 421
01131238002626 12/1/2009 6/30/2012 421
01131238002626 10/1/2012 6/30/2015 421
01131238002726 12/1/2009 6/30/2012 421
01131238002726 10/1/2012 6/30/2015 421
01150113576/13/1995 6/30/2001 160
011501135710/1/2003 522
011501135701 5/16/1994 141
011501157201 5/16/1994 141
011501157202 5/16/1994 141
011504157204 5/16/1994 141
011504157210 5/16/1994 141
011504215810/1/2003 522
0115042158 8/1/2010 ######## 1023
011504215811/1/2011 1167
011504215801 5/16/1994 141
011504215825 8/1/2009 141
0115043888 7/1/2009 8/31/2009 971
0115043888 9/1/2009 7/31/2010 986
0115043888 8/1/2010 1023
0115043888 7/1/2013 10010
011504388825 8/1/2009 141
011504398312/1/2012 ######## 1278
0115043983 7/1/2013 10001
0115043983 1/1/2014 1413
011507157203 6/1/2005 771
0115073802 6/1/2005 6/30/2009 771
0115073802 7/1/2009 8/31/2012 972
0115073802 9/1/2012 ######## 1250
011507380211/1/2012 2/28/2014 1268
0115073802 7/1/2013 10050
0115073802 3/1/2014 1419
011507380225 7/1/2013 1390
01150738022527 3/1/2013 1294
01150738022528 3/1/2013 1291
01150738022531 3/1/2013 6/30/2015 421
01150738022532 3/1/2013 6/30/2015 421
0115073807 4/1/2005 6/30/2009 766
011507380712/1/2007 902
0115073807 7/1/2009 8/31/2012 966
0115073807 9/1/2012 2/28/2013 1251
0115073807 7/1/2013 1342
0115073807 7/1/2013 10001
011507380726 9/1/2012 6/30/2013 549
011507380726 7/1/2013 1389
01150738072625 9/1/2012 6/30/2013 1253
01150738072625 12/1/2012 6/30/2015 421
01150738072625 3/1/2013 6/30/2015 421
01150738072626 9/1/2012 6/30/2013 1254
01150738072626 12/1/2012 6/30/2015 421
01150738072627 9/1/2012 6/30/2013 1255
01150738072627 12/1/2012 6/30/2015 421
0115073809 9/1/2012 ######## 1236
011507380911/1/2012 2/28/2014 1267
0115073809 3/1/2014 1419
011509 12/1/1997 2/28/2014 375
011509 3/1/2014 1420
0115091110 9/1/1997 ######## 360
011509111012/1/1997 9/30/1999 380
011509111010/1/1999 2/28/2005 496
011509111010/1/2003 522
0115091110 3/1/2005 764
011509111001 10/1/1999 9/30/2003 533
011509111002 10/1/1999 9/30/2003 533
011509165312/1/1995 ######## 80
011509165312/1/1995 ######## 81
011509165312/1/1997 206
011509165301 5/16/1994 ######## 81
011509165301 7/1/1996 533
011509630712/1/1995 ######## 359
011509630712/1/1997 9/30/1999 378
011509630710/1/1999 2/28/2005 495
011509630710/1/2003 522
0115096307 3/1/2005 763
011509630701 7/1/1996 8/31/1997 533
011509630702 10/1/1999 9/30/2003 533
011509630703 10/1/1999 9/30/2003 533
011509630704 10/1/1999 9/30/2003 533
011509630705 10/1/1999 9/30/2003 533
011509630706 10/1/1999 9/30/2003 533
011509630707 10/1/1999 9/30/2003 533
0115123968 9/1/2012 22
0115123968 9/1/2012 1237
0115123968 9/1/2012 1238
0115123968 9/1/2012 1239
011515 9/1/2012 1240
0115153969 9/1/2012 22
0115153969 9/1/2012 1241
0115153969 9/1/2012 7/31/2013 1242
0115153969 9/1/2012 7/31/2013 1243
0115153969 8/1/2013 1395
0115153970 9/1/2012 22
0115153970 9/1/2012 1244
0115153970 9/1/2012 7/31/2013 1245
0115153970 9/1/2012 7/31/2013 1246
0115153970 8/1/2013 1398
0115153971 9/1/2012 22
0115153971 9/1/2012 1247
0115153971 9/1/2012 1248
0115153984 1/1/2013 22
0115153984 1/1/2013 1241
0115153984 1/1/2013 7/31/2013 1242
0115153984 1/1/2013 7/31/2013 1243
0115153984 8/1/2013 1395
0115153985 1/1/2013 22
0115153985 1/1/2013 1241
0115153985 1/1/2013 7/31/2013 1242
0115153985 1/1/2013 7/31/2013 1243
0115153985 8/1/2013 1395
0115153986 1/1/2013 22
0115153986 1/1/2013 1241
0115153986 1/1/2013 7/31/2013 1242
0115153986 1/1/2013 7/31/2013 1243
0115153986 8/1/2013 1395
0115153987 1/1/2013 22
0115153987 1/1/2013 1241
0115153987 1/1/2013 7/31/2013 1242
0115153987 1/1/2013 7/31/2013 1243
0115153987 8/1/2013 1395
0122011126 3/1/1999 8/31/2006 458
0122011126 3/1/2005 3/31/2005 124
0122011126 4/1/2005 8/31/2006 767
0122011126 9/1/2006 6/30/2008 841
0122011126 7/1/2008 2/28/2010 914
0122011126 3/1/2010 2/29/2012 1003
0122011126 3/1/2012 6/30/2013 1188
0122011126 8/1/2012 ######## 1231
0122011126 7/1/2013 1383
012201112601 3/1/1999 2/28/2005 759
012201112601 12/1/2011 10
01220111260101 1/1/2006 6/30/2008 421
01220111260101 10/1/2008 6/30/2011 421
012201112625 3/1/2012 10
01220111262525 8/1/2012 6/30/2014 421
012201192501 5/10/1995 24
012201192502 5/10/1995 24
012201192503 5/10/1995 24
012201192509 5/10/1995 24
012201192510 5/10/1995 24
012201192511 5/10/1995 5/31/2010 24
012201192512 5/10/1995 24
012201192513 5/10/1995 5/31/2010 24
012201192514 5/10/1995 24
012201192515 5/10/1995 5/31/2010 24
012201192525 5/1/2000 5/31/2010 24
012201192525 8/1/2012 204
01220124195/16/1994 46
01250124525/16/1994 22
012501245210/1/2003 522
01250124520206 2/1/2011 6/30/2013 421
01250124520206 10/1/2013 6/30/2016 421
012501285910/1/2003 522
01250424295/16/1994 22
012504242910/1/2003 522
01250424290101 3/1/2003 6/30/2005 421
01250424290101 1/1/2006 6/30/2008 421
01250424290201 3/1/2003 6/30/2005 421
01250424290201 1/1/2006 6/30/2008 421
01250424290325 9/1/2010 6/30/2011 421
01250424290325 10/1/2011 6/30/2014 421
01250424290425 9/1/2010 6/30/2011 421
01250424290425 10/1/2011 6/30/2014 421
01250424290601 3/1/2003 6/30/2005 421
01250424305/16/1994 22
012504243010/1/2003 522
012504243011/1/2011 1168
012504243004 5/16/1994 6/30/1999 44
01250424300401 3/1/2003 6/30/2005 421
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160307197025 6/1/2000 10030
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160307197027 7/1/1996 10200
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160307197028 7/1/1996 ######## 10200
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16030719985/26/1995 7/31/1999 170
160307204601 7/1/1996 2/28/2001 10005
160307204602 7/1/1996 10005
16030720460201 12/1/2002 6/30/2005 421
16030720460201 10/1/2005 6/30/2008 421
16030720460201 1/1/2009 6/30/2011 421
16030720460201 12/1/2011 6/30/2014 421
160307398825 1/1/2013 10005
160310182810/1/2003 522
160310182801 7/1/2013 1355
160310224101 7/1/1996 2/28/2001 10030
16031024235/16/1994 5/31/1999 69
160310252910/1/2003 522
160310252901 7/1/1996 10030
160310252903 10/4/1997 10030
16031025290302 12/1/2000 4/30/2001 421
160310252904 10/4/1997 10030
16031025290401 12/1/2000 6/30/2003 421
16031025290401 10/1/2003 6/30/2006 421
16031025290401 10/1/2011 6/30/2014 421
1603103999 4/1/2013 1332
16031039992525 4/1/2013 29
16031039992525 4/1/2013 429
160313 9/1/2002 5029
160313125906 7/1/1996 24
16031312616/22/1995 24
16031313035/16/1994 ######## 24
160313130301 11/1/1999 ######## 504
160313130301 12/1/2008 944
16031313030101 1/1/2003 6/30/2005 421
16031313030101 10/1/2005 6/30/2008 421
16031313030125 8/1/2012 6/30/2013 421
16031313030125 11/1/2013 6/30/2016 421
160313130302 5/1/1994 429
160313130302 11/1/1999 233
160313130303 11/1/1999 24
16031313030301 1/1/2003 6/30/2005 421
16031313030301 10/1/2005 6/30/2008 421
16031313030301 10/1/2013 6/30/2016 421
16031313465/16/1994 7/31/2010 23
16031313465/16/1994 67
1603131346 1/1/1999 7/31/2010 227
1603131346 8/1/2010 24
16031313460125 1/1/2008 6/30/2010 421
160313136110/1/2003 522
160313136101 5/16/1994 10200
160313136102 5/16/1994 10030
16031313610201 2/1/2003 6/30/2005 421
16031313610201 10/1/2005 6/30/2008 421
16031313610206 11/1/1999 6/30/2002 421
160313136104 1/1/1999 10200
16031313610401 11/1/1999 6/30/2002 421
16031313610401 12/1/2002 6/30/2005 421
16031313610401 10/1/2005 6/30/2008 421
160313154601 5/26/1995 7/31/2010 23
160313154601 1/1/1999 7/31/2010 227
160313154601 8/1/2010 24
16031315460101 10/1/2003 6/30/2006 421
16031315460101 4/1/2013 1299
160313154602 5/26/1995 23
160313154602 1/1/1999 227
160313154603 5/26/1995 7/31/2010 23
160313154603 5/26/1995 518
160313154603 1/1/1999 7/31/2010 227
160313154603 8/1/2010 24
160313155401 5/16/1994 ######## 67
160313155401 1/1/1999 7/31/2010 227
160313155401 11/1/1999 6/30/2013 505
160313155401 7/1/2013 1356
160313155402 5/16/1994 ######## 67
160313155402 1/1/1999 7/31/2010 227
160313155402 11/1/1999 6/30/2013 505
160313155402 7/1/2013 1356
16031315540225 3/1/2013 29
16031315540225 4/1/2013 429
160313155403 5/16/1994 ######## 67
160313155403 1/1/1999 7/31/2010 227
160313155403 11/1/1999 6/30/2013 505
160313155403 7/1/2013 1356
16031315540301 1/1/2003 6/30/2005 421
16031315540301 9/1/2006 6/30/2009 421
16031315540301 1/1/2010 6/30/2012 421
16031315540301 10/1/2012 6/30/2015 421
16031317206/22/1995 7/31/1999 170
1603131852 1/1/1999 227
160313217101 5/16/1994 ######## 24
160313227401 5/16/1994 67
160313227402 5/16/1994 67
160313227402 1/1/1999 7/31/2010 227
16031322740203 10/1/2011 6/30/2014 421
160313230010/1/2003 522
160313230002 7/1/1996 10030
16031323000202 8/1/1999 6/30/2002 421
16031323000202 12/1/2002 6/30/2005 421
16031323000202 1/1/2006 6/30/2008 421
16031323000202 1/1/2009 6/30/2011 421
16031323145/16/1994 ######## 71
1603132314 1/1/1999 7/31/2010 227
160313231411/1/1999 6/30/2013 506
1603132314 7/1/2013 1357
16031323140101 12/1/2001 6/30/2004 421
16031323140201 12/1/2001 6/30/2004 421
16031323140301 12/1/2001 6/30/2004 421
16031323140325 7/1/2006 6/30/2008 421
16031323140325 1/1/2009 6/30/2011 421
16031323140325 10/1/2011 6/30/2014 421
160313244002 5/16/1994 68
16031325486/22/1995 23
1603132819 4/1/2013 4/30/2013 1300
1603132819 5/1/2013 1344
160313281901 5/26/1995 9/30/2005 24
160313281901 10/1/2005 10005
16031328190125 5/1/2003 6/30/2005 421
16031328190125 10/1/2005 6/30/2008 421
16031328190125 3/1/2012 6/30/2014 421
16031328190126 4/1/2009 6/30/2011 421
160313281902 5/26/1995 9/30/2005 24
160313281902 10/1/2005 10005
16031328190225 5/1/2003 6/30/2005 421
16031328190225 10/1/2005 6/30/2008 421
16031328190225 3/1/2012 6/30/2014 421
16031328190226 4/1/2009 6/30/2011 421
160313281903 5/26/1995 3/31/2013 24
16031328190325 5/1/2003 6/30/2005 421
16031328190325 10/1/2005 6/30/2008 421
16031328190325 3/1/2012 6/30/2014 421
16031328190326 4/1/2009 6/30/2011 421
160313392512/1/2010 6/30/2013 1065
1603133925 1/1/2011 549
1603133925 7/1/2013 1358
1603133932 2/1/2011 24
1603133932 4/1/2013 1302
16031339322525 2/1/2011 3/31/2011 29
1603133992 4/1/2013 1328
16031339922525 4/1/2013 29
16031339922525 4/1/2013 429
1603133993 4/1/2013 1331
16031339932525 4/1/2013 29
16031339932525 4/1/2013 429
1603133998 4/1/2013 1324
16031339982525 4/1/2013 29
16031339982525 4/1/2013 429
1604 9/1/2002 5012
1604 9/1/2002 5013
16040115135/16/1994 23
1604011513 1/1/1999 7/31/2005 226
1604011513 8/1/2005 227
160401169601 5/16/1994 24
160401169601 4/1/2013 6/30/2014 1303
160401169601 7/1/2014 14
160401169601 7/1/2014 1455
16040116960101 8/1/2004 6/30/2007 421
16040116960101 1/1/2014 29
16040116960101 1/1/2014 429
16040118815/18/1995 9/30/1999 163
160401188106 5/16/1994 9/30/1999 75
160401188125 5/16/1994 9/30/1999 76
16040118812502 11/1/2004 6/30/2007 421
16040118812502 1/1/2007 3/31/2010 29
16040118812502 10/1/2007 6/30/2010 421
16040118812502 12/1/2010 6/30/2013 421
160401188126 5/16/1994 9/30/1999 76
16040118812601 9/1/2004 6/30/2007 421
16040118812601 10/1/2007 6/30/2010 421
16040118812601 12/1/2010 6/30/2013 421
16040127095/16/1994 7/31/2010 23
1604012709 1/1/1999 7/31/2005 226
1604012709 8/1/2005 7/31/2010 227
1604012709 8/1/2010 5/31/2011 24
160401270901 6/1/2011 24
16040127090125 3/1/2006 6/30/2008 421
16040127090125 10/1/2008 6/30/2011 421
16040127090126 4/1/2012 6/30/2014 421
160401270902 6/1/2011 ######## 1132
160401270902 6/1/2011 6/30/2011 1133
160401270902 7/1/2011 ######## 1140
160401270902 12/1/2011 1172
160401270902 12/1/2011 1173
16040127090225 3/1/2006 6/30/2008 421
16040127090225 10/1/2008 6/30/2011 421
16040127090226 4/1/2012 6/30/2014 421
160401270903 6/1/2011 24
16040127090325 3/1/2007 6/30/2008 421
16040127090325 10/1/2008 6/30/2011 421
16040127090326 4/1/2012 6/30/2014 421
160401270925 8/1/2011 429
160401270925 8/1/2011 6/30/2013 1148
160401270925 7/1/2013 1359
16040128035/16/1994 7/31/2010 23
1604012803 1/1/1999 7/31/2005 226
1604012803 8/1/2005 7/31/2010 227
1604012803 8/1/2010 3/31/2013 24
160401280301 4/1/2013 4/30/2013 1339
160401280301 5/1/2013 1346
16040128030101 9/1/2007 6/30/2010 421
16040128030125 5/1/2011 6/30/2013 421
16040128030125 11/1/2013 6/30/2016 421
160401280325 4/1/2013 1322
16040128305/27/1995 8/31/2005 23
1604012830 1/1/1999 8/31/2005 226
1604012830 6/1/2012 522
160401283001 12/1/2011 10
16040128300126 12/1/2006 6/30/2008 421
16040128300126 10/1/2008 6/30/2011 421
16040128300127 2/1/2012 6/30/2014 421
160401397811/1/2012 1273
160401397827 11/1/2012 429
1604013989 1/1/2013 1285
161001128010/1/2003 522
16100120735/16/1994 8/31/1998 23
1610014002 4/1/2013 1326
16100140022525 4/1/2013 29
16100140022525 4/1/2013 429
161204207910/1/2003 522
161204207901 11/1/1997 370
16120420790104 12/1/2000 6/30/2003 421
16120420790104 10/1/2003 6/30/2006 421
16120420790104 10/1/2006 6/30/2009 421
161204207902 11/1/1997 370
16120420790205 12/1/2000 6/30/2003 421
16120420790205 10/1/2003 6/30/2006 421
16120420790205 10/1/2006 6/30/2009 421
16120420790205 1/1/2010 6/30/2012 421
161301182001 7/1/1996 10030
16130118200102 11/1/1999 6/30/2002 421
16130118200102 9/1/2004 6/30/2007 421
16130118200202 11/1/1999 6/30/2002 421
16130118200202 9/1/2004 6/30/2007 421
16130119060101 12/1/2001 6/30/2004 421
161601 5/16/1994 856
16160112095/16/1994 7/31/1997 24
Trial Version
Code Memoranda
6 Special Authority for Subsidy - Form SA0006Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
9 In combination
10 Pharmaceutical with a standardised formula for compounding in Ora products
11 Special Authority for Subsidy - Form SA0011Initial application only from a relevant specialist. Approvals valid for 2 years where the patient has diabetes. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
14 Pharmaceutical Cancer Treatment in respect of which DHB hospital pharmacies and other Contractors can claim Subsidies.
15 Pharmaceutical Cancer Treatment in respect of which only DHB hospital pharmacies can claim Subsidies.
21 Month Restriction
22 Only on a prescription
23 Hospital Pharmacy - Specialist
24 Retail Pharmacy - Specialist
25 Specialist
26 Maximum daily dose of 400 mg
27 a) Only on a prescription. b) Not as an effervescent or dispersible tab.
28 Special Authority for Subsidy - Form SA0028Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 All of the following: 1.1 Treatment with other lipid modifying medicines has been unsuccessful; and 1.2 6 months of dietary modification has been unsuccessful; and 1.3 Cholesterol level > 7.0 mmol/litre; and 1.4 Either: 1.4.1 Familial hypercholesterolaemia; or 1.4.2 Manifest coronary heart disease, which has been clinically proven, or previously treated by coronary artery surgery; or 2 Cholesterol level > 9.0 mmol/litre:.Renewal only from a general practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. NoteFamilial hypercholesterolaemia is defined as being hypercholesterolaemia in the presence of tendon xanthomas or in association with a family history of premature heart disease (before age 55) or consisten
29 Unapproved medication supplied under Section 29 of the Medicines Act 1981. Practitioners prescribing this medication should: (a) be aware of and comply with their obligations under Section 29 of the Medicines Act 1981 and otherwise under that Act and the Medicines Regulations 1984; (b) be aware of and comply with their obligations under the Health and Disability Commissioner's Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and(c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an indication for which it is not approved.
31 Special Authority for Subsidy - Form SA0031Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Oesophageal stricture; or 2 Terminal care; or 3 Too young to swallow conventional tablets; or 4 Too old to swallow conventional tablets. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
33 a) When ordered by a medical practitioner on a practitioner's supply order for ventricular arrhythmias and the order is endorsed accordinglyb) When ordered for a dialysis patient or a child with rhumatic fever and the order is endorsed accordingly
34 Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
35 Special Authority for Manufacturers Price - Form SA0035Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Both: 1 Either: 1.1 Both: 1.1.1 Duodenal and gastric ulcers, reflux oesophagitis and Zollinger-Ellison syndrome; and 1.1.2 Other treatments have failed; or 1.2 Patients who are on a Social Welfare benefit or an income no greater than a benefit; and 2 Patients must have endoscopically demonstrated lesions prior to commencement of treatment.. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
36 restricted to children under seven years of age
38 Only as tablets
39 Not more than 30 patches per month
40 Only as capsules
41 Special Authority for Subsidy - Form SA0041Initial application only from a relevant specialist. Approvals valid for 2 years where alternative antihypertensives have failed. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
43 Note: Danthron with poloxamer is only approved for the prevention or treatment of constipation in the terminally ill. Studies in rats have associated use of danthron with tumours.
44 Oral use only
45 Special Authority for Subsidy - Form SA0045Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Continuation of treatment commenced prior to 1 August 1990; and 2 Alternatives (salbutamol and terbutaline) have been tried; and 3 Either: 3.1 Asthma; or 3.2 Chronic obstructive airways disease (COAD); and 4 Applicants must provide details of dose. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
46 Special Authority for Subsidy - Form SA0046Initial application only from a gastroenterologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Functioning gall bladder; and 2 Either: 2.1 Uncalcified gallbladder stones with a maximum size of 20 mm; or 2.2 Adjunctive treatment after extra corporeal lithotrypsy. Renewal only from a gastroenterologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
47 Special Authority for Subsidy - Form SA0047Initial application only from a paediatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Child under 2 years of age; or 2 Both: 2.1 Child with major physical or intellectual disabilities; and 2.2 Lacks the necessary coordination to use aerosols with a spacer device. NoteThe cost of nebuliser therapy greatly exceeds other inhaled forms. Steroid nebulising solution can cause cataract formation. Renewal only from a paediatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
48 Not in combination
49 For terminal care patients, usually those in a hospice. Diagnosis needs to be provided.
50 Special Authority for Subsidy - Form SA0050Initial application only from a relevant specialist. Approvals valid for 2 years where terminally ill patient. Renewal only from a relevant specialist. Approvals valid for 2 years where terminally ill patient.
51 Special Authority for Subsidy - Form SA0051Initial application from any medical practitioner. Approvals valid for 6 months where control of nausea in the treatment of malignant disease. Renewal from any medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
53 Special Authority for Subsidy - Form SA0053Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 RAST or skin test positive; and 2 Patient has had severe generalised reaction to the sensitising agent. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
54 Only on a prescrition when prescribed for prophylaxis of asthma
55 Special Authority for Subsidy - Form SA0055Initial application only from a psychiatrist, geriatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 For use only as an anxiolytic; and 2 Other agents are contraindicated or have failed. Renewal only from a psychiatrist, geriatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
56 Special Authority for Subsidy - Form SA0056Initial application only from a psychiatrist. Approvals valid for 5 years for applications meeting the following criteria: Both: 1 Long-standing delusional states; and 2 Other injectable anti-psychotics have proven to be ineffective or inappropriate. Renewal only from a psychiatrist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
57 Special Authority for Subsidy - Form SA0057Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Depression; and 2 Any of the following: 2.1 Both: 2.1.1 Failed trials with other antidepressants; and 2.1.2 Patient has been maintained on mianserin prior to December1993; or 2.2 Co-existent bladder neck obstruction; or 2.3 Cardiovascular disease. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
58 Maximum of 1 patch per week.
59 In a quantity not exceeding 3 tablets per prescription
60 Not more than 6 tablets per month
61 Only on a PSO
62 Only on a prescription.
63 PSO must be endorsed 'not for anaesthetic procedures'.
64 Not more than 2 per dispensing
66 Precriber needs approval from the Minister of Health
67 Subsidised only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly
68 Injections (both 500 mg and 1 g) subsidised: a) only if prescribed for a dialysis or cystic fibrosis patient; and b) the prescription is endorsed accordingly.
69 Special Authority for Subsidy - Form SA0069Initial application only from a general physician, nephrologist or neurologist. Approvals valid for 5 years where syndrome of inappropriate anti-diuretic hormone secretion (SIADH). Renewal only from a general physician, nephrologist or neurologist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
70 Special Authority for Manufacturers Price - Form SA0070Initial application only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Avium intracellular atypical mycobacterial infections; or 2 Multiple drug resistant tuberculosis; or 3 Atypical and drug-resistant mycobacterial infections in patients with AIDS. Renewal only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
71 Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudo membranous colitis and the prescription is endorsed accordingly
73 Not exceeding 30 ml per person.
74 Not exceeding 6 tab per person.
75 a) Maximum of one pack per month of oral powder.
76 Maximum of 42 cap or tab per prescription.
77 a) Only granted after the patient has proven to be intolerant to zidovudine or whose health has significantly deteriorated while on zidovudine. It is impossible to have approvals for both AZT and DDI concurrently but it is not expected that both medicines would be consumed at the same time. Applications can be made without patients having had a preliminary trialb) Specialist must make application
78 a) Approvals granted as third line therapy after patient has developed intolerance or treatment failure to both zidovudine and DDI b) Specialist must make application
79 a) All patients with AIDS meeting the definition developed by the Centres for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88)b) Patients with AIDS Related Complex (ARC)c) HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatologyd) Prophylactically for persons following severe parenteral exposure from a known HIV positive sourcee) HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count f) Applications can only be made by appropriate specialists. Prescriptions for those patients approved to use these medicines can be written either by the specialist or general practitioner with an endorsement of the name of the recommending specialist. g) Prescriptions for these can be written for a period of three months' supply. However, medicine must be dispensed on a monthly basis.
80 NOTE: Evidence that a patient is on insulin therapy can be by way of either: a) insulin being on the same prescription ofb) by the word "insulin patient" be in written on the prescription by either the doctor or the contractor.
81 All non-disposible diabetic supplies are only eligible for subsidy if there is produced to the contractor a certificate the gives the nome, address, and age of the patient and that:1) is signed by a doctor and2) is dated less than two years propr to the date of supply; and that 3) states that the patient is receiving iusulin therapy.
82 Only on a WSO
83 Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the low dose oestrogens.
84 Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
85 Special Authority for Subsidy - Form SA0085Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
86 a) Males: Fertile eunuch syndrome, females: anovulatory infertilityb) A declaration is required from the applying doctor that these agents are not being used as part of an IVF programmec) Approvals are valid for 6 months with a revewal for a further 6 months if the patient has some response and the prescriber believes further treatment will be effectived) Specialist must make application - endocrinologists and gynaecologists only
87 Special Authority for Subsidy - Form SA0087Initial application only from an endocrinologist or gynaecologist. Approvals valid for 6 months where hypogonadotrophic hypogonadism (including anovulatory infertility and cryptochidism). Renewal only from an endocrinologist or gynaecologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
88 Special Authority for Subsidy - Form SA0088Initial application only from an endocrinologist or gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Either: 1.1 Female with anovulatory infertility, males: hypogonadotrophic hypogonadism; or 1.2 Male with hypogonadotrophic hypogonadism; and 2 These agents are not being used as part of an IVF programme. Renewal only from an endocrinologist or gynaecologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
89 Special Authority for Subsidy - Form SA0089Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. NoteThe maximum treatment period for a GnRH analogue is: 3 months to assess whether surgery is appropriate3 months for infertile patients after surgery6 months for
90 Special Authority for Subsidy - Form SA0090Initial application only from a relevant specialist. Approvals valid for 2 years where patient cannot use desmopressin nasal spray or nasal drops. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
91 Special Authority for Subsidy - Form SA0091Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Paget's disease; or 2 Both: 2.1 Patients under hospice care; and 2.2 Either: 2.2.1 Tumour-induced hypercalcaemia; or 2.2.2 Tumour-induced osteolysis without hypercalcaemia. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
92 Special Authority for Subsidy - Form SA0092Initial application only from a relevant specialist. Approvals valid for 5 years where treatment of refractory absorptive hypercalcaemia. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
94 Special Authority for Subsidy - Form SA0094Initial application only from a relevant specialist (Only for Epsom Day Unit in Auckland). Approvals valid for 1 month where termination of advanced pregnancy i.e. beyond 12 weeks. Only for Epsom Day Unit in Auckland.
96 Special Authority for Subsidy - Form SA0096Initial application - (Organ transplant, Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Organ transplant; or 2 Bone marrow transplant; or 3 Graft v host disease. Initial application - (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Psoriasis; and 2 Other systemic and topical therapy has failed. Initial application - (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not resopnsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application - (Nephrotic Syndrome) from any medical practitioner. Approvals valid for 2 years for applications meeting the following cri
97 Special Authority for Subsidy - Form SA0097Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. Initial application - (Indications other than Chronic hepatitis C) only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 AIDS related Kaposi's sarcoma; or 6 Multiple myeloma; or 7 Chronic active hepatitis B. Renewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other than Chronic hepatitis C) only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
98 a) Hairy cell leukaemia, Kaposi's sarcoma, chronic active hepatitis B, chronic hepatitis C (6 month approval only), chronic myelogenous leukaemia, multiple myelomab) Specialist must make applicationc) No further approvals for:Malignant melanoma, superficial and noduloulcerative basal cell carcinomaNote: Patients with existing approvals can continue to have therapy
99 Special Authority for Subsidy - Form SA0099Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patients who have failed surgery, radiotherapy, bromocriptine and other oral therapies; or 2 Both: 2.1 Either: 2.1.1 Vipomas; or 2.1.2 Glucagonomas; and 2.2 Patients who are seriously ill in order to improve their clinical state prior to definitive surgery; or 3 Both: 3.1 Gastrinoma; and 3.2 Either: 3.2.1 Patient has failed surgery; or 3.2.2 Patient is in metastatic disease after H2 antagonists (or omeprazole) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or where surgery has failed; or 5 Pre-operative control of hypoglycaemia; or 6 Maintenance therapy. NoteThe use of octreotide in patients with fistulae, oesophageal varices, miscellaneous diarrhoea and hypotension will
100 Special Authority for Subsidy - Form SA0100Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either: 4.6.2.1 Heart failure (low card
101 Maximum of 2 patches per week.
102 Only in quantities of 50 ml or less per unit
103 a) Maximum of 50 mls per unit b) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent c) On a bulk supply orderd) When used in the extemporaneous compounding of eye drops
104 Not exceeding a strength of 50 mg per dose.
107 Maximum of 1 pack (10 patches and 12 tablets) per month.
108 Special Authority for Subsidy - Form SA0108Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Hairy cell leukaemia; or 2 Chronic active hepatitis B. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
110 Special Authority for Subsidy - Form SA0110Initial application only from a relevant specialist. Approvals valid for 5 years where biotinidase deficiency. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
112 Maximum 4 tablets per day
115 Special Authority for Subsidy - Form SA0115Initial application - (Oesophageal stricture) only from a general practitioner or relevant specialist. Approvals valid for 2 years where patient with oesophageal stricture who is unable to take capsules. Initial application - (Indications other than oesophageal stricture) only from a paediatrician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 infant or child with liver disease or short gut syndrome; and 2 Requires vitamin supplementation; and 3 Unable to swallow capsules. Renewal only from a general practitioner, relevant specialist or paediatrician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
116 Only on a prescription
117 Maximum of 30 capsules per month
118 If not more than 3 months supply is prescribed
119 Special Authority for Subsidy - Form SA0119Initial application only from a rheumatologist. Approvals valid for 5 years where ankylosing spondylitis. Renewal only from a rheumatologist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
120 Maximum of 1% strength
121 Special Authority for Subsidy - Form SA0121Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient has to use an unpreserved solution due to an allergy to the preservative; or 2 Patient wears soft contact lenses. NoteMinims for a general practice are considered to be "tools of trade" and are not approved as special authority items. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
122 Special Authority for Subsidy - Form SA0122Initial application only from a relevant specialist. Approvals valid for 2 years where filamentary keratitis. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
124 Retail Pharmacy - Specialist prescription
125 Special Authority for Subsidy - Form SA0125Initial application - (Chronic post-thrombotic venous stasis ulcers) from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Chronic post-thrombotic venous stasis ulcers of more than 4 months duration; and 2 Other interventions have failed. Initial application - (Sudden hearing loss) only from an otolaryngologist. Approvals valid for 2 years where sudden hearing loss. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
126 a) Subsidised only if prescribed for an amputee with an artificial limb, or for a paraplegic patient; andb) On a prescription endorsed accordingly.
127 When prescribed in a quantity not exceeding 15 g per prescription
128 Not when prescribed as a contraceptive
129 b) When prescribed in a quantity not exceeding 3.5 ml per prescription.
131 a) With other pharmaceutical requirementsb) In extemporaneously compounded preparations.
133 a) Should be strictly reserved for use as second line therapy in: - patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema- cases of scabies which are resistent to gamma benzene hexachlorideb) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: - a definite diagnosis of scabies should be made- it should be ascertained that the medication was administered properly- the possibility of reinfestation should have been excluded
134 Maximum of 100 g per prescription.
137 Maximum of 14 g per prescription.
138 Special Authority - Hospital pharmacya) Approvals granted only for children receiving chemotherapyb) Specialist must make application
140 Special Authority for Subsidy - Form SA0140Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Pain management in the terminally ill; and 2 Standard therapy has failed. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
141 Not on a bulk supply order
142 Maximum 3.5 ml per prescription.
144 Only on a WSO. Distributed by the Asthma Foundation. Forward orders to: The Asthma Foundation, PO Box 1459, Wellington. Distributed by the Asthma Foundation. Also available to paediatricians employed by an HHS, on a wholesale supply order signed by the paediatrician. Orders via a hospital pharmacy.
145 Only available for children aged six years and under.
146 Only when dispensed as an ingredient in a preparation specified in the Pharmaceutical Schedule. Industrial - In combination
148 Maximum of 100 ml per prescription.
149 Only on the prescription of a practitioner.
150 Approvals for a CHEM number to waive the premium in the following circumstances: 1. Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism (2 year approval with renewal, applications only from cardiothoracic surgeons, cardiologists and general physicians). 2. Patients after coronary artery vein bypass graft - as an adjunct to aspirin (1 year approval only, applications only from cardiothoracic surgeons, cardiologists and general physicians). 3. Patients who continue to have transient ischaemic episodes despite aspirin therapy. A course of up to six months in combination with aspirin. Applications only from neurologists, cardiologists, vascular surgeons and general physicians. Six month approval only. Reapplications only if there is demonstrated recurrence of symptoms when dipyridamole therapy is discontinued. Note: these transitional criteria are currently being reviewed.
151 Only on a WSO.
153 a) Approvals to fund the manufacturer's surcharge in the following circumstances: - Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism (2 year approval with renewal, applications only from cardiothoracic surgeons, cardiologists and general physicians). - Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below (1 year approval only, applications only from cardiothoracic surgeons, cardiologists and general physicians); or- Patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below (2 year approval with renewal, applications only from neurologists, neurosurgeons, cardiologists, vascular surgeons and general physicians). b) Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant
154 Only on a BSO.
155 Subsidised only for patients with ventricular arrhythmia and PSO is endorsed accordingly.
157 Special Authority for Manufacturers Price - Form SA0157Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Liver disease; or 2 Past history of thromboembolism; or 3 Significant hypertension; or 4 Hypertension associated with oral oestrogen therapy. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
158 When ordered with a spermicide
159 Tablets only when prescribed for a dialysis patient
160 Only in 36 tab pack or packs
162 Only as an injection
163 Not as a sterile powder
166 Maximum of 500mls per month
167 Only for a dialysis patient
168 Note: Marevan and Coumadin are not interchangeable
169 Not in any topical form except where explicitly listed in the Pharmaceutical Schedule
170 Not in any topical preparation
171 Subsidy is paid on acyclovir tablets for treatment of herpes zoster and genital herpes. Prescriptions with doses: 1. exceeding 1,600 mg per day for a period of more than one week will not be subsidised; and2. up to 4,000 mg per day for a maximum period of one week will be subsidised.
172 a) Maximum of 6 tablets per prescription; orb) Retail Pharmacy - specialist
173 Not in topical applications
175 Special Authority for Waiver of Rule - Form SA0175Initial application only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where pathological hyperprolactinemia. Renewal only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
177 Only for treatment of uncomplicated urethritis or cervicitis due to chlamydia trachomatis and these patients' sexual contacts. Prescription must be endorsed "certified condition" (typed or handwriten and initialised in the prescriber's own handwriting)
178 Special Authority for Manufacturers Price - Form SA0178Initial application from any medical practitioner. Approvals valid for 6 months where control of nausea and vomiting in the treatment of terminal care patients. Renewal from any medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
180 Only on a controlled drug form
181 Limited to one pack of 20 per order.
182 Only if prescribed for a dialysis patient and the prescription is endorsed accordingly.
183 Only in combination
184 Maximum of 100 mg per dose
185 Only as extemporaneously compounded mouthwash or shampoo.
186 Not if in any proprietary liquid oral form, unless it is separately specified in the Pharmaceutical Schedule
187 When prescribed (alone or in combination) for home renal dialysis
188 Not available on BSO or to rural doctors on PSO.
189 Only when extemporaneously compounded with idoxuridine
190 Not exceeding 10 ml per prescription
191 Only in extemporaneously compounded preparations, unles separately specified in the Pharmaceutical Schedule
192 only in ephedrine nasal drops BPC
193 - only in combination in oral mixtures
194 Maximum of 10 ml per prescription
195 Only if extemporaneously prepared
196 - only in phenol and hydrogen peroxide gargle
197 Max 2,000 ml per dispensing.
199 Only on the prescription of a practioner, or maternity hospital
200 Maximum of 100 ml per bulk supply order.
201 Not more than 100 ml per prescription
202 - not in lozenges
203 Maximum of 100 ml per prescription.
204 Dietitian may prescribe
205 Maximum of 25 ml
206 Only on the prescription of a doctor
207 Maximum of 1 patch per week.
208 Maternity hospital only
210 Restriction of two tablets per prescription.
212 except proprietary oral drops
213 Not on a PSO.
214 Not on a Prescription.
215 The new anticonvulsant drugs are restricted to1. neurologists2. paediatric neurologists3. any other prescriber approved in writing by the relevant RHA budget holding manager. The HFA holds a budget for expenditure on the new anticonvulsant drugs. Unless otherwise specified, ultimate authority for approving prescriptions for subsidy lies with the HFA budget holding manager for the new anticonvulsant drugs. The regional divisions of the HFA will be in contact with hospital pharmacists and approved prescribers with more detail of the approval system. GUIDELINES FOR USE OF THE NEW ANTICONVULSANTS ARE AS FOLLOWS: A. Entry criteriaThe following patients are eligible for trial on the new anticonvulsant drugs (NADs)1. Patients who are under the supervision of an approved prescriber, and whose seizures are not adequately controlled with optimal conventional anticonvulsant drug treatment. 2. Patients, who are under the supervision of an approved prescriber, and whose seizures are only controlled adequatel
216 Not on a WSO.
217 Only available on a WSO.
218 Only available on a WSO.
219 Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription is endorsed "certified condition".
220 Maximum of 3 capsules per dispensing.
221 Restricted to 10 PFMs per order form.
222 For a renal dialysis patient in the home of the patient concerned
223 Maximum of 4 g per prescription, inclusive of repeats.
224 Only if dispensed with a requirement specified in the Pharmaceutical Schedule
225 Available from hospital pharmacies providing an outpatient dispensing service, and selected retail pharmacies in the Northern, Western Bay of Plenty, Wellington, Christchurch or South Canterbury regions that have an exclusive contract to dispense 'Hospital Pharmacy' [HP1] pharmaceuticals.
226 Available from any retail pharmacy in the Southern region.
227 Available from hospital pharmacies providing an outpatient dispensing service, and any retail pharmacy in the Northern, Midland, Central (including Nelson and Blenheim) and South Canterbury regions, and selected retail pharmacies in the Christchurch region that have an exclusive contract to dispense 'Hospital Pharmacy' [HP3] pharmaceuticals.
228 Available from hospital pharmacies and retail pharmacies with a Funder contract to dispense particular medicines.
233 a) Maximum of 450mg (30 ml) per prescription; orb) Retail pharmacy - specialist.
234 a) Maximum of 750mg (1 injection) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
235 Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
256 Special Authority for Subsidy - Form SA0256Initial application only from a cardiologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Refractory angina; and 2 Patient is already on maximal anti-anginal therapy. Renewal only from a cardiologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
264 Special Authority for Subsidy - Form SA0264Initial application only from a paediatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Cystic fibrosis patient; or 2 Both: 2.1 Infant or child with liver disease or short gut syndrome; and 2.2 Requires vitamin supplementation. Renewal only from a paediatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
265 Special Authority for Manufacturers Price - Form SA0265Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Social Welfare Benefiary; or 2 Income no greater than a Benefiary. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
266 Special Authority for Subsidy - Form SA0266Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 AIDS related Kaposi's sarcoma; or 6 Multiple myeloma; or 7 Chronic active hepatitis B; or 8 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from trea
267 a) - hairy cell leukaemia - Kaposi's sarcoma - chronic active hepatitis B - chronic hepatitis C (6 month approval only) - chronic myelogenous leukaemia - multiple myeloma - basal cell carcinoma 1) Only for basal cell carcinoma unable to be treated surgically or by radiotherapy. 2) Applications only from radiation oncologists, plastic surgeons and dermatologists. Applications from dermatologists will only be accepted with evidence from either a plastic surgeon or oncologist that the patient was unsuitable for surgery. 3) Maximum reimbursable dosage 15 million iu/weekb) Specialist must make applicationc) No further approvals for: Malignant melanoma Note: Patients with existing approvals can continue to have therapy
269 Special Authority - Retail pharmacy: a) Existing patients only. b) Specialist must make application.
270 Lansoprazole is subsidised for patients who have one or more of the following conditions: 1. Duodenal ulcer proven by endoscopy or barium meal and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); and b)H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. 2. Gastric ulcer proven by endoscopy and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); andb)H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. 3. Gastro-oesophageal reflux disease (GORD) proven by endoscopy: i) Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for one month with multiple daily dosing; orii) Grades 1 and 2 GORD after failure of H2 antagonist therapy for one month with multiple daily dosing; or
271 Special Authority for Manufacturers Price - Form SA0271Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Either: 1 Continuation of treatment commenced prior to 1 October 1995; or 2 Both: 2.1 Either: 2.1.1 Asthma; or 2.1.2 Chronic obstructive airways disease; and 2.2 Patient has tried alternatives and these are unsuitable. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
273 a) All patients with AIDS meeting the definition developed by the Centres for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88)b) Patients with AIDS Related Complex (ARC)c) HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatologyd) Prophylactically for persons following severe parenteral exposure from a known HIV positive sourcee) HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count f) For the prevention of maternal foetal transmission of HIVg) Applications can only be made by appropriate specialists. Prescriptions for those patients approved to use these medicines can be written either by the specialist or general practitioner with an endorsement of the name of the recommending specialist. h) Prescriptions for these can be written for a period of three months' supply. However, medicine must be dispensed on a monthly basis.
274 Special Authority for Subsidy - Form SA0274Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Treatment with other lipid modifying medicines has been unsuccessful; and 1.2 6 months of dietary modification has been unsuccessful; and 1.3 Cholesterol level > 7.0 mmol/litre:; and 1.4 Either: 1.4.1 Familial hypercholesterolaemia; or 1.4.2 Manifest coronary heart disease, which has been clinically proven, or previously treated by coronary artery surgery; or 2 Cholesterol level > 9.0 mmol/litre:.NoteFamilial hypercholesterolaemia is defined as being hypercholesterolaemia in the presence of tendon xanthomas or in association with a family history of premature heart disease (before age 55) or consistent with autosomal dominant inheritance. Simvastatin and Pravastatin may be considered for first line therapy in patients with familial hypercholesterolaemia or
275 Special Authority for Subsidy - Form SA0275Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 Multiple myeloma; or 6 Chronic active hepatitis B; or 7 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other tha
276 Special Authority for Subsidy - Form SA0276Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Multiple myeloma; or 4 Chronic active hepatitis B; or 5 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiat
278 Patients who have been on omeprazole and have not accessed therapy through Special Authority will continue to have subsidy for six months, by which time the necessary investigations should have been carried out to determine if ongoing therapy is warranted. For these patients the following conditions will apply: Omeprazole(a) Retail pharmacy specialist (b) month restriction
279 Maximum of 125 ml per bulk supply order.
280 Omeprazole is subsidised for patients who have one or more of the conditions numbered 1-4: 1. Duodenal ulcer proven by endoscopy or barium meal and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); and b)H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. 2. Gastric ulcer proven by endoscopy and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); andb)H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. 3. Gastro-oesophageal reflux disease (GORD) proven by endoscopy: i) Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for one month with multiple daily dosing; orii) Grades 1 and 2 GORD after failure of H2 antagonist therapy for one month with multipl
281 Hospital Pharmacy - dermatologist
283 Retail Pharmacy - Specialist prescriptionPaediatricians and paediatric cardiologists may prescribe
284 maximum of 21 tablets per prescription
285 maximum of 15 tablets per prescription
286 Special Authority for Manufacturers Price - Form SA0286Initial application from any medical practitioner. Approvals valid for 5 years where patient is stabilised on aminophylline, theophylline, warfarin, or phenytoin..Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
289 Retail pharmacy-Specialist Specialist must be a paediatrician or paediatric cardiologist.
290 Special Authority for Subsidy - Form SA0290Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 AIDS meeting the definition developed by the Centers for Disease Control in the USA; or 2 AIDS Related Complex (ARC).; or 3 Both: 3.1 HIV infection regardless of symptomatology; and 3.2 CD4 (T4) counts < 500. NoteSee Circular Letter to Medical Practitioners HP2/88)Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
291 Special Authority for Manufacturers Price - Form SA0291Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Inflammatory arthritis (including osteoarthritis with an inflammatory component); and 2 Stabilised and are well controlled on the particular NSAID medication. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
293 No compounding fees will be paid when the prescribed strength of methadone is available in a proprietary solution
294 Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets)
295 Dispensing fee for commercially prepared methadone solutions is the Class A rate
298 Above local anesthetic strengths are: a) For a dialysis patient; orb) A child with rheumatic fever. c) Prescription must be endorsed accordingly.
300 Special Authority for Subsidy - Form SA0300Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated. NoteNot in long term combination with an anti-androgenInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis ; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. NoteThe maximum treatment period for a GnRH analogue is: 3 months to assess whether surgery is appropriate3 m
301 Special Authority for Subsidy - Form SA0301Initial application only from a relevant specialist. Approvals valid for 2 years where type III dyslipidaemias. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
303 Special Authority for Waiver of Rule - Form SA0303Initial application only from a paediatric surgeon or paediatrician. Approvals valid for 1 year where children post liver transplant. Renewal only from a paediatric surgeon or paediatrician. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment.
304 Safety medicine; prescriber may determine dispensing frequency
309 Special Authority for Subsidy - Form SA0309Initial application only from a neurologist or physician for the elderly (FRACP). Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Idiopathic Parkinson's disease; and 2 The patient does not have dementia and/or neuropsychiatric disorders; and 3 Has responded to L-dopa; and 4 Any of the following: 4.1 Has resistance to conventional treatment of severe motor fluctuations; or 4.2 Has severe "off" period disability; or 4.3 Has severe "off" period dystonic cramps. Renewal only from a neurologist or physician for the elderly (FRACP). Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
311 Special Authority for Subsidy - Form SA0311Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated or where the patient srongly opposes orchidectomy. NoteNot to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiatedInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetrio
312 Special Authority for Alternate Subsidy - Form SA0312Initial application only from an obstetrician, gynaecologist, general practitioner or general physician. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 acute or significant liver disease - a declaration must be provided from a gastroenterologist or general physician stating that oral oestrogens are contraindicated due to liver disease (Details to be attached to application); or 2 oestrogen induced hypertension requiring antihypertensive therapy - documented evidence must be provided that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens (Details to be attached to application); or 3 hypertriglyceridaemia - documented evidence must be provided that triglyceride levels increased to at least 2 x normal triglyceride levels post oral oestrogens (Details to be attached to application). NotePrescriptions with a valid Special Authority (
313 Special Authority for Manufacturers Price - Form SA0313Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
314 Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
315 Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the high dose oestrogens.
317 Special Authority for Subsidy - Form SA0317Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either:
319 Neurologists or Physician for the Elderly (FRACP) must write prescription
320 a) All nucleosides will be subsidised for patients meeting any of the following criteria: - All patients with AIDS meeting the definition developed by the Centers for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88); or- Patients with AIDS Related Complex (ARC); or- HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatology. b) Zidovudine will also be subsidised for patients meeting any of the following criteria: - Prophylactically for persons following severe parenteral exposure from a known HIV positive source; or- HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count; or- For the prevention of maternal foetal transmission of HIV. c) Applications can only be made by appropriate specialists. d) Prescriptions for those patients approved to use these medications can be written by either the specialist or general practitioner with an endorsement of the name of the recommending specialist.
323 Special Authority for Subsidy - Form SA0323Initial application only from a relevant specialist. Approvals valid for 2 years where children receiving frequent parenteral injections (i.e. intradermal, subcutaneous, intravenous or intramuscular) requiring a 21 gauge or larger bore needle. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
324 All oral Beta Adrenoceptor Blockers are exempted from monthly dispensing for patients with angina or arrhythmia.
325 Special Authority for Subsidy - Form SA0325Initial application from any medical practitioner. Approvals valid for 5 years where applicatons will be considered and approved subject to funding availability. NoteApplications to be made on the approved forms which are available from the co-ordinator for the Cystic Fibrosis DN'ase Advisory Panel: The Co-ordinatorCystic Fibrosis DN'ase Advisory PanelC/- Room 4-28, Building 13 Greenlane HospitalPrivate Bag, AUCKLANDPhone: 09 630 9871Facsimile: 09 631 0753
328 Special Authority for Subsidy - Form SA0328Initial application only from a general physician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 CD4 count < 500 cells/mm3; and 1.2 Viral load > 50,000> copies per ml (or equivalent value on the Chiron test); or 2 All of the following: 2.1 CD4 count < 500 cells/mm3; and 2.2 Viral load > 50,000> copies per ml (or equivalent value on the Chiron test); and 2.3 At least 6 weeks of dual therapy with nucleoside agents; or 3 Both: 3.1 CD4 count < 500 cells/mm3; and 3.2 CD4 counts are declining rapidly (>120 cells over 12 months or >60 - 80 cells over six months). Renewal only from a general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
338 Guidelines for use of cyclosporin A in rheumatoid arthritisMonitoring: All patients require frequent monitoring for creatinine levels and blood pressure:- fortnightly, in the first three months of therapy and then monthly, if results are stable; - if dose is increased or there is a rise in serum creatinine or blood pressure, then more frequent monitoring is required. Contraindications: Cyclosporin A is contraindicated in patients with the following conditions: - current or past malignancy; - uncontrolled hypertension; - renal dysfunction (abnormal serum creatinine for age and sex); - immunodeficiency and neutropenia; - abnormally low white blood cell count or platelet count; or- liver function tests more than twice the upper limit of normal. Caution in use: - age above 65 years; - controlled hypertension; - use of ant-epileptic medications; - use of NSAIDs; - use of ketoconazole, fluconazole, trimethoprim, erythromycin, verapamil, and diltiazem; - concurrent or previous use of al
341 Special Authority - Retail pharmacy (Salmeterol, eformoterol fumarate):a) Approvals are interchangeable between all presenations of salmeterol and eformoterol fumarate agents. b) Diagnosis of asthma confirmed. c) Inhaler/device technique checked. d) At least three months of >= 1500 ug daily of beclomethasone inhaled steroid (or equivalent) for adult, or >= 800 ug daily for child. e) Patient monitors PEFR regularly during exacerbations where appropriate. f) Evidence of poor control (at least one of the following): - short acting beta agonist used > 3-4 time daily - nocturnal awakenings >= 2 times per week. g) The first applicaton may be for six months and subsequent applications for two yars. The criteria for reapplication are: - compliant with medication - improved asthma symptom control. h) Appication for Special Authority to be made by general practitioners or appropriate specialist.
345 a) Should be strictly reserved for use as second line therapy in: - patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema; - cases of scabies which are resistent to gamma benzene hexachloride and resistant to malathion. b) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: - a definite diagnosis of scabies should be made; - it should be ascertained that the medication was administered properly; - the possibility of reinfestation should have been excluded.
348 a) Approvals will be granted for treating the following conditions: - avium intracellular atypical mycobacterial infections; and- multiple drug resistant tuberculosis; and- atypical and drug-resistant mycobacterial infections in patients with AIDS. b) Specialist must make application - respiratory physician/ infectious disease specialist. c) Approvals will be valid for two years.
349 Special Authority for Manufacturers Price - Form SA0349Initial application only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Avium intracellular atypical mycobacterial infections; or 2 Multiple drug resistant tuberculosis; or 3 Atypical and drug-resistant mycobacterial infections in patients with AIDS. Renewal only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
350 Omeprazole and pantoprazole is subsidised for patients who have one or more of the conditions a-d: a) Duodenal ulcer proven by endoscopy or barium meal and after failure of: - two alternative courses of H. pylori eradication therapy (if H. pylori positive); and - H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. b) Gastric ulcer proven by endoscopy and after failure of: - two alternative courses of H. pylori eradication therapy (if H. pylori positive); and - H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. c) Gastro-oesophageal reflux disease (GORD) proven by endoscopy: - Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for four weeks with multiple daily dosing; or - Grades 1 and 2 GORD after failure of H2 antagonist therapy for
355 a) Not to exceed 3 capsules per prescriptionb) No more than one prescription per month.
357 a) Not to exceed 6 tablets per prescription; andb) No more than one prescription per month.
359 Subsidy is available for disposable diabetic syringes and needles: 1) When the prescription is written on the same prescription form as the one used for the supply of insulin vials; or2) When "insulin patient" has been written on the prescription by either the doctor or the contractor; and3) For no more than 50 plastic syringes with attached needles as a single supply in the case of a prescription for three months supply of insulin vials; or4) For no more than 4 plastic syringes with attached needles as a single supply for each week's supply in the case of a prescription for less than three months supply of insulin vials.
360 Subsidy is available for insulin pen needles: 1) When the prescription is written on the same prescription form as the one used for the supply of insulin cartridges; or2) When "insulin patient" has been written on the prescription by either the doctor or the contractor; and3) For no more than 30 insulin pen needles as a single supply in the case of a prescription for three months supply of insulin cartridges; or4) For no more than 2 insulin pen needles as a single supply for each week's supply in the case of a prescription for less than three months supply of insulin cartridges.
361 Special Authority for Subsidy - Form SA0361Initial application only from a geriatrician, neurologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Disabling orthostatic hypotension not due to drugs; and 2 Patient has tried fludrocortisone (unless contra-indicated) with unsatisfactory results; and 3 Patient has tried non pharmacological treatments such as support hose, increased salt intake, exercise, and elevation of head and trunk at night. NoteTreatment should be started with small doses and titrated upwards as necessary. Hypertesion should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg. Renewal only from a geriatrician, neurologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
366 Special Authority for Subsidy - Form SA0366Initial application - (North Island patients) from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteFor details of the patient criteria, prescriber criteria, application and reporting forms contact the appointed clinician: Dr Richard FisherFertility Associates131 Remuera RoadAUCKLANDFax: 09 520 0499Appointed clinicians will distribute these agents to prescribers whose applications are approvedInitial application - (South Island patients) from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteFor details of the patient criteria, prescriber criteria, application and reporting forms contact the appointed clinician: Dr Peter BennyChristchurch Women's HospitalPrivate Bag 4711CHRISTCHURCHFax: 03 364 4634Appointed clinicians will distribute these agents to prescribers whose applications are approved
370 Child resistant closure (NZS 5825:1991) required and reimbursed when used to create an extemporaneously prepared oral solution.
375 Subsidy is available for disposable and non-disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly.
378 Up to 50 plastic syringes with attached needles may be dispensed in the case of a prescription for three months supply of insulin vials; orUp to four plastic syringes with attached needles may be dispensed for each week's supply in the case of a prescription for less than three months supply of insulin vials.
380 Up to 30 pen needles may be dispensed in the case of a prescription for three months supply of insulin cartridges; orUp to two pen needles may be dispensed for each week's supply in the case of a prescription for less than three months supply of insulin cartridges.
382 Special Authority for Subsidy - Form SA0382Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 All of the following: 1.1 Duodenal ulcer proven by endoscopy or barium meal; and 1.2 Failure of two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 1.3 Non healing duodenal ulcer proven by second barium meal; and 1.4 H2 antagonist therapy for 8 weeks; or 2 All of the following: 2.1 Gastric ulcer proven by endoscopy; and 2.2 Two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 2.3 Non healing gastric ulcer and excluded malignancy demonstrated by a second endoscopy; and 2.4 H2 antagonist therapy for 12 weeks; or 3 All of the following: 3.1 Grade 0 GORD (normal endoscopy); and 3.2 Positive 24 hour pH monitoring test; and 3.3 Failure of H2 antagonist t
383 n) Further approvals to fund the manufacturer's surcharge on either pravastatin or simvastatin (if applicable) may be granted to patients who are unable to continue treatment with fluvastatin due to adverse effects. Either general practitioners or specialist may make the application. To obtain a new Special Authority number, the application must include the following information: - the amount of time the patient has been treated with fluvastatin; and- the adverse effects experienced by the patient. o) Further approvals to fund the manufacturer's surcharge on simvastatin may be granted to patients with familial hypercholesterolaemia (FH) or familial combined hypercholesterolaemia (FCH) if a specialist considers that the patient is not achieving sufficient benefit from the fully funded statin(s). Only specialists may make application. To obtain a new Special Authority number, the application must include the following information: - the cholesterol level before and after treatment with the fully funded sta
386 Subsidised only for treatment of prostate cancer
387 Special Authority for Subsidy - Form SA0387Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated or where the patient srongly opposes orchidectomy. NoteNot to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiatedInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetrio
388 Subsidised only for treatment of prostate cancer endometriosis and precocious puberty.
389 Retail Pharmacy - Specialist when used in the treatment of eye conditions.
391 Special Authority for Subsidy - Form SA0391Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Either: 1 Liver transplant recipients; or 2 Renal transplant recipients - as rescue therapy only. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
392 Only when prescribed in a quantity of 100 ml per prescription form
394 Special Authority for Manufacturers Price - Form SA0394Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobacteri
396 a) Cyproterone acetate with ethinyloestradiol is available from retail pharmacy to patients as indicated. b) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - Prescription may be written for up to 6 months supply; and- Pharmacists may dispense up to 3 month supply. c) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. Eg. Prescriptons may be written for up to 3 months supply, and dispensed monthly. d) The Special Authority number for hormonal contraceptive agents (combined and progesterone-only) does not apply, and is not interchangeable. e) Health Benefits Limited will return any claims unpaid as follows: - any uncoded prescription; - any prescription that does not have a period of supply or the quantity
400 Preferred Supplier
401 Special Authority for Subsidy - Form SA0401Initial application - (Basal cell carcinoma) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Basal cell carcinoma unable to be treated surgically or by radiotherapy; and 2 Unsuitability for surgery confirmed by a Plastic Surgeon or Oncologist. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 12 months where chronic hepatitis C. Initial application - (Indications other than Basal cell carcinoma and Chronic hepatitis C) only from a relevant specialist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairy cell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 Multiple myelo
402 Special Authority for Subsidy - Form SA0402Initial application - (Patients aged 74 and under) only from a general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patients aged 74 and under; and 2 The patient has been offered 3-6 months of counselling and an opportunity to modify lifestyle; and 3 Any of the following: 3.1 Both: 3.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 3.1.2 total cholesterol > 6.0; or 3.2 Both: 3.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG); and 3.2.2 total cholesterol > 5.5; or 3.3 Both: 3.3.1 NHF B:Patients with > 20% 5-year cardiovascular disease risk; and 3.3.2 total cholesterol > 9.0; or 3.4 Both: 3.4.1 NHF C:15-20% 5-year cardiovascular disease risk; and 3.4.2 total cholesterol > 9.0; or 3.5 Both: 3.5.1 NHF D:10-15% 5-year cardiovascular disease risk; and 3.5.2 total cholesterol > 9.0; or 3.6
403 Special Authority for Subsidy - Form SA0403Initial application only from a nephrologist or transplant surgeon. Approvals valid for 12 months where renal transplant recipient. Renewal only from a nephrologist or transplant surgeon. Approvals valid for 12 months where re-graft patient.
404 Special Authority for Subsidy - Form SA0404Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Primary open-angle glaucoma; and 2 Either: 2.1 Other subsidised glaucoma medical therapy is contraindicated; or 2.2 Both: 2.2.1 intra-ocular pressure > 26 mmHg (average from consecutive measurements); and 2.2.2 Unable to be controlled using other subsidised medical therapy. Renewal only from an ophthalmologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
410 Special Authority for Manufacturers Price - Form SA0410Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Polycystic ovarian syndrome; or 2 Hirsutism; or 3 Androngenic alopecia. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
411 Special Authority for Manufacturers Price - Form SA0411Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
420 Funding of manufacturers surcharge for existing patients taking ACE inhibitors for Congestive Heart Failure.a) Patients taking any ACE inhibitor for the treatment of congestive heart failure prior to 1 June 1998 can continue to have their ACE inhibitor treatment fully subsidised; b) Prescribers must endorse the prescription 'Congestive Heart Failure'. The endorsement can be typed (this includes computer generated prescriptions) or handwritten; c) The endorsement must be initialled in the prescriber's own handwriting. Definition of Congestive Heart FailureAt the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a
421 Sole Supply
423 Special Authority for Subsidy - Form SA0423Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 All of the following: Duodenal Ulcer: 1.1 Duodenal ulcer proven by endoscopy or barium meal; and 1.2 Non healing duodenal ulcer proven by second barium meal; and 1.3 After failure of two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 1.4 After H2 antagonist therapy for 8 weeks; or 2 All of the following: Gastric Ulcer: 2.1 Gastric ulcer proven by endoscopy; and 2.2 Non healing gastric ulcer and excluded malignancy demonstrated by a second endoscopy; and 2.3 After two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 2.4 After H2 antagonist therapy for 12 weeks; or 3 All of the following: GORD: 3.1 Grade 0 GORD (normal endoscopy); and 3.2 Positive 24
424 Special Authority for Subsidy - Form SA0424Initial application - (Confirmed HIV/AIDS) only from a general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patients aged 6 years and over with HIV/AIDS; or 2.2 Both: 2.2.1 Asymptomatic patients aged 6 years and over; and 2.2.2 CD4 counts < 500 cells/mm3; or 2.3 Both: 2.3.1 Asymptomatic patients aged 6 years and over; and 2.3.2 Viral load counts > 10,000 copies per ml; or 2.4 Symptomatic patients aged under 6 with HIV/AIDS ; or 2.5 Asymptomatic patients aged 12 months and under; or 2.6 Both: 2.6.1 Asymptomatic patients aged 1 to 5 years; and 2.6.2 CD4 counts < 1,000 cells/mm3; or 2.7 Both: 2.7.1 Asymptomatic patients aged 1 to 5 years; and 2.7.2 CD4 counts < 0.25 x total white cell count; or 2.8 Both: 2.8.1 Asymptomatic patients aged under 6 years; and
429 If a Community Pharmaceutical is the liquid oral form of an antibiotic to which a diluent must be added by the Contractor at the time of dispensing and it is prescribed or ordered by a Practittioner in an amount that does not coincide with the amount contained in one or more standard packs of that Community Pharmaceutical, Subsidy will only be made for the amount prescribed or ordered by the Practitioner in accordance with either Clause 3.1 or Clause 3.3 of the Schedule, unless the Contractor satisfies the Funder that he or she has not been able to dispense the balance of the pack or packs from which the Community Pharmaceutical has been dispensed. In such cases all of that pack or those packs is eligible for Subsidy.
430 Special Authority for Subsidy - Form SA0430Initial application - (National Heart Foundation risk groups A1:1, A1:2, B, C, D or E) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 The patient has been offered 3-6 months of counselling and an opportunity to modify lifestyle; and 2 Any of the following: 2.1 Both: 2.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 2.1.2 total cholesterol * > 5.5; or 2.2 Both: 2.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG) or angioplasty; and 2.2.2 total cholesterol * > 4.5; or 2.3 Post heart transplant (regardless of cholesterol level); or 2.4 Both: 2.4.1 NHF B:Patients with > 20% 5-year cardiovascular disease risk; and 2.4.2 total cholesterol * > 9.0; or 2.5 Both: 2.5.1 NHF C:15-20% 5-year cardiovascular disease risk; and 2.5.2 total cholesterol * > 9
432 Maximum 15 g per prescription.
434 Special Authority for Manufacturers Price - Form SA0434Initial application only from a general practitioner, general physician, geriatrician or neurologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patients with swallowing difficulties; and 2 Applicant is a specialist or specialist has authorised treatment. Renewal only from a general practitioner, general physician, geriatrician or neurologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
435 Special Authority for Manufacturers Price - Form SA0435Initial application from any medical practitioner. Approvals valid for 6 months where control of nausea and vomiting in the treatment of terminal care patients. Renewal from any medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
436 Special Authority for Manufacturers Price - Form SA0436Initial application - (Patient with prosthetic heart valves) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 2 years where patient with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism. Initial application - (Following coronary artery vein bypass graft) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 1 year where patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below. Initial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid for 2 years where patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below. Renewal - (Fo
443 Special Authority for Subsidy - Form SA0443Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobacterial infection
445 Special Authority for Subsidy - Form SA0445Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patient has failed surgery, radiotherapy, bromocriptine or other oral therapies; or 2 VIPomas and Glucagonomas - for patients who are seriously ill in order to improve their clinical state prior to definitive surgery.; or 3 Both: 3.1 Gastrinoma; and 3.2 Patient has failed surgery, or metastatic disease after H2 antagoists (or proton pump inhibitors) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or has failed; or 5 For pre-operative control of hypoglycaemia and for maintenance therapy; or 6 Both: 6.1 Carcinoidsyndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis); and 6.2 Disabling symptoms not controlled by maximal medical therapy. NoteThe use of octretide in patients with fis
446 Maximum one pack (two 500 mg tablets) per prescription.
447 Retail Pharmacy - Specialist prescriptionSpecialist must be either a neurologist, geriatrician or general physician
450 Special Authority for Subsidy - Form SA0450Initial application only from a psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 Patients suffering from schizophrenia and related psychoses; and 2 Either: 2.1 Failed to respond to full trials (duration of at least 6 weeks each) of effective doses of at least two classes of anti-psychotic agents (refer to guidelines below); or 2.2 Demonstrated intolerance to other neuroleptic agents. NoteClinicians must confirm that informed consent and a satisfactory White Bloodcell Count (WBC) result has been obtained. Diagnosis: Treatment resistant schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present. Treatment: Trial therapy undertaken before initiating treatment with clozapine could
451 Special Authority for Manufacturers Price - Form SA0451Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Patients being treated for advanced breast cancer who are refractory to tamoxifen; and 2 Any of the following: 2.1 Unable to tolerate aminoglutethimide; or 2.2 Unable to tolerate megestrol acetate; or 2.3 Unable to tolerate medroxyprogesterone acetate.Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
452 Special Authority for Manufacturers Price - Form SA0452Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Patients being treated for advanced breast cancer who are refractory to tamoxifen; and 2 Any of the following: 2.1 Unable to tolerate aminoglutethimide; or 2.2 Unable to tolerate megestrol acetate; or 2.3 Unable to tolerate medroxyprogesterone acetate.Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
454 Guidelines for the use of atypical anti-psychotic agents Diagnosis: Schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present. Treatment: Before initiating atypical anti-psychotic therapy, physicians should consider whether the patient is likely to respond to and/or tolerate conventional anti-psychotic therapy and, where appropriate, trial one or more conventional agent prior to use of an atypical agent.
455 Maximum 100 ml per prescription.
456 Special Authority for Subsidy - Form SA0456Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patients suffering from schizophrenia and related psychoses who are likely to benefit from anti-psychotic treatment; and 2 Any of the following: 2.1 Effective dose of risperidone has been discontinued because of recurrent acute dystonias; or 2.2 Effective dose of risperidone has been discontinued because of excessive Parkinson-like symptoms; or 2.3 Effective dose of risperidone has been discontinued after 6 weeks because of inadequate clinical response. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
458 Special Authority for Subsidy - Form SA0458Initial application only from a gastroenterologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and 2 Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis). NoteLiver biopsy is not usually required for diagnosis but is helpful to stage the diseaseRenewal only from a gastroenterologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteActigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transplant centreTreatment failure - doubling of serum bilirubin levels, absence of a signi
459 Special Authority for Subsidy - Form SA0459Initial application only from a gastroenterologist or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Both: 2.4.1 Severe acne; and 2.4.2 Treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
460 Special Authority for Manufacturers Price - Form SA0460Initial application - (Patient with prosthetic heart valves) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 2 years where patient with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism. Initial application - (Following coronary artery vein bypass graft) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 1 year where patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below. Initial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid for 2 years where patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below. Renewal - (Fo
461 Special Authority for Subsidy - Form SA0461Initial application - (Basal cell carcinoma) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Basal cell carcinoma unable to be treated surgically or by radiotherapy; and 2 Unsuitablity for surgery confirmed by a Plastic Surgeon or Radiation Oncologist. NoteThe maximum reimbursable dosage is 15 million iu per weekInitial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 12 months where chronic hepatitis C. Initial application - (Indications other than Basal cell carcinoma and Chronic hepatitis C) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairy cell leukaemia; or 3 Multiple myeloma; or 4 Chronic active hepatitis B. Renewal - (Basal cell carcinoma) only from a dermato
462 Hospital pharmacy - Specialist prescription. Note: Prescribing and dispensing of clozapine is subject to Ministry of Health restrictions including the requirement for blood monitoring.
464 Special Authority for Subsidy - Form SA0464Initial application only from a diabetologist, general physician or paediatrician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Use alone (monotherapy); and 1.2 The patient is unable to use any other insulins including those on insulin pump treatment; or 2 Both: 2.1 Use with Humulin 70/30 or Humulin 80/20; and 2.2 A reasonable trial of Humulin N has been undertaken and it is not effective or not well tolerated; or 3 Both: 3.1 Use with insulins (aside from insulin zinc suspension) other than Humulin 70/30, Humulin 80/20, or Humulin N; and 3.2 A reasonable trial of one or more of these Humulin insulins has been undertaken and it is/are ineffective or not well tolerated; or 4 Both: 4.1 Use with Humulin L or Humulin U; and 4.2 Use with Humulin N is not appropriate; or 5 Both: 5.1 Use with other insulin zinc suspensio
465 Maximum 500ml per month.
466 Special Authority for Alternate Subsidy - Form SA0466Initial application only from a relevant specialist or general practitioner. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Angina that is not controlled by other anginal medications; or 2 Continuation of treatment commenced prior to 1 June 1999; or 3 Receiving maximal antihypertensive therapy, requires a DHP CCB, and cannot tolerate felodipine. Renewal only from a relevant specialist or general practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
467 Special Authority for Subsidy - Form SA0467Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Paget's disease; and 2 Any of the following: 2.1 Bone or articular pain; or 2.2 Bone deformity; or 2.3 Bone, articular or neurological complications; or 2.4 Asymptomatic disease, but risk of complications due to site (base of skull, spine, long bones of lower limbs); or 2.5 Preparation for orthopaedic surgery. Renewal only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
468 Retail Pharmacy-Specialist Prescriptiona) Specialist must be an ophthalmologist. b) For treatment of bacterial keratitis or severe bacterial conjunctivitis resistant to chloramphenicol.
469 a) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent b) On a bulk supply orderc) When used in the extemporaneous compounding of eye drops
470 Special Authority for Subsidy - Form SA0470Initial application - (Organ transplant) only from a relevant specialist. Approvals valid without further renewal unless notified where organ transplant. Initial application - (Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Bone marrow transplant; or 2 Graft v host disease. Initial application - (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Psoriasis; and 2 Applicant must state which systemic and topical therapies have failed. Initial application - (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not responsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application - (N
471 Special Authority for Subsidy - Form SA0471Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year where advanced prostatic cancer when orchidectomy is contraindicated or where the patient strongly opposes orchidectomy. NoteNot to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiatedInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis ; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone
472 Special Authority for Subsidy - Form SA0472Initial application only from a cardiologist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Congestive heart failure; and 1.2 Cannot tolerate currently fully subsidised ACE inhibitors due to persistent cough that resolves on cessation and recurs on re-challenge with ACE inhibitor; or 2 Patients who have experienced angioedema on an ACE inhibitor at any time in the past; or 3 Patients who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal only from a cardiologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
473 Special Authority for Subsidy - Form SA0473Initial application from any medical practitioner. Approvals valid for 1 year where the patient is likely to benefit from treatment. Note Applications to be made on the approved forms which are available from: The Co-ordinatorGaucher's Treatment PanelPhone: (04) 460 4990 PHARMAC, PO Box 10 254 WellingtonFacsimile: (04) 916 7571Email: erin.murphy@pharmac.govt.nzPrescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.
479 Max 6,000 ml per prescription.
480 a) When prescribed (alone or in combination) for renal dialysis in the home of the patient concerned.b) Only maternity hospital, or on the prescription of a practitioner. c) Obstetric cream only in a quantity not exceeding 500 ml per prescription or on a bulk supply order. d) Solution 5% in quantity not exceeding 100 ml per prescription or on a bulk supply order.
481 a) Up to 10 %;b) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
482 a) Up to 2 %; b) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
483 a) Up to 5 %; b) In a dermatological base (not proprietary Topical Corticosteriod - Plain);c) With or without other dermatological galenicals.
484 a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without phenol liquefied.
485 a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without menthol crystals.
486 a) In a dermatological base or proprietary Topical Corticosteroid - Plain; b) With or without other dermatological galenicals. c) In a 'standard formula'.
487 a) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
488 Special Authority for Subsidy - Form SA0488Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Both: 2.4.1 Severe acne; and 2.4.2 Treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
489 Special Authority for Manufacturers Price - Form SA0489Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Both: 2.1 Patients after coronary artery vein bypass graft; and 2.2 Any of the following: 2.2.1 aspirin induced asthma; or 2.2.2 aspirin induced anaphylaxi; or 2.2.3 significant aspirin induced bleeding excluding bruising. Initial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patients who continue to have transient ischaemic episodes despite aspirin therapy; or 2 Both: 2.1 Patients wh
490 Special Authority for Subsidy - Form SA0490Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Requires but is not able to tolerate metformin therapy; or 2 Requires metformin but metformin is contraindicated; or 3 Has not responded to or tolerated the maximum appropriate dose of metformin. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
491 a) only if prescribed for prohylaxis of endocarditis and the prescription is endorsed accordingly.
493 Maximum of 500ml per month.
494 Special Authority for Subsidy - Form SA0494Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, or Beta-blockers are contraindicated; or 1.2.2 Patient cannot tolerate Pilocarpine, or Pilocarpine is contraindicated; or 1.2.3 Patient cannot tolerate Dorzolamide, or Dorzolamide is contraindicated; or 1.2.4 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 2 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker. NoteSubsidised as monotherapy onlyRenewal only from an ophthalmologist. Approvals valid for 2 years where the treatment remains appropriate and the patient
495 a) Maximum of 50 plastic syringes with attached needles per prescription.
496 a) Maximum of 30 pen needles per prescription.
497 a) All transdermal patches are only on prescription.
498 a) Not more than 6 per prescription.
499 b) Not more than 6 per dispensing.
500 Special Authority for Alternate Subsidy - Form SA0500Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Patient is on a Social Welfare benefit; or 1.2 Patient has an income no greater than the benefit; and 2 Has tried at least one of the fully funded options and has been unable to tolerate it. Renewal from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient is on a Social Welfare benefit; or 2 Patient has an income no greater than the benefit. NoteThe approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon and Marvelon. The additional subsidy will fund Mercilon and Marvelon up to the manufacturer's price for each of these products as identified on the Schedule at 1 November 1999Special Authorities approved before 1 November 1999 remain valid until the expiry d
502 a) Hospital pharmacy [HP3] - Maximum of 750mg (3 injections) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
503 a) Maximum of 500mg per prescription; orb) More than 500mg per prescription - Special Authority available
504 a) Maximum of 450mg (3 capsules) per prescription; orb) Retail pharmacy - specialist.
505 a) Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and; b) the prescription is endorsed accordingly.
506 a) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudo membranous colitis or for prophylaxis of endocarditis; and b) The prescription is endorsed accordingly.
508 Special Authority for Subsidy - Form SA0508Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patient with raised blood pressure; and 2 A beta blocker or diuretic is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 3 An ACE inhibitor is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
509 Special Authority for Subsidy - Form SA0509Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patient suffering from schizophrenia and related psychoses who is likely to benefit from anti-psychotic treatment; and 2.2 Both: 2.2.1 An effective dose of risperidone had been trialled and has been discontinued either because of; and 2.2.2 Any of the following: 2.2.2.1 Patient has recurrent acute dystonias; or 2.2.2.2 Patient has excessive Parkinson-like symptoms; or 2.2.2.3 Patient has hyperprolactinaemia; or 2.2.2.4 Patient has inadequate clinical response after four weeks. NoteDiscontinued treatment should be notified to HealthPAC if possibleRenewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
510 Special Authority for Alternate Subsidy - Form SA0510Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Angina that is not controlled by other anginal medications (including felodipine); or 2 Patient was taking Adalat Oros for the treatment of angina prior to 1 June 1999; or 3 Receiving maximal antihypertensive therapy, requires a DHP CCB, and cannot tolerate felodipine. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
511 Special Authority for Subsidy - Form SA0511Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of two previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the tr
512 Special Authority for Subsidy - Form SA0512Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Either: 2.1 Diabetes; or 2.2 Both: 2.2.1 Treatment with conventional corticosteroid therapy; and 2.2.2 Any of the following: 2.2.2.1 Cushingoid habitus; or 2.2.2.2 Osteoporosis where there is significant risk of fracture; or 2.2.2.3 Severe acne. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the patient has had no more than 1 prior approval in the last 12 months. The patient must have had no more than 1 prior approval in the last year. NoteClinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate
513 Special Authority for Subsidy - Form SA0513Initial application - (Narcolepsy) only from a neurologist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients aged 5 years or over) only from a paediatrician or psychiatrist. Approvals valid for 24 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Initial application - (ADHD in patients under 5 years of age) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients under 5 years of age; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Renewal - (Narcolepsy or ADHD in patients under 5 years of age) only from a neurologist, paediatrician or psychiatrist. Approvals valid for 24 months where the treatment remains appr
514 Hospital Pharmacy - Specialist prescription
515 Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the highdose oestrogens.
516 Special Authority for Subsidy - Form SA0516Initial application from any medical practitioner. Approvals valid for 2 years where the patient is likely to benefit from treatment. Note Applications to be made on the approved forms which are available from: Prof. Wayne CutfieldNational Co-ordinatorNew Zealand Growth Hormone CommitteeC/- Department of PaediatricsUniversity of AucklandPrivate Bag 92019AUCKLAND
518 Injection 500 mg subsidised: a) only if prescribed for a dialysis or cystic fibrosis patient; and b) the prescription is endorsed accordingly.
519 (Only in aspirin and chloroform application)
521 (Only in extemporaneously compounded methadone mixture, codeine linctus diabetic or codeine linctus paediatric)
522 Must be dispensed in one lot
523 Special Authority for Subsidy - Form SA0523Initial application only from a relevant specialist or general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Diagnosis of asthma confirmed; and 2 Inhaler/device technique checked; and 3 Patient monitors PEFR regularly during exacerbations where appropriate; and 4 Any of the following: 4.1 At least three months of 1500 ug or more daily of inhaled beclomethasone or budesonide for adult; or 4.2 At least three months of 750 ug or more daily of inhaled fluticasone) for adult; or 4.3 At least three months of 800 ug or more daily inhaled beclomethasone or budesonide for child; or 4.4 At least three months of 400 ug or more daily inhaled fluticasone) for child; and 5 Either: 5.1 Short acting beta agonist used at least 3-4 times daily; or 5.2 Nocturnal awakenings at least twice a week. Renewal only from a relevant specialist or general practitioner. Appro
524 Maximum of 35 tablets per prescription
525 Maximum of 25 tablets per prescription
526 Maximum of one pack (21 tabs) per prescription
527 Maximum of one pack (42 tabs) per prescription
528 Special Authority for Subsidy - Form SA0528Initial application - (Narcolepsy) only from a neurologist or respiratory specialist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients 5 or over) only from a paediatrician, psychiatrist or general practitioner. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Applicant is a specialist or specialist has recommended treatment. Initial application - (ADHD in patients under 5) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients under 5 years of age; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Renewal - (Narcolepsy) only from a neurologist or respiratory spec
530 Safety cap reimbursed
532 Oral contraceptive
533 Exempt from monthly dispensing
535 ACE inhibitors will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking an ACE inhibitor for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Additional subsidy for lisinopril is available only up to the price of the least expensive brand listed in the Schedule. Definition of Congestive Heart FailureAt the request of some prescribers the PTAC Cardiovascular subcommittee has provided adefinition of congestive heart failure for the purposes of the funding of the manufacturer'ssurcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for thefunding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requir
536 Additional subsidy by endorsement for:Moclobemide tab 150 mg x 100 (Aurorix) up to $47.00Moclobemide tab 300 mg x 60 (Aurorix) up to $56.40Nefazadone tab 100 mg x 56 (Serzone) up to $20.16Nefazadone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Cipramil) up to $27.00is available for patients who: * are taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February2000; * have previously responded to treatment with moclobemide or nefazodone or citalopram; * have had a trial of fluoxetine and have to discontinue due to: - inability to tolerate the drug due to side effects OR - failed to respond to an adequate dose and duration of treatment; * have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions); The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these particular words are not a requirement.
537 Maximum of 12 tablets per prescription.
538 Special Authority for Subsidy - Form SA0538Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and 1.1.2 HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; and 1.1.3 ALT greater than twice upper limit of normal or stage 3 or 4 fibrosis on liver histology clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or 1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; and 2 All of the following: 2.1 No continuing alcohol abuse or intravenous drug use; and 2.2 Not coinfected with HCV, HDV, or HIV; and 2.3 Neither ALT nor AST greater than 10 times upper limit of normal; and 2.4
539 Special Authority for Subsidy - Form SA0539Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteApplications to be made on the approved forms which are available from: The Co-ordinatorPhone: 09 580 9176Multiple Sclerosis Treatment CommitteeFacsimile: 09 580 9205Level 3, Unisys HouseEmail: murray@ppc.govt.nz650 Great South Road, PenrosePrivate Bag, AUCKLANDBudget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC). Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below). Completed application forms must be sent to the co-ordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity. Notification of MSTAC's decision will be sent to the patient, the applying clinician and the patient's GP (if specified). These agents will N
541 Only if prescribed for renal dialysis, maternity or post-natal care in the home of the patient and the prescription is endorsed accordingly.
542 Only when prescribed in a quantity not exceeding 15 g per prescription form.
543 Not on a WSO.
544 Oral liq prescriptions: a) Must be written by a Paediatrician or Paediatric Cardiologist; orb) On the recommendation of a Paediatrician or Paediatric Cardiologist.
545 Restricted to children under 12 years of age.
546 Additional subsidy by endorsement for:Moclobemide tab 150 mg x 100 (Aurorix) up to $47.00Moclobemide tab 300 mg x 60 (Aurorix) up to $56.40Nefazadone tab 100 mg x 56 (Serzone) up to $20.16Nefazadone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Cipramil) up to $27.00is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or* have previously responded to treatment with moclobemide, nefazodone or citalopram; or* have had a trial of fluoxetine and have to discontinue due to: - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions); The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these words are not a requirement.
547 Alphagan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Alphagan should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: (a) that person has previously trialled all other such subsidised agents (except dorzolamide hydrochloride); and(b) those trials have indicated that that person does not respond adequately to or does not tolerate treatment with those other agents.
548 a) Maximum of 4 tablets per prescription
549 No user copayment payable
550 Maximum user copayment of $3
551 Special Authority for Subsidy - Form SA0551Initial application only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. NoteApproval entitles patients to a subsidy for one NAED. Dual NAED therapy will be subsidised for patients who were already stabilised on two NAEDs on or before 31 July 2000 or, for whom a second NAED has been added to therapy with one NAED provided an attempt to withdraw one NAED has been made and was unsuccessful. "Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combin
552 Nicotine patches and gum: a) are only available /subsidised on presentation of a Quitline exchange card.b) for reimbursement refer to the Claiming Procedures for the Subsidised Nicotine Patches and Gum Programme. c) have a maximum patient co-payment (contribution) of $10 per exchange card.
554 Special Authority for Subsidy - Form SA0554Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Liver transplant recipients; or 2 Renal transplant recipients - as rescue therapy only. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
555 a) Fluoxetine hydrochloride tab dispersible 20 mg restricted to a maximum daily dose of 10 mg. b) Tablets can be combined with capsules to facilitate incremental 10 mg doses.
556 Special Authority for Subsidy - Form SA0556Initial application - (Confirmed HIV/AIDS) only from a named general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Both: 2.2.1 Asymptomatic patient; and 2.2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Asymptomatic patient; and 2.3.2 Patient has viral load counts > 10,000 copies per ml or equivalent value on the Chiron test; or 2.4 All of the following: 2.4.1 Asymptomatic patient; and 2.4.2 Patient aged 1 to 5 years; and 2.4.3 CD4 counts < 1,000 cells/mm3; or 2.5 All of the following: 2.5.1 Asymptomatic patient; and 2.5.2 Patient aged 1 to 5 years; and 2.5.3 CD4 counts < 0.25 x total white cell count; or 2.6 All of the following: 2.6.1 Asymptomatic patient; and 2.6.2 Patient aged 6 years and over; and 2.6.3 CD4 counts
557 Special Authority for Subsidy - Form SA0557Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note"Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of complianceAs a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anti-convulsan
558 Additional subsidy by endorsement for:Moclobemide tab 150mg x 100 (Aurorix) up to $32.90Moclobemide tab 300mg x 60 (Aurorix) up to $39.48Nefazodone tab 100mg x 56 (Serzone) up to $20.16Nefazodone tab 200mg x 56 (Serzone) up to $40.32Citalopram tab 20mg x 28 (Cipramil) up to $27.00is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or* have previously responded to treatment with moclobemide, nefazodone or citalopram; or* have had a trial of fluoxetine and have had to discontinue due to - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these words are not a requirement.
560 Additional subsidy by endorsement for:Moclobemide tab 150mg x 100 (Aurorix) up to $32.90Moclobemide tab 300mg x 60 (Aurorix) up to $39.48Nefazodone tab 100mg x 56 (Serzone) up to $20.16Nefazodone tab 200mg x 56 (Serzone) up to $40.32Citalopram tab 20mg x 28 (Cipramil and Celapram) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on Februrary 2001; or * have previously responded to treatment with moclobemide or nefazodone or citalopram or paroxetine hydrochloride; or* have had a trial of fluoxetine and have had to discontinue due to - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be e
561 Not on a BSO.
563 Special Authority for Subsidy - Form SA0563Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patient has failed surgery, radiotherapy, bromocriptine and other oral therapies; or 2 VIPomas and Glucagonomas - for patients who are seriously ill in order to improve their clinical state prior to definitive surgery.; or 3 Both: 3.1 Gastrinoma; and 3.2 Either: 3.2.1 Patient has failed surgery; or 3.2.2 Patient in metastatic disease after H2 antagonists (or proton pump inhibitors) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or has failed; or 5 For pre-operative control of hypoglycaemia and for maintenance therapy; or 6 Both: 6.1 Carcinoid syndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis); and 6.2 Disabling symptoms not controlled by maximal medical therapy. No
564 Only if prescribed on a prescription for for renal dialysis, maternity or post-natal care in the home of the patient, or on a PSO for emergency use.
566 Trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include pat
567 Additional subsidy by endorsement for dispersible tablets
568 Perindopril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include pati
569 Special Authority for Subsidy - Form SA0569Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. Renewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the t
570 Not on a Prescription.
571 a) Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use.
572 Special Authority for Subsidy - Form SA0572Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient presenting with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patients suffers from schizophrenia or related psychoses ; and 2.2 Either: 2.2.1 A trial of risperidone has been discontinued because of unacceptable side effects; or 2.2.2 A trial of risperidone has been discontinued because of inadequate response. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
574 Subsidy is available for patients with poorly controlled asthma where: a) at least three months of 750 mcg or more daily of inhaled beclomethasone or budesonide(or 400 mcg of fluticasone) for adults has been used; orb) at least three months of 400 mcg or more daily of inhaled beclomethasone or budesonide (or 200mcg of fluticasone) for children 12 years or older has been used; The prescription must be endorsed accordingly. We recommend that the words used to indicateeligibility are "poor control with ICS" or "certified condition".
575 Special Authority for Subsidy - Form SA0575Initial application - (Confirmed HIV/AIDS) only from a named general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Both: 2.2.1 Asymptomatic patient; and 2.2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Asymptomatic patient; and 2.3.2 Patient has viral load counts > 10,000 copies per ml or equivalent value on the Chiron test; or 2.4 All of the following: 2.4.1 Asymptomatic patient; and 2.4.2 Patient aged 1 to 5 years; and 2.4.3 CD4 counts < 1,000 cells/mm3; or 2.5 All of the following: 2.5.1 Asymptomatic patient; and 2.5.2 Patient aged 1 to 5 years; and 2.5.3 CD4 counts < 0.25 x total white cell count; or 2.6 All of the following: 2.6.1 Asymptomatic patient; and 2.6.2 Patient aged 6 years and over
577 Dispersible tablets are subsidised only for patients who are unable to swallow tablets and the prescription is endorsed accordingly.
579 Special Authority for Subsidy - Form SA0579Initial application - (Cystic fibrosis or renal failure) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 cystic fibrosis; or 2 chronic renal failure or continuous ambulatory peritoneal dialysis (CAPD) patient. Initial application - (Indications other than cystic fibrosis or renal failure) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 cancer in children; or 2 cancers affecting alimentary tract where there are malabsorption problems in patients over the age of 20 years; or 3 failure to thrive; or 4 growth deficiency; or 5 bronchopulmonary dysplasia; or 6 premature and post premature infant. Renewal - (Cystic fibrosis or renal failure) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applicatio
580 Special Authority for Subsidy - Form SA0580Initial application - (Inborn errors of metabolism) only from a relevant specialist. Approvals valid for 3 years where inborn errors of metabolism. Initial application - (Indications other than inborn errors of metabolism) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 failure to thrive ; or 2 growth deficiency; or 3 bronchopulmonary dysplasia ; or 4 fat malabsorption ; or 5 lymphangiectasia; or 6 short bowel syndrome ; or 7 infants with necrotising enterocolitis; or 8 biliary atresia. Renewal - (Inborn errors of metabolism) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of
581 Special Authority for Subsidy - Form SA0581Initial application - (Cystic fibrosis) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 infant aged four years or under; and 2 cystic fibrosis. Initial application - (Indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 infant aged four years or under; and 2 Any of the following: 2.1 cancer in children; or 2.2 failure to thrive; or 2.3 growth deficiency; or 2.4 bronchopulmonary dysplasia; or 2.5 premature and post premature infants. Renewal - (Cystic fibrosis) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practiti
582 Special Authority for Subsidy - Form SA0582Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 protein losing enteropathy; or 2 high protein needs (eg burns). Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
585 Special Authority for Subsidy - Form SA0585Initial application - (Cystic fibrosis) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: All of the following: 1 Cystic fibrosis; and 2 other lower calorie products have been tried; and 3 patient has substantially increased metabolic requirements; and 4 Either: 4.1 The product is to be used as a supplement; or 4.2 The product is to be used as a complete diet.Initial application - (Indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Any of the following: 1.1 any condition causing malabsorption ; or 1.2 failure to thrive ; or 1.3 increased nutritional requirements.; and 2 other lower calorie products have been tried; and 3 patient has substantially increased metabolic requirements; and 4 Either: 4.1 The product is to be used a
587 Special Authority for Subsidy - Form SA0587Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 acute or chronic renal failure; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
588 Special Authority for Subsidy - Form SA0588Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 CORD patients who have hypercapnia; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
589 Special Authority for Subsidy - Form SA0589Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Anorexia and weight loss; and 2 Either: 2.1 decompensating liver disease without encephalopathy ; or 2.2 protein losing gastro-enteropathy; and 3 Either: 3.1 The product is to be used as a supplement (maximum 500 ml per day); or 3.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialis
590 Special Authority for Subsidy - Form SA0590Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 infant aged one to six years; and 2 Any of the following: 2.1 any condition causing malabsorption ; or 2.2 failure to thrive; or 2.3 increased nutritional requirements; and 3 Either: 3.1 The product is to be used as a supplement (maximum 500 ml per day); or 3.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must
591 Special Authority for Subsidy - Form SA0591Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 enteral feeding; or 1.2 nasogastric; or 1.3 nasoduodenal ; or 1.4 nasojejunal; or 1.5 gastrostomy/jejunostomy; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal only from a general practitioner or relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
592 Special Authority for Subsidy - Form SA0592Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 malabsorption ; or 1.2 short bowel syndrome; or 1.3 enterocutaneous fistulas ; or 1.4 pancreatitis; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.NoteEach of these products is highly specialised and would be prescribed only by an expert for a specific disorder. The alternative is hospitalisation. Elemental 028 Extra is more expensive than other products listed in this section and should only be used where the alternatives have been tried first and/or are unsuitable. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following:
594 Special Authority for Subsidy - Form SA0594Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Type I and II diabetics who require nutritional supplementation.; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
595 Special Authority for Subsidy - Form SA0595Initial application only from a relevant specialist. Approvals valid for 1 year where patient has motor neurone disease with swallowing disorder. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
596 Special Authority for Subsidy - Form SA0596Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 gluten enteropathy has been diagnosed by biopsy; or 2 dermatitis herpetiformis. NoteA premium may be payable if the subsidy does not match the price charged by the manufacturer. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
597 Special Authority for Subsidy - Form SA0597Initial application - (PKU Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 PKU; and 2 blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Initial application - (Patient aged over 16) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 dietary management of homocystinuria; or 2 inborn errors of metabolism other than PKU; or 3 dietary management of maple syrup urine disease..Initial application - (Patient aged 16 or under) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 dietary management of homocystinuria; or 2 PKU and other inborn errors of metabolism; or 3 dietary management of maple syrup urine disease..Renewal - (PKU Patient aged over 16
599 NoteLofenalac when used with Ketovite is considerably cheaper than Maxamaid or Maxamum.
600 Special Authority for Subsidy - Form SA0600Initial application only from a relevant specialist. Approvals valid for 3 years where inborn errors of metabolism. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
601 Special Authority for Subsidy - Form SA0601Initial application only from a relevant specialist. Approvals valid for 1 year where Infant suffering from Williams Syndrome and associated hypercalcaemia. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
602 Special Authority for Subsidy - Form SA0602Initial application only from a relevant specialist. Approvals valid for 6 months where infant weighing less than 1.5 kg at birth.
603 Special Authority for Subsidy - Form SA0603Initial application only from a relevant specialist. Approvals valid for 1 year where infant suffering from malabsorption and other gastrointestinal problems. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
604 Special Authority for Subsidy - Form SA0604Initial application - (Lactase deficiency or disaccharide intolerance) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patient is less than 3 years of age; and 2 Either: 2.1 diagnosed as suffering from congenital lactase deficiency; or 2.2 suffering from disaccharide intolerance. NoteSecondary lactose intolerance in children is usually short lasting, and can be controlled by dietary measures and by giving sufficient calories to regenerate digestive enzymes. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Initial application - (Infant with intolerance to cows' milk) only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 intolerant to cows' milk; and 2 patient is less than 3 years of age. No
605 Special Authority for Subsidy - Form SA0605Initial application - (Cystic fibrosis or renal disorder) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Either: 1.1 cystic fibrosis; or 1.2 renal disorder; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Initial application - (Indications other than cystic fibrosis or renal disorder) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 any condition causing malabsorption; or 1.2 failure to thrive; or 1.3 increased nutritional requirements; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal - (Cystic fibrosis or renal disorder) only from a relevant specialist or general practitioner. Approvals valid for 3 years
606 Special Authority for Subsidy - Form SA0606Initial application only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 child (up to 18 years) with chronic renal failure.; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.
607 Special Authority for Subsidy - Form SA0607Initial application only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Child (up to 18 years) who is awaiting liver transplant; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.
609 Special Authority for Subsidy - Form SA0609Initial application - (Serevent MDI, Serevent Accuhaler Foradil, Oxis Turbuhaler 12 mcg, Symbicort Turbuhaler) only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Child under the age of 12 with poorly controlled asthma; and 1.2 Either: 1.2.1 Required at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide; or 1.2.2 Required at least three months of 200 mcg or more of fluticasone; or 2 Both: 2.1 Adult with poorly controlled asthma; and 2.2 Either: 2.2.1 Required at least three months of 1500 mcg or more daily inhaled beclomethasone or budesonide; or 2.2.2 Required at least three months of 750 mcg or more of fluticasone. NotePatients are to be reviewed at least at six months to assess compliance and effectiveness of therapy. Special Authority approvals are interchangeable among all prese
610 Special Authority for Subsidy - Form SA0610Initial application from any specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Quantity used by patient on a weekly volume intraveneously (Details to be attached to application); and 2 Amount of nutrition patient is able to receive orally (Details to be attached to application); and 3 Exact formula of TPN (Details to be attached to application); and 4 Who has paid for TPN so far (Details to be attached to application); and 5 Place of manufacture (Details to be attached to application); and 6 Complete medical history of patient including details of previous therapies. (Details to be attached to application). Renewal - (Previous approval has expired) from any specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
611 Special Authority for Subsidy - Form SA0611Initial application from any medical practitioner. Approvals valid for 1 year where applicaton approved by the Cystic Fibrosis DN'ase Advisory Panel. NoteApplications to be made on the approved forms which are available from: The Co-ordinatorCystic Fibrosis DN'ase Advisory PanelPhone: (04) 460 4990 PHARMAC, PO Box 10 254 WellingtonFacsimile: (04) 916 7571Email: erin.murphy@pharmac.govt.nzPrescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.
612 Special Authority for Manufacturers Price - Form SA0612Renewal from any medical practitioner. Approvals valid for 2 years where patient recieved Special Authority prior to 1 June 1998.
613 Special Authority for Alternate Subsidy - Form SA0613Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Polycystic ovarian syndrome; or 2 Hirsutism; or 3 Androngenic alopecia. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
614 Special Authority for Subsidy - Form SA0614Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the tr
615 Special Authority for Subsidy - Form SA0615Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The product is to be used as a complete diet; and 2 Either: 2.1 Patient has metabolic disorders of fat metabolism; or 2.2 Patient has chylothorax. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
616 Special Authority for Manufacturers Price - Form SA0616Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. NoteAspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruisingInitial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic
617 Nicotine patches and gum are only available /subsidised on presentation of a Quitline exchange card.
618 Special Authority - Retail pharmacy
619 Special Authority - Hospital pharmacy
620 a) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - prescription may be written for up to six months supply; and- pharmacists may dispense up to three months supply. b) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. ie. Prescriptions may be written for up to three months supply, and dispensed monthly
621 Special Authority for Subsidy - Form SA0621Initial application only from a relevant specialist. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
622 Special Authority for Subsidy - Form SA0622Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals va
623 Special Authority for Subsidy - Form SA0623Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is not predisposed to heart arrhythmias; and 2 The patient does not have a pre-existing QT-prolongation or hepatic failure; and 3 The patient is not using other medications which either inhibit the cytochrome P450 3A4 enzyme system or prolong the QT interval; and 4 Any of the following: 4.1 Both: 4.1.1 The patient is an adult with severe reflux oesophagitis; and 4.1.2 other treatment, including acid suppression with proton pump inhibitors, has failed; or 4.2 gastroparesis; or 4.3 malignancy of GI tract causing gastroparesis (or gastric outlet obstruction); or 4.4 The patient is a child (not including infants from 0 to 3 months of age who were born prematurely) with severe gastro-oesophageal reflux; and 5 Diagnosis has been made or confirmed by a general p
624 Subsidy by endorsement Oral liquid is subsidised only for patients: - with oesophageal stricture, orin terminal care, or- who are either too young or too old to swallow conventional tablets and the prescription is endorsed accordingly. Note: the cost of treatment with ranitidine oral liquid is more than 10 times higher than that of ranitidine tablets. Following the derestriction of access PHARMAC will be monitoring expenditure on ranitidine oral liquid more closely and may, subject to consultation and PHARMAC Board approval, restrict access again if the expenditure was to grow substantially.
625 Maximum of 20 per WSO.
626 Special Authority for Subsidy - Form SA0626Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Dependent on regular blood transfusion but cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemo
627 Prescribing GuidelineTreatment with HMG CoA Reductase Inhibitors (Statins) is recommended for patients withdyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater. New Zealand Cardiovascular Guideline Group statement. "The 1996 Heart Foundation guidelines for the Assessment and Management of Dyslipidaemia are currently being revised. An evidence-based guideline on the Assessment and Management of Cardiovascular Risk will be developed in 2002. The Cardiovascular Guideline Group has written an interim consensus statement for themanagement of dyslipidaemia. The Heart Foundation cardiovascular risk tables should be used to determine risk. Certain groups are classified to be at very high risk (>20%) and should be treated as such: - Patients who have had a previous cardiovascular event (angina, MI, angioplasty, coronary artery bypass grafts, TIA, ischaemic stroke and peripheral vascular disease)- Patients with genetic lipid disorders- Patients with diabetes and associated microa
628 Special Authority for Subsidy - Form SA0628Initial application only from a cardiologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Congestive heart failure; and 1.2 Cannot tolerate two ACE inhibitors due to persistent cough that resolves on cessation and recurs on re-challenge with ACE inhibitor; or 2 Patients who have experienced angioedema on an ACE inhibitor at any time in the past; or 3 Patients who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal - ((2 year approvals granted before April 2002)) only from a cardiologist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
631 Special Authority for Subsidy - Form SA0631Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, or Beta-blockers are contraindicated; or 1.2.2 Patient cannot tolerate Pilocarpine, or Pilocarpine is contraindicated; or 1.2.3 Patient cannot tolerate Dorzolamide, or Dorzolamide is contraindicated; or 1.2.4 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 2 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker. NoteSubsidised also for adjunctive use for the treatment of patients who have met the initial application criteria, and in whom latanoprost monotherapy has bee
633 Special Authority for Subsidy - Form SA0633Initial application only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient is already on an ACE inhibitor or Angiotensin II Antagonist; and 2 Any of the following: 2.1 Both: 2.1.1 Symptomatic heart failure NYHA functional class II-III; and 2.1.2 Patient has been treated with metoprolol and is intolerant to metoprolol or has demonstrated a sub-optimal response to metoprolol; or 2.2 Symptomatic heart failure NYHA functional class III-IV; or 2.3 Patient has left ventricular systolic dysfunction with an ejection fraction of less than 35%.NoteWhere possible treatment should be initiated by or on the recommendation of a specialist.
634 a) Oral liquid restricted to children under 12 years of age.
635 Special Authority for Subsidy - Form SA0635Initial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Rheumatoid arthritis; and 2 Patient is not a pregnant woman, or a woman of child-bearing age without adequate contraception; and 3 Patient has been unable to tolerate or has a contraindication to or has had an inadequate response to sulphasalazine and methotrexate (individually or in combination). Renewal only from a rheumatologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Compliance (prescriber determined) with medication; and 2 Improved rheumatoid arthritis symptom control. NotePatient should have full blood count and liver function tests regularly monitored.
636 Retail pharmacy - subsidy by endorsement a) Subsidised for:i) patients presenting with first episode schizophrenia or related psychoses; andii) patients suffering from schizophrenia or related psychoses after a trial of an effective dose of risperidone that has been discontinued because of unacceptable side effects or inadequate response. b) Initial prescription must be written by a relevant specialist. c) Subsequent prescriptions may be written by a general practitioner. d) The prescription must be endorsed "certified condition".
637 Special Authority for Subsidy - Form SA0637Initial application - (National Heart Foundation risk groups A1:1, A1:2, B, C, D or E) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient has been offered 3-6 months of counseling and an opportunity to modify lifestyle; and 2 Any of the following: 2.1 Both: 2.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 2.1.2 total cholesterol > 5.5; or 2.2 Both: 2.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG) or angioplasty; and 2.2.2 total cholesterol > 4.5; or 2.3 Post heart transplant (regardless of cholesterol level); or 2.4 Both: 2.4.1 NHF B: Patients with > 20% 5-year cardiovascular disease risk; and 2.4.2 total cholesterol > 9.0; or 2.5 Both: 2.5.1 NHF C: 15-20% 5-year cardiovascular disease risk; and 2.5.2 total cholesterol >
638 Note: only one multidose cartridge starter pack to be prescribed and dispensed per patient per approval.
639 Special Authority for Subsidy - Form SA0639Initial application - (No previous use) only from a relevant specialist or general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 The patient has a clinical diagnosis of heavy menstrual bleeding; and 2 The patient has failed to respond to or is unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines; and 3 Either: 3.1 serum ferritin level < 16 mg/l (within the last 12 months); or 3.2 haemoglobin level < 120 g/l . NoteApplications are not to be made for use in patients as contraception except where they meet the above criteriaInitial application - (Previous use before 1 October 2002) only from a relevant specialist or general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 The patient had a clinical diagnosis of heavy menstrual bleeding; and 2
640 Special Authority for Manufacturers Price - Form SA0640Initial application only from a relevant specialist. Approvals valid for 3 years where patients being treated for advanced breast cancer who are refractory to tamoxifen. Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
641 Special Authority for Waiver of Rule - Form SA0641Initial application only from a diabetologist, general physician or paediatrician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Both: 1.1 Use alone (monotherapy); and 1.2 The patient is unable to use any other insulins including those on insulin pump treatment; or 2 Both: 2.1 Use with insulin other than insulin isophane (including ready-mixed preparations); and 2.2 A reasonable trial of insulin isophane has been undertaken and it is not effective or not well tolerated. Note"Reasonable trial", "unable to use", "not effective", "not well tolerated", and "not well tolerated" are not defined and we ask clinicians to use their clinical judgement in interpreting these terms.
642 Restricted to 20 PFMs per order form.
643 Special Authority for Subsidy - Form SA0643Initial application - (CML) only from an oncologist or relevant specialist. Approvals valid for 7 months where approved by the The Glivec Co-ordinator. Initial application - (GIST) only from an oncologist. Approvals valid for 1 year where approved by the The Glivec Co-ordinator. Renewal - (CML) only from an oncologist or relevant specialist. Approvals valid for 6 months where approved by the The Glivec Co-ordinator. Initial application - (GIST) only from an oncologist. Approvals valid for 1 year where approved by the The Glivec Co-ordinator. NoteApplication forms are available from, and prescriptions should be sent to: The Glivec Co-ordinatorPhone: 09 580 9176Level 3, Unisys HouseFacsimile: 09 580 9205650 Great South Road, PenroseEmail: murray@ppc.govt.nzPrivate Bag, AUCKLANDSpecial Authority criteria for CML - access by applicationFunded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) i
645 Special Authority for Subsidy - Form SA0645Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin <= 100 g/L; and 2 Either: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate <= 30 ml/min; or 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate <= 45 ml/min. Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteErythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over:GFR (male)
646 Special Authority for Subsidy - Form SA0646Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin <= 100 g/L; and 2 Any of the following: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate <= 30 ml/min; or 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate <= 45 ml/min; or 2.3 patient is on haemodialysis or peritoneal dialysis. Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteErythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estim
648 Special Authority for Manufacturers Price - Form SA0648Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. NoteAspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruisingInitial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic
649 Special Authority for Subsidy - Form SA0649Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. NoteAspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruisingInitial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic episodes des
650 Etidronate for osteoporosis should be prescribed for 14 days (400 mg in the morning) and repeated every three months. It should not be taken at the same time of the day as any calcium supplementation (minimum dose - 500 mg per day of elemental calcium). Etidronate should be taken at least 2 hours before or after any food or fluid, except water
652 Special Authority for Subsidy - Form SA0652Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note"Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of complianceInitial application - (Dual NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 18 months for app
656 Additional subsidy by endorsement for:Calcium carbonate tablets x 1,000 (Titralac) up to $35.10 is available for pregnant women. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these particular words are not a requirement.
657 Special Authority for Subsidy - Form SA0657Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobact
658 Additional subsidy by endorsement for:Moclobemide tab 150 mg x 500 (Apo-Moclobemide) up to $46.00Moclobemide tab 150 mg x 100 (Aurorix) up to $32.90Moclobemide tab 300 mg x 100 (Apo-Moclobemide) up to $26.11Moclobemide tab 300 mg x 60 (Aurorix) up to $39.48Nefazodone tab 100 mg x 56 (Serzone) up to $20.16Nefazodone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: - were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with moclobemide or nefazodone or citalopram or paroxetine hydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or
661 Special Authority for Subsidy - Form SA0661Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has "treatment resistant" depression; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and failed to respond to an adequate dose over an adequate period of time. Renewal from any medical practitioner. Approvals valid for 2 years where patient has a high risk of relapse (prescriber determined)..NoteFirst prescription can be written by a psychiatrist or psychiatric registrar. Subsequent prescriptions may be written by a General Practitioner
663 a) Injection subsidised only if not more than 10 injections per prescription.
665 Prescribing GuidelinesBoth Trusopt and Cosopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Trusopt and Cosopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: i) that person has previously trialled all other such subsidised agents (except brimonidine tartrate); andii) those trials have indicated that that person does not respond adequately to treatment with those other agents.
666 a) Spacer devices and masks also available to paediatricians employed by a DHB on a wholesalesupply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via ahospital pharmacy. b) Only available for children aged six years and under. c) For Space Chamber and Foremount Child's Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. d) Distributed by Airflow Products. Forward orders to: Airflow ProductsPO Box 1485 Telephone: 04 499 1240 or 0800 AIR FLOWWellington Facsimile: 04 499 1245 or 0800 323 270
667 Special Authority for Subsidy - Form SA0667Initial application only from a named specialist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 To be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Patient is less than 18 years of age at commencement of treatment; and 3 Patient has had severe active polyarticular course Juvenile Idiopathic Arthritis (JIA) for 6 months duration or longer; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of 10-20mg/m2 weekly in combination with oral corticosteroids (prednisone 0.25 mg/kg); and 5 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-15mg/m2 weekly) in combination with one other disease-modifying agent; and 6 Both: 6.1 Either: 6.1.1 Patient has persistent symptoms of poorly-cont
668 Note: Due to uncertainty around the long term effects of Selegiline it is not recommended as a first line agent.
669 Special Authority for Subsidy - Form SA0669Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where organ transplant recipients. NoteSubsidy applies for either primary or rescue therapy
670 Special Authority available.
671 Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide.
672 Additional subsidy by endorsement for:Nefazodone tab 100 mg x 56 (Serzone) up to $20.16Nefazodone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with nefazodone or citalopram or paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
673 Special Authority for Manufacturers Price - Form SA0673Initial application from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient considered unsafe to switch to m-Eslon; and 2 Patient was stabilised and well controlled on Kapanol, MST or LA-Morph before 1 December 2003. NoteSpecial Authority effective from 1 February 2004 to 31 July 2004
674 Note: Combivir counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority
675 Tablets can be combined with capsules to facilitate incremental 10 mg doses.
676 Only in extemporaneously compounded methyl hydroxybenzoate 10% solution
677 Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric
679 Only in extemporaneously compounded oral mixtures
681 Only a prescription for a female patient
683 Special Authority available.
684 Rapid acting insulin analogues are subsidised when: 1) prescribed with insulin isophane or insulin glargine but are on a different prescription and the prescription is endorsed accordingly; or prescribed on the same prescription as insulin isophane or insulin glargine in which case the prescription is deemed to be endorsed; or2) a Special Authority has been approved. For 1and 2 first prescription to be written by a specialist (diabetologist, general physician or paediatrician). Any medical practitioner can writte subsequent prescriptions.
685 Not more than one prescription per month.
686 Additional subsidy by Special Authority - Retail Pharmacy - for: - Nifedipine tab long-acting 30mg x 30 (Adalat Oros) up to $19.90 - Nifedipine tab long-acting 60mg x 30 (Adalat Oros) up to $29.50
687 Additional subsidy by Special Authority - Retail Pharmacy - for: - Amlodipine 5mg x 30 (Norvasc) up to $19.90 - Amlodipine 10mg x 30 (Norvasc) up to $29.50
688 Only in combination with a dermatological galenical or as a diluent for a proprietary Topical Corticosteroid - Plain.
692 Special Authority for Subsidy - Form SA0692Initial application from any specialist. Approvals valid for 11 months where patient has chronic, genotype 1 hepatitis C.
693 Special Authority for Subsidy - Form SA0693Initial application only from a relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fracture demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal - ((2 year approvals granted before February 2002)) only from a geriatrician, rheumatologist, endocrinologist, gynaecologis
694 Subsidy is available for patients with poorly controlled asthma where: a) at least three months of 750 mcg or more daily of inhaled beclomethasone or budesonide (or 400 mcg or fluticasone) for adults has been used; orb) at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide (or 200 mcg or fluticasone) for children has been used; The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "poor control with ICS" or "certified exemption".
696 Special Authority for Subsidy - Form SA0696Initial application - (Narcolepsy) only from a neurologist or respiratory specialist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients 5 or over) only from a paediatrician, psychiatrist or general practitioner on the recommendation of such a specialist. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficit and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Either: 3.1 Applicant is a specialist; or 3.2 Both: 3.2.1 Applicant is a GP and a specialist has recommended treatment; and 3.2.2 Provide name of specialist (Details to be attached to application). Initial application - (ADHD in patients under 5) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Defi
698 Special Authority for Subsidy - Form SA0698Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Severe acne following treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. The patient must have had no more than 1 prior approval in the last year. NoteClinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate.
699 Special Authority for Subsidy - Form SA0699Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is not predisposed to heart arrhythmias; and 2 The patient does not have a pre-existing QT-prolongation or hepatic failure; and 3 The patient is not using other medications which either inhibit the cytochrome P450 3A4 enzyme system or prolong the QT interval; and 4 Any of the following: 4.1 Both: 4.1.1 adult with severe reflux oesophagitis; and 4.1.2 other treatment, including acid suppression with proton pump inhibitors, has failed; or 4.2 gastroparesis; or 4.3 malignancy of GI tract causing gastroparesis (or gastric outlet obstruction); or 4.4 child (not including infants from 0 to 3 months of age who were born prematurely) with severe gastro-oesophageal reflux; and 5 Diagnosis has been made or confirmed by a general physician, gastroenterologist, or ge
700 Special Authority for Subsidy - Form SA0700Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Monotherapy in primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, Pilocarpine and Dorzolamide; or 1.2.2 Beta-blockers, Pilocarpine and Dorzolamide are contraindicated; or 1.2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 1.2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker; or 2 Adjunctive use for the treatment of patients who have met the initial application criteria, and in whom latanoprost monotherapy has been ineffective in controlling intraocular pressure.Note An adjunctive agent may be added without a
701 Prescriptions can be written either by specialist or general practitioner.
702 Special Authority for Subsidy - Form SA0702Initial application - (Oral feed for cystic fibrosis patient) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Cystic fibrosis; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Initial application - (Oral feed for indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 any condition causing malabsorption; or 1.2 failure to thrive; or 1.3 increased nutritional requirements; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal - (Oral feed cystic fibrosis patient) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years f
703 Special Authority for Subsidy - Form SA0703Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patient has raised blood pressure; and 2 The use of fully funded beta blockers is contraindicated, or not well tolerated; or where use of fully funded beta blockers and diuretics are insufficient to control blood pressure adequately at appropriate doses; and 3 Either: 3.1 Has been treated with, and cannot tolerate two ACE inhibitors, due to persistent cough; or 3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
705 Only in infants under two years
706 Special Authority for Subsidy - Form SA0706Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Both: 1.1 Patient with congestive heart failure; and 1.2 Either: 1.2.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 1.2.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years; or 2 All of the following: 2.1 Patient with raised blood pressure; and 2.2 Use of fully funded beta blockers or diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 2.3 Either: 2.3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 2.3.2 Has experienced angioedema on an ACE in
708 Effective, consistent management of herpes from prescribing to these guidelines will improve patient outcomes. The guidelines on the following four pages are for the prescribing of aciclovir. The guidelines aim to: - improve patient care and clinical outcome through faster, more accessible treatment - protect patients' wider wellbeing by reinforcing the psychosocial aspects of treatment - improve the consistency and breadth of medical management of genital herpes in New Zealand. The guidelines are: - integral to ensuring a consistent, effective treatment regimen- the result of consultation with clinicians and patient representatives- set out in line with the recommended international algorithm format for treatment. The guidelines are endorsed by the Herpes Foundation's professional advisory board whose members represent venereology, NZDS, RNZCGP, RNZCOG, psychotherapy and nursing. Herpes Foundation Helpline: Toll free 0508 11 12 13Auckland Branch Herpes Foundation: 09 360 1966
709 Guidelines for the use of interferon in the treatment of hepatitis C: Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or aninfectious disease physician. All subjects undergoing treatment require careful monitoring for side effects. Patients should be otherwise fit. Hepatocellular carcinoma should be excluded by ultrasound examination and alpha-fetoprotein level. Criteria for Treatment a) Diagnosis- Anti-HCV positive on at least two occasions with a positive PCR for HCV-RNA and preferably confirmed by asupplementary RIBA test; or- PCR-RNA positive for HCV on at least 2 occasions if antibody negative; or- Anti-HCV positive on at least two occasions with a positive supplementary RIBA test with a negative PCR forHCV RNA but with a liver biopsy consistent with 2(b) following. b) Establishing Active Chronic Liver Disease- Confirmed HCV infection and serum ALT/AST levels measured on at least three occasions over six monthsaveraging >
710 Special Authority for Subsidy - Form SA0710Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Monotherapy in primary open-angle glaucoma; or 1.2 Adjunctive use for the treatment of open-angle glaucoma in a patient who has met the initial application criteria, and in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure; and 2 Any of the following: 2.1 Patient cannot tolerate beta-blockers, pilocarpine, and carbonic anhydrase inhibitors; or 2.2 Beta-blockers, pilocarpine and carbonic anhydrase inhibitors are contraindicated; or 2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using carbonic anhydrase inhibitor either alone or in combination with a beta blocker; or 2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with carbonic anhydrase inhibitor either alo
713 Special Authority for Subsidy - Form SA0713Initial application from any specialist. Approvals valid for 11 months for applications meeting the following criteria: Either: 1 Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or 2 Patient has chronic hepatitis C, genotype 2 or 3 infection with bridging fibrosis or cirrhosis (Metavir stage 3 or 4, or equivalent).
714 Special Authority for Subsidy - Form SA0714Initial application from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Patient is currently enrolled in a recognised comprehensive treatment programme for alcohol dependence in a service accredited against the New Zealand Alcohol and Other Drug Sector Standard or the National Mental Health Sector Standard; and 2 Applicant works in an Alcohol & Drug Service; and 3 Applicant must include the address of the service (Details to be attached to application). Renewal from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Compliance with the medication (prescriber determined); and 2 Any of the following: 2.1 Patient is still unstable and requires further treatment; or 2.2 Patient achieved significant improvement but requires further treatment; or 2.3 Patient is well controlled but requires maint
715 Prescribing GuidelinesTrusopt, Cosopt and Azopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Trusopt, Cosopt and Azopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: a) that person has previously trialled all other such subsidised agents (except brimonidine tartrate); andb) those trials have indicated that that person does not respond adequately to treatment with those other agents.
716 Prescribing GuidelineTreatment with HMG CoA Reductase Inhibitors (statins) is recommended for patients with dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater.
717 Special Authority for Manufacturers Price - Form SA0717Initial application only from a relevant specialist or general practitioner. Approvals valid for 12 weeks for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin; or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.3 LDL cholesterol test 2 >= 2.5 mmol/litre (at least 1 w
718 No more than 1 tab per day
719 Repeat dispensings fully subsidised where initial dispensing was before 1 June 2004.
720 Maximum of 108 g available on PSO
721 Special Authority for Subsidy - Form SA0721Initial application only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient already has a Special Authority approval for anti-retroviral therapy (Details to be attached to application); and 2 Kaletra is to be used as a salvage therapy in place of one protease inhibitor; and 3 The patient must have trialed for at least six months and have failed on currently funded NNRTI based regimens or triple NRTI regimens; and 4 The patient must have trialed for at least six months and have failed on currently funded PI based regimens. NoteFailure is defined as: a) not achieving HIV RNA < 400 copies/ml after 24 weeks of a regimen, orb) an increase of HIV RNA to > 400 copies/ml on two separate occasions not less than one month apart, after suppression to < 400 copies/ml in a patient taking the regimen.
722 Special Authority for Subsidy - Form SA0722Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Gluten enteropathy has been diagnosed by biopsy; or 2 Patient suffers from dermatitis herpetiformis.
723 Special Authority for Subsidy - Form SA0723Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 1.2 Patient cannot tolerate statin therapy at a dose of 40 mg per day; and 1.3 Either: 1.3.1 All of the following: 1.3.1.1 Patient has venous CABG; and 1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 1.3.2 All of the following: 1.3.2.1 Patient does not have venous CABG; and 1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 1.3.2.3 LDL cholesterol >= 2.5 mmol/litre (at least 1 week after test 1 - see note); or 2 All of the following: 2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholesterol
724 Special Authority for Manufacturers Price - Form SA0724Initial application only from a relevant specialist or general practitioner. Approvals valid for 12 weeks for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin (blood tests are not required); or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.3 LDL cholesterol test 2 >
725 Special Authority for Subsidy - Form SA0725Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient with raised blood pressure; and 2 Use of fully funded beta blockers and diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 3 Either: 3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal - (Previous approval has expired) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
726 Maximum one pack (two 500mg tablets) per prescription.
727 Special Authority for Subsidy - Form SA0727Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Control of intractable nausea, vomiting, or inability to swallow saliva in the treatment of malignancy or chronic disease; and 2 Patient cannot tolerate or does not adequately respond to oral anti-nausea agents; and 3 The applicant must specify the underlying malignancy or chronic disease (Details to be attached to application). Renewal from any medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment.
728 Retail pharmacy - subsidy by endorsement a) Subsidised for:(i) patients presenting with first episode schizophrenia or related psychoses, or manic episodes associated with bipolar disorder; and(ii) patients suffering from schizophrenia or related psychoses, or manic episodes associated with bipolar disorder, after a trial of an effective dose of risperidone that has been discontinued because of unacceptable side effects or inadequate response. b) Initial prescription must be written by a relevant specialist. c) Subsequent prescriptions may be written by a general practitioner. d) The prescription must be endorsed "certified condition".
729 Only in extemporaneously compounded methadone mixture, codeine linctus diabetic or codeine linctus paediatric or phenobarbitone oral liquid
730 No more than 1.5 tabs per day
731 No more than 1 tab per day
732 Special Authority for Subsidy - Form SA0732Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 dietary management of homocystinuria; or 2 dietary management of maple syrup urine disease. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
733 Special Authority for Subsidy - Form SA0733Initial application - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 dietary management of PKU; and 2 blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Initial application - (Patient aged 16 or under) only from a relevant specialist. Approvals valid for 3 years where dietary management of PKU.Renewal - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Renewal - (Patient aged 16 or under) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2
734 GuidelinesIt can cost up to $70,000 a year to keep an adult on protein supplements. Because protein substitutes are so expensive and because they are only effective in controlling PKU if a restricted diet is followed, adults with PKU will be required to demonstrate they are following the prescribed diet by regular blood testing. The requirement for testing applies to those aged over 16 years. Failure to follow an appropriate diet results in high blood phenylalanine levels. Those consistently testing above 15 mg (900 micromol) over a twelve month period will not be able to claim these products as a Special Authority. Specialists will be required to renew applications for their PKU patients every year and, when they do so, will have to submit the results of two blood tests.
735 Neocate should be used only as a last resort when the infant is unable to absorb any of the above formulae. The objective with each of thees formulae prescribed is to get the infant off them as soon as possible. This may take six months, it may take three years. Because of this, variation on age limit is not regarded as appropriate.These formulae will be available only from a hospital pharmacy. Vivonex Pediatric may be a suitable and less expensive alternative for many children that would otherwise be eligible for a subsidy for Neocate and should, therefore, be tried first in these cases. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products.
738 Special Authority for Subsidy - Form SA0738Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 All of the following: 1.1 To be used as monotherapy for patients with type 2 diabetes who after six months of diet and lifestyle changes do not have adequate glycaemic control (inadequate control defined as HbA1c > 8.0% in tests carried out at least two months apart); and 1.2 Metformin is not tolerated or contraindicated. Intolerance and contraindications as defined in the notes below, a minimum of a four week trial period of metformin is required; and 1.3 Sulphonylurea is not tolerated or contraindicated. Overweight patients are only eligible under the criteria of contraindication to sulphonylureas if their body mass index (BMI) exceeds 35; or 2 Both: 2.1 For use in combination with a sulphonylurea when diet and lifestyle changes and a twelve month trial of sulphonylurea results in inadequate glycaem
740 Prescribing GuidelineHRT should be taken at the lowest dose for the shortest period of time necessary to control symptoms. Patients should be reviewed 6 monthly in line with the updated NZGG "Evidence-based Best Practice Guideline on Hormone Replacement Therapy March 2004".
741 Special Authority for Subsidy - Form SA0741Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Patient with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patient suffering from schizophrenia and related psychoses; or acute mania in bipolar disorder who is likely to benefit from anti-psychotic treatment; and 2.2 Either: 2.2.1 An effective dose of risperidone had been trialled and has been discontinued because of unacceptable side effects; or 2.2.2 An effective dose of risperidone had been trialled and has been discontinued because of inadequate clinical response after 4 weeks; or 3 The patient has suffered from an acute episode of schizophrenia or bipolar mania and has been treated with olanzapine short-acting intra-muscular injection. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefit
742 Special Authority for Subsidy - Form SA0742Initial application - (genotype 1, 4, 5 or 6 infection) from any specialist. Approvals valid for 11 months where patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection. Initial application - (genotype 2 or 3 infection) from any specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Patient has chronic hepatitis C, genotype 2 or 3 infection; and 2 Patient has bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent).
743 Special Authority for Subsidy - Form SA0743Initial application only from a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is terminally ill and is opioid-responsive; and 2 Either: 2.1 is unable to take oral medication; or 2.2 is intolerant to morphine, or morphine is contraindicated..Renewal only from a relevant specialist or general practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
745 Only in extemporaneously compounded omeprazole suspension
746 Maximum of 6 capsules per prescription.
749 Additional subsidy by endorsement for:Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with citalopram or paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
750 Special Authority for Subsidy - Form SA0750Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where continuation of previous therapy.
751 Special Authority for Subsidy - Form SA0751Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Monotherapy in primary open-angle glaucoma; or 1.2 Adjunctive use for the treatment of open-angle glaucoma in a patient who has met the initial application criteria, and in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure; and 2 Any of the following: 2.1 Patient cannot tolerate beta-blockers, pilocarpine, and carbonic anhydrase inhibitors; or 2.2 Beta-blockers, pilocarpine and carbonic anhydrase inhibitors are contraindicated; or 2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using carbonic anhydrase inhibitor either alone or in combination with a beta blocker; or 2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with carbonic anhydrase inhibitor either alo
752 (a) Subsidy is available between 1 March and 30 June of each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii) diabetes; iv) chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi) the following other conditions: 1) autoimmune disease, 2) immune suppression, 3) HIV, 4) transplant recipients, 5) neuromuscular and CNS diseases, 6) haemoglobinopathies, or 7) children on long term aspirin. The following conditions are excluded from funding: i) asthma not requiri
753 Special Authority for Manufacturers Price - Form SA0753Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Patient is a postmenopausal women; and 2 Patient has hormone receptor positive advanced breast cancer (Stage IIIb, or metastatic Stage IV). Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
754 Special Authority for Subsidy - Form SA0754Initial application only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient already has a Special Authority approval for anti-retroviral therapy (Details to be attached to application); and 2 Kaletra is to be used as a salvage therapy in place of one protease inhibitor; and 3 The patient must have trialed for at least six months and have failed on currently funded NNRTI based regimens or triple NRTI regimens; and 4 The patient must have trialed for at least six months and have failed on currently funded PI based regimens. NoteFailure is defined as: a) not achieving HIV RNA < 400 copies/ml after 24 weeks of a regimen, orb) an increase of HIV RNA to > 400 copies/ml on two separate occasions not less than one month apart, after suppression to < 400 copies/ml in a patient taking the regimen.
755 Special Authority for Subsidy - Form SA0755Initial application from any medical practitioner. Approvals valid for 2 years where the patient is likely to benefit from treatment. Note Applications to be made on the approved forms which are available from: Prof. Wayne CutfieldNational Co-ordinatorNew Zealand Growth Hormone CommitteeC/- Department of PaediatricsUniversity of AucklandPrivate Bag 92019AUCKLAND
756 Pharmacies cannot claim subsidy because PHARMAC has made alternative distribution arrangements.
757 Special Authority for Subsidy - Form SA0757Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient is less than 2 years of age; and 2 Intolerant to cows' milk; and 3 Diagnosed as suffering from congenital lactase deficiency. Renewal only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
758 Special Authority for Subsidy - Form SA0758Initial application only from a general practitioner or relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 To be used for the long-term maintenance treatment of bronchospasm and dyspnoea associated with COPD; and 2 In addition to standard treatment, the patient has trialled a dose of at least 40 mcg ipratropium q.i.d; and 3 The patient's breathlessness >= grade 4 according to the Medical Research Council dyspnoea scale (see note); and 4 FEV1 (litres) < 0.4 x predicted (litres); and 5 Either: 5.1 Patient is not a smoker (for reporting purposes only); or 5.2 Patient is a smoker and been offered smoking cessation councilling; and 6 The patient has been offered annual influenza immunisation. Renewal only from a general practitioner or relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1
759 Prescriptions must be written by a gastroenterologist.
760 a) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - prescription may be written for up to six months supply. b) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. ie. Prescriptions may be written for up to three months supply.
761 Only in children up to 12 years
763 Maximum of 100 plastic syringes with attached needles per prescription.
764 Maximum 100 pen needles per prescription.
765 Subject to budgetary cap. Applications will be considered and approved subject to funding availability.
766 A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005. Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly.
767 Retail pharmacy - specialist prescriptionPrescriptions must be written by a gastroenterologist
768 Hospital pharmacy - specialist prescriptionSpecialist must be a psychiatrist
770 (a) Subsidy is available between 1 March and 30 June of each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii) diabetes; iv) chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi) the following other conditions: 1) autoimmune disease, 2) immune suppression, 3) HIV, 4) transplant recipients, 5) neuromuscular and CNS diseases, 6) haemoglobinopathies, or 7) children on long term aspirin. The following conditions are excluded from funding: i) asthma not requiri
771 The number of test strips available on a prescription is restricted to 50 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; orb) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; orc) Prescribed for a pregnant woman with diabetes and endorsed accordingly.
772 Special Authority for Subsidy - Form SA0772Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and 1.1.2 HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; and 1.1.3 ALT greater than twice upper limit of normal or stage 3 or 4 fibrosis on liver histology clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or 1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; or 1.4 Hepatitis B surface antigen positive (HbsAg) patient who is receiving chemotherapy for a malignancy, or who has received such treatment within the previous two months; and 2 All of the following: 2.1 No continuing
773 Additional subsidy by endorsement for:Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking paroxetine hydrochloride on February 2001; or- have previously responded to treatment with paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
774 Special Authority for Subsidy - Form SA0774Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has advanced gastrointestinal malignancy; or 2 The patient has metastatic breast cancer*; or 3 Both: 3.1 The patient has poor venous access or needle phobia*; and 3.2 The patient requires a substitute for single agent fluoropyrimidine*. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment. Noteindications marked with * are unapproved indications.
775 Special Authority for Subsidy - Form SA0775Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastatic colorectal cancer; and 2 Either: 2.1 To be used for first or second line use as part of a combination chemotherapy regimen; or 2.2 As single agent chemotherapy in fluropyrimidine-relapsed disease. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment.
776 Special Authority for Subsidy - Form SA0776Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but has not previously been treated with taxanes; or 2 The patient has metastatic breast cancer; or 3 Both: 3.1 The patient has non-small cell lung cancer; and 3.2 Either: 3.2.1 The patient has advanced disease (stage IIIa or above); or 3.2.2 The patient is receiving combined chemotherapy and radiotherapy; or 4 Both: 4.1 The patient has small-cell lung cancer*; and 4.2 Paclitaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastati
777 Special Authority for Subsidy - Form SA0777Initial application - (Post-transplant) only from a relevant specialist. Approvals valid for 6 months where the patient has B-cell post-transplant lymphoproliferative disorder*. NoteFor no more than 8 treatment cycles. Initial application - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for 6 months where the patient has low grade NHL - relapsed disease following prior chemotherapy. NoteFor no more than 4 treatment cycles. Initial application - (Large cell lymphomas) only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has treatment naive large B-cell NHL; and 2 To be used with CHOP (or alternative anthracycline containing multi-agent chemotherapy regime given with curative intent).NoteFor no more than 8 treatment cycles. Renewal - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for 6 months for applications meeting
779 Special Authority for Subsidy - Form SA0779Initial application - (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1,000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 x total lymphocyte count; or 2.3.2.3 Viral load counts > 100,000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 cells/mm3. NoteTenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals. Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including r
780 Special Authority for Subsidy - Form SA0780Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note"Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of complianceInitial application - (Dual NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 18 months for app
781 Special Authority for Subsidy - Form: SA0781Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: Monotherapy1 All of the following: 1.1 To be used as monotherapy for patients with type 2 diabetes who after six months of diet and lifestyle changes do not have adequate glycaemic control (inadequate control defined as HbA1c > 7.0% in tests carried out at least two months apart); and 1.2 Metformin is not tolerated or contraindicated. Intolerance and contraindications as defined in the notes below, a minimum of a four week trial period of metformin is required; and 1.3 Sulphonylurea is not tolerated or contraindicated. Obesity is only eligible under the criteria of contraindication to sulphonylureas if the patient's body mass index (BMI) exceeds 33 , intolerance as defined in the notes below; orIn combination with sulphonylurea2 Both: 2.1 For use in combination with a sulphonylure
782 Special Authority for Subsidy - Form SA0782Initial application - (No previous use) only from a relevant specialist or general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has a clinical diagnosis of heavy menstrual bleeding; and 2 The patient has failed to respond to or is unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines; and 3 Either: 3.1 serum ferritin level < 16 mg/l (within the last 12 months); or 3.2 haemoglobin level < 120 g/l . NoteApplications are not to be made for use in patients as contraception except where they meet the above criteriaInitial application - (Previous use before 1 October 2002) only from a relevant specialist or general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient had a clinical diagnosis of heavy menstrual bleeding; and 2
783 Special Authority for Manufacturers Price - Form: SA0783Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal women; and2 Patient has hormone receptor positive advanced breast cancer; and3 Any of the following: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.2 The patient has a very clear history of intolerance to tamoxifen; or 3.3 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
784 Special Authority for Subsidy - Form: SA0784Initial application from any specialist. Approvals valid for 12 months where patient has chronic hepatitis C (all genotypes).
786 Prescribing GuidelinePrescribers should note that oxycodone is significantly more expensive than long-acting morphine sulphate and clinical advice suggests that it is reasonable to consider this as a second-line agent to be used after morphine.
788 Special Authority for Manufacturers Price - Form SA0788Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin (blood tests are not required); or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.
789 Special Authority for Subsidy - Form SA0789Initial application only from a relevant specialist or vocationally registered general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has "treatment resistant" depression; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and failed to respond to an adequate dose over an adequate period of time. Renewal from any medical practitioner. Approvals valid for 2 years where patient has a high risk of relapse (prescriber determined).
790 Prescribing GuidelineBimatoprost, lantanoprost and travoprost are subsidised for use in the treatment of glaucoma as either monotherapy or as an adjunctive agent for patients in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure.Bimatoprost, lantanoprost and travoprost should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: 1 That person has previously trialled all other such subsidised agents (beta-blockers, pilocarpine, carbonic anhydrase inhibitors); and2 Those trials have indicated that that person does not respond adequately to treatment with those other agents.
791 Mycophenolate powder for oral liquid is subsidised only for patients unable to swallow tablets and capsules, and when the prescription is endorsed accordingly.
792 Special Authority for Subsidy - Form: SA0792Initial application only from a psychiatrist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has schizophrenia or other psychotic disorder; and2 Has tried but failed to comply with treatment using oral atypical anti-psychotic agents; and3 Has been admitted to hospital or treated in respite care, or intensive outpatient or home-based treatment for 30 days or more in last 12 months. Renewal only from a psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Either: 4 Both: 4.1 The patient has had less than 12 months treatment with risperidone microspheres; and 4.2 There is no clinical reason to discontinue treatment; or5 The initiation of risperidone microspheres has been associated with fewer days of intensive intervention than was the case during a corresponding period of time prior to the initiation of risperidone microspheres. NoteRisp
793 a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; orb) for the treatment of confirmed ciprofloxacin-resistant gonorrhoea; orc) for the treatment of suspected meningitis in patients who have a known allergy to penicillin; andd) the prescription is endorsed accordingly
795 Maximum of 4 available on PSO
796 Special Authority for Subsidy - Form: SA0796Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 ezetimibe is to be used in combination with simvastatin; or 1.2 ezetimibe is to be used without a statin; and2 Either: 2.1 All of the following: 2.1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 2.1.2 Patient cannot tolerate statin therapy at a dose of 40 mg per day; and 2.1.3 Either: 2.1.3.1 All of the following: 2.1.3.1.1 Patient has venous CABG; and 2.1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 2.1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 2.1.3.2 All of the following: 2.1.3.2.1 Patient does not have venous CABG; and 2.1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 2.1.3.2.3 LDL cholest
797 Special Authority for Subsidy - Form: SA0797Initial application - (Underlying cause - Osteoporosis) only from a relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) >= 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score <= -2.5); or2 History of one significant osteoporotic fracture demonstrated radiologically and the patient is either over 75 years of age or is too frail* to undergo a bone mass density scan; or3 History of two significant osteoporotic fractures demonstrated radiologically; or4 Documented T-Score <= -3.0. Note*The patient may be considered to be frail if it is expected that there is significant risk of further fracture or other negative health outcome if the patient were to undergo a BMD s
798 Special Authority for Subsidy - Form: SA0798Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Renal transplant recipient; or2 Heart transplant recipient. or; 3 Patient has an organ transplant and has severe tophaceous gout making azathioprine unsuitableRenewal only from a relevant specialist. Approvals valid without further renewal unless notified where patient had a previous Special Authority approval and was receiving mycophenolate prior to 1 October 2005
799 Special Authority for Subsidy - Form: SA0799Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient has metastatic breast cancer; or2 The patient has non-small cell lung cancer (stage IIIa, or above).Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 3 The patient requires continued therapy; or4 The tumour has relapsed and requires re-treatment.
801 Special Authority for Subsidy - Form SA0801Initial application - (Serevent Accuhaler, Foradil, Symbicort Turbuhaler) only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Child under the age of 12 with poorly controlled asthma; and 1.2 Either: 1.2.1 Required at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide; or 1.2.2 Required at least three months of 200 mcg or more of fluticasone; or 2 Both: 2.1 Adult with poorly controlled asthma; and 2.2 Either: 2.2.1 Required at least three months of 1500 mcg or more daily inhaled beclomethasone or budesonide; or 2.2.2 Required at least three months of 750 mcg or more of fluticasone. NotePatients are to be reviewed at least at six months to assess compliance and effectiveness of therapy. Special Authority approvals are interchangeable among all presentations of inhaled long-acting beta
802 Special Authority for Subsidy - Form SA0802Initial application - (genotype 1, 4, 5 or 6 infection or co-infection with HIV) from any specialist. Approvals valid for 11 months for applications meeting the following criteria: 1. Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or2. Patient has chronic hepatitis C and is co-infected with HIV. Note: consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure.Initial application - (genotype 2 or 3 infection without co-infection with HIV) from any specialist. Approvals valid for 6 months for applications meeting the following criteria: 3. Patient has chronic hepatitis C, genotype 2 or 3 infection; andEither: 3.1 Patient has bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent); or 3.2 is unsuitable for liver biopsy due to coagulopathy.
803 Special Authority for Subsidy - Form SA0803Initial application from any specialist. Approvals valid for 11 months for applications meeting the following criteria: either: 1 Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or2 Patient has chronic hepatitis C, genotype 2 or 3 infection; and 2.1 With has bridging fibrosis or cirrhosis (Metavir stage 3 or 4, or equivalent). 2.2 is unsuitable for liver biopsy due to coagulopathy. Note: consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure.
804 Prescribing Guideline for Inhaled Long-Acting Beta-Adrenoceptor AgonistsThe addition of inhaled long-acting beta-adrenoceptor agonists (LABAs) to inhaled corticosteroids is recommended: - For younger children (aged under 12 years) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 200 mcg beclomethasone or budesonide (or 100 mcg fluticasone).- For adults and older children (aged 12 years and over) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 400 mcg beclomethasone or budesonide (or 200 mcg fluticasone).Note: Further information on the place of inhaled corticosteroids and inhaled LABAs in the management of asthma can be found in the New Zealand guidelines for asthma in adults (www.nzgg.org.nz) and in the New Zealand guidelines for asthma in children aged 1-15 (www.paediatrics.org.nz).
805 Access by applicationa) Budget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC). b) Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below). c) Applications to be made on the approved forms which are available from the co-ordinator for MSTAC:The Co-ordinator Phone: (04) 460 4990Multiple Sclerosis Treatment Assessments Committee Facsimile: (04) 916 7571PHARMAC, PO Box 10 254 E mail: silvia.valsenti@pharmac.govt.nzWellingtond) Completed application forms must be sent to the co-ordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity. e) Notification of MSTAC's decision will be sent to the patient, the applying clinician and the patient's GP (if specified). f) These agents will not be subsidised if dispensed from a community or hospital pharmacy. Regular supplies will be distributed to all approved patients or their c
806 a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; orb) for the treatment of confirmed ciprofloxacin-resistant gonorrhoea; orc) for the treatment of suspected meningitis in patients who have a known allergy to penicillin; andd) the prescription or PSO is endorsed accordingly
807 subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly.
808 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 1 The patient has metastatic colorectal cancer; and2 To be used for first or second line use as part of a combination chemotherapy regimen. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 3 The patient requires continued therapy; or4 The tumour has relapsed and requires re-treatment.
809 Special Authority for Subsidy - Form: SA0809Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian*, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but has not previously been treated with taxanes; or2 The patient has metastatic breast cancer; or3 Both: 3.1 The patient has non small-cell lung cancer; and 3.2 Either: 3.2.1 Has advanced disease (stage IIIa or above); or 3.2.2 Is receiving combined chemotherapy and radiotherapy; or4 Both: 4.1 The patient has small-cell lung cancer*; and 4.2 Docetaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the followingcriteria: 5. The patient has metastatic breast cancer, non small-cell lung cancer,
810 Special Authority for Alternate SubsidyInitial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal women; and2 Patient has hormone receptor positive breast cancer; and3 Any of the following: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.2 The patient has a very clear history of intolerance to tamoxifen; or 3.3 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
811 Special Authority for Alternate SubsidyInitial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal women; and2 Patient has hormone receptor positive breast cancer; and3 Any of the following: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.2 The patient has a very clear history of intolerance to tamoxifen; or 3.3 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
812 Special Authority for SubsidyInitial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following1 Patient is an adult who has had severe and active erosive Rheumatoid Arthritis for six months duration or longer; and2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and5 Patient has tried and not responded to at least three months therapy at th
813 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or2 The patient has advanced malignant mesothelioma*; or3 The patient has advanced pancreatic carcinoma; or4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 5 The patient requires continued therapy; or6 The tumour has relapsed and requires re-treatment. Note indications marked with a * are unapproved indications.
814 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has primary thrombocythaemia; and2 Either 2.1 is at high risk (previous thromboembolic disease, bleeding or platelet count >1500/ml); or 2.2 is intolerant or refractory to hydroxyurea or interferon. Renewal only from a relevant specialist. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. NoteIt is recommended that treatment with anagrelide be initiated only on the recommendation of a haematologist.
817 Special Authority for Subsidy Initial application - (for new patients) only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has refractory, progressive or relapsed multiple myeloma; and2 The patient has received prior chemotherapy. Initial application - (for patients receiving thalidomide prior to 1 January 2006) only from a relevant specialist. Approvals valid without further renewal where the patient was receiving treatment with thalidomide for multiple myeloma on or before 31 December 2005. Renewal only from a relevant specialist. Approvals valid without further renewal where the patient has obtained a response from treatment during the initial approval period. Note: Prescription must be written by registered prescriber in the thalidomide risk management programme operated by the supplier. Maximum dose of 400 mg daily as monotherapy or in a combination therapy regimen.
819 Special Authority for Subsidy Initial application for patients with type 2 diabetes only from a relevant specialist. Approvals valid for one year for applications meeting the following criteria: Any of the following: Monotherapy1 All of the following: 1.1 To be used as monotherapy for patients who after six months of diet and lifestyle changes have inadequate glycaemic control (defined as HbA1c > 7.0% in tests carried out at least two months apart); and 1.2 Metformin is contraindicated or not tolerated after a minimum of a four week trial period; and 1.3 Sulphonylurea is contraindicated or not tolerated or the patient's body mass index (BMI) exceeds 33 kg/m2; orIn combination with sulphonylurea2 Both: 2.1 For use in combination with a sulphonylurea for patients who after diet and lifestyle changes and a six-month trial of sulphonylurea have poor glycaemic control (defined as HbA1c > 8.0% measured within the last month of the six month period); and 2.2 Metformin is contrain
822 Subsidised only for treatment of prostate cancer and breast cancer
824 Prescribing GuidelineCombigan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Combigan should only be prescribed when: a) less expensive first line agents for the treatment of glaucoma are contraindicated; orb) the response to such subsidised agents is inadequate; orc) the patient cannot tolerate such subsidised agents.
825 Perindopril and trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considere
826 Special Authority for Subsidy - Form: SA0826Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 1.2 Patient cannot tolerate statin therapy at a dose of >= 40 mg per day; and 1.3 Either: 1.3.1 All of the following: 1.3.1.1 Patient has venous CABG; and 1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 1.3.2 All of the following: 1.3.2.1 Patient does not have venous CABG; and 1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 1.3.2.3 LDL cholesterol >= 2.5 mmol/litre (at least 1 week after test 1 - see note); or2 All of the following: 2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholest
827 Subsidy by endorsement: a. Only if prescribed for post-herpetic neuralgia or diabetic peripheral neuropathy; andb. The prescription is endorsed accordingly.
829 Special Authority for Subsidy - Retail Pharmacy - Form SA0829Initial Application only from gastroenterologist or infectious disease specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1. Patient has confirmed Hepatitis B infection (HBsAg+); andDocumented resistance to lamivudine, defined as: 2. patient has raised serum ALT (> 1 x ULN); and3. patient has HBV DNA greater than 100,000 copies per mL, or viral load ? 10 fold over nadir; and4. detection of M204I or M204V mutation; and5. Either5.1. Both5.1.1. patient is cirrhotic; and5.1.2. adefovir dipivoxil to be used in combination with lamivudine; or5.2. Both5.2.1. patient is not cirrhotic; and5.2.2. adefovir dipivoxil to be used as monotherapyRenewal only from a gastroenterologist or infectious disease specialist. Approvals valid for 2 years for applications where in the opinion of the treating physician, treatment remains appropriate and patient is benefiting from treatmen
831 Special Authority for Subsidy - Form: SA0831Application only from a relevant specialist. Approvals valid for 10 months for applications meeting the following criteria: 1. Patient has newly diagnosed glioblastoma multiforme; and2. Temozolomide is to be (or has been) given concomitantly with radiotherapy; and3. Following concomitant treatment temozolomide is to be used for a maximum of six cycles of 5 days treatment, at a maximum dose of 200 mg/m2. Note: Temozolomide is not subsidised for the treatment of relapsed glioblastoma multiforme. Studies of temozolomide show that its benefit is predominantly in those patients with a good performance status (WHO grade 0 or 1 or Karnofsky score >80), and in patients who have had at least a partial resection of the tumour.
832 Special Authority for Subsidy - Form: SA0832Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and1.1.2 HBeAg positive or HBV DNA positive defined as > 100,000 copies per ml by quantitative PCR at a reference laboratory; and1.1.3 ALT greater than twice upper limit of normal or bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent) on liver histology or clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; or1.4 Hepatitis B surface antigen positive (HbsAg) patient who is receiving chemotherapy for a malignancy, or who has received such treatment within the previous two months;
833 Special Authority for Subsidy - Form SA0833Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or2 The patient has advanced malignant mesothelioma*; or3 The patient has advanced pancreatic carcinoma; or4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*; or5 The patient has advanced transitional cell carcinoma of the urothelial tract (locally advanced or metastatic). Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 6 The patient requires continued therapy; or7 The tumour has relapsed and requires re-treatment. Note indications marked with a * are unapproved indications.
834 Special Authority for Subsidy - Form: SA0834Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Both: 1.1 Patient has type 1 diabetes and has received an intensive regimen (injections at least three times a day) of an intermediate acting insulin in combination with a rapid acting insulin analogue for at least three months; and1.2 Either: 1.2.1 Patient has experienced more than one unexplained severe hypoglycaemic episode in the previous 12 months (severe defined as requiring the assistance of another person); or1.2.2 Patient has experienced unexplained symptomatic nocturnal hypoglycaemia, biochemically documented at <3.0 mmol/L, more than once a month despite optimal management; or2 Patient has documented severe, or continuing, systemic or local allergic reaction to existing insulins. Note this does not include hypoglycaemic episodes. Renewal only from a relevant specialist or general practitioner. Approv
835 Special Authority for Subsidy - Form SA0835Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year: where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Advanced prostatic cancer;. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis; and2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note The maximum treatment period for a GnRH analogue is:
836 Special Authority for Subsidy - Form SA0836Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or. 2 Locally advanced prostatic cancer. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 3 Endometriosis; and4 Either: 4.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or4.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note
837 Special Authority for Subsidy - Form SA0837Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year where the patient has: Advanced prostatic cancer;. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis; and2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note The maximum treatment period for a GnRH analogue is: - 3 months to assess whet
838 Special Authority for Subsidy - Form: SA0838Initial Application only from a relevant specialist or General Practitioner. Approvals valid for 2 years forapplications meeting the following criteria: Either: 1 All of the following: 1.1 Patient is a child under the age of 12; and1.2 All of the following: Has, for 3 months or more, been treated with:1.2.1 An inhaled long-acting beta adrenoceptor agonist; and1.2.2 Inhaled corticosteroids at a dose of at least 400 mcg per day beclomethasone or budesonide, or200 mcg per day fluticasone; and1.3 The prescriber considers that the patient would receive additional clinical benefit from switching to acombination product; or2 All of the following: 2 .1 Patient is over the age of 12; and2 .2 All of the following: Has, for 3 months or more, been treated with:2 .2.1 An inhaled long-acting beta adrenoceptor agonist; and2 .2.2 Inhaled corticosteroids at a dose of at least 800 mcg per day beclomethasone or budesonide, or500 mcg per day fluticasone;
839 Special Authority for Subsidy - Form SA0839Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or. 2 Neoadjuvant or adjuvant treatment of locally advanced prostatic cancer. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 3 Endometriosis; and4 Either: 4.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or4.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazo
840 Maximum of 2 inhalations per day
841 Special Authority for Subsidy - form: SA0841Initial application only from a gastroenterologist or general physician. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and2 Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis). NoteLiver biopsy is not usually required for diagnosis but is helpful to stage the diseaseRenewal only from a gastroenterologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: The treatment remains appropriate and the patient is benefiting from treatment. NoteActigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transp
842 Special Authority for Subsidy - Form: SA842Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but have not previously been treated with taxanes; or2 The patient has metastatic breast cancer; or3 The patient has node-positive early breast cancer; or4 Both 4.1 The patient has non small-cell lung cancer; and 4.2 Either: 4.2.1 Has advancing disease (stage IIIa or above); or 4.2.2 Is receiving combined chemotherapy and radiotherapy; or5 Both: 5.1 The patient has small-cell lung cancer*; and 5.2 Paclitaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 6 The patient has metasta
843 Only one multidose cartridge starter pack to be prescribed and dispensed per patient.
Trial Version
Special Authority for Subsidy - Form SA0006Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0011Initial application only from a relevant specialist. Approvals valid for 2 years where the patient has diabetes. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Pharmaceutical Cancer Treatment in respect of which DHB hospital pharmacies and other Contractors can claim Subsidies.
Pharmaceutical Cancer Treatment in respect of which only DHB hospital pharmacies can claim Subsidies.
Special Authority for Subsidy - Form SA0028Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Either: 1 All of the following: 1.1 Treatment with other lipid modifying medicines has been unsuccessful; and 1.2 6 months of dietary modification has been unsuccessful; and 1.3 Cholesterol level > 7.0 mmol/litre; and 1.4 Either: 1.4.1 Familial hypercholesterolaemia; or 1.4.2 Manifest coronary heart disease, which has been clinically proven, or previously treated by coronary artery surgery; or 2 Cholesterol level > 9.0 mmol/litre:.Renewal only from a general practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. NoteFamilial hypercholesterolaemia is defined as being hypercholesterolaemia in the presence of tendon xanthomas or in association with a family history of premature heart disease (before age 55) or consisten
Unapproved medication supplied under Section 29 of the Medicines Act 1981. Practitioners prescribing this medication should: (a) be aware of and comply with their obligations under Section 29 of the Medicines Act 1981 and otherwise under that Act and the Medicines Regulations 1984; (b) be aware of and comply with their obligations under the Health and Disability Commissioner's Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and(c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an indication for which it is not approved.
Special Authority for Subsidy - Form SA0031Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Oesophageal stricture; or 2 Terminal care; or 3 Too young to swallow conventional tablets; or 4 Too old to swallow conventional tablets. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) When ordered by a medical practitioner on a practitioner's supply order for ventricular arrhythmias and the order is endorsed accordinglyb) When ordered for a dialysis patient or a child with rhumatic fever and the order is endorsed accordingly
Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
Special Authority for Manufacturers Price - Form SA0035Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Both: 1 Either: 1.1 Both: 1.1.1 Duodenal and gastric ulcers, reflux oesophagitis and Zollinger-Ellison syndrome; and 1.1.2 Other treatments have failed; or 1.2 Patients who are on a Social Welfare benefit or an income no greater than a benefit; and 2 Patients must have endoscopically demonstrated lesions prior to commencement of treatment.. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0041Initial application only from a relevant specialist. Approvals valid for 2 years where alternative antihypertensives have failed. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Note: Danthron with poloxamer is only approved for the prevention or treatment of constipation in the terminally ill. Studies in rats have associated use of danthron with tumours.
Special Authority for Subsidy - Form SA0045Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Continuation of treatment commenced prior to 1 August 1990; and 2 Alternatives (salbutamol and terbutaline) have been tried; and 3 Either: 3.1 Asthma; or 3.2 Chronic obstructive airways disease (COAD); and 4 Applicants must provide details of dose. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0046Initial application only from a gastroenterologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Functioning gall bladder; and 2 Either: 2.1 Uncalcified gallbladder stones with a maximum size of 20 mm; or 2.2 Adjunctive treatment after extra corporeal lithotrypsy. Renewal only from a gastroenterologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0047Initial application only from a paediatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Child under 2 years of age; or 2 Both: 2.1 Child with major physical or intellectual disabilities; and 2.2 Lacks the necessary coordination to use aerosols with a spacer device. NoteThe cost of nebuliser therapy greatly exceeds other inhaled forms. Steroid nebulising solution can cause cataract formation. Renewal only from a paediatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0050Initial application only from a relevant specialist. Approvals valid for 2 years where terminally ill patient. Renewal only from a relevant specialist. Approvals valid for 2 years where terminally ill patient.
Special Authority for Subsidy - Form SA0051Initial application from any medical practitioner. Approvals valid for 6 months where control of nausea in the treatment of malignant disease. Renewal from any medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0053Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 RAST or skin test positive; and 2 Patient has had severe generalised reaction to the sensitising agent. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0055Initial application only from a psychiatrist, geriatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 For use only as an anxiolytic; and 2 Other agents are contraindicated or have failed. Renewal only from a psychiatrist, geriatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0056Initial application only from a psychiatrist. Approvals valid for 5 years for applications meeting the following criteria: Both: 1 Long-standing delusional states; and 2 Other injectable anti-psychotics have proven to be ineffective or inappropriate. Renewal only from a psychiatrist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0057Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Depression; and 2 Any of the following: 2.1 Both: 2.1.1 Failed trials with other antidepressants; and 2.1.2 Patient has been maintained on mianserin prior to December1993; or 2.2 Co-existent bladder neck obstruction; or 2.3 Cardiovascular disease. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Subsidised only if prescribed for dialysis or cystic fibrosis patient and the prescription is endorsed accordingly
Injections (both 500 mg and 1 g) subsidised: a) only if prescribed for a dialysis or cystic fibrosis patient; and b) the prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0069Initial application only from a general physician, nephrologist or neurologist. Approvals valid for 5 years where syndrome of inappropriate anti-diuretic hormone secretion (SIADH). Renewal only from a general physician, nephrologist or neurologist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0070Initial application only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Avium intracellular atypical mycobacterial infections; or 2 Multiple drug resistant tuberculosis; or 3 Atypical and drug-resistant mycobacterial infections in patients with AIDS. Renewal only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudo membranous colitis and the prescription is endorsed accordingly
a) Only granted after the patient has proven to be intolerant to zidovudine or whose health has significantly deteriorated while on zidovudine. It is impossible to have approvals for both AZT and DDI concurrently but it is not expected that both medicines would be consumed at the same time. Applications can be made without patients having had a preliminary trialb) Specialist must make application
a) Approvals granted as third line therapy after patient has developed intolerance or treatment failure to both zidovudine and DDI b) Specialist must make application
a) All patients with AIDS meeting the definition developed by the Centres for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88)b) Patients with AIDS Related Complex (ARC)c) HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatologyd) Prophylactically for persons following severe parenteral exposure from a known HIV positive sourcee) HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count f) Applications can only be made by appropriate specialists. Prescriptions for those patients approved to use these medicines can be written either by the specialist or general practitioner with an endorsement of the name of the recommending specialist. g) Prescriptions for these can be written for a period of three months' supply. However, medicine must be dispensed on a monthly basis.
NOTE: Evidence that a patient is on insulin therapy can be by way of either: a) insulin being on the same prescription ofb) by the word "insulin patient" be in written on the prescription by either the doctor or the contractor.
All non-disposible diabetic supplies are only eligible for subsidy if there is produced to the contractor a certificate the gives the nome, address, and age of the patient and that:1) is signed by a doctor and2) is dated less than two years propr to the date of supply; and that 3) states that the patient is receiving iusulin therapy.
Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the low dose oestrogens.
Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
a) Males: Fertile eunuch syndrome, females: anovulatory infertilityb) A declaration is required from the applying doctor that these agents are not being used as part of an IVF programmec) Approvals are valid for 6 months with a revewal for a further 6 months if the patient has some response and the prescriber believes further treatment will be effectived) Specialist must make application - endocrinologists and gynaecologists only
Special Authority for Subsidy - Form SA0087Initial application only from an endocrinologist or gynaecologist. Approvals valid for 6 months where hypogonadotrophic hypogonadism (including anovulatory infertility and cryptochidism). Renewal only from an endocrinologist or gynaecologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0088Initial application only from an endocrinologist or gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Either: 1.1 Female with anovulatory infertility, males: hypogonadotrophic hypogonadism; or 1.2 Male with hypogonadotrophic hypogonadism; and 2 These agents are not being used as part of an IVF programme. Renewal only from an endocrinologist or gynaecologist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0089Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. NoteThe maximum treatment period for a GnRH analogue is: 3 months to assess whether surgery is appropriate3 months for infertile patients after surgery6 months for
Special Authority for Subsidy - Form SA0090Initial application only from a relevant specialist. Approvals valid for 2 years where patient cannot use desmopressin nasal spray or nasal drops. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0091Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Paget's disease; or 2 Both: 2.1 Patients under hospice care; and 2.2 Either: 2.2.1 Tumour-induced hypercalcaemia; or 2.2.2 Tumour-induced osteolysis without hypercalcaemia. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0092Initial application only from a relevant specialist. Approvals valid for 5 years where treatment of refractory absorptive hypercalcaemia. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0094Initial application only from a relevant specialist (Only for Epsom Day Unit in Auckland). Approvals valid for 1 month where termination of advanced pregnancy i.e. beyond 12 weeks. Only for Epsom Day Unit in Auckland.
Special Authority for Subsidy - Form SA0096Initial application - (Organ transplant, Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Organ transplant; or 2 Bone marrow transplant; or 3 Graft v host disease. Initial application - (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Psoriasis; and 2 Other systemic and topical therapy has failed. Initial application - (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not resopnsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application - (Nephrotic Syndrome) from any medical practitioner. Approvals valid for 2 years for applications meeting the following cri
Special Authority for Subsidy - Form SA0097Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. Initial application - (Indications other than Chronic hepatitis C) only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 AIDS related Kaposi's sarcoma; or 6 Multiple myeloma; or 7 Chronic active hepatitis B. Renewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other than Chronic hepatitis C) only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) Hairy cell leukaemia, Kaposi's sarcoma, chronic active hepatitis B, chronic hepatitis C (6 month approval only), chronic myelogenous leukaemia, multiple myelomab) Specialist must make applicationc) No further approvals for:Malignant melanoma, superficial and noduloulcerative basal cell carcinomaNote: Patients with existing approvals can continue to have therapy
Special Authority for Subsidy - Form SA0099Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patients who have failed surgery, radiotherapy, bromocriptine and other oral therapies; or 2 Both: 2.1 Either: 2.1.1 Vipomas; or 2.1.2 Glucagonomas; and 2.2 Patients who are seriously ill in order to improve their clinical state prior to definitive surgery; or 3 Both: 3.1 Gastrinoma; and 3.2 Either: 3.2.1 Patient has failed surgery; or 3.2.2 Patient is in metastatic disease after H2 antagonists (or omeprazole) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or where surgery has failed; or 5 Pre-operative control of hypoglycaemia; or 6 Maintenance therapy. NoteThe use of octreotide in patients with fistulae, oesophageal varices, miscellaneous diarrhoea and hypotension will
Special Authority for Subsidy - Form SA0100Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either: 4.6.2.1 Heart failure (low card
a) Maximum of 50 mls per unit b) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent c) On a bulk supply orderd) When used in the extemporaneous compounding of eye drops
Special Authority for Subsidy - Form SA0108Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Hairy cell leukaemia; or 2 Chronic active hepatitis B. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0110Initial application only from a relevant specialist. Approvals valid for 5 years where biotinidase deficiency. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0115Initial application - (Oesophageal stricture) only from a general practitioner or relevant specialist. Approvals valid for 2 years where patient with oesophageal stricture who is unable to take capsules. Initial application - (Indications other than oesophageal stricture) only from a paediatrician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 infant or child with liver disease or short gut syndrome; and 2 Requires vitamin supplementation; and 3 Unable to swallow capsules. Renewal only from a general practitioner, relevant specialist or paediatrician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0119Initial application only from a rheumatologist. Approvals valid for 5 years where ankylosing spondylitis. Renewal only from a rheumatologist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0121Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient has to use an unpreserved solution due to an allergy to the preservative; or 2 Patient wears soft contact lenses. NoteMinims for a general practice are considered to be "tools of trade" and are not approved as special authority items. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0122Initial application only from a relevant specialist. Approvals valid for 2 years where filamentary keratitis. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0125Initial application - (Chronic post-thrombotic venous stasis ulcers) from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Chronic post-thrombotic venous stasis ulcers of more than 4 months duration; and 2 Other interventions have failed. Initial application - (Sudden hearing loss) only from an otolaryngologist. Approvals valid for 2 years where sudden hearing loss. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) Subsidised only if prescribed for an amputee with an artificial limb, or for a paraplegic patient; andb) On a prescription endorsed accordingly.
a) With other pharmaceutical requirementsb) In extemporaneously compounded preparations.
a) Should be strictly reserved for use as second line therapy in: - patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema- cases of scabies which are resistent to gamma benzene hexachlorideb) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: - a definite diagnosis of scabies should be made- it should be ascertained that the medication was administered properly- the possibility of reinfestation should have been excluded
Special Authority - Hospital pharmacya) Approvals granted only for children receiving chemotherapyb) Specialist must make application
Special Authority for Subsidy - Form SA0140Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Pain management in the terminally ill; and 2 Standard therapy has failed. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Only on a WSO. Distributed by the Asthma Foundation. Forward orders to: The Asthma Foundation, PO Box 1459, Wellington. Distributed by the Asthma Foundation. Also available to paediatricians employed by an HHS, on a wholesale supply order signed by the paediatrician. Orders via a hospital pharmacy.
Only when dispensed as an ingredient in a preparation specified in the Pharmaceutical Schedule. Industrial - In combination
Approvals for a CHEM number to waive the premium in the following circumstances: 1. Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism (2 year approval with renewal, applications only from cardiothoracic surgeons, cardiologists and general physicians). 2. Patients after coronary artery vein bypass graft - as an adjunct to aspirin (1 year approval only, applications only from cardiothoracic surgeons, cardiologists and general physicians). 3. Patients who continue to have transient ischaemic episodes despite aspirin therapy. A course of up to six months in combination with aspirin. Applications only from neurologists, cardiologists, vascular surgeons and general physicians. Six month approval only. Reapplications only if there is demonstrated recurrence of symptoms when dipyridamole therapy is discontinued. Note: these transitional criteria are currently being reviewed.
a) Approvals to fund the manufacturer's surcharge in the following circumstances: - Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism (2 year approval with renewal, applications only from cardiothoracic surgeons, cardiologists and general physicians). - Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below (1 year approval only, applications only from cardiothoracic surgeons, cardiologists and general physicians); or- Patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below (2 year approval with renewal, applications only from neurologists, neurosurgeons, cardiologists, vascular surgeons and general physicians). b) Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant
Special Authority for Manufacturers Price - Form SA0157Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Liver disease; or 2 Past history of thromboembolism; or 3 Significant hypertension; or 4 Hypertension associated with oral oestrogen therapy. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Subsidy is paid on acyclovir tablets for treatment of herpes zoster and genital herpes. Prescriptions with doses: 1. exceeding 1,600 mg per day for a period of more than one week will not be subsidised; and2. up to 4,000 mg per day for a maximum period of one week will be subsidised.
Special Authority for Waiver of Rule - Form SA0175Initial application only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where pathological hyperprolactinemia. Renewal only from an obstetrician, endocrinologist or gynaecologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Only for treatment of uncomplicated urethritis or cervicitis due to chlamydia trachomatis and these patients' sexual contacts. Prescription must be endorsed "certified condition" (typed or handwriten and initialised in the prescriber's own handwriting)
Special Authority for Manufacturers Price - Form SA0178Initial application from any medical practitioner. Approvals valid for 6 months where control of nausea and vomiting in the treatment of terminal care patients. Renewal from any medical practitioner. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Not if in any proprietary liquid oral form, unless it is separately specified in the Pharmaceutical Schedule
Only in extemporaneously compounded preparations, unles separately specified in the Pharmaceutical Schedule
The new anticonvulsant drugs are restricted to1. neurologists2. paediatric neurologists3. any other prescriber approved in writing by the relevant RHA budget holding manager. The HFA holds a budget for expenditure on the new anticonvulsant drugs. Unless otherwise specified, ultimate authority for approving prescriptions for subsidy lies with the HFA budget holding manager for the new anticonvulsant drugs. The regional divisions of the HFA will be in contact with hospital pharmacists and approved prescribers with more detail of the approval system. GUIDELINES FOR USE OF THE NEW ANTICONVULSANTS ARE AS FOLLOWS: A. Entry criteriaThe following patients are eligible for trial on the new anticonvulsant drugs (NADs)1. Patients who are under the supervision of an approved prescriber, and whose seizures are not adequately controlled with optimal conventional anticonvulsant drug treatment. 2. Patients, who are under the supervision of an approved prescriber, and whose seizures are only controlled adequatel
Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription is endorsed "certified condition".
Available from hospital pharmacies providing an outpatient dispensing service, and selected retail pharmacies in the Northern, Western Bay of Plenty, Wellington, Christchurch or South Canterbury regions that have an exclusive contract to dispense 'Hospital Pharmacy' [HP1] pharmaceuticals.
Available from hospital pharmacies providing an outpatient dispensing service, and any retail pharmacy in the Northern, Midland, Central (including Nelson and Blenheim) and South Canterbury regions, and selected retail pharmacies in the Christchurch region that have an exclusive contract to dispense 'Hospital Pharmacy' [HP3] pharmaceuticals.
Available from hospital pharmacies and retail pharmacies with a Funder contract to dispense particular medicines.
a) Maximum of 750mg (1 injection) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0256Initial application only from a cardiologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Refractory angina; and 2 Patient is already on maximal anti-anginal therapy. Renewal only from a cardiologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0264Initial application only from a paediatrician or respiratory specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Cystic fibrosis patient; or 2 Both: 2.1 Infant or child with liver disease or short gut syndrome; and 2.2 Requires vitamin supplementation. Renewal only from a paediatrician or respiratory specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0265Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Social Welfare Benefiary; or 2 Income no greater than a Benefiary. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0266Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 AIDS related Kaposi's sarcoma; or 6 Multiple myeloma; or 7 Chronic active hepatitis B; or 8 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from trea
a) - hairy cell leukaemia - Kaposi's sarcoma - chronic active hepatitis B - chronic hepatitis C (6 month approval only) - chronic myelogenous leukaemia - multiple myeloma - basal cell carcinoma 1) Only for basal cell carcinoma unable to be treated surgically or by radiotherapy. 2) Applications only from radiation oncologists, plastic surgeons and dermatologists. Applications from dermatologists will only be accepted with evidence from either a plastic surgeon or oncologist that the patient was unsuitable for surgery. 3) Maximum reimbursable dosage 15 million iu/weekb) Specialist must make applicationc) No further approvals for: Malignant melanoma Note: Patients with existing approvals can continue to have therapy
Special Authority - Retail pharmacy: a) Existing patients only. b) Specialist must make application.
Lansoprazole is subsidised for patients who have one or more of the following conditions: 1. Duodenal ulcer proven by endoscopy or barium meal and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); and b)H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. 2. Gastric ulcer proven by endoscopy and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); andb)H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. 3. Gastro-oesophageal reflux disease (GORD) proven by endoscopy: i) Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for one month with multiple daily dosing; orii) Grades 1 and 2 GORD after failure of H2 antagonist therapy for one month with multiple daily dosing; or
Special Authority for Manufacturers Price - Form SA0271Initial application from any medical practitioner. Approvals valid for 5 years for applications meeting the following criteria: Either: 1 Continuation of treatment commenced prior to 1 October 1995; or 2 Both: 2.1 Either: 2.1.1 Asthma; or 2.1.2 Chronic obstructive airways disease; and 2.2 Patient has tried alternatives and these are unsuitable. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) All patients with AIDS meeting the definition developed by the Centres for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88)b) Patients with AIDS Related Complex (ARC)c) HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatologyd) Prophylactically for persons following severe parenteral exposure from a known HIV positive sourcee) HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count f) For the prevention of maternal foetal transmission of HIVg) Applications can only be made by appropriate specialists. Prescriptions for those patients approved to use these medicines can be written either by the specialist or general practitioner with an endorsement of the name of the recommending specialist. h) Prescriptions for these can be written for a period of three months' supply. However, medicine must be dispensed on a monthly basis.
Special Authority for Subsidy - Form SA0274Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Treatment with other lipid modifying medicines has been unsuccessful; and 1.2 6 months of dietary modification has been unsuccessful; and 1.3 Cholesterol level > 7.0 mmol/litre:; and 1.4 Either: 1.4.1 Familial hypercholesterolaemia; or 1.4.2 Manifest coronary heart disease, which has been clinically proven, or previously treated by coronary artery surgery; or 2 Cholesterol level > 9.0 mmol/litre:.NoteFamilial hypercholesterolaemia is defined as being hypercholesterolaemia in the presence of tendon xanthomas or in association with a family history of premature heart disease (before age 55) or consistent with autosomal dominant inheritance. Simvastatin and Pravastatin may be considered for first line therapy in patients with familial hypercholesterolaemia or
Special Authority for Subsidy - Form SA0275Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 Multiple myeloma; or 6 Chronic active hepatitis B; or 7 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other tha
Special Authority for Subsidy - Form SA0276Initial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where chronic hepatitis C. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairycell leukaemia; or 3 Multiple myeloma; or 4 Chronic active hepatitis B; or 5 Basal cell carcinoma unable to be treated surgically or by radiotherapy. NoteMaximum reimbursable dosage 15 million iu/weekRenewal - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment. Renewal - (Indications other than chronic hepatitis C) only from a dermatologist, plastic surgeon or radiat
Patients who have been on omeprazole and have not accessed therapy through Special Authority will continue to have subsidy for six months, by which time the necessary investigations should have been carried out to determine if ongoing therapy is warranted. For these patients the following conditions will apply: Omeprazole(a) Retail pharmacy specialist (b) month restriction
Omeprazole is subsidised for patients who have one or more of the conditions numbered 1-4: 1. Duodenal ulcer proven by endoscopy or barium meal and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); and b)H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. 2. Gastric ulcer proven by endoscopy and after failure of: a)two alternative courses of H. pylori eradication therapy (if H. pylori positive); andb)H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. 3. Gastro-oesophageal reflux disease (GORD) proven by endoscopy: i) Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for one month with multiple daily dosing; orii) Grades 1 and 2 GORD after failure of H2 antagonist therapy for one month with multipl
Retail Pharmacy - Specialist prescriptionPaediatricians and paediatric cardiologists may prescribe
Special Authority for Manufacturers Price - Form SA0286Initial application from any medical practitioner. Approvals valid for 5 years where patient is stabilised on aminophylline, theophylline, warfarin, or phenytoin..Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0290Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 AIDS meeting the definition developed by the Centers for Disease Control in the USA; or 2 AIDS Related Complex (ARC).; or 3 Both: 3.1 HIV infection regardless of symptomatology; and 3.2 CD4 (T4) counts < 500. NoteSee Circular Letter to Medical Practitioners HP2/88)Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0291Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Inflammatory arthritis (including osteoarthritis with an inflammatory component); and 2 Stabilised and are well controlled on the particular NSAID medication. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
No compounding fees will be paid when the prescribed strength of methadone is available in a proprietary solution
Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets)
Above local anesthetic strengths are: a) For a dialysis patient; orb) A child with rheumatic fever. c) Prescription must be endorsed accordingly.
Special Authority for Subsidy - Form SA0300Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated. NoteNot in long term combination with an anti-androgenInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis ; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. NoteThe maximum treatment period for a GnRH analogue is: 3 months to assess whether surgery is appropriate3 m
Special Authority for Subsidy - Form SA0301Initial application only from a relevant specialist. Approvals valid for 2 years where type III dyslipidaemias. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Waiver of Rule - Form SA0303Initial application only from a paediatric surgeon or paediatrician. Approvals valid for 1 year where children post liver transplant. Renewal only from a paediatric surgeon or paediatrician. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0309Initial application only from a neurologist or physician for the elderly (FRACP). Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Idiopathic Parkinson's disease; and 2 The patient does not have dementia and/or neuropsychiatric disorders; and 3 Has responded to L-dopa; and 4 Any of the following: 4.1 Has resistance to conventional treatment of severe motor fluctuations; or 4.2 Has severe "off" period disability; or 4.3 Has severe "off" period dystonic cramps. Renewal only from a neurologist or physician for the elderly (FRACP). Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0311Initial application - (Breast or prostatic cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy; or 2 Advanced prostatic cancer when orchidectomy is contraindicated or where the patient srongly opposes orchidectomy. NoteNot to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiatedInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Endometriosis; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetrio
Special Authority for Alternate Subsidy - Form SA0312Initial application only from an obstetrician, gynaecologist, general practitioner or general physician. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 acute or significant liver disease - a declaration must be provided from a gastroenterologist or general physician stating that oral oestrogens are contraindicated due to liver disease (Details to be attached to application); or 2 oestrogen induced hypertension requiring antihypertensive therapy - documented evidence must be provided that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens (Details to be attached to application); or 3 hypertriglyceridaemia - documented evidence must be provided that triglyceride levels increased to at least 2 x normal triglyceride levels post oral oestrogens (Details to be attached to application). NotePrescriptions with a valid Special Authority (
Special Authority for Manufacturers Price - Form SA0313Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal from any medical practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens.
Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the high dose oestrogens.
Special Authority for Subsidy - Form SA0317Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemoglobin < 90 g/L; and 4.6.2 Either:
a) All nucleosides will be subsidised for patients meeting any of the following criteria: - All patients with AIDS meeting the definition developed by the Centers for Disease Control in the USA (see Circular Letter to Medical Practitioners HP2/88); or- Patients with AIDS Related Complex (ARC); or- HIV infected patients with CD4 (T4) counts below 500 regardless of symptomatology. b) Zidovudine will also be subsidised for patients meeting any of the following criteria: - Prophylactically for persons following severe parenteral exposure from a known HIV positive source; or- HIV infected persons with associated thrombocytopenia regardless of CD4 (T4) count; or- For the prevention of maternal foetal transmission of HIV. c) Applications can only be made by appropriate specialists. d) Prescriptions for those patients approved to use these medications can be written by either the specialist or general practitioner with an endorsement of the name of the recommending specialist.
Special Authority for Subsidy - Form SA0323Initial application only from a relevant specialist. Approvals valid for 2 years where children receiving frequent parenteral injections (i.e. intradermal, subcutaneous, intravenous or intramuscular) requiring a 21 gauge or larger bore needle. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
All oral Beta Adrenoceptor Blockers are exempted from monthly dispensing for patients with angina or arrhythmia.
Special Authority for Subsidy - Form SA0325Initial application from any medical practitioner. Approvals valid for 5 years where applicatons will be considered and approved subject to funding availability. NoteApplications to be made on the approved forms which are available from the co-ordinator for the Cystic Fibrosis DN'ase Advisory Panel: The Co-ordinatorCystic Fibrosis DN'ase Advisory PanelC/- Room 4-28, Building 13 Greenlane HospitalPrivate Bag, AUCKLANDPhone: 09 630 9871Facsimile: 09 631 0753
Special Authority for Subsidy - Form SA0328Initial application only from a general physician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 CD4 count < 500 cells/mm3; and 1.2 Viral load > 50,000> copies per ml (or equivalent value on the Chiron test); or 2 All of the following: 2.1 CD4 count < 500 cells/mm3; and 2.2 Viral load > 50,000> copies per ml (or equivalent value on the Chiron test); and 2.3 At least 6 weeks of dual therapy with nucleoside agents; or 3 Both: 3.1 CD4 count < 500 cells/mm3; and 3.2 CD4 counts are declining rapidly (>120 cells over 12 months or >60 - 80 cells over six months). Renewal only from a general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Guidelines for use of cyclosporin A in rheumatoid arthritisMonitoring: All patients require frequent monitoring for creatinine levels and blood pressure:- fortnightly, in the first three months of therapy and then monthly, if results are stable; - if dose is increased or there is a rise in serum creatinine or blood pressure, then more frequent monitoring is required. Contraindications: Cyclosporin A is contraindicated in patients with the following conditions: - current or past malignancy; - uncontrolled hypertension; - renal dysfunction (abnormal serum creatinine for age and sex); - immunodeficiency and neutropenia; - abnormally low white blood cell count or platelet count; or- liver function tests more than twice the upper limit of normal. Caution in use: - age above 65 years; - controlled hypertension; - use of ant-epileptic medications; - use of NSAIDs; - use of ketoconazole, fluconazole, trimethoprim, erythromycin, verapamil, and diltiazem; - concurrent or previous use of al
Special Authority - Retail pharmacy (Salmeterol, eformoterol fumarate):a) Approvals are interchangeable between all presenations of salmeterol and eformoterol fumarate agents. b) Diagnosis of asthma confirmed. c) Inhaler/device technique checked. d) At least three months of >= 1500 ug daily of beclomethasone inhaled steroid (or equivalent) for adult, or >= 800 ug daily for child. e) Patient monitors PEFR regularly during exacerbations where appropriate. f) Evidence of poor control (at least one of the following): - short acting beta agonist used > 3-4 time daily - nocturnal awakenings >= 2 times per week. g) The first applicaton may be for six months and subsequent applications for two yars. The criteria for reapplication are: - compliant with medication - improved asthma symptom control. h) Appication for Special Authority to be made by general practitioners or appropriate specialist.
a) Should be strictly reserved for use as second line therapy in: - patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema; - cases of scabies which are resistent to gamma benzene hexachloride and resistant to malathion. b) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: - a definite diagnosis of scabies should be made; - it should be ascertained that the medication was administered properly; - the possibility of reinfestation should have been excluded.
a) Approvals will be granted for treating the following conditions: - avium intracellular atypical mycobacterial infections; and- multiple drug resistant tuberculosis; and- atypical and drug-resistant mycobacterial infections in patients with AIDS. b) Specialist must make application - respiratory physician/ infectious disease specialist. c) Approvals will be valid for two years.
Omeprazole and pantoprazole is subsidised for patients who have one or more of the conditions a-d: a) Duodenal ulcer proven by endoscopy or barium meal and after failure of: - two alternative courses of H. pylori eradication therapy (if H. pylori positive); and - H2 antagonist therapy for 8 weeks; and where a second endoscopy/barium meal has demonstrated non healing duodenal ulcer. b) Gastric ulcer proven by endoscopy and after failure of: - two alternative courses of H. pylori eradication therapy (if H. pylori positive); and - H2 antagonist therapy for 12 weeks; and where a second endoscopy has demonstrated non healing gastric ulcer and excluded malignancy. c) Gastro-oesophageal reflux disease (GORD) proven by endoscopy: - Grade 0 GORD (normal endoscopy) after positive 24 hour pH monitoring test and failure of H2 antagonist therapy for four weeks with multiple daily dosing; or - Grades 1 and 2 GORD after failure of H2 antagonist therapy for
a) Not to exceed 3 capsules per prescriptionb) No more than one prescription per month.
a) Not to exceed 6 tablets per prescription; andb) No more than one prescription per month.
Subsidy is available for disposable diabetic syringes and needles: 1) When the prescription is written on the same prescription form as the one used for the supply of insulin vials; or2) When "insulin patient" has been written on the prescription by either the doctor or the contractor; and3) For no more than 50 plastic syringes with attached needles as a single supply in the case of a prescription for three months supply of insulin vials; or4) For no more than 4 plastic syringes with attached needles as a single supply for each week's supply in the case of a prescription for less than three months supply of insulin vials.
Subsidy is available for insulin pen needles: 1) When the prescription is written on the same prescription form as the one used for the supply of insulin cartridges; or2) When "insulin patient" has been written on the prescription by either the doctor or the contractor; and3) For no more than 30 insulin pen needles as a single supply in the case of a prescription for three months supply of insulin cartridges; or4) For no more than 2 insulin pen needles as a single supply for each week's supply in the case of a prescription for less than three months supply of insulin cartridges.
Special Authority for Subsidy - Form SA0361Initial application only from a geriatrician, neurologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Disabling orthostatic hypotension not due to drugs; and 2 Patient has tried fludrocortisone (unless contra-indicated) with unsatisfactory results; and 3 Patient has tried non pharmacological treatments such as support hose, increased salt intake, exercise, and elevation of head and trunk at night. NoteTreatment should be started with small doses and titrated upwards as necessary. Hypertesion should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg. Renewal only from a geriatrician, neurologist or general physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0366Initial application - (North Island patients) from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteFor details of the patient criteria, prescriber criteria, application and reporting forms contact the appointed clinician: Dr Richard FisherFertility Associates131 Remuera RoadAUCKLANDFax: 09 520 0499Appointed clinicians will distribute these agents to prescribers whose applications are approvedInitial application - (South Island patients) from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteFor details of the patient criteria, prescriber criteria, application and reporting forms contact the appointed clinician: Dr Peter BennyChristchurch Women's HospitalPrivate Bag 4711CHRISTCHURCHFax: 03 364 4634Appointed clinicians will distribute these agents to prescribers whose applications are approved
Child resistant closure (NZS 5825:1991) required and reimbursed when used to create an extemporaneously prepared oral solution.
Subsidy is available for disposable and non-disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly.
Up to 50 plastic syringes with attached needles may be dispensed in the case of a prescription for three months supply of insulin vials; orUp to four plastic syringes with attached needles may be dispensed for each week's supply in the case of a prescription for less than three months supply of insulin vials.
Up to 30 pen needles may be dispensed in the case of a prescription for three months supply of insulin cartridges; orUp to two pen needles may be dispensed for each week's supply in the case of a prescription for less than three months supply of insulin cartridges.
Special Authority for Subsidy - Form SA0382Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 All of the following: 1.1 Duodenal ulcer proven by endoscopy or barium meal; and 1.2 Failure of two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 1.3 Non healing duodenal ulcer proven by second barium meal; and 1.4 H2 antagonist therapy for 8 weeks; or 2 All of the following: 2.1 Gastric ulcer proven by endoscopy; and 2.2 Two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 2.3 Non healing gastric ulcer and excluded malignancy demonstrated by a second endoscopy; and 2.4 H2 antagonist therapy for 12 weeks; or 3 All of the following: 3.1 Grade 0 GORD (normal endoscopy); and 3.2 Positive 24 hour pH monitoring test; and 3.3 Failure of H2 antagonist t
n) Further approvals to fund the manufacturer's surcharge on either pravastatin or simvastatin (if applicable) may be granted to patients who are unable to continue treatment with fluvastatin due to adverse effects. Either general practitioners or specialist may make the application. To obtain a new Special Authority number, the application must include the following information: - the amount of time the patient has been treated with fluvastatin; and- the adverse effects experienced by the patient. o) Further approvals to fund the manufacturer's surcharge on simvastatin may be granted to patients with familial hypercholesterolaemia (FH) or familial combined hypercholesterolaemia (FCH) if a specialist considers that the patient is not achieving sufficient benefit from the fully funded statin(s). Only specialists may make application. To obtain a new Special Authority number, the application must include the following information: - the cholesterol level before and after treatment with the fully funded sta
Special Authority for Subsidy - Form SA0391Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Either: 1 Liver transplant recipients; or 2 Renal transplant recipients - as rescue therapy only. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0394Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobacteri
a) Cyproterone acetate with ethinyloestradiol is available from retail pharmacy to patients as indicated. b) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - Prescription may be written for up to 6 months supply; and- Pharmacists may dispense up to 3 month supply. c) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. Eg. Prescriptons may be written for up to 3 months supply, and dispensed monthly. d) The Special Authority number for hormonal contraceptive agents (combined and progesterone-only) does not apply, and is not interchangeable. e) Health Benefits Limited will return any claims unpaid as follows: - any uncoded prescription; - any prescription that does not have a period of supply or the quantity
Special Authority for Subsidy - Form SA0401Initial application - (Basal cell carcinoma) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Basal cell carcinoma unable to be treated surgically or by radiotherapy; and 2 Unsuitability for surgery confirmed by a Plastic Surgeon or Oncologist. NoteMaximum reimbursable dosage 15 million iu/weekInitial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 12 months where chronic hepatitis C. Initial application - (Indications other than Basal cell carcinoma and Chronic hepatitis C) only from a relevant specialist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairy cell leukaemia; or 3 Cutaneous T cell lymphoma; or 4 Essential thrombocythaemia; or 5 Multiple myelo
Special Authority for Subsidy - Form SA0402Initial application - (Patients aged 74 and under) only from a general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patients aged 74 and under; and 2 The patient has been offered 3-6 months of counselling and an opportunity to modify lifestyle; and 3 Any of the following: 3.1 Both: 3.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 3.1.2 total cholesterol > 6.0; or 3.2 Both: 3.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG); and 3.2.2 total cholesterol > 5.5; or 3.3 Both: 3.3.1 NHF B:Patients with > 20% 5-year cardiovascular disease risk; and 3.3.2 total cholesterol > 9.0; or 3.4 Both: 3.4.1 NHF C:15-20% 5-year cardiovascular disease risk; and 3.4.2 total cholesterol > 9.0; or 3.5 Both: 3.5.1 NHF D:10-15% 5-year cardiovascular disease risk; and 3.5.2 total cholesterol > 9.0; or 3.6
Special Authority for Subsidy - Form SA0403Initial application only from a nephrologist or transplant surgeon. Approvals valid for 12 months where renal transplant recipient. Renewal only from a nephrologist or transplant surgeon. Approvals valid for 12 months where re-graft patient.
Special Authority for Subsidy - Form SA0404Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Primary open-angle glaucoma; and 2 Either: 2.1 Other subsidised glaucoma medical therapy is contraindicated; or 2.2 Both: 2.2.1 intra-ocular pressure > 26 mmHg (average from consecutive measurements); and 2.2.2 Unable to be controlled using other subsidised medical therapy. Renewal only from an ophthalmologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0410Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Polycystic ovarian syndrome; or 2 Hirsutism; or 3 Androngenic alopecia. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0411Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Funding of manufacturers surcharge for existing patients taking ACE inhibitors for Congestive Heart Failure.a) Patients taking any ACE inhibitor for the treatment of congestive heart failure prior to 1 June 1998 can continue to have their ACE inhibitor treatment fully subsidised; b) Prescribers must endorse the prescription 'Congestive Heart Failure'. The endorsement can be typed (this includes computer generated prescriptions) or handwritten; c) The endorsement must be initialled in the prescriber's own handwriting. Definition of Congestive Heart FailureAt the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a
Special Authority for Subsidy - Form SA0423Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 All of the following: Duodenal Ulcer: 1.1 Duodenal ulcer proven by endoscopy or barium meal; and 1.2 Non healing duodenal ulcer proven by second barium meal; and 1.3 After failure of two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 1.4 After H2 antagonist therapy for 8 weeks; or 2 All of the following: Gastric Ulcer: 2.1 Gastric ulcer proven by endoscopy; and 2.2 Non healing gastric ulcer and excluded malignancy demonstrated by a second endoscopy; and 2.3 After two alternative courses of H. pylori eradication therapy (if H. pylori positive); and 2.4 After H2 antagonist therapy for 12 weeks; or 3 All of the following: GORD: 3.1 Grade 0 GORD (normal endoscopy); and 3.2 Positive 24
Special Authority for Subsidy - Form SA0424Initial application - (Confirmed HIV/AIDS) only from a general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patients aged 6 years and over with HIV/AIDS; or 2.2 Both: 2.2.1 Asymptomatic patients aged 6 years and over; and 2.2.2 CD4 counts < 500 cells/mm3; or 2.3 Both: 2.3.1 Asymptomatic patients aged 6 years and over; and 2.3.2 Viral load counts > 10,000 copies per ml; or 2.4 Symptomatic patients aged under 6 with HIV/AIDS ; or 2.5 Asymptomatic patients aged 12 months and under; or 2.6 Both: 2.6.1 Asymptomatic patients aged 1 to 5 years; and 2.6.2 CD4 counts < 1,000 cells/mm3; or 2.7 Both: 2.7.1 Asymptomatic patients aged 1 to 5 years; and 2.7.2 CD4 counts < 0.25 x total white cell count; or 2.8 Both: 2.8.1 Asymptomatic patients aged under 6 years; and
If a Community Pharmaceutical is the liquid oral form of an antibiotic to which a diluent must be added by the Contractor at the time of dispensing and it is prescribed or ordered by a Practittioner in an amount that does not coincide with the amount contained in one or more standard packs of that Community Pharmaceutical, Subsidy will only be made for the amount prescribed or ordered by the Practitioner in accordance with either Clause 3.1 or Clause 3.3 of the Schedule, unless the Contractor satisfies the Funder that he or she has not been able to dispense the balance of the pack or packs from which the Community Pharmaceutical has been dispensed. In such cases all of that pack or those packs is eligible for Subsidy.
Special Authority for Subsidy - Form SA0430Initial application - (National Heart Foundation risk groups A1:1, A1:2, B, C, D or E) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 The patient has been offered 3-6 months of counselling and an opportunity to modify lifestyle; and 2 Any of the following: 2.1 Both: 2.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 2.1.2 total cholesterol * > 5.5; or 2.2 Both: 2.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG) or angioplasty; and 2.2.2 total cholesterol * > 4.5; or 2.3 Post heart transplant (regardless of cholesterol level); or 2.4 Both: 2.4.1 NHF B:Patients with > 20% 5-year cardiovascular disease risk; and 2.4.2 total cholesterol * > 9.0; or 2.5 Both: 2.5.1 NHF C:15-20% 5-year cardiovascular disease risk; and 2.5.2 total cholesterol * > 9
Special Authority for Manufacturers Price - Form SA0434Initial application only from a general practitioner, general physician, geriatrician or neurologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patients with swallowing difficulties; and 2 Applicant is a specialist or specialist has authorised treatment. Renewal only from a general practitioner, general physician, geriatrician or neurologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0436Initial application - (Patient with prosthetic heart valves) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 2 years where patient with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism. Initial application - (Following coronary artery vein bypass graft) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 1 year where patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below. Initial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid for 2 years where patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below. Renewal - (Fo
Special Authority for Subsidy - Form SA0443Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist or infectious disease specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobacterial infection
Special Authority for Subsidy - Form SA0445Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patient has failed surgery, radiotherapy, bromocriptine or other oral therapies; or 2 VIPomas and Glucagonomas - for patients who are seriously ill in order to improve their clinical state prior to definitive surgery.; or 3 Both: 3.1 Gastrinoma; and 3.2 Patient has failed surgery, or metastatic disease after H2 antagoists (or proton pump inhibitors) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or has failed; or 5 For pre-operative control of hypoglycaemia and for maintenance therapy; or 6 Both: 6.1 Carcinoidsyndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis); and 6.2 Disabling symptoms not controlled by maximal medical therapy. NoteThe use of octretide in patients with fis
Retail Pharmacy - Specialist prescriptionSpecialist must be either a neurologist, geriatrician or general physician
Special Authority for Subsidy - Form SA0450Initial application only from a psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 Patients suffering from schizophrenia and related psychoses; and 2 Either: 2.1 Failed to respond to full trials (duration of at least 6 weeks each) of effective doses of at least two classes of anti-psychotic agents (refer to guidelines below); or 2.2 Demonstrated intolerance to other neuroleptic agents. NoteClinicians must confirm that informed consent and a satisfactory White Bloodcell Count (WBC) result has been obtained. Diagnosis: Treatment resistant schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present. Treatment: Trial therapy undertaken before initiating treatment with clozapine could
Special Authority for Manufacturers Price - Form SA0451Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Patients being treated for advanced breast cancer who are refractory to tamoxifen; and 2 Any of the following: 2.1 Unable to tolerate aminoglutethimide; or 2.2 Unable to tolerate megestrol acetate; or 2.3 Unable to tolerate medroxyprogesterone acetate.Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
Guidelines for the use of atypical anti-psychotic agents Diagnosis: Schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present. Treatment: Before initiating atypical anti-psychotic therapy, physicians should consider whether the patient is likely to respond to and/or tolerate conventional anti-psychotic therapy and, where appropriate, trial one or more conventional agent prior to use of an atypical agent.
Special Authority for Subsidy - Form SA0456Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patients suffering from schizophrenia and related psychoses who are likely to benefit from anti-psychotic treatment; and 2 Any of the following: 2.1 Effective dose of risperidone has been discontinued because of recurrent acute dystonias; or 2.2 Effective dose of risperidone has been discontinued because of excessive Parkinson-like symptoms; or 2.3 Effective dose of risperidone has been discontinued after 6 weeks because of inadequate clinical response. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0458Initial application only from a gastroenterologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and 2 Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis). NoteLiver biopsy is not usually required for diagnosis but is helpful to stage the diseaseRenewal only from a gastroenterologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteActigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transplant centreTreatment failure - doubling of serum bilirubin levels, absence of a signi
Special Authority for Subsidy - Form SA0459Initial application only from a gastroenterologist or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Both: 2.4.1 Severe acne; and 2.4.2 Treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0461Initial application - (Basal cell carcinoma) only from a dermatologist, plastic surgeon or radiation oncologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Basal cell carcinoma unable to be treated surgically or by radiotherapy; and 2 Unsuitablity for surgery confirmed by a Plastic Surgeon or Radiation Oncologist. NoteThe maximum reimbursable dosage is 15 million iu per weekInitial application - (Chronic hepatitis C) only from a relevant specialist. Approvals valid for 12 months where chronic hepatitis C. Initial application - (Indications other than Basal cell carcinoma and Chronic hepatitis C) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Chronic myelogenous leukaemia; or 2 Hairy cell leukaemia; or 3 Multiple myeloma; or 4 Chronic active hepatitis B. Renewal - (Basal cell carcinoma) only from a dermato
Hospital pharmacy - Specialist prescription. Note: Prescribing and dispensing of clozapine is subject to Ministry of Health restrictions including the requirement for blood monitoring.
Special Authority for Subsidy - Form SA0464Initial application only from a diabetologist, general physician or paediatrician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Use alone (monotherapy); and 1.2 The patient is unable to use any other insulins including those on insulin pump treatment; or 2 Both: 2.1 Use with Humulin 70/30 or Humulin 80/20; and 2.2 A reasonable trial of Humulin N has been undertaken and it is not effective or not well tolerated; or 3 Both: 3.1 Use with insulins (aside from insulin zinc suspension) other than Humulin 70/30, Humulin 80/20, or Humulin N; and 3.2 A reasonable trial of one or more of these Humulin insulins has been undertaken and it is/are ineffective or not well tolerated; or 4 Both: 4.1 Use with Humulin L or Humulin U; and 4.2 Use with Humulin N is not appropriate; or 5 Both: 5.1 Use with other insulin zinc suspensio
Special Authority for Alternate Subsidy - Form SA0466Initial application only from a relevant specialist or general practitioner. Approvals valid for 5 years for applications meeting the following criteria: Any of the following: 1 Angina that is not controlled by other anginal medications; or 2 Continuation of treatment commenced prior to 1 June 1999; or 3 Receiving maximal antihypertensive therapy, requires a DHP CCB, and cannot tolerate felodipine. Renewal only from a relevant specialist or general practitioner. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0467Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Paget's disease; and 2 Any of the following: 2.1 Bone or articular pain; or 2.2 Bone deformity; or 2.3 Bone, articular or neurological complications; or 2.4 Asymptomatic disease, but risk of complications due to site (base of skull, spine, long bones of lower limbs); or 2.5 Preparation for orthopaedic surgery. Renewal only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Retail Pharmacy-Specialist Prescriptiona) Specialist must be an ophthalmologist. b) For treatment of bacterial keratitis or severe bacterial conjunctivitis resistant to chloramphenicol.
a) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent b) On a bulk supply orderc) When used in the extemporaneous compounding of eye drops
Special Authority for Subsidy - Form SA0470Initial application - (Organ transplant) only from a relevant specialist. Approvals valid without further renewal unless notified where organ transplant. Initial application - (Bone marrow transplant or Graft v host disease) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Bone marrow transplant; or 2 Graft v host disease. Initial application - (Psoriasis) only from a dermatologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Psoriasis; and 2 Applicant must state which systemic and topical therapies have failed. Initial application - (Severe atopic dermatitis) only from a dermatologist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Severe atopic dermatitis; and 2 Not responsive to topical therapy, oral antihistamines and other commonly used orthodox therapies. Initial application - (N
Special Authority for Subsidy - Form SA0471Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where breast cancer in pre menopausal women unwilling or unable to undergo surgical or radiation oophorectomy. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year where advanced prostatic cancer when orchidectomy is contraindicated or where the patient strongly opposes orchidectomy. NoteNot to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is intiatedInitial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis ; and 2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or 2.2 The patient has failed to tolerate the treatment with medroxyprogesterone
Special Authority for Subsidy - Form SA0472Initial application only from a cardiologist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Congestive heart failure; and 1.2 Cannot tolerate currently fully subsidised ACE inhibitors due to persistent cough that resolves on cessation and recurs on re-challenge with ACE inhibitor; or 2 Patients who have experienced angioedema on an ACE inhibitor at any time in the past; or 3 Patients who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal only from a cardiologist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0473Initial application from any medical practitioner. Approvals valid for 1 year where the patient is likely to benefit from treatment. Note Applications to be made on the approved forms which are available from: The Co-ordinatorGaucher's Treatment PanelPhone: (04) 460 4990 PHARMAC, PO Box 10 254 WellingtonFacsimile: (04) 916 7571Email: erin.murphy@pharmac.govt.nzPrescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.
a) When prescribed (alone or in combination) for renal dialysis in the home of the patient concerned.b) Only maternity hospital, or on the prescription of a practitioner. c) Obstetric cream only in a quantity not exceeding 500 ml per prescription or on a bulk supply order. d) Solution 5% in quantity not exceeding 100 ml per prescription or on a bulk supply order.
a) Up to 10 %;b) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
a) Up to 2 %; b) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
a) Up to 5 %; b) In a dermatological base (not proprietary Topical Corticosteriod - Plain);c) With or without other dermatological galenicals.
a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without phenol liquefied.
a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without menthol crystals.
a) In a dermatological base or proprietary Topical Corticosteroid - Plain; b) With or without other dermatological galenicals. c) In a 'standard formula'.
a) Only in combination with a dermatological base or proprietary Topical Corticosteriod - Plain; c) With or without other dermatological galenicals.
Special Authority for Subsidy - Form SA0488Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Both: 2.4.1 Severe acne; and 2.4.2 Treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Manufacturers Price - Form SA0489Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Both: 2.1 Patients after coronary artery vein bypass graft; and 2.2 Any of the following: 2.2.1 aspirin induced asthma; or 2.2.2 aspirin induced anaphylaxi; or 2.2.3 significant aspirin induced bleeding excluding bruising. Initial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patients who continue to have transient ischaemic episodes despite aspirin therapy; or 2 Both: 2.1 Patients wh
Special Authority for Subsidy - Form SA0490Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Requires but is not able to tolerate metformin therapy; or 2 Requires metformin but metformin is contraindicated; or 3 Has not responded to or tolerated the maximum appropriate dose of metformin. Renewal only from a relevant specialist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) only if prescribed for prohylaxis of endocarditis and the prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0494Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, or Beta-blockers are contraindicated; or 1.2.2 Patient cannot tolerate Pilocarpine, or Pilocarpine is contraindicated; or 1.2.3 Patient cannot tolerate Dorzolamide, or Dorzolamide is contraindicated; or 1.2.4 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 2 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker. NoteSubsidised as monotherapy onlyRenewal only from an ophthalmologist. Approvals valid for 2 years where the treatment remains appropriate and the patient
Special Authority for Alternate Subsidy - Form SA0500Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Patient is on a Social Welfare benefit; or 1.2 Patient has an income no greater than the benefit; and 2 Has tried at least one of the fully funded options and has been unable to tolerate it. Renewal from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient is on a Social Welfare benefit; or 2 Patient has an income no greater than the benefit. NoteThe approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon and Marvelon. The additional subsidy will fund Mercilon and Marvelon up to the manufacturer's price for each of these products as identified on the Schedule at 1 November 1999Special Authorities approved before 1 November 1999 remain valid until the expiry d
a) Hospital pharmacy [HP3] - Maximum of 750mg (3 injections) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
a) Maximum of 500mg per prescription; orb) More than 500mg per prescription - Special Authority available
a) Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and; b) the prescription is endorsed accordingly.
a) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudo membranous colitis or for prophylaxis of endocarditis; and b) The prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0508Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patient with raised blood pressure; and 2 A beta blocker or diuretic is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 3 An ACE inhibitor is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0509Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patient suffering from schizophrenia and related psychoses who is likely to benefit from anti-psychotic treatment; and 2.2 Both: 2.2.1 An effective dose of risperidone had been trialled and has been discontinued either because of; and 2.2.2 Any of the following: 2.2.2.1 Patient has recurrent acute dystonias; or 2.2.2.2 Patient has excessive Parkinson-like symptoms; or 2.2.2.3 Patient has hyperprolactinaemia; or 2.2.2.4 Patient has inadequate clinical response after four weeks. NoteDiscontinued treatment should be notified to HealthPAC if possibleRenewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Alternate Subsidy - Form SA0510Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Angina that is not controlled by other anginal medications (including felodipine); or 2 Patient was taking Adalat Oros for the treatment of angina prior to 1 June 1999; or 3 Receiving maximal antihypertensive therapy, requires a DHP CCB, and cannot tolerate felodipine. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0511Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of two previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the tr
Special Authority for Subsidy - Form SA0512Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Either: 2.1 Diabetes; or 2.2 Both: 2.2.1 Treatment with conventional corticosteroid therapy; and 2.2.2 Any of the following: 2.2.2.1 Cushingoid habitus; or 2.2.2.2 Osteoporosis where there is significant risk of fracture; or 2.2.2.3 Severe acne. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the patient has had no more than 1 prior approval in the last 12 months. The patient must have had no more than 1 prior approval in the last year. NoteClinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate
Special Authority for Subsidy - Form SA0513Initial application - (Narcolepsy) only from a neurologist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients aged 5 years or over) only from a paediatrician or psychiatrist. Approvals valid for 24 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Initial application - (ADHD in patients under 5 years of age) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients under 5 years of age; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Renewal - (Narcolepsy or ADHD in patients under 5 years of age) only from a neurologist, paediatrician or psychiatrist. Approvals valid for 24 months where the treatment remains appr
Additional Subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the highdose oestrogens.
Special Authority for Subsidy - Form SA0516Initial application from any medical practitioner. Approvals valid for 2 years where the patient is likely to benefit from treatment. Note Applications to be made on the approved forms which are available from: Prof. Wayne CutfieldNational Co-ordinatorNew Zealand Growth Hormone CommitteeC/- Department of PaediatricsUniversity of AucklandPrivate Bag 92019AUCKLAND
Injection 500 mg subsidised: a) only if prescribed for a dialysis or cystic fibrosis patient; and b) the prescription is endorsed accordingly.
(Only in extemporaneously compounded methadone mixture, codeine linctus diabetic or codeine linctus paediatric)
Special Authority for Subsidy - Form SA0523Initial application only from a relevant specialist or general practitioner. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Diagnosis of asthma confirmed; and 2 Inhaler/device technique checked; and 3 Patient monitors PEFR regularly during exacerbations where appropriate; and 4 Any of the following: 4.1 At least three months of 1500 ug or more daily of inhaled beclomethasone or budesonide for adult; or 4.2 At least three months of 750 ug or more daily of inhaled fluticasone) for adult; or 4.3 At least three months of 800 ug or more daily inhaled beclomethasone or budesonide for child; or 4.4 At least three months of 400 ug or more daily inhaled fluticasone) for child; and 5 Either: 5.1 Short acting beta agonist used at least 3-4 times daily; or 5.2 Nocturnal awakenings at least twice a week. Renewal only from a relevant specialist or general practitioner. Appro
Special Authority for Subsidy - Form SA0528Initial application - (Narcolepsy) only from a neurologist or respiratory specialist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients 5 or over) only from a paediatrician, psychiatrist or general practitioner. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Applicant is a specialist or specialist has recommended treatment. Initial application - (ADHD in patients under 5) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Deficient and Hyperactivity Disorder) patients under 5 years of age; and 2 Diagnosed according to DSM-IV or ICD 10 criteria. Renewal - (Narcolepsy) only from a neurologist or respiratory spec
ACE inhibitors will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking an ACE inhibitor for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Additional subsidy for lisinopril is available only up to the price of the least expensive brand listed in the Schedule. Definition of Congestive Heart FailureAt the request of some prescribers the PTAC Cardiovascular subcommittee has provided adefinition of congestive heart failure for the purposes of the funding of the manufacturer'ssurcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for thefunding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requir
Additional subsidy by endorsement for:Moclobemide tab 150 mg x 100 (Aurorix) up to $47.00Moclobemide tab 300 mg x 60 (Aurorix) up to $56.40Nefazadone tab 100 mg x 56 (Serzone) up to $20.16Nefazadone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Cipramil) up to $27.00is available for patients who: * are taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February2000; * have previously responded to treatment with moclobemide or nefazodone or citalopram; * have had a trial of fluoxetine and have to discontinue due to: - inability to tolerate the drug due to side effects OR - failed to respond to an adequate dose and duration of treatment; * have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions); The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these particular words are not a requirement.
Special Authority for Subsidy - Form SA0538Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and 1.1.2 HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; and 1.1.3 ALT greater than twice upper limit of normal or stage 3 or 4 fibrosis on liver histology clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or 1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; and 2 All of the following: 2.1 No continuing alcohol abuse or intravenous drug use; and 2.2 Not coinfected with HCV, HDV, or HIV; and 2.3 Neither ALT nor AST greater than 10 times upper limit of normal; and 2.4
Special Authority for Subsidy - Form SA0539Initial application from any medical practitioner. Approvals valid for 5 years where the patient is likely to benefit from treatment. NoteApplications to be made on the approved forms which are available from: The Co-ordinatorPhone: 09 580 9176Multiple Sclerosis Treatment CommitteeFacsimile: 09 580 9205Level 3, Unisys HouseEmail: murray@ppc.govt.nz650 Great South Road, PenrosePrivate Bag, AUCKLANDBudget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC). Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below). Completed application forms must be sent to the co-ordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity. Notification of MSTAC's decision will be sent to the patient, the applying clinician and the patient's GP (if specified). These agents will N
Only if prescribed for renal dialysis, maternity or post-natal care in the home of the patient and the prescription is endorsed accordingly.
Oral liq prescriptions: a) Must be written by a Paediatrician or Paediatric Cardiologist; orb) On the recommendation of a Paediatrician or Paediatric Cardiologist.
Additional subsidy by endorsement for:Moclobemide tab 150 mg x 100 (Aurorix) up to $47.00Moclobemide tab 300 mg x 60 (Aurorix) up to $56.40Nefazadone tab 100 mg x 56 (Serzone) up to $20.16Nefazadone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Cipramil) up to $27.00is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or* have previously responded to treatment with moclobemide, nefazodone or citalopram; or* have had a trial of fluoxetine and have to discontinue due to: - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions); The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these words are not a requirement.
Alphagan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Alphagan should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: (a) that person has previously trialled all other such subsidised agents (except dorzolamide hydrochloride); and(b) those trials have indicated that that person does not respond adequately to or does not tolerate treatment with those other agents.
Special Authority for Subsidy - Form SA0551Initial application only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. NoteApproval entitles patients to a subsidy for one NAED. Dual NAED therapy will be subsidised for patients who were already stabilised on two NAEDs on or before 31 July 2000 or, for whom a second NAED has been added to therapy with one NAED provided an attempt to withdraw one NAED has been made and was unsuccessful. "Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combin
Nicotine patches and gum: a) are only available /subsidised on presentation of a Quitline exchange card.b) for reimbursement refer to the Claiming Procedures for the Subsidised Nicotine Patches and Gum Programme. c) have a maximum patient co-payment (contribution) of $10 per exchange card.
Special Authority for Subsidy - Form SA0554Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Liver transplant recipients; or 2 Renal transplant recipients - as rescue therapy only. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
a) Fluoxetine hydrochloride tab dispersible 20 mg restricted to a maximum daily dose of 10 mg. b) Tablets can be combined with capsules to facilitate incremental 10 mg doses.
Special Authority for Subsidy - Form SA0556Initial application - (Confirmed HIV/AIDS) only from a named general physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Both: 2.2.1 Asymptomatic patient; and 2.2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Asymptomatic patient; and 2.3.2 Patient has viral load counts > 10,000 copies per ml or equivalent value on the Chiron test; or 2.4 All of the following: 2.4.1 Asymptomatic patient; and 2.4.2 Patient aged 1 to 5 years; and 2.4.3 CD4 counts < 1,000 cells/mm3; or 2.5 All of the following: 2.5.1 Asymptomatic patient; and 2.5.2 Patient aged 1 to 5 years; and 2.5.3 CD4 counts < 0.25 x total white cell count; or 2.6 All of the following: 2.6.1 Asymptomatic patient; and 2.6.2 Patient aged 6 years and over; and 2.6.3 CD4 counts
Special Authority for Subsidy - Form SA0557Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note"Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of complianceAs a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anti-convulsan
Additional subsidy by endorsement for:Moclobemide tab 150mg x 100 (Aurorix) up to $32.90Moclobemide tab 300mg x 60 (Aurorix) up to $39.48Nefazodone tab 100mg x 56 (Serzone) up to $20.16Nefazodone tab 200mg x 56 (Serzone) up to $40.32Citalopram tab 20mg x 28 (Cipramil) up to $27.00is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or* have previously responded to treatment with moclobemide, nefazodone or citalopram; or* have had a trial of fluoxetine and have had to discontinue due to - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these words are not a requirement.
Additional subsidy by endorsement for:Moclobemide tab 150mg x 100 (Aurorix) up to $32.90Moclobemide tab 300mg x 60 (Aurorix) up to $39.48Nefazodone tab 100mg x 56 (Serzone) up to $20.16Nefazodone tab 200mg x 56 (Serzone) up to $40.32Citalopram tab 20mg x 28 (Cipramil and Celapram) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: * were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on Februrary 2001; or * have previously responded to treatment with moclobemide or nefazodone or citalopram or paroxetine hydrochloride; or* have had a trial of fluoxetine and have had to discontinue due to - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or* have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be e
Special Authority for Subsidy - Form SA0563Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Acromegaly; and 1.2 Patient has failed surgery, radiotherapy, bromocriptine and other oral therapies; or 2 VIPomas and Glucagonomas - for patients who are seriously ill in order to improve their clinical state prior to definitive surgery.; or 3 Both: 3.1 Gastrinoma; and 3.2 Either: 3.2.1 Patient has failed surgery; or 3.2.2 Patient in metastatic disease after H2 antagonists (or proton pump inhibitors) have failed; or 4 Both: 4.1 Insulinomas; and 4.2 Surgery is contraindicated or has failed; or 5 For pre-operative control of hypoglycaemia and for maintenance therapy; or 6 Both: 6.1 Carcinoid syndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis); and 6.2 Disabling symptoms not controlled by maximal medical therapy. No
Only if prescribed on a prescription for for renal dialysis, maternity or post-natal care in the home of the patient, or on a PSO for emergency use.
Trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include pat
Perindopril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include pati
Special Authority for Subsidy - Form SA0569Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. Renewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the t
a) Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use.
Special Authority for Subsidy - Form SA0572Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient presenting with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patients suffers from schizophrenia or related psychoses ; and 2.2 Either: 2.2.1 A trial of risperidone has been discontinued because of unacceptable side effects; or 2.2.2 A trial of risperidone has been discontinued because of inadequate response. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Subsidy is available for patients with poorly controlled asthma where: a) at least three months of 750 mcg or more daily of inhaled beclomethasone or budesonide(or 400 mcg of fluticasone) for adults has been used; orb) at least three months of 400 mcg or more daily of inhaled beclomethasone or budesonide (or 200mcg of fluticasone) for children 12 years or older has been used; The prescription must be endorsed accordingly. We recommend that the words used to indicateeligibility are "poor control with ICS" or "certified condition".
Special Authority for Subsidy - Form SA0575Initial application - (Confirmed HIV/AIDS) only from a named general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV/AIDS; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Both: 2.2.1 Asymptomatic patient; and 2.2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Asymptomatic patient; and 2.3.2 Patient has viral load counts > 10,000 copies per ml or equivalent value on the Chiron test; or 2.4 All of the following: 2.4.1 Asymptomatic patient; and 2.4.2 Patient aged 1 to 5 years; and 2.4.3 CD4 counts < 1,000 cells/mm3; or 2.5 All of the following: 2.5.1 Asymptomatic patient; and 2.5.2 Patient aged 1 to 5 years; and 2.5.3 CD4 counts < 0.25 x total white cell count; or 2.6 All of the following: 2.6.1 Asymptomatic patient; and 2.6.2 Patient aged 6 years and over
Dispersible tablets are subsidised only for patients who are unable to swallow tablets and the prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0579Initial application - (Cystic fibrosis or renal failure) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 cystic fibrosis; or 2 chronic renal failure or continuous ambulatory peritoneal dialysis (CAPD) patient. Initial application - (Indications other than cystic fibrosis or renal failure) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 cancer in children; or 2 cancers affecting alimentary tract where there are malabsorption problems in patients over the age of 20 years; or 3 failure to thrive; or 4 growth deficiency; or 5 bronchopulmonary dysplasia; or 6 premature and post premature infant. Renewal - (Cystic fibrosis or renal failure) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applicatio
Special Authority for Subsidy - Form SA0580Initial application - (Inborn errors of metabolism) only from a relevant specialist. Approvals valid for 3 years where inborn errors of metabolism. Initial application - (Indications other than inborn errors of metabolism) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 failure to thrive ; or 2 growth deficiency; or 3 bronchopulmonary dysplasia ; or 4 fat malabsorption ; or 5 lymphangiectasia; or 6 short bowel syndrome ; or 7 infants with necrotising enterocolitis; or 8 biliary atresia. Renewal - (Inborn errors of metabolism) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of
Special Authority for Subsidy - Form SA0581Initial application - (Cystic fibrosis) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 infant aged four years or under; and 2 cystic fibrosis. Initial application - (Indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 infant aged four years or under; and 2 Any of the following: 2.1 cancer in children; or 2.2 failure to thrive; or 2.3 growth deficiency; or 2.4 bronchopulmonary dysplasia; or 2.5 premature and post premature infants. Renewal - (Cystic fibrosis) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practiti
Special Authority for Subsidy - Form SA0582Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 protein losing enteropathy; or 2 high protein needs (eg burns). Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0585Initial application - (Cystic fibrosis) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: All of the following: 1 Cystic fibrosis; and 2 other lower calorie products have been tried; and 3 patient has substantially increased metabolic requirements; and 4 Either: 4.1 The product is to be used as a supplement; or 4.2 The product is to be used as a complete diet.Initial application - (Indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Any of the following: 1.1 any condition causing malabsorption ; or 1.2 failure to thrive ; or 1.3 increased nutritional requirements.; and 2 other lower calorie products have been tried; and 3 patient has substantially increased metabolic requirements; and 4 Either: 4.1 The product is to be used a
Special Authority for Subsidy - Form SA0587Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 acute or chronic renal failure; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0588Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 CORD patients who have hypercapnia; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0589Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Anorexia and weight loss; and 2 Either: 2.1 decompensating liver disease without encephalopathy ; or 2.2 protein losing gastro-enteropathy; and 3 Either: 3.1 The product is to be used as a supplement (maximum 500 ml per day); or 3.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialis
Special Authority for Subsidy - Form SA0590Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 infant aged one to six years; and 2 Any of the following: 2.1 any condition causing malabsorption ; or 2.2 failure to thrive; or 2.3 increased nutritional requirements; and 3 Either: 3.1 The product is to be used as a supplement (maximum 500 ml per day); or 3.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must
Special Authority for Subsidy - Form SA0591Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 enteral feeding; or 1.2 nasogastric; or 1.3 nasoduodenal ; or 1.4 nasojejunal; or 1.5 gastrostomy/jejunostomy; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal only from a general practitioner or relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0592Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 malabsorption ; or 1.2 short bowel syndrome; or 1.3 enterocutaneous fistulas ; or 1.4 pancreatitis; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.NoteEach of these products is highly specialised and would be prescribed only by an expert for a specific disorder. The alternative is hospitalisation. Elemental 028 Extra is more expensive than other products listed in this section and should only be used where the alternatives have been tried first and/or are unsuitable. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following:
Special Authority for Subsidy - Form SA0594Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Type I and II diabetics who require nutritional supplementation.; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet; and 3 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0595Initial application only from a relevant specialist. Approvals valid for 1 year where patient has motor neurone disease with swallowing disorder. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0596Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 gluten enteropathy has been diagnosed by biopsy; or 2 dermatitis herpetiformis. NoteA premium may be payable if the subsidy does not match the price charged by the manufacturer. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0597Initial application - (PKU Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 PKU; and 2 blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Initial application - (Patient aged over 16) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 dietary management of homocystinuria; or 2 inborn errors of metabolism other than PKU; or 3 dietary management of maple syrup urine disease..Initial application - (Patient aged 16 or under) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Any of the following: 1 dietary management of homocystinuria; or 2 PKU and other inborn errors of metabolism; or 3 dietary management of maple syrup urine disease..Renewal - (PKU Patient aged over 16
NoteLofenalac when used with Ketovite is considerably cheaper than Maxamaid or Maxamum.
Special Authority for Subsidy - Form SA0600Initial application only from a relevant specialist. Approvals valid for 3 years where inborn errors of metabolism. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0601Initial application only from a relevant specialist. Approvals valid for 1 year where Infant suffering from Williams Syndrome and associated hypercalcaemia. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0602Initial application only from a relevant specialist. Approvals valid for 6 months where infant weighing less than 1.5 kg at birth.
Special Authority for Subsidy - Form SA0603Initial application only from a relevant specialist. Approvals valid for 1 year where infant suffering from malabsorption and other gastrointestinal problems. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0604Initial application - (Lactase deficiency or disaccharide intolerance) only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Patient is less than 3 years of age; and 2 Either: 2.1 diagnosed as suffering from congenital lactase deficiency; or 2.2 suffering from disaccharide intolerance. NoteSecondary lactose intolerance in children is usually short lasting, and can be controlled by dietary measures and by giving sufficient calories to regenerate digestive enzymes. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Initial application - (Infant with intolerance to cows' milk) only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 intolerant to cows' milk; and 2 patient is less than 3 years of age. No
Special Authority for Subsidy - Form SA0605Initial application - (Cystic fibrosis or renal disorder) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Either: 1.1 cystic fibrosis; or 1.2 renal disorder; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Initial application - (Indications other than cystic fibrosis or renal disorder) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 any condition causing malabsorption; or 1.2 failure to thrive; or 1.3 increased nutritional requirements; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal - (Cystic fibrosis or renal disorder) only from a relevant specialist or general practitioner. Approvals valid for 3 years
Special Authority for Subsidy - Form SA0606Initial application only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 child (up to 18 years) with chronic renal failure.; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.
Special Authority for Subsidy - Form SA0607Initial application only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Child (up to 18 years) who is awaiting liver transplant; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.Renewal only from a paediatrician. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 Either: 2.1 The product is to be used as a supplement (maximum 500 ml per day); or 2.2 The product is to be used as a complete diet.
Special Authority for Subsidy - Form SA0609Initial application - (Serevent MDI, Serevent Accuhaler Foradil, Oxis Turbuhaler 12 mcg, Symbicort Turbuhaler) only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Child under the age of 12 with poorly controlled asthma; and 1.2 Either: 1.2.1 Required at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide; or 1.2.2 Required at least three months of 200 mcg or more of fluticasone; or 2 Both: 2.1 Adult with poorly controlled asthma; and 2.2 Either: 2.2.1 Required at least three months of 1500 mcg or more daily inhaled beclomethasone or budesonide; or 2.2.2 Required at least three months of 750 mcg or more of fluticasone. NotePatients are to be reviewed at least at six months to assess compliance and effectiveness of therapy. Special Authority approvals are interchangeable among all prese
Special Authority for Subsidy - Form SA0610Initial application from any specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Quantity used by patient on a weekly volume intraveneously (Details to be attached to application); and 2 Amount of nutrition patient is able to receive orally (Details to be attached to application); and 3 Exact formula of TPN (Details to be attached to application); and 4 Who has paid for TPN so far (Details to be attached to application); and 5 Place of manufacture (Details to be attached to application); and 6 Complete medical history of patient including details of previous therapies. (Details to be attached to application). Renewal - (Previous approval has expired) from any specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0611Initial application from any medical practitioner. Approvals valid for 1 year where applicaton approved by the Cystic Fibrosis DN'ase Advisory Panel. NoteApplications to be made on the approved forms which are available from: The Co-ordinatorCystic Fibrosis DN'ase Advisory PanelPhone: (04) 460 4990 PHARMAC, PO Box 10 254 WellingtonFacsimile: (04) 916 7571Email: erin.murphy@pharmac.govt.nzPrescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.
Special Authority for Manufacturers Price - Form SA0612Renewal from any medical practitioner. Approvals valid for 2 years where patient recieved Special Authority prior to 1 June 1998.
Special Authority for Alternate Subsidy - Form SA0613Initial application from any medical practitioner. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Polycystic ovarian syndrome; or 2 Hirsutism; or 3 Androngenic alopecia. Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0614Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid for 2 years where the tr
Special Authority for Subsidy - Form SA0615Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The product is to be used as a complete diet; and 2 Either: 2.1 Patient has metabolic disorders of fat metabolism; or 2.2 Patient has chylothorax. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Manufacturers Price - Form SA0616Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. NoteAspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruisingInitial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic
Nicotine patches and gum are only available /subsidised on presentation of a Quitline exchange card.
a) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - prescription may be written for up to six months supply; and- pharmacists may dispense up to three months supply. b) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. ie. Prescriptions may be written for up to three months supply, and dispensed monthly
Special Authority for Subsidy - Form SA0621Initial application only from a relevant specialist. Approvals valid for 5 years where the patient is likely to benefit from treatment. Renewal only from a relevant specialist. Approvals valid for 5 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0622Initial application only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fractures demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal only from a geriatrician, rheumatologist, endocrinologist, gynaecologist or general physician. Approvals va
Special Authority for Subsidy - Form SA0623Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is not predisposed to heart arrhythmias; and 2 The patient does not have a pre-existing QT-prolongation or hepatic failure; and 3 The patient is not using other medications which either inhibit the cytochrome P450 3A4 enzyme system or prolong the QT interval; and 4 Any of the following: 4.1 Both: 4.1.1 The patient is an adult with severe reflux oesophagitis; and 4.1.2 other treatment, including acid suppression with proton pump inhibitors, has failed; or 4.2 gastroparesis; or 4.3 malignancy of GI tract causing gastroparesis (or gastric outlet obstruction); or 4.4 The patient is a child (not including infants from 0 to 3 months of age who were born prematurely) with severe gastro-oesophageal reflux; and 5 Diagnosis has been made or confirmed by a general p
Subsidy by endorsement Oral liquid is subsidised only for patients: - with oesophageal stricture, orin terminal care, or- who are either too young or too old to swallow conventional tablets and the prescription is endorsed accordingly. Note: the cost of treatment with ranitidine oral liquid is more than 10 times higher than that of ranitidine tablets. Following the derestriction of access PHARMAC will be monitoring expenditure on ranitidine oral liquid more closely and may, subject to consultation and PHARMAC Board approval, restrict access again if the expenditure was to grow substantially.
Special Authority for Subsidy - Form SA0626Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: All of the following: General Criteria: 1 Anaemia of end-stage renal failure (other treatable causes of anaemia being excluded); and 2 Been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months; and 3 Not under evaluation for, or awaiting, a live donor kidney transplant; and 4 Any of the following: Specific Criteria: 4.1 Anephric; or 4.2 Dependent on regular blood transfusion (1 unit each 4-8 weeks) to maintain haemoglobin > 60g/L; or 4.3 Dependent on regular blood transfusion but cannot be transfused because of severe transfusion reactions; or 4.4 Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1500 ug/L); or 4.5 Haemoglobin < 70 g/L (mean of at least 4 haemoglobin concentrations over 4 months); or 4.6 Both: 4.6.1 Haemo
Prescribing GuidelineTreatment with HMG CoA Reductase Inhibitors (Statins) is recommended for patients withdyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater. New Zealand Cardiovascular Guideline Group statement. "The 1996 Heart Foundation guidelines for the Assessment and Management of Dyslipidaemia are currently being revised. An evidence-based guideline on the Assessment and Management of Cardiovascular Risk will be developed in 2002. The Cardiovascular Guideline Group has written an interim consensus statement for themanagement of dyslipidaemia. The Heart Foundation cardiovascular risk tables should be used to determine risk. Certain groups are classified to be at very high risk (>20%) and should be treated as such: - Patients who have had a previous cardiovascular event (angina, MI, angioplasty, coronary artery bypass grafts, TIA, ischaemic stroke and peripheral vascular disease)- Patients with genetic lipid disorders- Patients with diabetes and associated microa
Special Authority for Subsidy - Form SA0628Initial application only from a cardiologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 Both: 1.1 Congestive heart failure; and 1.2 Cannot tolerate two ACE inhibitors due to persistent cough that resolves on cessation and recurs on re-challenge with ACE inhibitor; or 2 Patients who have experienced angioedema on an ACE inhibitor at any time in the past; or 3 Patients who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal - ((2 year approvals granted before April 2002)) only from a cardiologist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0631Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, or Beta-blockers are contraindicated; or 1.2.2 Patient cannot tolerate Pilocarpine, or Pilocarpine is contraindicated; or 1.2.3 Patient cannot tolerate Dorzolamide, or Dorzolamide is contraindicated; or 1.2.4 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 2 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker. NoteSubsidised also for adjunctive use for the treatment of patients who have met the initial application criteria, and in whom latanoprost monotherapy has bee
Special Authority for Subsidy - Form SA0633Initial application only from a general practitioner or relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient is already on an ACE inhibitor or Angiotensin II Antagonist; and 2 Any of the following: 2.1 Both: 2.1.1 Symptomatic heart failure NYHA functional class II-III; and 2.1.2 Patient has been treated with metoprolol and is intolerant to metoprolol or has demonstrated a sub-optimal response to metoprolol; or 2.2 Symptomatic heart failure NYHA functional class III-IV; or 2.3 Patient has left ventricular systolic dysfunction with an ejection fraction of less than 35%.NoteWhere possible treatment should be initiated by or on the recommendation of a specialist.
Special Authority for Subsidy - Form SA0635Initial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 Rheumatoid arthritis; and 2 Patient is not a pregnant woman, or a woman of child-bearing age without adequate contraception; and 3 Patient has been unable to tolerate or has a contraindication to or has had an inadequate response to sulphasalazine and methotrexate (individually or in combination). Renewal only from a rheumatologist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Compliance (prescriber determined) with medication; and 2 Improved rheumatoid arthritis symptom control. NotePatient should have full blood count and liver function tests regularly monitored.
Retail pharmacy - subsidy by endorsement a) Subsidised for:i) patients presenting with first episode schizophrenia or related psychoses; andii) patients suffering from schizophrenia or related psychoses after a trial of an effective dose of risperidone that has been discontinued because of unacceptable side effects or inadequate response. b) Initial prescription must be written by a relevant specialist. c) Subsequent prescriptions may be written by a general practitioner. d) The prescription must be endorsed "certified condition".
Special Authority for Subsidy - Form SA0637Initial application - (National Heart Foundation risk groups A1:1, A1:2, B, C, D or E) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient has been offered 3-6 months of counseling and an opportunity to modify lifestyle; and 2 Any of the following: 2.1 Both: 2.1.1 NHF A1:1 - Clinically proven ischaemic heart disease; and 2.1.2 total cholesterol > 5.5; or 2.2 Both: 2.2.1 NHF A1:2 - Post coronary artery bypass graft (CABG) or angioplasty; and 2.2.2 total cholesterol > 4.5; or 2.3 Post heart transplant (regardless of cholesterol level); or 2.4 Both: 2.4.1 NHF B: Patients with > 20% 5-year cardiovascular disease risk; and 2.4.2 total cholesterol > 9.0; or 2.5 Both: 2.5.1 NHF C: 15-20% 5-year cardiovascular disease risk; and 2.5.2 total cholesterol >
Note: only one multidose cartridge starter pack to be prescribed and dispensed per patient per approval.
Special Authority for Subsidy - Form SA0639Initial application - (No previous use) only from a relevant specialist or general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 The patient has a clinical diagnosis of heavy menstrual bleeding; and 2 The patient has failed to respond to or is unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines; and 3 Either: 3.1 serum ferritin level < 16 mg/l (within the last 12 months); or 3.2 haemoglobin level < 120 g/l . NoteApplications are not to be made for use in patients as contraception except where they meet the above criteriaInitial application - (Previous use before 1 October 2002) only from a relevant specialist or general practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 The patient had a clinical diagnosis of heavy menstrual bleeding; and 2
Special Authority for Manufacturers Price - Form SA0640Initial application only from a relevant specialist. Approvals valid for 3 years where patients being treated for advanced breast cancer who are refractory to tamoxifen. Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Waiver of Rule - Form SA0641Initial application only from a diabetologist, general physician or paediatrician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Both: 1.1 Use alone (monotherapy); and 1.2 The patient is unable to use any other insulins including those on insulin pump treatment; or 2 Both: 2.1 Use with insulin other than insulin isophane (including ready-mixed preparations); and 2.2 A reasonable trial of insulin isophane has been undertaken and it is not effective or not well tolerated. Note"Reasonable trial", "unable to use", "not effective", "not well tolerated", and "not well tolerated" are not defined and we ask clinicians to use their clinical judgement in interpreting these terms.
Special Authority for Subsidy - Form SA0643Initial application - (CML) only from an oncologist or relevant specialist. Approvals valid for 7 months where approved by the The Glivec Co-ordinator. Initial application - (GIST) only from an oncologist. Approvals valid for 1 year where approved by the The Glivec Co-ordinator. Renewal - (CML) only from an oncologist or relevant specialist. Approvals valid for 6 months where approved by the The Glivec Co-ordinator. Initial application - (GIST) only from an oncologist. Approvals valid for 1 year where approved by the The Glivec Co-ordinator. NoteApplication forms are available from, and prescriptions should be sent to: The Glivec Co-ordinatorPhone: 09 580 9176Level 3, Unisys HouseFacsimile: 09 580 9205650 Great South Road, PenroseEmail: murray@ppc.govt.nzPrivate Bag, AUCKLANDSpecial Authority criteria for CML - access by applicationFunded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) i
Special Authority for Subsidy - Form SA0645Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin <= 100 g/L; and 2 Either: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate <= 30 ml/min; or 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate <= 45 ml/min. Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteErythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over:GFR (male)
Special Authority for Subsidy - Form SA0646Initial application only from a renal physician. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Both: 1.1 patient in chronic renal failure; and 1.2 Haemoglobin <= 100 g/L; and 2 Any of the following: 2.1 Both: 2.1.1 patient is not diabetic; and 2.1.2 glomerular filtration rate <= 30 ml/min; or 2.2 Both: 2.2.1 patient is diabetic; and 2.2.2 glomerular filtration rate <= 45 ml/min; or 2.3 patient is on haemodialysis or peritoneal dialysis. Renewal only from a renal physician. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. NoteErythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. The Cockroft-Gault Formula may be used to estim
Special Authority for Subsidy - Form SA0649Initial application - (Conditions other than transient ischaemic episodes) only from a cardiothoracic surgeon, cardiologist or general physician. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patients with prosthetic heart valves - as an adjunct to oral anticoagulation for prophylaxis of thromboembolism; or 2 Patients after coronary artery vein bypass graft - as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant. NoteAspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxi, or those with significant aspirin induced bleeding, excluding bruisingInitial application - (Transient ischaemic episodes) only from a neurologist, neuro surgeon, cardiologist, vascular surgeon or general physician. Approvals valid without further renewal unless notified where patients who continue to have transient ischaemic episodes des
Etidronate for osteoporosis should be prescribed for 14 days (400 mg in the morning) and repeated every three months. It should not be taken at the same time of the day as any calcium supplementation (minimum dose - 500 mg per day of elemental calcium). Etidronate should be taken at least 2 hours before or after any food or fluid, except water
Special Authority for Subsidy - Form SA0652Initial application - (Single NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 15 months for applications meeting the following criteria: Any of the following: 1 Was on NAED therapy before 1 September 2000; or 2 Seizures are not adequately controlled with optimal older anti-epilepsy drug treatment; or 3 Seizures are controlled adequately but who experience unacceptable side effects from older anti-epilepsy drug treatment. Note"Optimal older anti-epilepsy drug therapy" is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of complianceInitial application - (Dual NAED Therapy) only from a paediatrician, neurologist or general physician. Approvals valid for 18 months for app
Additional subsidy by endorsement for:Calcium carbonate tablets x 1,000 (Titralac) up to $35.10 is available for pregnant women. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" however these particular words are not a requirement.
Special Authority for Subsidy - Form SA0657Initial application - (Helicobacter pylori infections) only from a general practitioner or relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Eradication of Helicobacter pylori in patient with proven infection; and 2 Peptic ulcer disease proven by endoscopy. NoteMaximum of two prescriptions (two courses) per patient. Initial application - (Mycobacterial infections) only from a respiratory specialist, infectious disease specialist or paediatrician. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Mycobacterium Avium Intracellulare Complex infections in patient with AIDS; or 2 Atypical and drug-resistant mycobacterial infection; or 3 All of the following: 3.1 Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infection; and 3.2 HIV infection; and 3.3 CD4 count <= 50 cells/mm3. Renewal - (Mycobact
Additional subsidy by endorsement for:Moclobemide tab 150 mg x 500 (Apo-Moclobemide) up to $46.00Moclobemide tab 150 mg x 100 (Aurorix) up to $32.90Moclobemide tab 300 mg x 100 (Apo-Moclobemide) up to $26.11Moclobemide tab 300 mg x 60 (Aurorix) up to $39.48Nefazodone tab 100 mg x 56 (Serzone) up to $20.16Nefazodone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: - were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with moclobemide or nefazodone or citalopram or paroxetine hydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or
Special Authority for Subsidy - Form SA0661Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has "treatment resistant" depression; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and failed to respond to an adequate dose over an adequate period of time. Renewal from any medical practitioner. Approvals valid for 2 years where patient has a high risk of relapse (prescriber determined)..NoteFirst prescription can be written by a psychiatrist or psychiatric registrar. Subsequent prescriptions may be written by a General Practitioner
Prescribing GuidelinesBoth Trusopt and Cosopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Trusopt and Cosopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: i) that person has previously trialled all other such subsidised agents (except brimonidine tartrate); andii) those trials have indicated that that person does not respond adequately to treatment with those other agents.
a) Spacer devices and masks also available to paediatricians employed by a DHB on a wholesalesupply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via ahospital pharmacy. b) Only available for children aged six years and under. c) For Space Chamber and Foremount Child's Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. d) Distributed by Airflow Products. Forward orders to: Airflow ProductsPO Box 1485 Telephone: 04 499 1240 or 0800 AIR FLOWWellington Facsimile: 04 499 1245 or 0800 323 270
Special Authority for Subsidy - Form SA0667Initial application only from a named specialist. Approvals valid for 4 months for applications meeting the following criteria: All of the following: 1 To be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and 2 Patient is less than 18 years of age at commencement of treatment; and 3 Patient has had severe active polyarticular course Juvenile Idiopathic Arthritis (JIA) for 6 months duration or longer; and 4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of 10-20mg/m2 weekly in combination with oral corticosteroids (prednisone 0.25 mg/kg); and 5 Patient has tried and not responded to at least three months of oral or parenteral methotrexate (at a dose of 10-15mg/m2 weekly) in combination with one other disease-modifying agent; and 6 Both: 6.1 Either: 6.1.1 Patient has persistent symptoms of poorly-cont
Note: Due to uncertainty around the long term effects of Selegiline it is not recommended as a first line agent.
Special Authority for Subsidy - Form SA0669Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where organ transplant recipients. NoteSubsidy applies for either primary or rescue therapy
Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide.
Additional subsidy by endorsement for:Nefazodone tab 100 mg x 56 (Serzone) up to $20.16Nefazodone tab 200 mg x 56 (Serzone) up to $40.32Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with nefazodone or citalopram or paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
Special Authority for Manufacturers Price - Form SA0673Initial application from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient considered unsafe to switch to m-Eslon; and 2 Patient was stabilised and well controlled on Kapanol, MST or LA-Morph before 1 December 2003. NoteSpecial Authority effective from 1 February 2004 to 31 July 2004
Note: Combivir counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority
Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric
Rapid acting insulin analogues are subsidised when: 1) prescribed with insulin isophane or insulin glargine but are on a different prescription and the prescription is endorsed accordingly; or prescribed on the same prescription as insulin isophane or insulin glargine in which case the prescription is deemed to be endorsed; or2) a Special Authority has been approved. For 1and 2 first prescription to be written by a specialist (diabetologist, general physician or paediatrician). Any medical practitioner can writte subsequent prescriptions.
Additional subsidy by Special Authority - Retail Pharmacy - for: - Nifedipine tab long-acting 30mg x 30 (Adalat Oros) up to $19.90 - Nifedipine tab long-acting 60mg x 30 (Adalat Oros) up to $29.50
Additional subsidy by Special Authority - Retail Pharmacy - for: - Amlodipine 5mg x 30 (Norvasc) up to $19.90 - Amlodipine 10mg x 30 (Norvasc) up to $29.50
Only in combination with a dermatological galenical or as a diluent for a proprietary Topical Corticosteroid - Plain.
Special Authority for Subsidy - Form SA0692Initial application from any specialist. Approvals valid for 11 months where patient has chronic, genotype 1 hepatitis C.
Special Authority for Subsidy - Form SA0693Initial application only from a relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Severe osteoporosis; and 2 History of one previous significant osteoporotic fracture demonstrated radiologically; and 3 T-Score <= -3.0 (bone mass density (BMD) >= 3.0 standard deviations below the mean normal value in young adults). NoteIn line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral bodyRenewal - ((2 year approvals granted before February 2002)) only from a geriatrician, rheumatologist, endocrinologist, gynaecologis
Subsidy is available for patients with poorly controlled asthma where: a) at least three months of 750 mcg or more daily of inhaled beclomethasone or budesonide (or 400 mcg or fluticasone) for adults has been used; orb) at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide (or 200 mcg or fluticasone) for children has been used; The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "poor control with ICS" or "certified exemption".
Special Authority for Subsidy - Form SA0696Initial application - (Narcolepsy) only from a neurologist or respiratory specialist. Approvals valid for 24 months where narcolepsy. Initial application - (ADHD in patients 5 or over) only from a paediatrician, psychiatrist or general practitioner on the recommendation of such a specialist. Approvals valid for 24 months for applications meeting the following criteria: All of the following: 1 ADHD (Attention Deficit and Hyperactivity Disorder) patients aged 5 years or over; and 2 Diagnosed according to DSM-IV or ICD 10 criteria; and 3 Either: 3.1 Applicant is a specialist; or 3.2 Both: 3.2.1 Applicant is a GP and a specialist has recommended treatment; and 3.2.2 Provide name of specialist (Details to be attached to application). Initial application - (ADHD in patients under 5) only from a paediatrician or psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 ADHD (Attention Defi
Special Authority for Subsidy - Form SA0698Initial application only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Mild to moderate ileal, ileocaecal or proximal Crohn's disease; and 2 Any of the following: 2.1 Diabetes; or 2.2 Cushingoid habitus; or 2.3 Osteoporosis where there is significant risk of fracture; or 2.4 Severe acne following treatment with conventional corticosteroid therapy. Renewal only from a gastroenterologist, general surgeon or general physician. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. The patient must have had no more than 1 prior approval in the last year. NoteClinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate.
Special Authority for Subsidy - Form SA0699Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 The patient is not predisposed to heart arrhythmias; and 2 The patient does not have a pre-existing QT-prolongation or hepatic failure; and 3 The patient is not using other medications which either inhibit the cytochrome P450 3A4 enzyme system or prolong the QT interval; and 4 Any of the following: 4.1 Both: 4.1.1 adult with severe reflux oesophagitis; and 4.1.2 other treatment, including acid suppression with proton pump inhibitors, has failed; or 4.2 gastroparesis; or 4.3 malignancy of GI tract causing gastroparesis (or gastric outlet obstruction); or 4.4 child (not including infants from 0 to 3 months of age who were born prematurely) with severe gastro-oesophageal reflux; and 5 Diagnosis has been made or confirmed by a general physician, gastroenterologist, or ge
Special Authority for Subsidy - Form SA0700Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Monotherapy in primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, Pilocarpine and Dorzolamide; or 1.2.2 Beta-blockers, Pilocarpine and Dorzolamide are contraindicated; or 1.2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 1.2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker; or 2 Adjunctive use for the treatment of patients who have met the initial application criteria, and in whom latanoprost monotherapy has been ineffective in controlling intraocular pressure.Note An adjunctive agent may be added without a
Special Authority for Subsidy - Form SA0702Initial application - (Oral feed for cystic fibrosis patient) only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Cystic fibrosis; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Initial application - (Oral feed for indications other than cystic fibrosis) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 any condition causing malabsorption; or 1.2 failure to thrive; or 1.3 increased nutritional requirements; and 2 Either: 2.1 The product is to be used as a supplement; or 2.2 The product is to be used as a complete diet.Renewal - (Oral feed cystic fibrosis patient) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years f
Special Authority for Subsidy - Form SA0703Initial application only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 Patient has raised blood pressure; and 2 The use of fully funded beta blockers is contraindicated, or not well tolerated; or where use of fully funded beta blockers and diuretics are insufficient to control blood pressure adequately at appropriate doses; and 3 Either: 3.1 Has been treated with, and cannot tolerate two ACE inhibitors, due to persistent cough; or 3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal only from a relevant specialist or general practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0706Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Both: 1.1 Patient with congestive heart failure; and 1.2 Either: 1.2.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 1.2.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years; or 2 All of the following: 2.1 Patient with raised blood pressure; and 2.2 Use of fully funded beta blockers or diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 2.3 Either: 2.3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 2.3.2 Has experienced angioedema on an ACE in
Effective, consistent management of herpes from prescribing to these guidelines will improve patient outcomes. The guidelines on the following four pages are for the prescribing of aciclovir. The guidelines aim to: - improve patient care and clinical outcome through faster, more accessible treatment - protect patients' wider wellbeing by reinforcing the psychosocial aspects of treatment - improve the consistency and breadth of medical management of genital herpes in New Zealand. The guidelines are: - integral to ensuring a consistent, effective treatment regimen- the result of consultation with clinicians and patient representatives- set out in line with the recommended international algorithm format for treatment. The guidelines are endorsed by the Herpes Foundation's professional advisory board whose members represent venereology, NZDS, RNZCGP, RNZCOG, psychotherapy and nursing. Herpes Foundation Helpline: Toll free 0508 11 12 13Auckland Branch Herpes Foundation: 09 360 1966
Guidelines for the use of interferon in the treatment of hepatitis C: Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or aninfectious disease physician. All subjects undergoing treatment require careful monitoring for side effects. Patients should be otherwise fit. Hepatocellular carcinoma should be excluded by ultrasound examination and alpha-fetoprotein level. Criteria for Treatment a) Diagnosis- Anti-HCV positive on at least two occasions with a positive PCR for HCV-RNA and preferably confirmed by asupplementary RIBA test; or- PCR-RNA positive for HCV on at least 2 occasions if antibody negative; or- Anti-HCV positive on at least two occasions with a positive supplementary RIBA test with a negative PCR forHCV RNA but with a liver biopsy consistent with 2(b) following. b) Establishing Active Chronic Liver Disease- Confirmed HCV infection and serum ALT/AST levels measured on at least three occasions over six monthsaveraging >
Special Authority for Subsidy - Form SA0710Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 Monotherapy in primary open-angle glaucoma; or 1.2 Adjunctive use for the treatment of open-angle glaucoma in a patient who has met the initial application criteria, and in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure; and 2 Any of the following: 2.1 Patient cannot tolerate beta-blockers, pilocarpine, and carbonic anhydrase inhibitors; or 2.2 Beta-blockers, pilocarpine and carbonic anhydrase inhibitors are contraindicated; or 2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using carbonic anhydrase inhibitor either alone or in combination with a beta blocker; or 2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with carbonic anhydrase inhibitor either alo
Special Authority for Subsidy - Form SA0713Initial application from any specialist. Approvals valid for 11 months for applications meeting the following criteria: Either: 1 Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or 2 Patient has chronic hepatitis C, genotype 2 or 3 infection with bridging fibrosis or cirrhosis (Metavir stage 3 or 4, or equivalent).
Special Authority for Subsidy - Form SA0714Initial application from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: All of the following: 1 Patient is currently enrolled in a recognised comprehensive treatment programme for alcohol dependence in a service accredited against the New Zealand Alcohol and Other Drug Sector Standard or the National Mental Health Sector Standard; and 2 Applicant works in an Alcohol & Drug Service; and 3 Applicant must include the address of the service (Details to be attached to application). Renewal from any medical practitioner. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Compliance with the medication (prescriber determined); and 2 Any of the following: 2.1 Patient is still unstable and requires further treatment; or 2.2 Patient achieved significant improvement but requires further treatment; or 2.3 Patient is well controlled but requires maint
Prescribing GuidelinesTrusopt, Cosopt and Azopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Trusopt, Cosopt and Azopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: a) that person has previously trialled all other such subsidised agents (except brimonidine tartrate); andb) those trials have indicated that that person does not respond adequately to treatment with those other agents.
Prescribing GuidelineTreatment with HMG CoA Reductase Inhibitors (statins) is recommended for patients with dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater.
Special Authority for Manufacturers Price - Form SA0717Initial application only from a relevant specialist or general practitioner. Approvals valid for 12 weeks for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin; or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.3 LDL cholesterol test 2 >= 2.5 mmol/litre (at least 1 w
Special Authority for Subsidy - Form SA0721Initial application only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 The patient already has a Special Authority approval for anti-retroviral therapy (Details to be attached to application); and 2 Kaletra is to be used as a salvage therapy in place of one protease inhibitor; and 3 The patient must have trialed for at least six months and have failed on currently funded NNRTI based regimens or triple NRTI regimens; and 4 The patient must have trialed for at least six months and have failed on currently funded PI based regimens. NoteFailure is defined as: a) not achieving HIV RNA < 400 copies/ml after 24 weeks of a regimen, orb) an increase of HIV RNA to > 400 copies/ml on two separate occasions not less than one month apart, after suppression to < 400 copies/ml in a patient taking the regimen.
Special Authority for Subsidy - Form SA0722Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Gluten enteropathy has been diagnosed by biopsy; or 2 Patient suffers from dermatitis herpetiformis.
Special Authority for Subsidy - Form SA0723Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 1.2 Patient cannot tolerate statin therapy at a dose of 40 mg per day; and 1.3 Either: 1.3.1 All of the following: 1.3.1.1 Patient has venous CABG; and 1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 1.3.2 All of the following: 1.3.2.1 Patient does not have venous CABG; and 1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 1.3.2.3 LDL cholesterol >= 2.5 mmol/litre (at least 1 week after test 1 - see note); or 2 All of the following: 2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholesterol
Special Authority for Manufacturers Price - Form SA0724Initial application only from a relevant specialist or general practitioner. Approvals valid for 12 weeks for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin (blood tests are not required); or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.3 LDL cholesterol test 2 >
Special Authority for Subsidy - Form SA0725Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient with raised blood pressure; and 2 Use of fully funded beta blockers and diuretics are contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and 3 Either: 3.1 Has been treated with, and cannot tolerate, two ACE inhibitors, due to persistent cough; or 3.2 Has experienced angioedema on an ACE inhibitor at any time in the past or who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. Renewal - (Previous approval has expired) only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0727Initial application from any medical practitioner. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Control of intractable nausea, vomiting, or inability to swallow saliva in the treatment of malignancy or chronic disease; and 2 Patient cannot tolerate or does not adequately respond to oral anti-nausea agents; and 3 The applicant must specify the underlying malignancy or chronic disease (Details to be attached to application). Renewal from any medical practitioner. Approvals valid for 1 year where the treatment remains appropriate and the patient is benefiting from treatment.
Retail pharmacy - subsidy by endorsement a) Subsidised for:(i) patients presenting with first episode schizophrenia or related psychoses, or manic episodes associated with bipolar disorder; and(ii) patients suffering from schizophrenia or related psychoses, or manic episodes associated with bipolar disorder, after a trial of an effective dose of risperidone that has been discontinued because of unacceptable side effects or inadequate response. b) Initial prescription must be written by a relevant specialist. c) Subsequent prescriptions may be written by a general practitioner. d) The prescription must be endorsed "certified condition".
Only in extemporaneously compounded methadone mixture, codeine linctus diabetic or codeine linctus paediatric or phenobarbitone oral liquid
Special Authority for Subsidy - Form SA0732Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Either: 1 dietary management of homocystinuria; or 2 dietary management of maple syrup urine disease. Renewal only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2 General Practitioners must include the name of the specialist and date contacted.
Special Authority for Subsidy - Form SA0733Initial application - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 dietary management of PKU; and 2 blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Initial application - (Patient aged 16 or under) only from a relevant specialist. Approvals valid for 3 years where dietary management of PKU.Renewal - (Patient aged over 16) only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: blood phenylalanine level < 900 mmol/litre (average of tests over last 12 months). Renewal - (Patient aged 16 or under) only from a relevant specialist or general practitioner on the recommendation of such a specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 The treatment remains appropriate and the patient is benefiting from treatment; and 2
GuidelinesIt can cost up to $70,000 a year to keep an adult on protein supplements. Because protein substitutes are so expensive and because they are only effective in controlling PKU if a restricted diet is followed, adults with PKU will be required to demonstrate they are following the prescribed diet by regular blood testing. The requirement for testing applies to those aged over 16 years. Failure to follow an appropriate diet results in high blood phenylalanine levels. Those consistently testing above 15 mg (900 micromol) over a twelve month period will not be able to claim these products as a Special Authority. Specialists will be required to renew applications for their PKU patients every year and, when they do so, will have to submit the results of two blood tests.
Neocate should be used only as a last resort when the infant is unable to absorb any of the above formulae. The objective with each of thees formulae prescribed is to get the infant off them as soon as possible. This may take six months, it may take three years. Because of this, variation on age limit is not regarded as appropriate.These formulae will be available only from a hospital pharmacy. Vivonex Pediatric may be a suitable and less expensive alternative for many children that would otherwise be eligible for a subsidy for Neocate and should, therefore, be tried first in these cases. The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products.
Special Authority for Subsidy - Form SA0738Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 All of the following: 1.1 To be used as monotherapy for patients with type 2 diabetes who after six months of diet and lifestyle changes do not have adequate glycaemic control (inadequate control defined as HbA1c > 8.0% in tests carried out at least two months apart); and 1.2 Metformin is not tolerated or contraindicated. Intolerance and contraindications as defined in the notes below, a minimum of a four week trial period of metformin is required; and 1.3 Sulphonylurea is not tolerated or contraindicated. Overweight patients are only eligible under the criteria of contraindication to sulphonylureas if their body mass index (BMI) exceeds 35; or 2 Both: 2.1 For use in combination with a sulphonylurea when diet and lifestyle changes and a twelve month trial of sulphonylurea results in inadequate glycaem
Prescribing GuidelineHRT should be taken at the lowest dose for the shortest period of time necessary to control symptoms. Patients should be reviewed 6 monthly in line with the updated NZGG "Evidence-based Best Practice Guideline on Hormone Replacement Therapy March 2004".
Special Authority for Subsidy - Form SA0741Initial application only from a psychiatrist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Patient with first episode schizophrenia or related psychoses; or 2 Both: 2.1 Patient suffering from schizophrenia and related psychoses; or acute mania in bipolar disorder who is likely to benefit from anti-psychotic treatment; and 2.2 Either: 2.2.1 An effective dose of risperidone had been trialled and has been discontinued because of unacceptable side effects; or 2.2.2 An effective dose of risperidone had been trialled and has been discontinued because of inadequate clinical response after 4 weeks; or 3 The patient has suffered from an acute episode of schizophrenia or bipolar mania and has been treated with olanzapine short-acting intra-muscular injection. Renewal only from a psychiatrist. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefit
Special Authority for Subsidy - Form SA0742Initial application - (genotype 1, 4, 5 or 6 infection) from any specialist. Approvals valid for 11 months where patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection. Initial application - (genotype 2 or 3 infection) from any specialist. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Patient has chronic hepatitis C, genotype 2 or 3 infection; and 2 Patient has bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent).
Special Authority for Subsidy - Form SA0743Initial application only from a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is terminally ill and is opioid-responsive; and 2 Either: 2.1 is unable to take oral medication; or 2.2 is intolerant to morphine, or morphine is contraindicated..Renewal only from a relevant specialist or general practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment.
Additional subsidy by endorsement for:Citalopram tab 20 mg x 28 (Celapram) up to $4.00Citalopram tab 20 mg x 28 (Cipramil) up to $10.00Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking citalopram on 1 February 2000; or paroxetine hydrochloride on February 2001; or- have previously responded to treatment with citalopram or paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
Special Authority for Subsidy - Form SA0750Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where continuation of previous therapy.
(a) Subsidy is available between 1 March and 30 June of each year for patients who meet the following criteria, as set by the Ministry of Health: a) all people 65 years of age and over; b) people under 65 years of age with: i) the following cardiovascular disease: 1) ischaemic heart disease, 2) congestive heart disease, 3) rheumatic heart disease, 4) congenital heart disease, or 5) cerebo-vascular disease; ii) the following chronic respiratory disease: 1) asthma, if on a regular preventative therapy, or 2) other chronic respiratory disease with impaired lung function; iii) diabetes; iv) chronic renal disease; v) any cancer, excluding basal and squamous skin cancers if not invasive; vi) the following other conditions: 1) autoimmune disease, 2) immune suppression, 3) HIV, 4) transplant recipients, 5) neuromuscular and CNS diseases, 6) haemoglobinopathies, or 7) children on long term aspirin. The following conditions are excluded from funding: i) asthma not requiri
Special Authority for Manufacturers Price - Form SA0753Initial application only from a relevant specialist. Approvals valid for 3 years for applications meeting the following criteria: Both: 1 Patient is a postmenopausal women; and 2 Patient has hormone receptor positive advanced breast cancer (Stage IIIb, or metastatic Stage IV). Renewal only from a relevant specialist. Approvals valid for 3 years where the treatment remains appropriate and the patient is benefiting from treatment.
Pharmacies cannot claim subsidy because PHARMAC has made alternative distribution arrangements.
Special Authority for Subsidy - Form SA0757Initial application only from a relevant specialist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient is less than 2 years of age; and 2 Intolerant to cows' milk; and 3 Diagnosed as suffering from congenital lactase deficiency. Renewal only from a relevant specialist. Approvals valid for 6 months where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form SA0758Initial application only from a general practitioner or relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1 To be used for the long-term maintenance treatment of bronchospasm and dyspnoea associated with COPD; and 2 In addition to standard treatment, the patient has trialled a dose of at least 40 mcg ipratropium q.i.d; and 3 The patient's breathlessness >= grade 4 according to the Medical Research Council dyspnoea scale (see note); and 4 FEV1 (litres) < 0.4 x predicted (litres); and 5 Either: 5.1 Patient is not a smoker (for reporting purposes only); or 5.2 Patient is a smoker and been offered smoking cessation councilling; and 6 The patient has been offered annual influenza immunisation. Renewal only from a general practitioner or relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: All of the following: 1
a) Prescribers may code prescriptions "contraceptive" (code "O") when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - prescription may be written for up to six months supply. b) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the non-contraceptive period of supply. ie. Prescriptions may be written for up to three months supply.
Subject to budgetary cap. Applications will be considered and approved subject to funding availability.
A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005. Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly.
Retail pharmacy - specialist prescriptionPrescriptions must be written by a gastroenterologist
The number of test strips available on a prescription is restricted to 50 unless: a) Prescribed with insulin or a sulphonylurea but are on a different prescription and the prescription is endorsed accordingly; orb) Prescribed on the same prescription as insulin or a sulphonylurea in which case the prescription is deemed to be endorsed; orc) Prescribed for a pregnant woman with diabetes and endorsed accordingly.
Special Authority for Subsidy - Form SA0772Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and 1.1.2 HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; and 1.1.3 ALT greater than twice upper limit of normal or stage 3 or 4 fibrosis on liver histology clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or 1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; or 1.4 Hepatitis B surface antigen positive (HbsAg) patient who is receiving chemotherapy for a malignancy, or who has received such treatment within the previous two months; and 2 All of the following: 2.1 No continuing
Additional subsidy by endorsement for:Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02is available for patients who: -were taking paroxetine hydrochloride on February 2001; or- have previously responded to treatment with paroxetinehydrochloride; or- have had a trial of fluoxetine and have had to discontinue due to- inability to tolerate the drug due to side effects; or- failed to respond to an adequate dose and duration of treatment; or- have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions). The prescription must be endorsed accordingly.
Special Authority for Subsidy - Form SA0774Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has advanced gastrointestinal malignancy; or 2 The patient has metastatic breast cancer*; or 3 Both: 3.1 The patient has poor venous access or needle phobia*; and 3.2 The patient requires a substitute for single agent fluoropyrimidine*. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment. Noteindications marked with * are unapproved indications.
Special Authority for Subsidy - Form SA0775Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastatic colorectal cancer; and 2 Either: 2.1 To be used for first or second line use as part of a combination chemotherapy regimen; or 2.2 As single agent chemotherapy in fluropyrimidine-relapsed disease. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient requires continued therapy; or 2 The tumour has relapsed and requires re-treatment.
Special Authority for Subsidy - Form SA0776Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but has not previously been treated with taxanes; or 2 The patient has metastatic breast cancer; or 3 Both: 3.1 The patient has non-small cell lung cancer; and 3.2 Either: 3.2.1 The patient has advanced disease (stage IIIa or above); or 3.2.2 The patient is receiving combined chemotherapy and radiotherapy; or 4 Both: 4.1 The patient has small-cell lung cancer*; and 4.2 Paclitaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has metastati
Special Authority for Subsidy - Form SA0777Initial application - (Post-transplant) only from a relevant specialist. Approvals valid for 6 months where the patient has B-cell post-transplant lymphoproliferative disorder*. NoteFor no more than 8 treatment cycles. Initial application - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for 6 months where the patient has low grade NHL - relapsed disease following prior chemotherapy. NoteFor no more than 4 treatment cycles. Initial application - (Large cell lymphomas) only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has treatment naive large B-cell NHL; and 2 To be used with CHOP (or alternative anthracycline containing multi-agent chemotherapy regime given with curative intent).NoteFor no more than 8 treatment cycles. Renewal - (Low-grade lymphomas) only from a relevant specialist. Approvals valid for 6 months for applications meeting
Special Authority for Subsidy - Form SA0779Initial application - (Confirmed HIV/AIDS) only from a named specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Confirmed HIV infection; and 2 Any of the following: 2.1 Symptomatic patient; or 2.2 Patient aged 12 months and under; or 2.3 Both: 2.3.1 Patient aged 1 to 5 years; and 2.3.2 Any of the following: 2.3.2.1 CD4 counts < 1,000 cells/mm3; or 2.3.2.2 CD4 counts < 0.25 x total lymphocyte count; or 2.3.2.3 Viral load counts > 100,000 copies per ml; or 2.4 Both: 2.4.1 Patient aged 6 years and over; and 2.4.2 CD4 counts < 350 cells/mm3. NoteTenofovir disoproxil fumarate prescribed under endorsement for HIV/AIDS is included in the count of up to 3 subsidised antiretrovirals. Subsidies for a combination of up to three anti-retroviral medications, including a maximum of two protease inhibitors. Combinations including r
Special Authority for Subsidy - Form: SA0781Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Any of the following: Monotherapy1 All of the following: 1.1 To be used as monotherapy for patients with type 2 diabetes who after six months of diet and lifestyle changes do not have adequate glycaemic control (inadequate control defined as HbA1c > 7.0% in tests carried out at least two months apart); and 1.2 Metformin is not tolerated or contraindicated. Intolerance and contraindications as defined in the notes below, a minimum of a four week trial period of metformin is required; and 1.3 Sulphonylurea is not tolerated or contraindicated. Obesity is only eligible under the criteria of contraindication to sulphonylureas if the patient's body mass index (BMI) exceeds 33 , intolerance as defined in the notes below; orIn combination with sulphonylurea2 Both: 2.1 For use in combination with a sulphonylure
Special Authority for Manufacturers Price - Form: SA0783Initial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal women; and2 Patient has hormone receptor positive advanced breast cancer; and3 Any of the following: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.2 The patient has a very clear history of intolerance to tamoxifen; or 3.3 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for Subsidy - Form: SA0784Initial application from any specialist. Approvals valid for 12 months where patient has chronic hepatitis C (all genotypes).
Prescribing GuidelinePrescribers should note that oxycodone is significantly more expensive than long-acting morphine sulphate and clinical advice suggests that it is reasonable to consider this as a second-line agent to be used after morphine.
Special Authority for Manufacturers Price - Form SA0788Initial application only from a relevant specialist or general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Both: 1 Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 years; and 2 Either: 2.1 Patient has severe documented intolerance to simvastatin (blood tests are not required); or 2.2 Both: 2.2.1 Patient has been compliant with a dose of simvastatin of 80 mg per day for at least 2 months; and 2.2.2 Either: 2.2.2.1 All of the following: 2.2.2.1.1 Patient has venous CABG; and 2.2.2.1.2 LDL cholesterol test 1 >= 2.0 mmol/litre; and 2.2.2.1.3 LDL cholesterol test 2 >= 2.0 mmol/litre (at least 1 week after test 1); or 2.2.2.2 All of the following: 2.2.2.2.1 Patient does not have venous CABG; and 2.2.2.2.2 LDL cholesterol test 1 >= 2.5 mmol/litre; and 2.2.2.2.
Special Authority for Subsidy - Form SA0789Initial application only from a relevant specialist or vocationally registered general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 The patient has "treatment resistant" depression; and 2 Either: 2.1 The patient must have had a trial of two different antidepressants and failed to respond to an adequate dose over an adequate period of time (usually at least four weeks); or 2.2 Both: 2.2.1 The patient is currently a hospital in-patient as a result of an acute depressive episode; and 2.2.2 The patient must have had a trial of one other antidepressant and failed to respond to an adequate dose over an adequate period of time. Renewal from any medical practitioner. Approvals valid for 2 years where patient has a high risk of relapse (prescriber determined).
Prescribing GuidelineBimatoprost, lantanoprost and travoprost are subsidised for use in the treatment of glaucoma as either monotherapy or as an adjunctive agent for patients in whom prostaglandin analogue monotherapy has been ineffective in controlling intraocular pressure.Bimatoprost, lantanoprost and travoprost should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: 1 That person has previously trialled all other such subsidised agents (beta-blockers, pilocarpine, carbonic anhydrase inhibitors); and2 Those trials have indicated that that person does not respond adequately to treatment with those other agents.
Mycophenolate powder for oral liquid is subsidised only for patients unable to swallow tablets and capsules, and when the prescription is endorsed accordingly.
Special Authority for Subsidy - Form: SA0792Initial application only from a psychiatrist. Approvals valid for 6 months for applications meeting the following criteria: All of the following: 1 The patient has schizophrenia or other psychotic disorder; and2 Has tried but failed to comply with treatment using oral atypical anti-psychotic agents; and3 Has been admitted to hospital or treated in respite care, or intensive outpatient or home-based treatment for 30 days or more in last 12 months. Renewal only from a psychiatrist. Approvals valid for 12 months for applications meeting the following criteria: Either: 4 Both: 4.1 The patient has had less than 12 months treatment with risperidone microspheres; and 4.2 There is no clinical reason to discontinue treatment; or5 The initiation of risperidone microspheres has been associated with fewer days of intensive intervention than was the case during a corresponding period of time prior to the initiation of risperidone microspheres. NoteRisp
a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; orb) for the treatment of confirmed ciprofloxacin-resistant gonorrhoea; orc) for the treatment of suspected meningitis in patients who have a known allergy to penicillin; andd) the prescription is endorsed accordingly
Special Authority for Subsidy - Form: SA0796Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1.1 ezetimibe is to be used in combination with simvastatin; or 1.2 ezetimibe is to be used without a statin; and2 Either: 2.1 All of the following: 2.1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 2.1.2 Patient cannot tolerate statin therapy at a dose of 40 mg per day; and 2.1.3 Either: 2.1.3.1 All of the following: 2.1.3.1.1 Patient has venous CABG; and 2.1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 2.1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 2.1.3.2 All of the following: 2.1.3.2.1 Patient does not have venous CABG; and 2.1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 2.1.3.2.3 LDL cholest
Special Authority for Subsidy - Form: SA0797Initial application - (Underlying cause - Osteoporosis) only from a relevant specialist or vocationally registered general practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria: Any of the following: 1 History of one significant osteoporotic fracture demonstrated radiologically and documented bone mass density (BMD) >= 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score <= -2.5); or2 History of one significant osteoporotic fracture demonstrated radiologically and the patient is either over 75 years of age or is too frail* to undergo a bone mass density scan; or3 History of two significant osteoporotic fractures demonstrated radiologically; or4 Documented T-Score <= -3.0. Note*The patient may be considered to be frail if it is expected that there is significant risk of further fracture or other negative health outcome if the patient were to undergo a BMD s
Special Authority for Subsidy - Form: SA0798Initial application only from a relevant specialist. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Renal transplant recipient; or2 Heart transplant recipient. or; 3 Patient has an organ transplant and has severe tophaceous gout making azathioprine unsuitableRenewal only from a relevant specialist. Approvals valid without further renewal unless notified where patient had a previous Special Authority approval and was receiving mycophenolate prior to 1 October 2005
Special Authority for Subsidy - Form: SA0799Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 1 The patient has metastatic breast cancer; or2 The patient has non-small cell lung cancer (stage IIIa, or above).Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Either: 3 The patient requires continued therapy; or4 The tumour has relapsed and requires re-treatment.
Special Authority for Subsidy - Form SA0801Initial application - (Serevent Accuhaler, Foradil, Symbicort Turbuhaler) only from a relevant specialist or general practitioner. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Child under the age of 12 with poorly controlled asthma; and 1.2 Either: 1.2.1 Required at least three months of 400 mcg or more daily inhaled beclomethasone or budesonide; or 1.2.2 Required at least three months of 200 mcg or more of fluticasone; or 2 Both: 2.1 Adult with poorly controlled asthma; and 2.2 Either: 2.2.1 Required at least three months of 1500 mcg or more daily inhaled beclomethasone or budesonide; or 2.2.2 Required at least three months of 750 mcg or more of fluticasone. NotePatients are to be reviewed at least at six months to assess compliance and effectiveness of therapy. Special Authority approvals are interchangeable among all presentations of inhaled long-acting beta
Special Authority for Subsidy - Form SA0802Initial application - (genotype 1, 4, 5 or 6 infection or co-infection with HIV) from any specialist. Approvals valid for 11 months for applications meeting the following criteria: 1. Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or2. Patient has chronic hepatitis C and is co-infected with HIV. Note: consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure.Initial application - (genotype 2 or 3 infection without co-infection with HIV) from any specialist. Approvals valid for 6 months for applications meeting the following criteria: 3. Patient has chronic hepatitis C, genotype 2 or 3 infection; andEither: 3.1 Patient has bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent); or 3.2 is unsuitable for liver biopsy due to coagulopathy.
Special Authority for Subsidy - Form SA0803Initial application from any specialist. Approvals valid for 11 months for applications meeting the following criteria: either: 1 Patient has chronic hepatitis C, genotype 1, 4, 5 or 6 infection; or2 Patient has chronic hepatitis C, genotype 2 or 3 infection; and 2.1 With has bridging fibrosis or cirrhosis (Metavir stage 3 or 4, or equivalent). 2.2 is unsuitable for liver biopsy due to coagulopathy. Note: consider stopping treatment if there is absence of a virological response (defined as at least a 2-log reduction in viral load) following 12 weeks of treatment since this is predictive of treatment failure.
Prescribing Guideline for Inhaled Long-Acting Beta-Adrenoceptor AgonistsThe addition of inhaled long-acting beta-adrenoceptor agonists (LABAs) to inhaled corticosteroids is recommended: - For younger children (aged under 12 years) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 200 mcg beclomethasone or budesonide (or 100 mcg fluticasone).- For adults and older children (aged 12 years and over) where asthma is poorly controlled despite using inhaled corticosteroids for at least three months at total daily doses of 400 mcg beclomethasone or budesonide (or 200 mcg fluticasone).Note: Further information on the place of inhaled corticosteroids and inhaled LABAs in the management of asthma can be found in the New Zealand guidelines for asthma in adults (www.nzgg.org.nz) and in the New Zealand guidelines for asthma in children aged 1-15 (www.paediatrics.org.nz).
Access by applicationa) Budget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC). b) Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below). c) Applications to be made on the approved forms which are available from the co-ordinator for MSTAC:The Co-ordinator Phone: (04) 460 4990Multiple Sclerosis Treatment Assessments Committee Facsimile: (04) 916 7571PHARMAC, PO Box 10 254 E mail: silvia.valsenti@pharmac.govt.nzWellingtond) Completed application forms must be sent to the co-ordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity. e) Notification of MSTAC's decision will be sent to the patient, the applying clinician and the patient's GP (if specified). f) These agents will not be subsidised if dispensed from a community or hospital pharmacy. Regular supplies will be distributed to all approved patients or their c
a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; orb) for the treatment of confirmed ciprofloxacin-resistant gonorrhoea; orc) for the treatment of suspected meningitis in patients who have a known allergy to penicillin; andd) the prescription or PSO is endorsed accordingly
subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly.
Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 1 The patient has metastatic colorectal cancer; and2 To be used for first or second line use as part of a combination chemotherapy regimen. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 3 The patient requires continued therapy; or4 The tumour has relapsed and requires re-treatment.
Special Authority for Subsidy - Form: SA0809Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian*, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but has not previously been treated with taxanes; or2 The patient has metastatic breast cancer; or3 Both: 3.1 The patient has non small-cell lung cancer; and 3.2 Either: 3.2.1 Has advanced disease (stage IIIa or above); or 3.2.2 Is receiving combined chemotherapy and radiotherapy; or4 Both: 4.1 The patient has small-cell lung cancer*; and 4.2 Docetaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the followingcriteria: 5. The patient has metastatic breast cancer, non small-cell lung cancer,
Special Authority for Alternate SubsidyInitial application only from a relevant specialist. Approvals valid for 5 years for applications meeting the following criteria: All of the following: 1 Patient is a postmenopausal women; and2 Patient has hormone receptor positive breast cancer; and3 Any of the following: 3.1 The cancer is advanced (Stage IIIb, or metastatic Stage IV); or 3.2 The patient has a very clear history of intolerance to tamoxifen; or 3.3 The use of tamoxifen is contraindicated due to a history of thromboembolic disease. Renewal only from a relevant specialist. Approvals valid without further renewal unless notified where the treatment remains appropriate and the patient is benefiting from treatment.
Special Authority for SubsidyInitial application only from a rheumatologist. Approvals valid for 6 months for applications meeting the following criteria: All of the following1 Patient is an adult who has had severe and active erosive Rheumatoid Arthritis for six months duration or longer; and2 Treatment is to be used as an adjunct to methotrexate therapy or monotherapy where use of methotrexate is limited by toxicity or intolerance; and3 Patient has tried and not responded to at least three months of oral or parenteral methotrexate at a dose of at least 20 mg weekly or a maximum tolerated dose; and4 Patient has tried and not responded to at least three months of oral or parenteral methotrexate in combination with at least two of the following (triple therapy): sulphasalazine, prednisone at a dose of at least 7.5 mg per day, azathioprine, intramuscular gold, or hydroxychloroquine sulphate (at maximum tolerated doses); and5 Patient has tried and not responded to at least three months therapy at th
Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or2 The patient has advanced malignant mesothelioma*; or3 The patient has advanced pancreatic carcinoma; or4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 5 The patient requires continued therapy; or6 The tumour has relapsed and requires re-treatment. Note indications marked with a * are unapproved indications.
Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has primary thrombocythaemia; and2 Either 2.1 is at high risk (previous thromboembolic disease, bleeding or platelet count >1500/ml); or 2.2 is intolerant or refractory to hydroxyurea or interferon. Renewal only from a relevant specialist. Approvals valid for 12 months where the treatment remains appropriate and the patient is benefiting from treatment. NoteIt is recommended that treatment with anagrelide be initiated only on the recommendation of a haematologist.
Special Authority for Subsidy Initial application - (for new patients) only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 1 The patient has refractory, progressive or relapsed multiple myeloma; and2 The patient has received prior chemotherapy. Initial application - (for patients receiving thalidomide prior to 1 January 2006) only from a relevant specialist. Approvals valid without further renewal where the patient was receiving treatment with thalidomide for multiple myeloma on or before 31 December 2005. Renewal only from a relevant specialist. Approvals valid without further renewal where the patient has obtained a response from treatment during the initial approval period. Note: Prescription must be written by registered prescriber in the thalidomide risk management programme operated by the supplier. Maximum dose of 400 mg daily as monotherapy or in a combination therapy regimen.
Special Authority for Subsidy Initial application for patients with type 2 diabetes only from a relevant specialist. Approvals valid for one year for applications meeting the following criteria: Any of the following: Monotherapy1 All of the following: 1.1 To be used as monotherapy for patients who after six months of diet and lifestyle changes have inadequate glycaemic control (defined as HbA1c > 7.0% in tests carried out at least two months apart); and 1.2 Metformin is contraindicated or not tolerated after a minimum of a four week trial period; and 1.3 Sulphonylurea is contraindicated or not tolerated or the patient's body mass index (BMI) exceeds 33 kg/m2; orIn combination with sulphonylurea2 Both: 2.1 For use in combination with a sulphonylurea for patients who after diet and lifestyle changes and a six-month trial of sulphonylurea have poor glycaemic control (defined as HbA1c > 8.0% measured within the last month of the six month period); and 2.2 Metformin is contrain
Prescribing GuidelineCombigan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Combigan should only be prescribed when: a) less expensive first line agents for the treatment of glaucoma are contraindicated; orb) the response to such subsidised agents is inadequate; orc) the patient cannot tolerate such subsidised agents.
Perindopril and trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are "certified condition" or an appropriate description of the patient such as "congestive heart failure", "CHF", "congestive cardiac failure" or "CCF". Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer's surcharge: "Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considere
Special Authority for Subsidy - Form: SA0826Initial application only from a relevant specialist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 All of the following: 1.1 Patient has a calculated absolute risk of cardiovascular disease >20% over 5 years; and 1.2 Patient cannot tolerate statin therapy at a dose of >= 40 mg per day; and 1.3 Either: 1.3.1 All of the following: 1.3.1.1 Patient has venous CABG; and 1.3.1.2 LDL cholesterol >= 2.0 mmol/litre (see note); and 1.3.1.3 LDL cholesterol >= 2.0 mmol/litre (at least 1 week after test 1 - see note); or 1.3.2 All of the following: 1.3.2.1 Patient does not have venous CABG; and 1.3.2.2 LDL cholesterol >= 2.5 mmol/litre (see note); and 1.3.2.3 LDL cholesterol >= 2.5 mmol/litre (at least 1 week after test 1 - see note); or2 All of the following: 2.1 Patient has homozygous familial hypercholesterolemia, or heterozygous familial hypercholest
Subsidy by endorsement: a. Only if prescribed for post-herpetic neuralgia or diabetic peripheral neuropathy; andb. The prescription is endorsed accordingly.
Special Authority for Subsidy - Retail Pharmacy - Form SA0829Initial Application only from gastroenterologist or infectious disease specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1. Patient has confirmed Hepatitis B infection (HBsAg+); andDocumented resistance to lamivudine, defined as: 2. patient has raised serum ALT (> 1 x ULN); and3. patient has HBV DNA greater than 100,000 copies per mL, or viral load ? 10 fold over nadir; and4. detection of M204I or M204V mutation; and5. Either 5.1. Both5.1.1. patient is cirrhotic; and5.1.2. adefovir dipivoxil to be used in combination with lamivudine; or5.2. Both5.2.1. patient is not cirrhotic; and5.2.2. adefovir dipivoxil to be used as monotherapyRenewal only from a gastroenterologist or infectious disease specialist. Approvals valid for 2 years for applications where in the opinion of the treating physician, treatment remains appropriate and patient is benefiting from treatmen
Special Authority for Subsidy - Form: SA0831Application only from a relevant specialist. Approvals valid for 10 months for applications meeting the following criteria: 1. Patient has newly diagnosed glioblastoma multiforme; and2. Temozolomide is to be (or has been) given concomitantly with radiotherapy; and3. Following concomitant treatment temozolomide is to be used for a maximum of six cycles of 5 days treatment, at a maximum dose of 200 mg/m2. Note: Temozolomide is not subsidised for the treatment of relapsed glioblastoma multiforme. Studies of temozolomide show that its benefit is predominantly in those patients with a good performance status (WHO grade 0 or 1 or Karnofsky score >80), and in patients who have had at least a partial resection of the tumour.
Special Authority for Subsidy - Form: SA0832Initial application only from a gastroenterologist, infectious disease specialist, paediatrician or general physician. Approvals valid for 1 year for applications meeting the following criteria: Both: 1 Any of the following: 1.1 All of the following: 1.1.1 HBsAg positive for more than 6 months; and1.1.2 HBeAg positive or HBV DNA positive defined as > 100,000 copies per ml by quantitative PCR at a reference laboratory; and1.1.3 ALT greater than twice upper limit of normal or bridging fibrosis or cirrhosis (Metavir stage 3 or 4 or equivalent) on liver histology or clinical/radiological evidence of cirrhosis; or 1.2 HBV DNA positive cirrhosis prior to liver transplantation; or1.3 HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant; or1.4 Hepatitis B surface antigen positive (HbsAg) patient who is receiving chemotherapy for a malignancy, or who has received such treatment within the previous two months;
Special Authority for Subsidy - Form SA0833Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or2 The patient has advanced malignant mesothelioma*; or3 The patient has advanced pancreatic carcinoma; or4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*; or5 The patient has advanced transitional cell carcinoma of the urothelial tract (locally advanced or metastatic). Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 6 The patient requires continued therapy; or7 The tumour has relapsed and requires re-treatment. Note indications marked with a * are unapproved indications.
Special Authority for Subsidy - Form: SA0834Initial application only from a relevant specialist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Both: 1.1 Patient has type 1 diabetes and has received an intensive regimen (injections at least three times a day) of an intermediate acting insulin in combination with a rapid acting insulin analogue for at least three months; and1.2 Either: 1.2.1 Patient has experienced more than one unexplained severe hypoglycaemic episode in the previous 12 months (severe defined as requiring the assistance of another person); or1.2.2 Patient has experienced unexplained symptomatic nocturnal hypoglycaemia, biochemically documented at <3.0 mmol/L, more than once a month despite optimal management; or2 Patient has documented severe, or continuing, systemic or local allergic reaction to existing insulins. Note this does not include hypoglycaemic episodes. Renewal only from a relevant specialist or general practitioner. Approv
Special Authority for Subsidy - Form SA0835Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year: where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Advanced prostatic cancer;. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis; and2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note The maximum treatment period for a GnRH analogue is:
Special Authority for Subsidy - Form SA0836Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or. 2 Locally advanced prostatic cancer. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 3 Endometriosis; and4 Either: 4.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or4.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note
Special Authority for Subsidy - Form SA0837Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year where the patient has: Advanced prostatic cancer;. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Endometriosis; and2 Either: 2.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or2.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazol or dimetriose for 6 months. Note The maximum treatment period for a GnRH analogue is: - 3 months to assess whet
Special Authority for Subsidy - Form: SA0838Initial Application only from a relevant specialist or General Practitioner. Approvals valid for 2 years forapplications meeting the following criteria: Either: 1 All of the following: 1.1 Patient is a child under the age of 12; and1.2 All of the following: Has, for 3 months or more, been treated with:1.2.1 An inhaled long-acting beta adrenoceptor agonist; and1.2.2 Inhaled corticosteroids at a dose of at least 400 mcg per day beclomethasone or budesonide, or200 mcg per day fluticasone; and1.3 The prescriber considers that the patient would receive additional clinical benefit from switching to acombination product; or2 All of the following: 2 .1 Patient is over the age of 12; and2 .2 All of the following: Has, for 3 months or more, been treated with:2 .2.1 An inhaled long-acting beta adrenoceptor agonist; and2 .2.2 Inhaled corticosteroids at a dose of at least 800 mcg per day beclomethasone or budesonide, or500 mcg per day fluticasone;
Special Authority for Subsidy - Form SA0839Initial application - (Breast cancer) from any medical practitioner. Approvals valid for 1 year where the patient is a premenopausal woman with breast cancer. Initial application - (Prostate cancer) only from an oncologist, urologist or endocrinologist. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Advanced prostatic cancer; or. 2 Neoadjuvant or adjuvant treatment of locally advanced prostatic cancer. Note Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. Initial application - (Endometriosis) only from a gynaecologist. Approvals valid for 3 months for applications meeting the following criteria: Both: 3 Endometriosis; and4 Either: 4.1 6 months treatment with medroxyprogesterone acetate, danazol or dimetriose has proven ineffective; or4.2 The patient has failed to tolerate the treatment with medroxyprogesterone acetate, danazo
Special Authority for Subsidy - form: SA0841Initial application only from a gastroenterologist or general physician. Approvals valid for 6 months for applications meeting the following criteria: Both: 1 Primary biliary cirrhosis confirmed by antimitochondrial antibody titre (AMA) > 1:80, and raised cholestatic liver enzymes with or without raised serum IgM or, if AMA is negative, by liver biopsy; and2 Patient not requiring a liver transplant (bilirubin > 170umol/l; decompensated cirrhosis). NoteLiver biopsy is not usually required for diagnosis but is helpful to stage the diseaseRenewal only from a gastroenterologist or general physician. Approvals valid for 2 years for applications meeting the following criteria: The treatment remains appropriate and the patient is benefiting from treatment. NoteActigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 micromol/l; decompensated cirrhosis). These patients should be referred to an appropriate transp
Special Authority for Subsidy - Form: SA842Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 Both: 1.1 The patient has ovarian, fallopian* or primary peritoneal cancer*; and 1.2 Either: 1.2.1 Has not received prior chemotherapy; or 1.2.2 Has received prior chemotherapy but have not previously been treated with taxanes; or2 The patient has metastatic breast cancer; or3 The patient has node-positive early breast cancer; or4 Both 4.1 The patient has non small-cell lung cancer; and 4.2 Either: 4.2.1 Has advancing disease (stage IIIa or above); or 4.2.2 Is receiving combined chemotherapy and radiotherapy; or5 Both: 5.1 The patient has small-cell lung cancer*; and 5.2 Paclitaxel is to be used as second-line therapy. Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: 6 The patient has metasta
a) When ordered by a medical practitioner on a practitioner's supply order for ventricular arrhythmias and the order is endorsed accordinglyb) When ordered for a dialysis patient or a child with rhumatic fever and the order is endorsed accordingly
Special Authority for Subsidy - Form SA0050Initial application only from a relevant specialist. Approvals valid for 2 years where terminally ill patient. Renewal only from a relevant specialist. Approvals valid for 2 years where terminally ill patient.
NOTE: Evidence that a patient is on insulin therapy can be by way of either: a) insulin being on the same prescription ofb) by the word "insulin patient" be in written on the prescription by either the doctor or the contractor.
Special Authority for Subsidy - Form SA0094Initial application only from a relevant specialist (Only for Epsom Day Unit in Auckland). Approvals valid for 1 month where termination of advanced pregnancy i.e. beyond 12 weeks. Only for Epsom Day Unit in Auckland.
a) Maximum of 50 mls per unit b) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent c) On a bulk supply orderd) When used in the extemporaneous compounding of eye drops
Subsidy is paid on acyclovir tablets for treatment of herpes zoster and genital herpes. Prescriptions with doses: 1. exceeding 1,600 mg per day for a period of more than one week will not be subsidised; and2. up to 4,000 mg per day for a maximum period of one week will be subsidised.
Only for treatment of uncomplicated urethritis or cervicitis due to chlamydia trachomatis and these patients' sexual contacts. Prescription must be endorsed "certified condition" (typed or handwriten and initialised in the prescriber's own handwriting)
Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription is endorsed "certified condition".
Available from hospital pharmacies providing an outpatient dispensing service, and selected retail pharmacies in the Northern, Western Bay of Plenty, Wellington, Christchurch or South Canterbury regions that have an exclusive contract to dispense 'Hospital Pharmacy' [HP1] pharmaceuticals.
a) Maximum of 750mg (1 injection) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
Subsidy is available for disposable and non-disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly.
Up to 30 pen needles may be dispensed in the case of a prescription for three months supply of insulin cartridges; orUp to two pen needles may be dispensed for each week's supply in the case of a prescription for less than three months supply of insulin cartridges.
Special Authority for Subsidy - Form SA0403Initial application only from a nephrologist or transplant surgeon. Approvals valid for 12 months where renal transplant recipient. Renewal only from a nephrologist or transplant surgeon. Approvals valid for 12 months where re-graft patient.
Special Authority for Manufacturers Price - Form SA0411Renewal from any medical practitioner. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment.
a) On a prescription or practitioner's supply order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent b) On a bulk supply orderc) When used in the extemporaneous compounding of eye drops
a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without phenol liquefied.
a) Only in combination with aqueous cream, 10 % urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without menthol crystals.
a) Hospital pharmacy [HP3] - Maximum of 750mg (3 injections) per prescription; orb) Hospital pharmacy [HP3] - specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and- The prescription is endorsed accordingly.
a) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudo membranous colitis or for prophylaxis of endocarditis; and b) The prescription is endorsed accordingly.
Special Authority for Subsidy - Form SA0669Initial application only from a relevant specialist. Approvals valid without further renewal unless notified where organ transplant recipients. NoteSubsidy applies for either primary or rescue therapy
Note: There is a significant cost differential between moclobemide and fluoxetine (moclobemide being about three times more expensive). For depressive syndromes it is therefore more cost-effective to start treatment with fluoxetine first before considering prescribing moclobemide.
Additional subsidy by Special Authority - Retail Pharmacy - for: - Nifedipine tab long-acting 30mg x 30 (Adalat Oros) up to $19.90 - Nifedipine tab long-acting 60mg x 30 (Adalat Oros) up to $29.50
Prescribing GuidelineHRT should be taken at the lowest dose for the shortest period of time necessary to control symptoms. Patients should be reviewed 6 monthly in line with the updated NZGG "Evidence-based Best Practice Guideline on Hormone Replacement Therapy March 2004".
A diagnostic blood glucose test meter is subsidised for patients who begin insulin or sulphonylurea therapy after 1 March 2005. Only one meter per patient. No further prescriptions will be subsidised. The prescription must be endorsed accordingly.
Prescribing GuidelinePrescribers should note that oxycodone is significantly more expensive than long-acting morphine sulphate and clinical advice suggests that it is reasonable to consider this as a second-line agent to be used after morphine.
a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; orb) for the treatment of confirmed ciprofloxacin-resistant gonorrhoea; orc) for the treatment of suspected meningitis in patients who have a known allergy to penicillin; andd) the prescription is endorsed accordingly
subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis proven or presumed to be due to Chlamydia trachomatis and their sexual contacts and prescription or PSO is endorsed accordingly.
Special Authority for Subsidy - Retail Pharmacy - Form SA0829Initial Application only from gastroenterologist or infectious disease specialist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1. Patient has confirmed Hepatitis B infection (HBsAg+); andDocumented resistance to lamivudine, defined as: 2. patient has raised serum ALT (> 1 x ULN); and3. patient has HBV DNA greater than 100,000 copies per mL, or viral load ? 10 fold over nadir; and4. detection of M204I or M204V mutation; and5. Either5.1. Both5.1.1. patient is cirrhotic; and5.1.2. adefovir dipivoxil to be used in combination with lamivudine; or5.2. Both5.2.1. patient is not cirrhotic; and5.2.2. adefovir dipivoxil to be used as monotherapyRenewal only from a gastroenterologist or infectious disease specialist. Approvals valid for 2 years for applications where in the opinion of the treating physician, treatment remains appropriate and patient is benefiting from treatmen
Special Authority for Subsidy - Form SA0833Initial application only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Any of the following: 1 The patient has non small cell lung carcinoma (stage IIIa, or above); or2 The patient has advanced malignant mesothelioma*; or3 The patient has advanced pancreatic carcinoma; or4 The patient has ovarian, fallopian tube* or primary peritoneal carcinoma*; or5 The patient has advanced transitional cell carcinoma of the urothelial tract (locally advanced or metastatic). Renewal only from a relevant specialist. Approvals valid for 12 months for applications meeting the following criteria: Both: 6 The patient requires continued therapy; or 7 The tumour has relapsed and requires re-treatment. Note indications marked with a * are unapproved indications.
Special Authority for Subsidy - Form SA0700Initial application only from an ophthalmologist. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Both: 1.1 Monotherapy in primary open-angle glaucoma; and 1.2 Any of the following: 1.2.1 Patient cannot tolerate Beta-blockers, Pilocarpine and Dorzolamide; or 1.2.2 Beta-blockers, Pilocarpine and Dorzolamide are contraindicated; or 1.2.3 A reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or 1.2.4 There is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker; or 2 Adjunctive use for the treatment of patients who have met the initial application criteria, and in whom latanoprost monotherapy has been ineffective in controlling intraocular pressure. Note An adjunctive agent may be added without a
RestrictionCode Type Value Attribute Waiver
129 FormMax 3 Rx
14 PCT
131 Combined
133 NO RULE
134 FormMax 100 Rx
136 FormReqd Rx
137 FormMax 14 Rx
139 FormReqd Rx
138 NO RULE
140 Special
141 FormBan BSO
142 FormMax 3.5 Rx
143 FormReqd Rx
146 Combined
153 SpecialWav
479 FormMax 6000 Rx
197 MaxQtyDisp 2000
447 SpecOnly Retail
157 SpecialWav
158 NO RULE
159 NO RULE
160 NO RULE
162 NO RULE
163 NO RULE
166 DoseMMax 500
167 NO RULE
168 NO RULE
169 NO RULE
170 NO RULE
171 NO RULE
172 FormMax 6 Rx SpecEnd
688 Combined
173 NO RULE
175 Application
15 PCT only
178 SpecialWav
615 Special
180 Controlled
781 Special
788 SpecialWav
183 Combined
184 DoseSMax 100
185 Combined
147 FormReqd Rx
186 NO RULE
187 NO RULE
189 Combined
190 FormMax 10 Rx
789 Special
191 NO RULE
192 Combined
193 Combined
194 FormMax 10 Rx
791 SubRxF
195 Combined
196 Combined
199 ProvReqd M
148 FormMax 100 Rx
201 FormMax 100 Rx
849 Special
202 NO RULE
203 FormMax 100 Rx
149 FormReqd Rx
205 MaxQtyDisp 25
756 Dispensary Xpharm
206 ProvReqd M
208 NO RULE
210 FormMax 2 Rx Special
693 Application
212 NO RULE
215 NO RULE
280 Special
150 SpecialWav
221 FormMax 10 WSO
151 FormReqd WSO
222 NO RULE
223 FormMax 4 Rx
152 FormReqd Rx
224 NO RULE
809 Special
810 AltSubSA
850 SubRxF
234 FormMax 1 Rx SubRxF
824 NO RULE Guideline
643 Special
609 Application
256 Special
826 Special
929 Special
25 SpecEnd Hospital
543 FormBan WSO
545 NO RULE
396 NO RULE
400 Preferred
401 Special
402 Special
403 Special
404 Special
936 Special
410 SpecialWav
411 SpecialWav
420 AltSubRxF
421 SoleSupply
423 Special
424 Special SpecEnd
429 Wastage
430 Special
432 FormMax 15 Rx
176 FormReqd Rx
434 SpecialWav
435 SpecialWav
436 SpecialWav
443 Special
445 Special
446 FormMax 2 Rx
450 Special
451 SpecialWav
452 SpecialWav
454 NO RULE
455 FormMax 100 Rx
179 FormReqd Rx
456 Special
458 Special
459 Special
460 SpecialWav
461 Special
710 Special
462 SpecOnly Hospital
464 Application
465 DoseMMax 500
5026 Xref A1904
466 AltSubSA
467 Application
827 SubRxF
468 SpecOnly Retail
469 NO RULE
470 Special
471 Special
472 Special
473 Special
474 FormMax 500 Rx
5027 Xref A0716
478 FormMax 200 Rx
701 ProvReqd M
188 FormReqd Rx
480 FormMax 100 Rx
481 Combined
482 Combined
483 Combined
484 Combined
485 Combined
486 Combined
487 Combined
488 Special
489 SpecialWav
490 Special
5028 Xref A1017
493 DoseMMax 500
702 Special
494 Special
495 FormMax 50 Rx
705 NO RULE
496 FormMax 30 Rx
706 Special
497 FormReqd Rx
498 FormMax 6 Rx
829 Special
499 MaxQtyDisp 6
500 AltSubSA
738 Special
502 FormMax 3 Rx SubRxF
833 Special
503 FormWt 500 Rx Special
834 Special
835 Special
29 S29
508 Special
509 Special
510 Application
511 Special
512 Special
939 Special
513 Special
838 Special
515 AltSubSA Claim only
207 DoseWMax 1
209 FormReqd Rx
516 Special
840 DoseDMax 2
519 Combined
521 Combined
610 Special
523 Special
524 FormMax 35 Rx
526 FormMax 21 Rx
841 Special
527 FormMax 42 Rx
528 Special
530 Safety Uncompounded
532 Contraceptive
533 Statim May
941 Special
535 AltSubRxF
536 AltSubRxF
537 FormMax 12 Rx
942 AltSubSA
538 Application
539 Special
943 AltSubSA
563 Special
542 FormMax 15 Rx
211 FormReqd Rx
213 FormBan PSO
1022 NO RULE
946 Special
947 Special
948 Special
949 Special
950 NO RULE
951 Special
952 Special
953 Special
973 Special
957 Special
967 Special
968 Special
969 Special
970 NO RULE
12000 FormMax 2000 PSO
974 Special
264 Special
265 SpecialWav
266 Special
267 NO RULE
269 Special
270 Special
271 SpecialWav
273 NO RULE
274 Special
275 Special
276 Special
975 Special
278 NO RULE
279 FormMax 125 BSO
154 FormReqd BSO
283 SpecOnly Retail
284 FormMax 21 Rx
844 Repeat
285 FormMax 15 Rx
845 Special
286 SpecialWav
611 Special
618 Special Claim only
717 SpecialWav
289 SpecEnd Retail
290 Special
291 Application
293 NO RULE
294 NO RULE
295 NO RULE
1006 NO RULE
214 FormBan Rx
300 Special
301 Special
303 Application
612 SpecialWav
1007 NO RULE
979 MaxQtyDisp 384
309 Special
980 MaxQtyDisp 216
311 Special
312 Application
313 SpecialWav
156 DoseWMax 2
161 FormReqd Rx
164 DoseWMax 2
165 FormReqd Rx
981 MaxQtyDisp 28
317 Special
719 Repeat
319 SpecOnly Retail
320 NO RULE
323 Special
324 NO RULE
325 Special
328 Special
621 Special
341 Special
622 Application
217 FormReqd WSO
720 FormMax 108 PSO
982 FormMax 768 Rx
348 NO RULE
349 Special
983 FormMax 432 Rx
613 AltSubSA
633 Special
355 FormMax 3 Rx
721 Special
357 FormMax 6 Rx
219 SubRxF
359 NO RULE
360 NO RULE
361 Special
366 Special
634 NO RULE
370 Safety Compounded
636 SubRxF
37 DoseDMax 1
638 NO RULE
727 Special
378 NO RULE
639 Special
380 NO RULE
5004 Xref A310301
382 Special
383 NO RULE
640 SpecialWav
386 NO RULE
387 Special
388 NO RULE
389 NO RULE
391 Special
392 FormMax 100 Rx
174 FormReqd Rx
394 SpecialWav
225 Dispensary HP1
984 FormMax 56 Rx
6 Special
9 Combined
11 Special
21 TreatMax 30
22 FormReqd Rx
23 SpecEnd Hospital
24 SpecEnd Retail
26 DoseDMax 2
27 FormReqd Rx
28 Special
730 DoseDMax 1.5
30 DoseDMax 1
31 Special
32 DoseDMax 1
33 FormReqd PSO
58 DoseWMax 1
62 FormReqd Rx
35 SpecialWav
36 NO RULE
732 Special
38 NotCombined
39 DoseMMax 30
40 NotCombined
41 Special
43 NO RULE
44 NO RULE
45 Special
46 Special
47 Special
48 NotCombined
49 NO RULE
50 Application
51 Special
53 Special
54 FormReqd Rx
55 Special
56 Special
57 Special
59 FormMax 3 Rx
847 Special
60 DoseMMax 6
61 FormReqd PSO
64 MaxQtyDisp 2
1008 NO RULE
66 NO RULE
733 Special
848 Combined
69 Special
70 SpecialWav
71 FormReqd Rx
5015 Xref StdFormulae
73 FormMax 30 Rx
986 SubRxF
74 FormMax 6 Rx
95 FormReqd Rx
75 DoseMMax 1
76 FormMax 42 Rx
987 Special
77 NO RULE
78 NO RULE
79 NO RULE
80 NO RULE
81 NO RULE
82 FormReqd WSO
101 DoseWMax 2
106 FormReqd Rx
107 DoseMMax 1
109 FormReqd Rx
85 Special
86 NO RULE
87 Special
88 Special
89 Special
90 Special
91 Special
92 Special
94 Special
96 Special
97 Special
98 NO RULE
99 Special
100 Special
102 NO RULE
103 NO RULE
108 Special
110 Special
111 DoseSMax 5
130 FormReqd Rx
112 DoseDMax 4
113 DoseSWt 100
132 FormReqd Rx
114 DoseSMax 1
135 FormReqd Rx
115 Special
117 DoseMMax 30
118 TreatMax 90
119 Special
120 NO RULE
121 Special
122 Special
124 SpecOnly Retail
125 Special
127 FormMax 15 Rx
128 NO RULE
544 NO RULE
546 AltSubRxF
63 SubRxF
551 Special
552 FormReqd QEC
555 DoseDWt 10
556 Special
568 AltSubRxF
572 Special
575 Application
577 SubRxF
579 Special
548 FormMax 4 Rx
624 SubRxF
606 Special
625 FormMax 20 WSO
637 Special
104 DoseSMax 1
116 FormReqd Rx
642 FormMax 20 WSO
645 Special
226 Dispensary HP2&3
227 Dispensary HP3
228 Dispensary HP4
774 Special
648 SpecialWav
649 Special
775 Special
776 Special
652 Application
851 Special
522 Statim Must
6001 Graphic cardiovascular.txg
696 Special
5002 Xref A220101
656 AltSubRxF
931 NO RULE
657 Application
658 AltSubRxF
661 Special
793 SubRxF
663 FormMax 10 Rx
5003 Xref A1622
345 NO RULE
666 NO RULE
667 Special
671 NO RULE
672 AltSubRxF
673 Application
676 NO RULE
677 Combined
679 Combined
681 NO RULE
683 SpecialWav Claim only
684 SubRxF Special
692 Special
700 Special
703 Special
792 Special
713 Special
725 Special
735 NO RULE
934 Special
743 Special
220 MaxQtyDisp 3
746 FormMax 6 Rx
757 Special
795 FormMax 4 PSO
749 AltSubRxF
750 Special
752 NO RULE
753 SpecialWav
754 Special
755 Special
758 Special
761 NO RULE
1023 FormMax 20 Rx
765 NO RULE
766 SubRxF
767 SpecOnly Retail
770 NO RULE
772 Application
773 AltSubRxF
796 Special
798 Special
799 Special
822 NO RULE
825 NO RULE
836 Special
832 Special
839 Special
846 Special
5022 Xref A310301
857 NO RULE
5025 Xref A1019
1026 Special
5007 Xref A1603
852 NO RULE
938 SpecialWav
855 Special
858 NO RULE
859 Special
958 Special
861 NO RULE
5029 Xref A1004
862 Special
863 Special
864 Special
873 Special
867 Special
868 Special
869 Special
870 Special
871 Special
875 Special
878 Special
879 Special
884 Special
886 AltSubRxF
887 Application
891 Special
892 FormMax 60 Rx
894 NO RULE
895 Special
897 AltSubRxF
898 Repeat
899 Special
900 Special
901 Special
903 AltSubRxF
904 Combined
905 SubRxF
906 Special
909 Special
910 NO RULE
911 Special
912 Special
913 Special
914 Special
918 SubRxF
976 Special
920 Special
921 Special
923 Special
925 Special
926 Special
928 Special
10001 FormMax 1 PSO
10005 FormMax 5 PSO
10006 FormMax 6 PSO
985 NO RULE
Trial Version
BrandCodeExtent Effective Expiry Type Value Attribute Waiver XML
10090101 ATC3 7/1/1999 6/30/2006 Special
10090101 Brand 11/1/2004 6/30/2007 SoleSupply
10090101 ATC3 9/1/1996 ######## Special
10090201 ATC3 9/1/1996 ######## Special
10090201 ATC3 7/1/1999 6/30/2006 Special
10090201 ATC3 2/1/1998 6/30/1999 Special
10090201 Chemical 7/1/2006 7/31/2009 Special
10090201 Chemical 1/1/1999 7/31/2010 Dispensary HP3
10090201 ATC3 12/1/1996 1/31/1998 Special
10090201 ATC3 5/16/1994 8/31/1996 Special
10092525 ATC3 5/16/1994 8/31/1996 Special
10092525 ATC3 12/1/1996 1/31/1998 Special
10092525 ATC3 2/1/1998 6/30/1999 Special
10092525 ATC3 7/1/1999 6/30/2006 Special
10092525 ATC3 9/1/1996 ######## Special
10092625 ATC3 9/1/1996 ######## Special
10092625 ATC3 2/1/1998 6/30/1999 Special
10092625 ATC3 7/1/1999 6/30/2006 Special
10092625 ATC3 12/1/1996 1/31/1998 Special
10092625 ATC3 5/16/1994 8/31/1996 Special
10092725 ATC3 5/16/1994 8/31/1996 Special
10092725 ATC3 12/1/1996 1/31/1998 Special
10092725 ATC3 7/1/1999 6/30/2006 Special
10092725 ATC3 2/1/1998 6/30/1999 Special
10092725 ATC3 9/1/1996 ######## Special
10092825 ATC3 9/1/1996 ######## Special
10092825 ATC3 2/1/1998 6/30/1999 Special
10092825 ATC3 7/1/1999 6/30/2006 Special
10092825 ATC3 12/1/1996 1/31/1998 Special
10092825 ATC3 5/16/1994 8/31/1996 Special
10092925 ATC3 5/16/1994 8/31/1996 Special
10092925 ATC3 12/1/1996 1/31/1998 Special
10092925 ATC3 7/1/1999 6/30/2006 Special
10092925 ATC3 2/1/1998 6/30/1999 Special
10092925 ATC3 9/1/1996 ######## Special
10093025 ATC3 9/1/1996 ######## Special
10093025 ATC3 2/1/1998 6/30/1999 Special
10093025 ATC3 7/1/1999 6/30/2006 Special
10093025 ATC3 12/1/1996 1/31/1998 Special
10093025 ATC3 5/16/1994 8/31/1996 Special
10093125 ATC3 5/16/1994 8/31/1996 Special
10093125 ATC3 12/1/1996 1/31/1998 Special
10093125 ATC3 7/1/1999 6/30/2006 Special
10093125 ATC3 2/1/1998 6/30/1999 Special
10093125 ATC3 9/1/1996 ######## Special
10100101 Chemical 8/1/2000 Special
10110101 Chemical 2/1/1999 8/31/2008 SpecEnd Retail
10110101 Chemical 9/1/2008 Application
10110101 Chemical 8/1/2012 SafetyListMedicine
10260226 Brand 4/1/2013 Wastage
10270201 Chemical 10/1/2003 Statim Must
10290101 Formulation 7/1/1996 Statim May
10310101 Chemical 4/1/2001 4/30/2013 AltSubRxF
10310101 ATC3 5/1/2000 3/31/2001 AltSubRxF
10310101 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310101 Chemical 5/1/2013 AltSubRxF
10310102 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310102 ATC3 5/1/2000 3/31/2001 AltSubRxF
10310201 ATC3 5/1/2000 3/31/2001 AltSubRxF
10310201 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310202 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310202 ATC3 5/1/2000 3/31/2001 AltSubRxF
10310301 ATC3 5/1/2000 3/31/2001 AltSubRxF
10310301 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310302 ATC3 6/1/1998 4/30/2000 AltSubRxF
10310302 ATC3 5/1/2000 3/31/2001 AltSubRxF
10320101 Chemical 7/1/1996 Statim May
10320101 Chemical 9/1/1995 ######## SpecEnd Retail
10340101 Formulation 2/1/2014 4/30/2014 Brandswitch 2452189 BSF Cellcept
10342725 Formulation10/1/2005 SubRxF
10370101 ATC3 10/1/2005 2/28/2009 Application
10370101 ATC3 10/1/2009 8/31/2010 Special
10370101 ATC3 2/1/2000 3/31/2001 Special
10370101 ATC3 2/1/2002 2/29/2004 Application
10370101 ATC3 3/1/2004 9/30/2005 Application
10370101 ATC3 3/1/2009 9/30/2009 Special
10370101 ATC3 4/1/2001 9/30/2001 Special
10370101 ATC3 10/1/2001 1/31/2002 Special
10370101 ATC3 9/1/2010 Special
10370101 Chemical 7/1/1999 2/28/2009 Special Claim only
10370201 ATC3 7/1/1999 2/28/2009 Application
10370201 ATC3 3/1/2009 Special
10372525 ATC3 2/1/2002 2/29/2004 Application
10372525 ATC3 2/1/2000 3/31/2001 Special
10372525 ATC3 10/1/2009 8/31/2010 Special
10372525 ATC3 10/1/2005 2/28/2009 Application
10372525 ATC3 3/1/2004 9/30/2005 Application
10372525 ATC3 9/1/2010 Special
10372525 ATC3 10/1/2001 1/31/2002 Special
10372525 ATC3 4/1/2001 9/30/2001 Special
10372525 ATC3 3/1/2009 9/30/2009 Special
10610201 Chemical 3/1/2012 5/31/2012 Brandswitch 2397153 BSF Arrow-losartan & H...
10610201 Chemical 6/1/2008 ######## Special
10610201 Formulation10/1/2003 Statim Must
10610225 Formulation 5/1/2007 5/31/2008 Special
10612625 Formulation 6/1/2008 Statim Must
10620125 ATC3 7/1/2005 7/31/2007 Application
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10620126 ATC3 8/1/2003 6/30/2005 Application
10620126 ATC3 7/1/2005 7/31/2007 Application
10620225 ATC3 7/1/2005 7/31/2007 Application
10620225 ATC3 8/1/2003 6/30/2005 Application
10620226 ATC3 8/1/2003 6/30/2005 Application
10620226 ATC3 7/1/2005 7/31/2007 Application
10622526 ATC3 7/1/2005 7/31/2007 Application
10622526 ATC3 8/1/2003 6/30/2005 Application
10622527 ATC3 8/1/2003 6/30/2005 Application
10622527 ATC3 7/1/2005 7/31/2007 Application
10630101 ATC3 12/1/1998 3/31/2002 Special
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10630102 ATC3 12/1/1995 ######## Special
10630102 ATC3 11/1/1997 ######## Special
10630102 ATC3 5/16/1994 ######## Special
10630102 ATC3 12/1/1998 3/31/2002 Special
10630202 ATC3 12/1/1998 3/31/2002 Special
10630202 ATC3 5/16/1994 ######## Special
10630202 ATC3 11/1/1997 ######## Special
10630202 ATC3 12/1/1995 ######## Special
10630203 ATC3 12/1/1995 ######## Special
10630203 ATC3 11/1/1997 ######## Special
10630203 ATC3 5/16/1994 ######## Special
10630203 ATC3 12/1/1998 3/31/2002 Special
10660101 Chemical 8/1/2001 ######## Special Claim only
10660101 ATC2 11/1/2005 7/31/2006 Application
10660101 ATC2 3/1/2000 7/31/2001 Special
10660101 ATC2 8/1/2001 ######## Application
10660101 ATC2 12/1/1996 2/29/2000 Special
10660201 ATC2 12/1/1996 2/29/2000 Special
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10660201 ATC2 11/1/2005 7/31/2006 Application
10660301 ATC2 11/1/2005 7/31/2006 Application
10720901 Formulation5/26/1995 2/28/2001 FormMax 5 PSO
10721001 Formulation 7/1/1996 2/28/2001 FormMax 5 PSO
10760101 Formulation 7/1/1998 9/30/2003 Statim May
10770101 ATC2 10/1/1998 ######## Special SpecEnd
10770101 ATC2 1/1/1999 7/31/2010 Dispensary HP1
10770101 ATC2 1/1/2001 5/31/2001 Special
10770101 ATC2 6/1/2001 6/30/2005 Application
10770101 ATC2 8/1/2010 6/30/2013 Application
10770101 ATC2 7/1/2005 6/30/2010 Application
10770101 Chemical 8/1/2010 Special Claim only
10770101 ATC2 4/1/1997 9/30/1998 Special
10770101 ATC2 7/1/2010 7/31/2010 Application
10770101 ATC2 7/1/2013 Application
10770125 ATC2 7/1/2010 7/31/2010 Application
10770125 ATC2 4/1/1997 9/30/1998 Special
10770125 ATC2 7/1/2005 6/30/2010 Application
10770125 ATC2 8/1/2010 6/30/2013 Application
10770125 ATC2 6/1/2001 6/30/2005 Application
10770125 ATC2 1/1/2001 5/31/2001 Special
10772525 ATC2 1/1/2001 5/31/2001 Special
10772525 ATC2 6/1/2001 6/30/2005 Application
10772525 ATC2 8/1/2010 6/30/2013 Application
10772525 ATC2 7/1/2005 6/30/2010 Application
10772525 ATC2 4/1/1997 9/30/1998 Special
10772525 ATC2 7/1/2010 7/31/2010 Application
10780101 Chemical 1/1/1999 Dispensary HP4
10780101 Chemical 4/1/1999 ######## SpecOnly Hospital
10800101 Chemical 5/16/1994 TreatMax 30
10800101 Chemical 5/16/1994 MaxCoPayment 0
10800101 Chemical 6/1/1995 Controlled
10810201 Chemical 10/1/1999 SubRxF
10830101 Chemical 2/1/2012 7/31/2012 Repeat
10830101 Formulation 8/1/2001 7/31/2006 Special Claim only
10830101 ATC2 11/1/2005 7/31/2006 Application
10830101 ATC2 3/1/2000 7/31/2001 Special
10830101 ATC2 8/1/2001 ######## Application
10830101 ATC2 12/1/1996 2/29/2000 Special
10830201 ATC2 12/1/1996 2/29/2000 Special
10830201 ATC2 8/1/2001 ######## Application
10830201 ATC2 3/1/2000 7/31/2001 Special
10830201 ATC2 11/1/2005 7/31/2006 Application
10830201 Formulation 8/1/2001 7/31/2006 Special Claim only
10830201 Chemical 2/1/2012 7/31/2012 Repeat
10830301 Chemical 2/1/2012 7/31/2012 Repeat
10830301 Formulation 3/1/2004 7/31/2006 SubRxF
10830301 ATC2 11/1/2005 7/31/2006 Application
10830301 ATC2 3/1/2000 7/31/2001 Special
10830301 ATC2 8/1/2001 ######## Application
10830301 ATC2 12/1/1996 2/29/2000 Special
10840101 Formulation 8/1/2010 ProvAllow Dietitian
10840101 Chemical 5/16/1994 7/31/2005 DoseSWt 100
10840101 Chemical 5/16/1994 FormReqd Rx
10840101 Chemical 8/1/2006 DoseSWt 100
10940105 Brand 11/1/1998 Preferred
10940126 Brand 12/1/2008 S29
10940126 Brand 4/1/2013 Wastage
10940205 Brand 11/1/1998 Preferred
10942525 Brand 2/1/2013 5/31/2014 S29
10942525 Brand 4/1/2013 5/31/2014 Wastage
10970202 Formulation5/16/1994 FormMax 5 PSO
10970601 Brand 1/1/2009 ######## SoleSupply
10990125 Brand 6/1/2012 S29
10990125 Brand 4/1/2013 Wastage
11000101 Chemical 5/16/1994 SpecEnd Retail
11000101 Formulation 1/1/2011 3/31/2011 Brandswitch 2377829 BSF Imuprine
11000103 Brand 11/1/1999 6/30/2001 Preferred
11020101 ATC2 7/1/2010 7/31/2010 Application
11100126 Chemical 10/1/1999 2/28/2005 FormMax 30 Rx
11100126 Chemical 3/1/2005 FormMax 100 Rx
11100201 Formulation10/1/1999 9/30/2003 Statim May
11100201 ATC3 3/1/2014 SubRxF
11100201 ATC3 12/1/1997 2/28/2014 SubRxF
11100226 ATC3 12/1/1997 2/28/2014 SubRxF
11100226 ATC3 3/1/2014 SubRxF
11100227 ATC3 3/1/2014 SubRxF
11100227 ATC3 12/1/1997 2/28/2014 SubRxF
11102525 ATC3 12/1/1997 2/28/2014 SubRxF
11102525 ATC3 3/1/2014 SubRxF
11102526 ATC3 3/1/2014 SubRxF
11102526 ATC3 12/1/1997 2/28/2014 SubRxF
11102625 ATC3 12/1/1997 2/28/2014 SubRxF
11102625 ATC3 3/1/2014 SubRxF
11102626 ATC3 3/1/2014 SubRxF
11102626 ATC3 12/1/1997 2/28/2014 SubRxF
11102627 ATC3 12/1/1997 2/28/2014 SubRxF
11102627 ATC3 3/1/2014 SubRxF
11102725 ATC3 3/1/2014 SubRxF
11102725 ATC3 12/1/1997 2/28/2014 SubRxF
11120101 ATC3 7/1/2013 Special
11160101 Formulation 6/1/1998 FormMax 150 PSO
11240301 Formulation 1/1/1998 Wastage
11250101 Chemical 2/1/2004 ######## AltSubRxF
11260101 Chemical 8/1/2012 ######## Brandswitch 2405857 BSF Ursosan
11260101 Chemical 3/1/2005 3/31/2005 SpecOnly Retail
11260101 Formulation 3/1/1999 2/28/2005 SpecOnly Retail
11262525 Formulation 3/1/2012 OraProduct
11262525 Chemical 8/1/2012 ######## Brandswitch 2405857 BSF Ursosan
11270101 Formulation 6/1/2014 8/31/2014 Brandswitch 2459299 Apo-Cilazapril
11270125 Formulation 6/1/2014 8/31/2014 Brandswitch 2459299 Apo-Cilazapril
11300125 Brand 9/1/2003 6/30/2004 S29
11300201 Formulation5/16/1994 ######## FormReqd PSO
11300201 Formulation######## FormReqd PSO
11330101 ATC3 8/1/2003 6/30/2005 Application
11330101 ATC3 7/1/2005 7/31/2007 Application
11370226 ATC3 12/1/1995 ######## Special
11370226 Chemical 6/1/2004 9/30/2004 Repeat
11370226 ATC3 5/16/1994 ######## Special
11370226 ATC3 12/1/1998 3/31/2002 Special
11370226 Chemical 6/1/2004 6/30/2004 SpecialWav
11370227 ATC3 12/1/1998 3/31/2002 Special
11370227 ATC3 5/16/1994 ######## Special
11370227 Chemical 6/1/2004 9/30/2004 Repeat
11370227 ATC3 12/1/1995 ######## Special
11370227 ATC3 11/1/1997 ######## Special
11370301 ATC3 11/1/1997 ######## Special
11370301 ATC3 12/1/1995 ######## Special
11370301 Chemical 6/1/2004 9/30/2004 Repeat
11370301 ATC3 12/1/1998 3/31/2002 Special
11370301 ATC3 5/16/1994 ######## Special
14790202 ATC2 1/1/2013 MaxCoPayment 5
14790301 Formulation 8/1/1999 Contraceptive
14790301 ATC2 5/16/1994 ######## MaxCoPayment 3
14790301 ATC3 8/1/1995 ######## SpecialWav
14790301 ATC3 11/1/1999 AltSubSA
14810101 ATC3 7/1/2005 7/31/2007 Application
14810101 ATC3 8/1/2003 6/30/2005 Application
14810201 ATC3 8/1/2003 6/30/2005 Application
14810201 ATC3 7/1/2005 7/31/2007 Application
14810201 Formulation 7/1/1996 Safety Uncompounded
14840101 ATC3 8/1/1995 ######## SpecialWav
14840101 ATC3 11/1/1999 AltSubSA
14920301 Formulation 1/1/2011 3/31/2011 Brandswitch 2377845 BSF Univent
15130101 Chemical 1/1/1999 7/31/2005 Dispensary HP2&3
15130101 Chemical 5/16/1994 SpecEnd Hospital
15290201 Formulation 7/1/2005 SpecEnd Retail
15290201 Formulation 7/1/2005 PCT
15292525 Formulation 7/1/2005 SpecEnd Hospital
15292525 Formulation 7/1/2005 PCT only
15292625 Formulation10/1/2005 PCT only
15292625 Formulation10/1/2005 SpecEnd Hospital
15360101 ATC3 3/1/1996 8/31/2010 Application
15360201 ATC3 3/1/1996 8/31/2010 Application
15360301 ATC3 3/1/1996 8/31/2010 Application
15370101 Chemical 5/16/1994 7/31/2010 SpecEnd Hospital
15370125 Brand 3/1/2013 S29
15370125 Brand 4/1/2013 Wastage
15420301 Formulation5/16/1994 FormReqd Rx
15420301 Formulation 6/1/2002 NotCombined
15440201 Formulation5/17/1995 ######## SpecEnd Retail
15440225 Brand 12/1/2009 7/31/2010 S29
15460101 Formulation5/26/1995 7/31/2010 SpecEnd Hospital
15460101 Formulation 1/1/1999 7/31/2010 Dispensary HP3
15460201 Formulation 1/1/1999 Dispensary HP3
15460801 Formulation12/1/1998 FormMax 15 Rx
15460801 Formulation10/1/1997 ######## FormMax 15 Rx
11370325 ATC3 5/16/1994 ######## Special
11370325 ATC3 12/1/1998 3/31/2002 Special
11370325 Chemical 6/1/2004 9/30/2004 Repeat
11370325 ATC3 12/1/1995 ######## Special
11370325 ATC3 11/1/1997 ######## Special
11370326 ATC3 11/1/1997 ######## Special
11370326 ATC3 12/1/1995 ######## Special
11370326 Chemical 6/1/2004 9/30/2004 Repeat
11370326 ATC3 12/1/1998 3/31/2002 Special
11370326 ATC3 5/16/1994 ######## Special
11370327 ATC3 5/16/1994 ######## Special
11370327 ATC3 12/1/1998 3/31/2002 Special
11370327 Chemical 6/1/2004 9/30/2004 Repeat
11370327 ATC3 12/1/1995 ######## Special
11370327 ATC3 11/1/1997 ######## Special
11372525 ATC3 11/1/1997 ######## Special
11372525 ATC3 12/1/1995 ######## Special
11372525 Chemical 6/1/2004 9/30/2004 Repeat
11372525 ATC3 12/1/1998 3/31/2002 Special
11372525 ATC3 5/16/1994 ######## Special
11372526 ATC3 12/1/1998 3/31/2002 Special
11372526 ATC3 5/16/1994 ######## Special
11372526 Chemical 6/1/2004 9/30/2004 Repeat
11372526 ATC3 12/1/1995 ######## Special
11372526 ATC3 11/1/1997 ######## Special
11372527 ATC3 11/1/1997 ######## Special
11372527 ATC3 12/1/1995 ######## Special
11372527 Chemical 6/1/2004 9/30/2004 Repeat
11372527 ATC3 5/16/1994 ######## Special
11372527 ATC3 12/1/1998 3/31/2002 Special
11372528 ATC3 12/1/1998 3/31/2002 Special
11372528 ATC3 5/16/1994 ######## Special
11372528 Chemical 6/1/2004 9/30/2004 Repeat
11372528 ATC3 12/1/1995 ######## Special
11372528 ATC3 11/1/1997 ######## Special
11400101 Brand 6/1/2011 8/31/2011 Special Claim only
11400101 Chemical 9/1/2004 8/31/2011 Application
11580126 Chemical 1/1/2006 ######## AltSubSA
11580126 Chemical 12/1/2008 1/31/2009 AltSubSA
11590101 Chemical 5/16/1994 6/30/1999 TreatMax 30
11660101 Chemical 5/16/1994 ######## TreatMax 30
11672525 Brand 9/1/2009 ######## S29
11680501 Formulation5/16/1994 Special
11680901 Formulation 9/1/2011 Special
11700101 ATC2 8/1/2010 6/30/2013 Application
11700101 ATC2 6/1/2001 6/30/2005 Application
11700101 ATC2 1/1/2001 5/31/2001 Special
11700101 ATC2 7/1/2005 6/30/2010 Application
11700101 Formulation 4/1/2013 Brandswitch 2433265 BSF Nevirapine Alphapharm
11700101 ATC2 4/1/1997 9/30/1998 Special
11700101 ATC2 7/1/2010 7/31/2010 Application
11700125 ATC2 7/1/2010 7/31/2010 Application
11700125 ATC2 4/1/1997 9/30/1998 Special
11700125 Formulation 4/1/2013 Brandswitch 2433265 BSF Nevirapine Alphapharm
11700125 ATC2 7/1/2005 6/30/2010 Application
11700125 ATC2 1/1/2001 5/31/2001 Special
11700125 ATC2 6/1/2001 6/30/2005 Application
11700125 ATC2 8/1/2010 6/30/2013 Application
11702525 ATC2 8/1/2010 6/30/2013 Application
11702525 ATC2 6/1/2001 6/30/2005 Application
11702525 ATC2 1/1/2001 5/31/2001 Special
11702525 ATC2 7/1/2005 6/30/2010 Application
11702525 ATC2 4/1/1997 9/30/1998 Special
11702525 ATC2 7/1/2010 7/31/2010 Application
11720101 ATC2 7/1/2005 6/30/2010 Application
11720101 ATC2 1/1/2001 5/31/2001 Special
11720101 ATC2 6/1/2001 6/30/2005 Application
11720101 ATC2 8/1/2010 6/30/2013 Application
11720101 ATC2 7/1/2010 7/31/2010 Application
11720101 ATC2 4/1/1997 9/30/1998 Special
11720201 ATC2 4/1/1997 9/30/1998 Special
11720201 ATC2 7/1/2010 7/31/2010 Application
11720201 ATC2 8/1/2010 6/30/2013 Application
11720201 ATC2 6/1/2001 6/30/2005 Application
11720201 ATC2 1/1/2001 5/31/2001 Special
11720201 ATC2 7/1/2005 6/30/2010 Application
11730101 Chemical 7/1/2005 PCT
11740101 ATC3 7/1/2013 Special
11740201 ATC3 7/1/2013 Special
11780101 Chemical 9/1/2010 5/31/2012 FormMax 8 PSO
11780101 Formulation 1/1/1999 6/30/2004 FormMax 2 Rx
11780101 Formulation 7/1/2004 ######## SubRxF
11780101 Formulation 6/1/2012 ######## Application
11780101 Chemical 7/1/2004 5/31/2012 FormMax 2 Rx Special
11780101 Chemical 12/1/2005 5/31/2012 SubRxF Special
11780101 Chemical 3/1/2013 TreatMax 5 Rx SubRxF
11780101 Formulation 6/1/2012 ######## FormMax 2 Rx Special
11780101 Formulation 6/1/2012 ######## SubRxF Special
11830401 Chemical 6/1/2002 6/30/2004 SubRxF
11832525 Chemical 6/1/2002 6/30/2004 SubRxF
11832525 Chemical 7/1/2004 9/30/2007 SubRxF
11832526 Chemical 7/1/2004 9/30/2007 SubRxF
11832526 Chemical 6/1/2002 6/30/2004 SubRxF
11832527 Chemical 6/1/2002 6/30/2004 SubRxF
11832527 Chemical 7/1/2004 9/30/2007 SubRxF
11870101 Formulation 5/1/2000 FormMax 12 Rx
11890101 Formulation5/16/1994 4/30/2002 SpecEnd Retail
11890301 Formulation5/16/1994 4/30/2002 Special
11910301 Formulation 8/1/2010 4/30/2012 ProvAllow Dietitian
11920101 ATC3 11/1/2002 8/31/2006 Application
11920101 Chemical 5/1/1999 ######## Application
11920101 ATC3 4/1/2004 8/31/2006 SubRxF Special
11920201 ATC3 4/1/2004 8/31/2006 SubRxF Special
11920201 Chemical 5/1/1999 ######## Application
11920201 ATC3 11/1/2002 8/31/2006 Application
11930101 Brand 11/1/2004 AltSubRxF
11930125 Brand 11/1/2004 5/31/2005 AltSubRxF
12210125 Brand 1/1/2014 Wastage
12230101 ATC2 7/1/2005 6/30/2010 Application
12230101 ATC2 1/1/2001 5/31/2001 Special
12230101 ATC2 6/1/2001 6/30/2005 Application
12230101 ATC2 8/1/2010 6/30/2013 Application
12230101 ATC2 4/1/1997 9/30/1998 Special
12230101 ATC2 7/1/2010 7/31/2010 Application
12230101 Formulation 3/1/2013 5/31/2013 Brandswitch 2433494 BSF Alphapharm
12230125 Formulation 3/1/2013 5/31/2013 Brandswitch 2433494 BSF Alphapharm
12230125 ATC2 7/1/2010 7/31/2010 Application
12230125 ATC2 4/1/1997 9/30/1998 Special
12230125 ATC2 8/1/2010 6/30/2013 Application
12230125 ATC2 6/1/2001 6/30/2005 Application
12230125 ATC2 1/1/2001 5/31/2001 Special
12230125 ATC2 7/1/2005 6/30/2010 Application
12280201 Formulation5/16/1994 Wastage
12320101 Chemical 5/16/1994 9/30/2005 SubRxF
12320101 Chemical 10/1/2005 ######## SubRxF
12320101 Chemical 10/1/2005 FormMax 5 PSO
12320101 Chemical 12/1/2005 6/30/2013 SubRxF
12320102 Chemical 12/1/2005 6/30/2013 SubRxF
12320102 Chemical 10/1/2005 ######## SubRxF
12320102 Chemical 5/16/1994 9/30/2005 SubRxF
12320201 Chemical 5/16/1994 9/30/2005 SubRxF
12320201 Chemical 10/1/2005 ######## SubRxF
12320201 Chemical 12/1/2005 6/30/2013 SubRxF
12320225 Chemical 12/1/2005 6/30/2013 SubRxF
12320225 Chemical 10/1/2005 ######## SubRxF
12320225 Chemical 5/16/1994 9/30/2005 SubRxF
12320226 Chemical 5/16/1994 9/30/2005 SubRxF
12320226 Chemical 10/1/2005 ######## SubRxF
12320226 Chemical 12/1/2005 6/30/2013 SubRxF
12320227 Chemical 12/1/2005 6/30/2013 SubRxF
12320227 Chemical 10/1/2005 ######## SubRxF
12320227 Chemical 5/16/1994 9/30/2005 SubRxF
12320228 Chemical 5/16/1994 9/30/2005 SubRxF
12320228 Chemical 10/1/2005 ######## SubRxF
12320228 Chemical 12/1/2005 6/30/2013 SubRxF
12320301 Chemical 12/1/2005 6/30/2013 SubRxF
12320301 Chemical 10/1/2005 ######## SubRxF
12320301 Chemical 5/16/1994 9/30/2005 SubRxF
12320325 Chemical 5/16/1994 9/30/2005 SubRxF
12320325 Chemical 10/1/2005 ######## SubRxF
12320325 Chemical 12/1/2005 6/30/2013 SubRxF
12320326 Chemical 12/1/2005 6/30/2013 SubRxF
12360226 Chemical 5/16/1994 6/30/2013 SubRxF
12360227 Chemical 5/16/1994 6/30/2013 SubRxF
12360228 Chemical 5/16/1994 6/30/2013 SubRxF
12382525 Brand 10/1/2010 2/28/2011 S29
12390101 Chemical 8/1/1999 Combined
12390125 Chemical 8/1/1999 Combined
12440101 Chemical 2/1/2004 DoseMMax 500
12440101 Chemical 6/7/1995 7/31/1999 Combined
12440101 Formulation 6/7/1995 7/31/1999 DoseMMax 500
12440101 Chemical 6/7/1995 7/31/1999 FormReqd Rx
12440201 Formulation10/1/1999 1/31/2004 SubRxF
12440201 Formulation10/1/1999 1/31/2004 DoseMMax 500
12470101 Chemical 3/1/2013 5/31/2013 Brandswitch 2433486 BSF Accarb
12480101 ATC3 3/1/2007 ######## Special
12480101 ATC3 12/1/2010 Special
12480101 ATC3 12/1/2005 2/28/2007 Special
12480101 ATC3 6/1/2000 ######## Special
12480101 ATC3 2/1/2005 Dispensary Xpharm
12820101 Chemical 10/1/2003 ######## Statim Must
12820201 Formulation 4/1/1996 ######## SpecEnd Retail
12900125 Brand 9/1/2012 S29
12900125 Brand 4/1/2013 Wastage
12910101 ATC3 5/16/1994 9/30/1997 SpecEnd Retail
12970101 Formulation5/16/1994 ######## DoseDMax 2
12970101 ATC3 3/1/1996 3/31/1996 SpecialWav
12970102 ATC3 3/1/1996 3/31/1996 SpecialWav
12970103 ATC3 3/1/1996 3/31/1996 SpecialWav
12970104 ATC3 3/1/1996 3/31/1996 SpecialWav
12970104 Brand 9/1/1998 8/31/2001 Preferred
12970201 ATC3 3/1/1996 3/31/1996 SpecialWav
12970202 ATC3 3/1/1996 3/31/1996 SpecialWav
12970203 ATC3 3/1/1996 3/31/1996 SpecialWav
12970204 ATC3 3/1/1996 3/31/1996 SpecialWav
12970204 Brand 9/1/1998 8/31/2001 Preferred
12970301 ATC3 3/1/1996 3/31/1996 SpecialWav
12970302 ATC3 3/1/1996 3/31/1996 SpecialWav
12970304 ATC3 3/1/1996 3/31/1996 SpecialWav
12970304 Brand 9/1/1998 8/31/2001 Preferred
12970401 ATC3 3/1/1996 3/31/1996 SpecialWav
13030101 Formulation12/1/2008 FormMax 4 Rx SpecEnd
13030101 Formulation11/1/1999 ######## FormMax 3 Rx SpecEnd
13030125 Formulation11/1/1999 ######## FormMax 3 Rx SpecEnd
13030301 Formulation11/1/1999 SpecEnd Retail
13080101 ATC3 8/1/2003 6/30/2005 Application
13200601 Formulation 6/1/2002 FormReqd Rx
13320102 Brand 6/1/1998 6/30/1999 Preferred
13320202 Brand 6/1/1998 6/30/1999 Preferred
13320302 Brand 6/1/1998 6/30/1999 Preferred
13320501 Formulation######## Safety Compounded
13320501 Formulation######## Combined
13570101 Formulation5/16/1994 FormBan BSO
13630101 Chemical 6/1/2002 NotCombined
13850101 Chemical 5/16/1994 1/31/2001 FormReqd WSO
13850101 Chemical 2/1/2001 2/28/2001 FormBan Rx
13850101 Chemical 4/1/2001 6/30/2001 FormBan WSO
13850101 Chemical 2/1/2001 2/28/2001 FormBan BSO
13850101 Chemical 3/1/2001 3/31/2001 FormReqd PSO
13890125 Brand 7/1/2014 S29
13890125 Brand 7/1/2014 Wastage
13970103 Formulation11/1/1997 Safety Compounded
13970103 Formulation5/16/1994 8/31/2010 TreatMax 30
14010901 ATC3 3/1/1996 8/31/2010 Application
14010901 Formulation 3/1/1996 SpecialWav Claim only
14011101 ATC3 3/1/1996 8/31/2010 Application
14011201 ATC3 3/1/1996 8/31/2010 Application
14011202 ATC3 3/1/1996 8/31/2010 Application
14011203 ATC3 3/1/1996 8/31/2010 Application
14011204 ATC3 3/1/1996 8/31/2010 Application
14011301 ATC3 3/1/1996 8/31/2010 Application
14110101 ATC3 3/1/1996 8/31/2010 Application
14110201 ATC3 3/1/1996 8/31/2010 Application
14110202 ATC3 3/1/1996 8/31/2010 Application
14240101 Formulation5/16/1994 7/31/1999 NotCombined
14240102 Brand 10/1/2008 ######## S29
14270101 Formulation 6/1/1997 ######## SpecialWav
14270101 Formulation 3/1/1999 8/31/1999 SpecialWav
14270101 Formulation11/1/2008 6/30/2009 SpecialWav
14270101 Chemical 9/1/1999 ######## SpecialWav
14751101 ATC3 8/1/1995 ######## SpecialWav
14751101 ATC3 11/1/1999 AltSubSA
14751201 ATC3 11/1/1999 AltSubSA
14751201 ATC3 8/1/1995 ######## SpecialWav
14760101 ATC3 8/1/1995 ######## SpecialWav
14760101 ATC3 11/1/1999 AltSubSA
14760201 ATC3 11/1/1999 AltSubSA
14760201 ATC3 8/1/1995 ######## SpecialWav
14770101 ATC3 8/1/1995 ######## SpecialWav
14770101 ATC3 11/1/1999 AltSubSA
14770201 ATC3 11/1/1999 AltSubSA
14770201 ATC3 8/1/1995 ######## SpecialWav
14770301 ATC3 8/1/1995 ######## SpecialWav
14770301 ATC3 11/1/1999 AltSubSA
14770401 ATC3 11/1/1999 AltSubSA
14770401 ATC3 8/1/1995 ######## SpecialWav
14790101 ATC3 8/1/1995 ######## SpecialWav
14790101 ATC3 11/1/1999 AltSubSA
14790102 ATC3 11/1/1999 AltSubSA
14790102 ATC3 8/1/1995 ######## SpecialWav
14790201 ATC3 8/1/1995 ######## SpecialWav
14790201 ATC3 11/1/1999 AltSubSA
14790202 ATC3 11/1/1999 AltSubSA
14790202 ATC3 8/1/1995 ######## SpecialWav
15540101 Formulation 7/1/2013 SubRxF
15540101 Formulation5/16/1994 ######## SubRxF
15540225 Brand 3/1/2013 S29
15540225 Brand 4/1/2013 Wastage
15740601 Formulation 7/1/2004 1/31/2007 Combined
15740601 Formulation 2/1/2007 Combined
15750101 Chemical 6/16/1995 2/28/2007 ProvReqd M
15770225 Brand 8/1/2008 2/28/2009 S29
15772525 Formulation11/1/2003 ######## FormMax 200 PSO
15890601 Formulation 1/1/1999 ######## Dispensary HP3
15890601 Formulation6/27/1995 ######## SpecEnd Hospital
15980201 Formulation######## SpecialWav
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16040126 Brand 5/1/2013 S29
16040126 Brand 8/1/2013 Wastage
16040301 Brand 10/1/2013 ######## Wastage
17950601 Formulation10/1/1996 Safety Uncompounded
17970101 Chemical 7/1/2005 ######## PCT
17970101 Formulation12/1/2005 PCT
17970102 Chemical 7/1/2005 ######## PCT
17970103 Chemical 7/1/2005 ######## PCT
17970125 Chemical 7/1/2005 ######## PCT
17970201 Chemical 7/1/2005 ######## PCT
17970225 Chemical 7/1/2005 ######## PCT
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17970501 Chemical 7/1/2005 ######## PCT
17970701 Chemical 7/1/2005 ######## PCT
17970703 Chemical 7/1/2005 ######## PCT
17970901 Chemical 7/1/2005 ######## PCT
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18812501 Formulation5/16/1994 9/30/1999 FormMax 42 Rx
18812502 Brand 1/1/2007 3/31/2010 S29
18860501 Formulation12/1/1996 ######## SpecialWav
18860501 ATC2 12/1/1996 6/30/2010 Application
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18860501 Formulation 3/1/1995 AltSubSA Claim only
18860525 ATC2 12/1/1996 6/30/2010 Application
18860525 Formulation12/1/1996 ######## SpecialWav
18860601 Formulation12/1/1996 DoseWMax 2
18860601 ATC2 12/1/1996 6/30/2010 Application
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18860625 ATC2 12/1/1996 6/30/2010 Application
18860701 ATC2 12/1/1996 6/30/2010 Application
18860725 ATC2 12/1/1996 6/30/2010 Application
18860801 ATC2 12/1/1996 6/30/2010 Application
18860802 ATC2 12/1/1996 6/30/2010 Application
18860803 ATC2 12/1/1996 6/30/2010 Application
18860901 ATC2 12/1/1996 6/30/2010 Application
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20880301 Chemical 4/1/2013 SubRxF SpecEnd
20960326 Brand 8/1/2012 S29
20960326 Brand 4/1/2013 Wastage
20960901 Brand 7/1/1996 FormMax 500 PSO
20960902 Brand 7/1/1996 FormMax 1000 PSO
21140101 Formulation5/16/1994 8/31/2004 FormReqd PSO
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21280125 Brand 4/1/2006 S29
21280125 Brand 4/1/2013 Wastage
21282525 Formulation10/1/2004 1/31/2012 Combined
11980101 Chemical 7/1/2005 9/30/2005 PCT
11980102 Chemical 7/1/2005 9/30/2005 PCT
11980103 Chemical 7/1/2005 9/30/2005 PCT
11980104 Chemical 7/1/2005 9/30/2005 PCT
11980201 Chemical 7/1/2005 9/30/2005 PCT
11980301 Chemical 7/1/2005 9/30/2005 PCT
11980401 Chemical 7/1/2005 9/30/2005 PCT
11980402 Chemical 7/1/2005 9/30/2005 PCT
11980425 Chemical 7/1/2005 9/30/2005 PCT
11982525 Chemical 7/1/2005 9/30/2005 PCT
11982526 Chemical 7/1/2005 9/30/2005 PCT
11982625 Chemical 7/1/2005 9/30/2005 PCT
11982626 Chemical 7/1/2005 9/30/2005 PCT
11982725 Chemical 7/1/2005 9/30/2005 PCT
11982825 Chemical 7/1/2005 9/30/2005 PCT
12170301 ATC3 7/1/2005 7/31/2007 Application
12170301 ATC3 8/1/2003 6/30/2005 Application
12170401 ATC3 8/1/2003 6/30/2005 Application
12170401 ATC3 7/1/2005 7/31/2007 Application
12170402 ATC3 7/1/2005 7/31/2007 Application
12170402 ATC3 8/1/2003 6/30/2005 Application
12170501 ATC3 8/1/2003 6/30/2005 Application
12170501 ATC3 7/1/2005 7/31/2007 Application
12170601 ATC3 7/1/2005 7/31/2007 Application
12170601 ATC3 8/1/2003 6/30/2005 Application
12170602 ATC3 8/1/2003 6/30/2005 Application
12170602 ATC3 7/1/2005 7/31/2007 Application
12170701 ATC3 7/1/2005 7/31/2007 Application
12170701 ATC3 8/1/2003 6/30/2005 Application
12210125 Brand 1/1/2014 S29
24242625 Formulation 9/1/2013 Special Claim only
24330101 Chemical 7/1/2005 ######## PCT
24330201 Chemical 7/1/2005 ######## PCT
24330301 Chemical 7/1/2005 ######## PCT
24330302 Chemical 7/1/2005 ######## PCT
24332525 Chemical 7/1/2005 ######## PCT
24332526 Chemical 7/1/2005 ######## PCT
24450101 Chemical 1/1/2006 PCT
24450201 Chemical 1/1/2006 PCT
24450301 Chemical 1/1/2006 PCT
24450401 Chemical 1/1/2006 PCT
24450601 Chemical 1/1/2006 PCT
24450701 Chemical 1/1/2006 PCT
24450901 Chemical 1/1/2006 PCT
24451001 Chemical 1/1/2006 PCT
24451101 Chemical 1/1/2006 PCT
24451201 Chemical 1/1/2006 PCT
16171601 Formulation5/23/1995 FormReqd PSO
16240125 Brand 3/1/2007 S29
16240125 Brand 4/1/2013 Wastage
16260101 Chemical 7/1/2005 PCT
12320326 Chemical 10/1/2005 ######## SubRxF
12320326 Chemical 5/16/1994 9/30/2005 SubRxF
12320327 Chemical 5/16/1994 9/30/2005 SubRxF
12320327 Chemical 10/1/2005 ######## SubRxF
12320327 Chemical 12/1/2005 6/30/2013 SubRxF
12320328 Chemical 12/1/2005 6/30/2013 SubRxF
12320328 Chemical 10/1/2005 ######## SubRxF
12320328 Chemical 5/16/1994 9/30/2005 SubRxF
12320329 Chemical 5/16/1994 9/30/2005 SubRxF
12320329 Chemical 10/1/2005 ######## SubRxF
12320329 Chemical 12/1/2005 6/30/2013 SubRxF
12330101 Formulation11/1/1999 FormMax 3 Rx SubRxF
12330101 Chemical 5/16/1994 ######## SpecEnd Hospital
12330101 Chemical 5/16/1994 ######## SubRxF
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12330201 Chemical 5/16/1994 ######## SubRxF
12330225 Chemical 5/16/1994 ######## SubRxF
12330226 Chemical 5/16/1994 ######## SubRxF
12330301 Chemical 5/16/1994 ######## SubRxF
12330325 Chemical 5/16/1994 ######## SubRxF
12330326 Chemical 5/16/1994 ######## SubRxF
12360101 Chemical 5/16/1994 6/30/2013 SubRxF
12360125 Chemical 5/16/1994 6/30/2013 SubRxF
12360126 Chemical 5/16/1994 6/30/2013 SubRxF
12360127 Chemical 5/16/1994 6/30/2013 SubRxF
12360128 Chemical 5/16/1994 6/30/2013 SubRxF
12360129 Chemical 5/16/1994 6/30/2013 SubRxF
12360201 Chemical 5/16/1994 6/30/2013 SubRxF
12360225 Chemical 5/16/1994 6/30/2013 SubRxF
16420125 Brand 9/1/2013 ######## Wastage
16430101 Chemical 1/1/2011 3/31/2011 Brandswitch 2377837 BSF Dapa-Tabs
16482501 Formulation10/1/1996 ######## Special
16530101 ATC3 3/1/2014 SubRxF
16530101 Chemical 12/1/1997 ProvReqd M
16530101 ATC3 12/1/1997 2/28/2014 SubRxF
16860101 Chemical 6/16/1995 ######## ProvReqd M
16880101 Chemical 5/16/1994 2/28/2009 SpecOnly Hospital
12482525 ATC3 6/1/2000 ######## Special
12482525 ATC3 12/1/2005 2/28/2007 Special
12482525 ATC3 3/1/2007 ######## Special
12482525 ATC3 12/1/2010 Special
12482625 ATC3 12/1/2010 Special
12482625 ATC3 3/1/2007 ######## Special
12482625 ATC3 12/1/2005 2/28/2007 Special
12482625 ATC3 6/1/2000 ######## Special
12500101 ATC3 6/1/2004 ######## Special
12500101 ATC3 11/1/2004 8/31/2005 Special
12500101 Chemical 10/1/1999 4/30/2012 Statim May
12500125 ATC3 11/1/2004 8/31/2005 Special
12500125 ATC3 6/1/2004 ######## Special
12540101 Chemical 11/1/2012 1/31/2013 Brandswitch 2426781 BSF Candestar
12540101 Formulation 7/1/2004 7/31/2012 DoseDMax 1.5
12540301 Formulation 7/1/2004 7/31/2012 DoseDMax 1
12550101 Chemical 7/1/2005 PCT
12550125 Chemical 7/1/2005 PCT
12550201 Chemical 7/1/2005 PCT
12730101 Formulation 6/1/1995 TreatMax 30
12750101 Formulation10/1/2003 3/31/2007 AltSubRxF
12750101 Formulation 4/1/2007 AltSubRxF
16960101 Brand 1/1/2014 S29
16960101 Brand 1/1/2014 Wastage
16960301 Formulation 3/1/1998 ######## FormReqd Rx
16960301 Formulation 3/1/1998 ######## FormMax 100 Rx
16970101 Chemical 3/1/1996 SpecialWav Claim only
16970101 ATC3 3/1/1996 8/31/2010 Application
16970302 ATC3 3/1/1996 8/31/2010 Application
16970303 ATC3 3/1/1996 8/31/2010 Application
16970505 ATC3 3/1/1996 8/31/2010 Application
16970601 ATC3 3/1/1996 8/31/2010 Application
16970701 ATC3 3/1/1996 8/31/2010 Application
16970801 ATC3 3/1/1996 8/31/2010 Application
16980101 Chemical 6/2/1995 7/31/1999 NotCombined
16992525 Brand 10/1/2005 S29
16992525 Brand 4/1/2013 Wastage
13080101 ATC3 7/1/2005 7/31/2007 Application
13120101 Brand 4/1/2013 S29
13120101 Brand 4/1/2013 Wastage
13160301 ATC3 8/1/2003 6/30/2005 Application
13160301 ATC3 7/1/2005 7/31/2007 Application
13170201 Formulation5/16/1994 9/30/1999 DoseWMax 1
13170201 Formulation5/16/1994 9/30/1999 FormReqd Rx
17170701 Formulation 7/1/1996 3/31/2008 SpecEnd Retail
17180201 ATC3 11/1/1999 AltSubSA
17180201 ATC3 8/1/1995 ######## SpecialWav
17180301 ATC3 8/1/1995 ######## SpecialWav
17180301 ATC3 11/1/1999 AltSubSA
17180401 ATC3 11/1/1999 AltSubSA
17180401 ATC3 8/1/1995 ######## SpecialWav
17180501 ATC3 8/1/1995 ######## SpecialWav
17180501 ATC3 11/1/1999 AltSubSA
17180502 ATC3 11/1/1999 AltSubSA
17180502 ATC3 8/1/1995 ######## SpecialWav
17180503 ATC3 8/1/1995 ######## SpecialWav
17180503 ATC3 11/1/1999 AltSubSA
17180601 ATC3 11/1/1999 AltSubSA
17180601 ATC3 8/1/1995 ######## SpecialWav
17180701 ATC3 8/1/1995 ######## SpecialWav
17180701 ATC3 11/1/1999 AltSubSA
17180801 ATC3 11/1/1999 AltSubSA
17180801 ATC3 8/1/1995 ######## SpecialWav
17180802 ATC3 8/1/1995 ######## SpecialWav
17180802 ATC3 11/1/1999 AltSubSA
17180901 Formulation 9/1/2012 2/28/2013 Brandswitch 2405865 BSF Ava 30 ED
17180901 ATC3 11/1/1999 AltSubSA
17180901 ATC3 8/1/1995 ######## SpecialWav
17180902 ATC3 8/1/1995 ######## SpecialWav
17180902 ATC3 11/1/1999 AltSubSA
17180903 ATC3 11/1/1999 AltSubSA
17180903 ATC3 8/1/1995 ######## SpecialWav
17180904 ATC3 8/1/1995 ######## SpecialWav
17180904 ATC3 11/1/1999 AltSubSA
10150301 ATC3 7/1/2013 Special
10242525 Brand 3/1/2008 S29
10242525 Brand 4/1/2013 Wastage
10260226 Brand 5/9/2011 S29
13690125 Brand 10/1/2013 S29
13690126 Brand 3/1/2014 S29
13690201 Brand 7/1/2005 2/28/2007 PCT
13690201 Brand 7/1/2005 2/28/2007 SpecEnd Retail
13690225 Brand 7/1/2005 2/28/2007 PCT only
13690225 Brand 7/1/2005 2/28/2007 SpecEnd Hospital
13740101 Brand 7/1/2010 ######## S29
13742525 Brand 7/1/2010 ######## S29
10430101 Brand 12/1/2006 2/28/2007 S29
10430101 ATC3 9/1/1996 ######## Application
10530103 Brand 8/1/2010 8/31/2010 S29
10570301 Formulation 5/1/2006 ######## FormMax 5 PSO
10600101 ATC3 7/1/2005 7/31/2007 Application
10600101 ATC3 8/1/2003 6/30/2005 Application
10600201 ATC3 8/1/2003 6/30/2005 Application
10600201 ATC3 7/1/2005 7/31/2007 Application
10602525 ATC3 7/1/2005 7/31/2007 Application
10602525 ATC3 8/1/2003 6/30/2005 Application
10602625 ATC3 8/1/2003 6/30/2005 Application
10602625 ATC3 7/1/2005 7/31/2007 Application
17180925 ATC3 8/1/1995 ######## SpecialWav
17180925 ATC3 11/1/1999 AltSubSA
17181001 ATC3 11/1/1999 AltSubSA
17181001 ATC3 8/1/1995 ######## SpecialWav
17181101 ATC3 8/1/1995 ######## SpecialWav
17181101 ATC3 11/1/1999 AltSubSA
17181201 ATC3 11/1/1999 AltSubSA
17181201 ATC3 8/1/1995 ######## SpecialWav
17181201 Formulation10/1/1998 Contraceptive
17181201 Formulation12/1/2012 5/30/2013 Brandswitch 2427958 BSF Ava 20 ED
17181202 ATC3 8/1/1995 ######## SpecialWav
17181202 ATC3 11/1/1999 AltSubSA
17181225 ATC3 11/1/1999 AltSubSA
17181225 ATC3 8/1/1995 ######## SpecialWav
17190101 Formulation 8/1/1996 FormReqd PSO
17190201 Formulation 8/1/1996 FormReqd PSO
17240101 ATC3 11/1/1999 AltSubSA
17240101 ATC3 8/1/1995 ######## SpecialWav
17240102 ATC3 8/1/1995 ######## SpecialWav
17240102 ATC3 11/1/1999 AltSubSA
10660301 Formulation11/1/2005 7/31/2006 Special Claim only
10660301 ATC2 3/1/2000 7/31/2001 Special
10660301 ATC2 8/1/2001 ######## Application
10660301 ATC2 12/1/1996 2/29/2000 Special
10662525 ATC2 3/1/2000 7/31/2001 Special
10662525 ATC2 12/1/1996 2/29/2000 Special
10662525 ATC2 8/1/2001 ######## Application
10662525 ATC2 11/1/2005 7/31/2006 Application
10680525 Formulation 6/1/2008 6/30/2008 Statim Must
10680526 Formulation 6/1/2008 6/30/2008 Statim Must
10720201 Formulation12/1/2013 RFPP 10
14010101 ATC3 3/1/1996 8/31/2010 Application
14010102 ATC3 3/1/1996 8/31/2010 Application
14010103 ATC3 3/1/1996 8/31/2010 Application
14010104 ATC3 3/1/1996 8/31/2010 Application
14010125 ATC3 3/1/1996 8/31/2010 Application
14010126 ATC3 3/1/1996 8/31/2010 Application
14010201 ATC3 3/1/1996 8/31/2010 Application
14010202 ATC3 3/1/1996 8/31/2010 Application
14010203 ATC3 3/1/1996 8/31/2010 Application
14010204 ATC3 3/1/1996 8/31/2010 Application
14010225 ATC3 3/1/1996 8/31/2010 Application
14010226 ATC3 3/1/1996 8/31/2010 Application
14010301 ATC3 3/1/1996 8/31/2010 Application
14010302 ATC3 3/1/1996 8/31/2010 Application
14010303 ATC3 3/1/1996 8/31/2010 Application
14010304 ATC3 3/1/1996 8/31/2010 Application
14010501 ATC3 3/1/1996 8/31/2010 Application
14010601 ATC3 3/1/1996 8/31/2010 Application
14010701 ATC3 3/1/1996 8/31/2010 Application
14010801 ATC3 3/1/1996 8/31/2010 Application
10860101 ATC2 8/1/2010 6/30/2013 Application
10860101 ATC2 6/1/2001 6/30/2005 Application
10860101 ATC2 1/1/2001 5/31/2001 Special
10860101 ATC2 7/1/2005 6/30/2010 Application
10860101 ATC2 7/1/2010 7/31/2010 Application
10860101 ATC2 4/1/1997 9/30/1998 Special
10860201 ATC2 4/1/1997 9/30/1998 Special
10860201 ATC2 7/1/2010 7/31/2010 Application
10860201 ATC2 7/1/2005 6/30/2010 Application
10860201 ATC2 1/1/2001 5/31/2001 Special
10860201 ATC2 6/1/2001 6/30/2005 Application
10860201 ATC2 8/1/2010 6/30/2013 Application
10862525 ATC2 8/1/2010 6/30/2013 Application
10862525 ATC2 6/1/2001 6/30/2005 Application
10862525 ATC2 1/1/2001 5/31/2001 Special
10862525 ATC2 7/1/2005 6/30/2010 Application
10862525 ATC2 4/1/1997 9/30/1998 Special
10862525 ATC2 7/1/2010 7/31/2010 Application
17242825 ATC3 11/1/1999 AltSubSA
17242825 ATC3 8/1/1995 ######## SpecialWav
17280102 Brand 11/1/1999 6/30/2001 Preferred
17290101 Formulation11/1/1997 2/28/1998 Safety Compounded
17600201 Brand 10/1/2013 ######## Wastage
11020101 ATC2 4/1/1997 9/30/1998 Special
11020101 ATC2 1/1/2001 5/31/2001 Special
11020101 ATC2 6/1/2001 6/30/2005 Application
11020101 ATC2 8/1/2010 6/30/2013 Application
11020101 ATC2 7/1/2005 6/30/2010 Application
11020201 ATC2 7/1/2005 6/30/2010 Application
11020201 ATC2 8/1/2010 6/30/2013 Application
11020201 ATC2 6/1/2001 6/30/2005 Application
11020201 ATC2 1/1/2001 5/31/2001 Special
11020201 ATC2 4/1/1997 9/30/1998 Special
11020201 ATC2 7/1/2010 7/31/2010 Application
11070101 Chemical 10/1/2004 MaxQtyDisp 3
11080101 Brand 10/1/1999 9/30/2002 Preferred
11080201 Brand 10/1/1999 9/30/2002 Preferred
11080301 Brand 10/1/1999 9/30/2002 Preferred
11090101 ATC2 7/1/2010 7/31/2010 Application
11090101 ATC2 4/1/1997 9/30/1998 Special
11090101 ATC2 7/1/2005 6/30/2010 Application
11090101 ATC2 1/1/2001 5/31/2001 Special
11090101 ATC2 6/1/2001 6/30/2005 Application
11090101 ATC2 8/1/2010 6/30/2013 Application
11090201 ATC2 8/1/2010 6/30/2013 Application
11090201 ATC2 6/1/2001 6/30/2005 Application
11090201 ATC2 1/1/2001 5/31/2001 Special
11090201 ATC2 7/1/2005 6/30/2010 Application
11090201 ATC2 4/1/1997 9/30/1998 Special
11090201 ATC2 7/1/2010 7/31/2010 Application
11090301 ATC2 7/1/2010 7/31/2010 Application
11090301 ATC2 4/1/1997 9/30/1998 Special
11090301 ATC2 7/1/2005 6/30/2010 Application
11090301 ATC2 1/1/2001 5/31/2001 Special
11090301 ATC2 6/1/2001 6/30/2005 Application
11090301 ATC2 8/1/2010 6/30/2013 Application
11090401 ATC2 8/1/2010 6/30/2013 Application
11090401 ATC2 6/1/2001 6/30/2005 Application
11090401 ATC2 1/1/2001 5/31/2001 Special
11090401 ATC2 7/1/2005 6/30/2010 Application
11090401 ATC2 4/1/1997 9/30/1998 Special
11090401 ATC2 7/1/2010 7/31/2010 Application
11090501 ATC2 7/1/2010 7/31/2010 Application
11090501 ATC2 4/1/1997 9/30/1998 Special
11090501 ATC2 7/1/2005 6/30/2010 Application
11090501 Brand 4/1/2013 S29
11090501 Brand 4/1/2013 Wastage
11090501 ATC2 1/1/2001 5/31/2001 Special
11090501 ATC2 6/1/2001 6/30/2005 Application
11090501 ATC2 8/1/2010 6/30/2013 Application
11100101 ATC3 12/1/1997 2/28/2014 SubRxF
11100101 ATC3 3/1/2014 SubRxF
11100125 ATC3 3/1/2014 SubRxF
11100125 ATC3 12/1/1997 2/28/2014 SubRxF
11100126 ATC3 12/1/1997 2/28/2014 SubRxF
11100126 ATC3 3/1/2014 SubRxF
14530301 Formulation6/24/1995 Combined
14750801 ATC3 8/1/1995 ######## SpecialWav
14750801 ATC3 11/1/1999 AltSubSA
14750901 ATC3 11/1/1999 AltSubSA
14750901 ATC3 8/1/1995 ######## SpecialWav
14750902 ATC3 8/1/1995 ######## SpecialWav
14750902 ATC3 11/1/1999 AltSubSA
14751001 ATC3 11/1/1999 AltSubSA
14751001 ATC3 8/1/1995 ######## SpecialWav
11330125 ATC3 7/1/2005 7/31/2007 Application
11330125 ATC3 8/1/2003 6/30/2005 Application
11330201 ATC3 8/1/2003 6/30/2005 Application
11330201 ATC3 7/1/2005 7/31/2007 Application
11330225 ATC3 7/1/2005 7/31/2007 Application
11330225 ATC3 8/1/2003 6/30/2005 Application
11330301 ATC3 8/1/2003 6/30/2005 Application
11330301 ATC3 7/1/2005 7/31/2007 Application
11330325 ATC3 7/1/2005 7/31/2007 Application
11330325 ATC3 8/1/2003 6/30/2005 Application
11330401 ATC3 8/1/2003 6/30/2005 Application
11330401 ATC3 7/1/2005 7/31/2007 Application
11330425 ATC3 7/1/2005 7/31/2007 Application
11330425 ATC3 8/1/2003 6/30/2005 Application
11332525 ATC3 8/1/2003 6/30/2005 Application
11332525 ATC3 7/1/2005 7/31/2007 Application
11332625 ATC3 7/1/2005 7/31/2007 Application
11332625 ATC3 8/1/2003 6/30/2005 Application
11370101 ATC3 11/1/1997 ######## Special
11370101 ATC3 12/1/1995 ######## Special
11370101 Chemical 6/1/2004 9/30/2004 Repeat
11370101 ATC3 5/16/1994 ######## Special
11370101 ATC3 12/1/1998 3/31/2002 Special
11370125 ATC3 12/1/1998 3/31/2002 Special
11370125 ATC3 5/16/1994 ######## Special
11370125 Chemical 6/1/2004 9/30/2004 Repeat
11370125 ATC3 12/1/1995 ######## Special
11370125 ATC3 11/1/1997 ######## Special
11370126 ATC3 11/1/1997 ######## Special
11370126 ATC3 12/1/1995 ######## Special
11370126 Chemical 6/1/2004 9/30/2004 Repeat
11370126 ATC3 5/16/1994 ######## Special
11370126 ATC3 12/1/1998 3/31/2002 Special
11370127 ATC3 12/1/1998 3/31/2002 Special
11370127 ATC3 5/16/1994 ######## Special
11370127 Chemical 6/1/2004 9/30/2004 Repeat
11370127 ATC3 12/1/1995 ######## Special
11370127 ATC3 11/1/1997 ######## Special
11370201 ATC3 11/1/1997 ######## Special
11370201 ATC3 12/1/1995 ######## Special
11370201 Chemical 6/1/2004 9/30/2004 Repeat
11370201 ATC3 12/1/1998 3/31/2002 Special
11370201 ATC3 5/16/1994 ######## Special
11370225 ATC3 12/1/1998 3/31/2002 Special
11370225 ATC3 5/16/1994 ######## Special
11370225 Chemical 6/1/2004 9/30/2004 Repeat
11370225 ATC3 12/1/1995 ######## Special
11370225 ATC3 11/1/1997 ######## Special
11370226 ATC3 11/1/1997 ######## Special
17660501 ATC2 12/1/1996 6/30/2010 Application
17660601 ATC2 12/1/1996 6/30/2010 Application
17660701 ATC2 12/1/1996 6/30/2010 Application
17660801 ATC3 11/1/1999 AltSubSA
17660801 ATC3 8/1/1995 ######## SpecialWav
17662525 ATC3 11/1/1999 AltSubSA
17662525 ATC3 8/1/1995 ######## SpecialWav
17690101 ATC3 3/1/1996 8/31/2010 Application
17690102 ATC3 3/1/1996 8/31/2010 Application
17730101 Chemical 7/1/2005 ######## PCT
17730201 Chemical 7/1/2005 ######## PCT
17732525 Chemical 7/1/2005 ######## PCT
17810101 Chemical 7/1/2005 PCT
17810201 Chemical 7/1/2005 PCT
17950101 Formulation 8/1/1996 7/31/1999 NotCombined
17950102 Formulation 8/1/1996 7/31/1999 NotCombined
17950201 Brand 11/1/2007 9/30/2008 S29
17950225 Brand 10/1/2003 S29
17950225 Brand 4/1/2013 Wastage
11440101 Formulation5/16/1994 Statim May
11560101 ATC2 12/1/1996 6/30/2010 Application
11560201 ATC2 12/1/1996 6/30/2010 Application
14982526 Brand 2/1/2006 S29
14982526 Brand 4/1/2013 Wastage
11830101 Chemical 6/1/2002 6/30/2004 SubRxF
11830101 Chemical 7/1/2004 9/30/2007 SubRxF
11830125 Chemical 7/1/2004 9/30/2007 SubRxF
11830125 Chemical 6/1/2002 6/30/2004 SubRxF
11830126 Chemical 6/1/2002 6/30/2004 SubRxF
11830126 Chemical 7/1/2004 9/30/2007 SubRxF
11830201 Chemical 7/1/2004 9/30/2007 SubRxF
11830201 Chemical 6/1/2002 6/30/2004 SubRxF
11830225 Chemical 6/1/2002 6/30/2004 SubRxF
11830225 Chemical 7/1/2004 9/30/2007 SubRxF
11830226 Chemical 7/1/2004 9/30/2007 SubRxF
11830226 Chemical 6/1/2002 6/30/2004 SubRxF
11830301 Chemical 6/1/2002 6/30/2004 SubRxF
11830301 Chemical 7/1/2004 9/30/2007 SubRxF
11830325 Chemical 7/1/2004 9/30/2007 SubRxF
11830325 Chemical 6/1/2002 6/30/2004 SubRxF
11830326 Chemical 6/1/2002 6/30/2004 SubRxF
11830326 Chemical 7/1/2004 9/30/2007 SubRxF
11830401 Chemical 7/1/2004 9/30/2007 SubRxF
10020101 ATC3 8/1/2003 6/30/2005 Application
10020101 ATC3 1/1/2001 7/31/2003 Special
10020101 ATC3 7/1/2005 7/31/2007 Application
10020201 ATC3 7/1/2005 7/31/2007 Application
10020201 ATC3 1/1/2001 7/31/2003 Special
10020201 ATC3 8/1/2003 6/30/2005 Application
10020301 ATC3 8/1/2003 6/30/2005 Application
10020301 ATC3 1/1/2001 7/31/2003 Special
10020301 ATC3 7/1/2005 7/31/2007 Application
10022501 ATC3 7/1/2005 7/31/2007 Application
10022501 ATC3 8/1/2003 6/30/2005 Application
10022525 ATC3 8/1/2003 6/30/2005 Application
10022525 ATC3 7/1/2005 7/31/2007 Application
10022601 ATC3 7/1/2005 7/31/2007 Application
10022601 ATC3 8/1/2003 6/30/2005 Application
10022625 ATC3 8/1/2003 6/30/2005 Application
10022625 ATC3 7/1/2005 7/31/2007 Application
10022626 ATC3 7/1/2005 7/31/2007 Application
10022626 ATC3 8/1/2003 6/30/2005 Application
10022627 ATC3 8/1/2003 6/30/2005 Application
10022627 ATC3 7/1/2005 7/31/2007 Application
10022701 ATC3 7/1/2005 7/31/2007 Application
10022701 ATC3 8/1/2003 6/30/2005 Application
10022725 ATC3 8/1/2003 6/30/2005 Application
10022725 ATC3 7/1/2005 7/31/2007 Application
10022726 ATC3 7/1/2005 7/31/2007 Application
10022726 ATC3 8/1/2003 6/30/2005 Application
10022727 ATC3 8/1/2003 6/30/2005 Application
10022727 ATC3 7/1/2005 7/31/2007 Application
10022801 ATC3 7/1/2005 7/31/2007 Application
10022801 ATC3 8/1/2003 6/30/2005 Application
10022825 ATC3 8/1/2003 6/30/2005 Application
10022825 ATC3 7/1/2005 7/31/2007 Application
10022826 ATC3 7/1/2005 7/31/2007 Application
10022826 ATC3 8/1/2003 6/30/2005 Application
10022827 ATC3 8/1/2003 6/30/2005 Application
10022827 ATC3 7/1/2005 7/31/2007 Application
10022925 ATC3 7/1/2005 7/31/2007 Application
10022925 ATC3 8/1/2003 6/30/2005 Application
10022926 ATC3 8/1/2003 6/30/2005 Application
10022926 ATC3 7/1/2005 7/31/2007 Application
10023025 ATC3 7/1/2005 7/31/2007 Application
10023025 ATC3 8/1/2003 6/30/2005 Application
10040101 ATC3 7/1/2005 7/31/2007 Application
10040101 ATC3 8/1/2003 6/30/2005 Application
10090101 ATC3 5/16/1994 8/31/1996 Special
10090101 ATC3 12/1/1996 1/31/1998 Special
10090101 ATC3 2/1/1998 6/30/1999 Special
17971002 Chemical 7/1/2005 ######## PCT
17971101 Chemical 7/1/2005 ######## PCT
17971125 Chemical 7/1/2005 ######## PCT
17971201 Chemical 7/1/2005 ######## PCT
17971202 Chemical 7/1/2005 ######## PCT
17971225 Chemical 7/1/2005 ######## PCT
17972525 Chemical 7/1/2005 ######## PCT
17972526 Chemical 7/1/2005 ######## PCT
17972625 Chemical 7/1/2005 ######## PCT
17972626 Chemical 7/1/2005 ######## PCT
17972725 Chemical 7/1/2005 ######## PCT
17972825 Chemical 7/1/2005 ######## PCT
17972825 Brand 6/1/2011 S29
17972825 Brand 4/1/2013 Wastage
17972925 Chemical 7/1/2005 ######## PCT
17973025 Chemical 7/1/2005 ######## PCT
17973125 Chemical 7/1/2005 ######## PCT
17973225 Chemical 7/1/2005 ######## PCT
17973325 Chemical 7/1/2005 ######## PCT
17973425 Chemical 7/1/2005 ######## PCT
18170101 Chemical 10/1/2007 3/31/2008 Repeat
18170101 Chemical 9/1/2012 ######## Brandswitch 2405873 BSF Metoprolol - AFT CR
18170125 Chemical 10/1/2007 3/31/2008 Repeat
18170126 Chemical 10/1/2007 3/31/2008 Repeat
18170201 Chemical 10/1/2007 3/31/2008 Repeat
18170225 Chemical 10/1/2007 3/31/2008 Repeat
18170226 Chemical 10/1/2007 3/31/2008 Repeat
18170301 Chemical 10/1/2007 3/31/2008 Repeat
18170325 Chemical 10/1/2007 3/31/2008 Repeat
18170326 Chemical 10/1/2007 3/31/2008 Repeat
18172525 Chemical 10/1/2007 3/31/2008 Repeat
18172526 Chemical 10/1/2007 3/31/2008 Repeat
18172527 Chemical 10/1/2007 3/31/2008 Repeat
18232525 Brand 10/1/2012 S29
18232525 Brand 4/1/2013 Wastage
18232625 Brand 10/1/2012 S29
18232625 Brand 4/1/2013 Wastage
18260101 Formulation 6/2/1995 2/28/2002 FormReqd WSO
18260101 Formulation 6/2/1995 2/28/2002 FormMax 20 WSO
18260101 Chemical 3/1/2002 7/31/2010 FormMax 20 WSO
18260101 Chemical 8/1/2010 ######## FormMax 20 PSO
18260101 Chemical 8/1/2010 FormReqd PSO
18260125 Chemical 8/1/2010 ######## FormMax 20 PSO
18270101 Formulation6/27/1995 ######## FormReqd WSO
18270101 Formulation6/27/1995 ######## FormMax 10 WSO
18270101 Formulation11/1/2002 4/30/2003 FormMax 20 WSO
18270101 Formulation11/1/2002 4/30/2003 FormReqd WSO
18280101 Formulation 7/1/2013 SpecialWav
18310101 Formulation 8/1/2004 1/31/2005 Repeat
18310101 Formulation 2/1/2004 7/31/2004 SpecialWav Claim only
18311325 Brand 4/1/2007 S29
18311325 Brand 4/1/2013 Wastage
18311425 Brand 3/1/2004 S29
18311425 Brand 4/1/2013 Wastage
18311525 Brand 3/1/2004 S29
18311525 Brand 4/1/2013 Wastage
18600101 Formulation5/16/1994 DoseDMax 4
18600101 Formulation5/16/1994 9/30/1999 DoseSMax 2
18610425 Brand 6/1/2004 S29
18610425 Brand 4/1/2013 Wastage
18630301 Formulation12/1/1999 8/31/2006 AltSubSA Claim only
18710101 ATC3 8/1/1995 ######## SpecialWav
18710101 ATC3 11/1/1999 AltSubSA
18730101 ATC3 11/1/1999 AltSubSA
18730101 ATC3 8/1/1995 ######## SpecialWav
18730201 ATC3 8/1/1995 ######## SpecialWav
18730201 ATC3 11/1/1999 AltSubSA
18740101 Formulation5/27/1995 6/30/2014 FormMax 6 Rx SpecEnd
18740125 Formulation5/27/1995 6/30/2014 FormMax 6 Rx SpecEnd
18750101 ATC3 11/1/1999 AltSubSA
18750101 ATC3 8/1/1995 ######## SpecialWav
18860903 ATC2 12/1/1996 6/30/2010 Application
18861001 ATC2 12/1/1996 6/30/2010 Application
18861101 ATC2 12/1/1996 6/30/2010 Application
18880102 ATC2 12/1/1996 6/30/2010 Application
18880202 ATC2 12/1/1996 6/30/2010 Application
18880302 ATC2 12/1/1996 6/30/2010 Application
19290202 Brand 6/1/1998 5/31/2000 Preferred
19290206 Brand 6/1/1998 5/31/2000 Preferred
19290207 Brand 8/1/1999 5/31/2000 Preferred
19290303 Brand 6/1/1998 5/31/2000 Preferred
19290305 Brand 8/1/1999 5/31/2000 Preferred
19530101 Brand 6/1/1998 5/31/2000 Preferred
19530201 Brand 6/1/1998 5/31/2000 Preferred
19562525 Brand 7/1/2013 S29
19562525 Brand 7/1/2013 Wastage
19660101 Brand 3/1/2008 S29
19660101 Brand 4/1/2013 Wastage
19660125 Brand 5/1/2014 S29
19660125 Brand 5/1/2014 Wastage
19700301 Brand 2/1/2000 6/30/2001 Preferred
19700401 Brand 2/1/2000 6/30/2001 Preferred
19780101 ATC3 8/1/2003 6/30/2005 Application
19780101 ATC3 7/1/2005 7/31/2007 Application
19780201 ATC3 7/1/2005 7/31/2007 Application
19780201 ATC3 8/1/2003 6/30/2005 Application
19780301 ATC3 8/1/2003 6/30/2005 Application
19780301 ATC3 7/1/2005 7/31/2007 Application
19780401 ATC3 7/1/2005 7/31/2007 Application
19780401 ATC3 8/1/2003 6/30/2005 Application
19780501 ATC3 8/1/2003 6/30/2005 Application
19780501 ATC3 7/1/2005 7/31/2007 Application
19870201 Brand 8/1/2009 ######## S29
19870301 Brand 8/1/2009 ######## S29
19870501 Brand 8/1/2009 ######## S29
19870701 Formulation10/1/2007 Special
19902525 Brand 2/1/2007 S29
19902525 Brand 4/1/2013 Wastage
19950101 Chemical 5/16/1994 TreatMax 30
20380101 Chemical 10/1/2003 6/30/2013 Statim Must
20380125 Brand 8/1/2013 S29
20380125 Brand 8/1/2013 Wastage
20410101 ATC3 8/1/2003 6/30/2005 Application
20410101 ATC3 7/1/2005 7/31/2007 Application
20410125 ATC3 7/1/2005 7/31/2007 Application
20410125 ATC3 8/1/2003 6/30/2005 Application
20450101 ATC2 12/1/1996 6/30/2010 Application
20450201 ATC2 12/1/1996 6/30/2010 Application
20470101 Chemical 1/1/2006 2/28/2014 PCT only
20470101 Chemical 3/1/2014 PCT
20470101 Brand 1/1/2006 S29
20470101 Brand 4/1/2013 Wastage
20500201 ATC2 12/1/1996 6/30/2010 Application
20500202 ATC2 12/1/1996 6/30/2010 Application
20500301 ATC2 12/1/1996 6/30/2010 Application
20500401 ATC2 12/1/1996 6/30/2010 Application
20500411 ATC2 12/1/1996 6/30/2010 Application
20500412 ATC2 12/1/1996 6/30/2010 Application
20500501 ATC2 12/1/1996 6/30/2010 Application
20530101 ATC2 12/1/1996 6/30/2010 Application
20560101 Formulation5/25/1995 DoseMMax 1
20560101 ATC2 12/1/1996 6/30/2010 Application
20560201 ATC2 12/1/1996 6/30/2010 Application
20560301 ATC2 12/1/1996 6/30/2010 Application
20560325 ATC2 12/1/1996 6/30/2010 Application
20560401 ATC2 12/1/1996 6/30/2010 Application
20600104 Brand 4/1/2012 S29
20600104 Brand 4/1/2013 Wastage
20600203 Brand 4/1/2012 S29
20600203 Brand 4/1/2013 Wastage
20602525 Brand 4/1/2013 S29
20602525 Brand 8/1/2013 Wastage
20620125 Brand 5/1/2012 S29
20620125 Brand 4/1/2013 Wastage
20630101 Brand 7/1/2013 S29
20630101 Brand 7/1/2013 Wastage
20690125 Brand 12/1/2003 4/30/2008 S29
20710201 Formulation 8/1/2005 MaxCoPayment 0
20710501 Formulation 6/8/1995 1/31/1998 DoseSMax 100
20710501 Formulation 6/8/1995 1/31/1998 FormReqd Rx
20800301 ATC3 3/1/1996 3/31/1996 SpecialWav
20800325 ATC3 3/1/1996 3/31/1996 SpecialWav
20800401 ATC3 3/1/1996 3/31/1996 SpecialWav
20800501 ATC3 3/1/1996 3/31/1996 SpecialWav
20800502 Brand 9/1/1998 8/31/2001 Preferred
20800502 ATC3 3/1/1996 3/31/1996 SpecialWav
20800503 ATC3 3/1/1996 3/31/1996 SpecialWav
20800525 ATC3 3/1/1996 3/31/1996 SpecialWav
20800601 ATC3 3/1/1996 3/31/1996 SpecialWav
20800602 ATC3 3/1/1996 3/31/1996 SpecialWav
20800602 Brand 9/1/1998 8/31/2001 Preferred
20800603 ATC3 3/1/1996 3/31/1996 SpecialWav
20800625 ATC3 3/1/1996 3/31/1996 SpecialWav
20802501 ATC3 3/1/1996 3/31/1996 SpecialWav
20802502 ATC3 3/1/1996 3/31/1996 SpecialWav
20802601 ATC3 3/1/1996 3/31/1996 SpecialWav
20802602 ATC3 3/1/1996 3/31/1996 SpecialWav
20870101 Formulation5/16/1994 DoseSMax 1
21580101 Chemical 8/1/2010 ######## FormMax 20 Rx
21582525 Formulation 8/1/2009 FormBan BSO
21582526 Formulation 8/1/2009 FormBan BSO
21660101 ATC3 8/1/2003 6/30/2005 Application
21660101 ATC3 7/1/2005 7/31/2007 Application
21660201 ATC3 7/1/2005 7/31/2007 Application
21660201 ATC3 8/1/2003 6/30/2005 Application
21660202 ATC3 8/1/2003 6/30/2005 Application
21660202 ATC3 7/1/2005 7/31/2007 Application
21660301 ATC3 7/1/2005 7/31/2007 Application
21660301 ATC3 8/1/2003 6/30/2005 Application
21660302 ATC3 8/1/2003 6/30/2005 Application
21660302 ATC3 7/1/2005 7/31/2007 Application
21660401 ATC3 7/1/2005 7/31/2007 Application
21660401 ATC3 8/1/2003 6/30/2005 Application
21660402 ATC3 8/1/2003 6/30/2005 Application
21660402 ATC3 7/1/2005 7/31/2007 Application
21660501 ATC3 7/1/2005 7/31/2007 Application
21660501 ATC3 8/1/2003 6/30/2005 Application
21930101 ATC3 3/1/1996 8/31/2010 Application
21930102 ATC3 3/1/1996 8/31/2010 Application
21930103 ATC3 3/1/1996 8/31/2010 Application
21930125 ATC3 3/1/1996 8/31/2010 Application
21930201 ATC3 3/1/1996 8/31/2010 Application
21930202 ATC3 3/1/1996 8/31/2010 Application
21930203 ATC3 3/1/1996 8/31/2010 Application
21930225 ATC3 3/1/1996 8/31/2010 Application
22120101 ATC3 8/1/2003 6/30/2005 Application
22120101 ATC3 7/1/2005 7/31/2007 Application
22120101 Formulation 7/1/1996 ######## Statim May
22120201 Formulation 7/1/1996 ######## Statim May
22120201 ATC3 7/1/2005 7/31/2007 Application
22120201 ATC3 8/1/2003 6/30/2005 Application
22242525 Formulation 5/1/2005 Safety Compounded
22242525 Brand 5/1/2006 ######## S29
22500401 Formulation 6/8/1995 1/31/1998 FormReqd Rx
22520101 Chemical 7/1/2005 PCT
22570101 Chemical 7/1/2005 7/31/2009 PCT
22570101 Chemical 8/1/2009 PCT only
22570101 Brand 3/1/2012 S29
22570125 Brand 8/1/2009 S29
22570125 Chemical 7/1/2005 7/31/2009 PCT
22570126 Chemical 7/1/2005 7/31/2009 PCT
22570126 Brand 9/1/2013 S29
22570201 Chemical 7/1/2005 7/31/2009 PCT
22632525 Formulation 8/1/2009 Safety Compounded
22660204 Brand 8/1/1998 7/31/2000 Preferred
22660404 Brand 8/1/1998 7/31/2000 Preferred
22980101 Brand 1/1/2007 2/28/2010 S29
22980125 Brand 1/1/2006 S29
22980125 Brand 4/1/2013 Wastage
22980201 Brand 3/1/2007 2/28/2010 S29
22980301 Brand 3/1/2007 2/28/2010 S29
22980325 Brand 1/1/2006 S29
22980325 Brand 4/1/2013 Wastage
23140101 Chemical 11/1/1999 6/30/2013 SubRxF
23140101 Chemical 5/16/1994 ######## FormReqd Rx
23140201 Chemical 11/1/1999 6/30/2013 SubRxF
23140301 Chemical 11/1/1999 6/30/2013 SubRxF
23140302 Chemical 11/1/1999 6/30/2013 SubRxF
23140325 Chemical 11/1/1999 6/30/2013 SubRxF
23190101 Chemical 7/1/2005 ######## PCT
23190102 Chemical 7/1/2005 ######## PCT
23192525 Chemical 7/1/2005 ######## PCT
23192526 Chemical 7/1/2005 ######## PCT
23200101 Chemical 7/1/2005 ######## PCT
23200201 Chemical 7/1/2005 ######## PCT
23202525 Chemical 7/1/2005 ######## PCT
Trial Version
Stamp
Pharmacode Effective Expiry Subsidy Alternate Price CBS OP Change
201502 4/1/1996 3/1/1997 151.69 151.69 151.69 FALSE FALSE Change -Subsidy -Price -Alternate
201502 2/1/2007 5/1/2007 24.95 24.95 87.98 FALSE FALSE Change -Subsidy -Alternate
201502 5/1/2007 0 0 0 FALSE FALSE Delisted
201510 5/16/1994 10/1/2006 141.54 141.54 141.54 FALSE FALSE New Listing
201510 10/1/2006 169.85 169.85 169.85 FALSE TRUE Change +Subsidy +Price +Alternate +OP
201529 6/1/1996 8/1/1997 16.84 16.84 16.84 FALSE FALSE Change +Subsidy +Price +Alternate
201588 3/1/2001 7/1/2001 29.06 29.06 33.28 FALSE FALSE Change +Price
201588 1/1/2002 6/1/2009 29.06 29.06 29.06 FALSE FALSE Change -Price
201642 6/3/1995 8/1/2000 8.6 8.6 8.6 FALSE TRUE New Listing
201642 8/1/2000 9/1/2002 8.6 8.6 9.14 FALSE TRUE Change +Price
201693 12/1/1999 4/1/2000 1.1 1.1 2.52 FALSE TRUE Change -Subsidy -Alternate
201766 1/1/1997 2/1/1999 9.2 9.2 12 FALSE FALSE Change -Price
201766 2/1/1999 8/1/2001 10.31 10.31 10.31 FALSE FALSE Change +Subsidy -Price +Alternate
201766 8/1/2001 13.36 13.36 13.36 FALSE FALSE Change +Subsidy +Price +Alternate
201839 6/1/1997 10/4/1997 2.96 2.96 5 FALSE TRUE New Listing
201839 10/4/1997 6/1/1998 2.96 2.96 4.46 FALSE TRUE Change -Price
201839 6/1/1998 2/1/1999 2.96 2.96 5 FALSE TRUE Change +Price
201839 8/1/2013 2.96 2.96 2.96 FALSE TRUE Change -Price
201855 5/1/2004 3.43 3.43 4.35 FALSE TRUE Change +Price
201863 5/1/2004 6.59 6.59 8 FALSE TRUE Change +Price
201960 7/1/2003 5.86 5.86 5.86 FALSE FALSE Change +Subsidy +Alternate
202118 8/1/2010 1/1/2014 60 60 60 FALSE FALSE Change +Subsidy +Price +Alternate
202118 1/1/2014 126 126 126 FALSE FALSE Change +Subsidy +Price +Alternate
202126 7/1/1999 10/1/2010 25 25 34.9 FALSE FALSE Change -Subsidy -Price -Alternate
202126 1/1/2011 2/1/2013 0 0 0 FALSE FALSE Delisted
202215 1/1/1999 5/1/2001 1 1 4.35 FALSE TRUE Change -Subsidy -Alternate
202215 5/1/2001 9/1/2002 1 1 4.6 FALSE TRUE Change +Price
202223 5/17/1995 5/1/1997 6.57 6.57 6.57 FALSE TRUE Change +Subsidy +Price +Alternate
200263 5/16/1994 9/1/2000 21 21 23.01 FALSE FALSE New Listing
200271 5/16/1994 31.31 31.31 31.31 FALSE FALSE New Listing
200379 5/16/1994 3/1/1998 9 9 9 FALSE TRUE New Listing
200379 3/1/1998 10/1/2001 6.57 6.57 6.57 FALSE TRUE Change -Subsidy -Price -Alternate
200573 11/1/2002 12/1/2002 10 10 14 FALSE FALSE Change -Subsidy -Alternate
200573 12/1/2002 2/1/2003 10 10 10 FALSE FALSE Change -Price
200905 12/1/2009 17.36 17.36 17.36 FALSE TRUE Change +Subsidy +Price +Alternate
201111 5/16/1994 3/1/1998 8 8 9.2 TRUE TRUE New Listing
201286 5/1/1996 4/1/2000 9.45 13.8 13.8 FALSE TRUE Change +Price +Alternate
201286 4/1/2000 2/1/2003 9.45 13.8 13.8 FALSE FALSE Change -OP
201308 7/1/2005 6/1/2010 680 680 680 FALSE FALSE New listing
201413 1/1/2001 3/1/2002 20 20 20 FALSE FALSE Change -Subsidy -Price -Alternate
201413 3/1/2004 8 8 8 FALSE FALSE Change -Subsidy -Price -Alternate
201421 3/1/2004 12.5 12.5 12.5 FALSE FALSE Change -Subsidy -Price -Alternate
202266 5/16/1994 4/3/1995 8.34 8.34 13 FALSE FALSE New Listing
202266 4/3/1995 10/1/2005 13 13 13 FALSE FALSE Change +Subsidy +Alternate
202525 7/1/1995 3/1/2001 21.21 21.21 21.21 FALSE FALSE Change +Subsidy +Alternate
202665 7/1/2000 8/1/2000 4.19 65.32 65.32 FALSE FALSE Change -Subsidy
202665 8/1/2000 11/1/2000 4.19 4.19 2 FALSE FALSE Change -Price -Alternate
202681 ######## 8/1/2000 0 0 0 TRUE FALSE New Listing
202681 8/1/2000 5/1/2002 137.06 137.06 137.06 FALSE FALSE Change +Subsidy +Price +Alternate -CBS
202770 8/1/2002 1/1/2004 9.45 15 15 FALSE FALSE Change +Price +Alternate
202770 1/1/2004 6.62 15 16.5 FALSE FALSE Change -Subsidy +Price
202827 8/1/1999 4/1/2000 9.45 9.45 9.45 FALSE TRUE Change -Price -Alternate
202827 4/1/2000 9.45 9.45 9.45 FALSE FALSE Change -OP
203017 8/1/2000 10/1/2002 9.45 14.49 14.49 FALSE FALSE Change +Price +Alternate
203106 5/16/1994 7/1/1999 13 13 13 FALSE FALSE New Listing
203106 7/1/1999 11/1/1999 2.75 2.75 13 FALSE FALSE Change -Subsidy -Alternate
203106 6/1/2009 5 5 5 FALSE FALSE New Listing
203300 11/1/1998 10/1/1999 50 50 50 FALSE TRUE Change -Subsidy -Price -Alternate
203300 10/1/1999 9/1/2000 50 50 50 FALSE FALSE Change -OP
203343 1/1/2006 13.52 13.52 13.52 FALSE FALSE New listing
203351 5/16/1994 8.76 8.76 8.76 FALSE TRUE New Listing
203483 3/1/2003 6/1/2003 32 32 37.42 FALSE FALSE Change -Subsidy -Alternate
204366 4/1/2002 10/1/2006 8 8 8 FALSE TRUE Change +Subsidy -Price +Alternate
204366 1/1/2008 3.3 3.3 3.3 FALSE TRUE Change -Subsidy -Price -Alternate
204374 4/1/2002 10/1/2006 8.5 8.5 8.5 FALSE TRUE Change +Subsidy -Price +Alternate
204528 ######## 9/1/2000 2.43 2.43 2.43 FALSE FALSE New Listing
204544 10/1/2004 7/1/2007 55.23 55.23 55.23 FALSE FALSE New listing
204625 5/16/1994 ######## 23.05 23.05 23.05 FALSE FALSE New Listing
204625 ######## 5/1/1998 23.05 23.05 23.04 FALSE FALSE Change -Price
204625 5/1/1998 8/1/1998 7.03 7.03 23.04 FALSE FALSE Change -Subsidy +Price -Alternate
204676 7/1/1999 11/1/1999 22.79 22.79 45 FALSE FALSE Change -Subsidy -Price -Alternate
204919 3/1/2000 2/1/2002 11.35 11.35 49 FALSE FALSE Change +Price
205001 9/1/2003 12/1/2003 16 16 20.57 FALSE FALSE Change +Subsidy +Price +Alternate
205133 7/1/1995 9/1/2000 4.48 4.48 10 FALSE TRUE Change +Price +OP
205265 3/1/1998 10/1/1998 3.33 3.33 9 FALSE TRUE Change -Subsidy -Alternate
205273 10/1/2000 14.95 14.95 22.29 FALSE FALSE Change -Subsidy -Alternate
206105 8/1/2003 31 31 31 FALSE FALSE Change +Subsidy +Alternate
206563 5/30/1995 ######## 3.98 3.98 3.98 FALSE FALSE New Listing
206563 ######## 10/1/2000 3.98 3.98 4.38 FALSE FALSE Change +Price
207462 1/1/2009 1/1/2012 2 2 2 FALSE TRUE Change +Subsidy +Price +Alternate
207462 1/1/2012 2 2 3.92 FALSE TRUE Change +Price
208051 3/1/1999 2/1/2000 0.26 9.95 9.95 FALSE FALSE Change -Price +Alternate
208388 8/1/2010 15 15 15 FALSE TRUE New Listing
209538 4/1/2008 18.4 18.4 38.1 FALSE FALSE Change +Price
209759 2/1/2004 3.49 3.49 4.9 FALSE TRUE Change -Subsidy -Alternate
209880 6/1/1999 3/1/2001 2.89 2.89 6.89 FALSE TRUE Change +Subsidy +Alternate
209945 10/1/1997 3/1/2001 8.81 8.81 8.81 FALSE TRUE Change +OP
210633 4/1/1997 6/1/2003 3 3 5 FALSE FALSE Change +Price
210633 6/1/2003 4/1/2005 3.95 3.95 5 FALSE FALSE Change +Subsidy +Alternate
211044 10/1/1998 1/1/1999 1.83 1.83 4.64 FALSE TRUE Change -Subsidy +Price -Alternate
211192 5/1/1997 2/1/2007 15 15 18.7 FALSE FALSE Change +Price
211389 11/1/2006 95 95 95 FALSE FALSE New listing
212059 10/1/2008 320 320 320 FALSE TRUE Change +Subsidy +Price +Alternate
213098 3/1/2003 12/1/2003 12.81 19.9 19.9 FALSE FALSE Change +Subsidy
213098 9/1/2006 5.5 5.5 19.9 FALSE FALSE Change +Subsidy -Alternate
213101 9/1/2006 8 8 29.5 FALSE FALSE Change +Subsidy -Alternate
215929 9/1/2006 2.79 2.79 8.06 FALSE TRUE Change +OP
216518 7/1/2012 0 0 84.83 FALSE FALSE New listing
218278 2/1/2007 3/1/2007 1.26 1.99 4.2 FALSE FALSE Change -Alternate
218278 3/1/2007 5/1/2007 1.26 4.2 4.2 FALSE FALSE Change +Alternate
221775 3/1/2001 36.8 36.8 135 FALSE FALSE Change +Price
222011 8/1/2007 4/1/2013 0.75 0.75 0.75 FALSE TRUE New listing
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Code Name AbbreviationPhone Fax Post Site Type
1 3M Pharmaceuticals (NZ) Ltd 3M 0 9 444 5289 0 9 444 5770 C P O Box 2201Shortland Street Auckland 1015 3M Building 250 Archers RoadGlenfieldAuckland Manufacturer
2 Abbott Laboratories (NZ) Ltd Abbott 0 4 567 0039 0 4 567 0032 P O Box 35-128NaenaeLOWER HUTT 227 Cambridge TerraceNaenaeLOWER HUTT Manufacturer
3 Alcon Laboratories Ltd Alcon 0 9 579 7923 0 9 579 3698 P O Box 14-562PanmureAUCKLAND 67 Leonard RoadMt WellingtonAUCKLAND Manufacturer
4 New Zealand Distributors Ltd NZ Distributors 0 9 815 1031 P O Box 41-014St LukesAUCKLAND 2-6 Argyle Street MorningsideAUCKLAND Importer
5 Allergan New Zealand Ltd Allergan 0 9 573 0609 0 9 573 0622 PO Box 1873Mt WellingtonAUCKLAND 10 8D Sylvia Park RoadMt WellingtonAUCKLAND 10 Manufacturer
6 New Zealand Medical and Scientific Ltd NZ Medical0 9 634 1036 0 9 634 5146 P O Box 24-138Royal OakAUCKLAND 90 Mays RoadTakapunaAUCKLAND Importer
7 Ansell International Ansell 0 9 267 9897 0 9 267 6343 P O Box 97-041South Auckland Mail CentreAUCKLAND 67 Dalgety DriveManakau CityAUCKLAND Manufacturer
8 Novo-Nordisk Pharmaceuticals Ltd Novo-Nordisk 0 9 579 0653 0 9 579 0654 P O Box 51-268PakurangaAUCKLAND 642 Great South RoadEllerslieAUCKLAND Manufacturer
9 Pacific Pharmaceuticals Ltd Pacific 0 9 573 2792 0 9 579 7072 P O Box 11-183EllerslieAUCKLAND 76 Leonard RoadMt Wellington AUCKLAND Importer
10 Apotex (NZ) Inc Apotex 0 9 444 2073 0 9 444 2951 Private Bag 102-995North Shore Mail CentreAUCKLAND 32 Hillside RoadGlenfieldAUCKLAND Manufacturer
11 Astra Pharmaceuticals (NZ) Ltd Astra 0 9 623 6300 0 9 623 6301 PO Box 1301AUCKLAND 303 Manukau RoadEpsomAUCKLAND Manufacturer
12 Baxter Healthcare Ltd Baxter 0 9 527 1489 0 9 527 3614 Private Box 14-062PanmureAUCKLAND 18 Allright PlaceMt Wellington AUCKLAND Manufacturer
13 Bayer Diagnostics Bayer 0 9 634 6000 0 9 634 6005 P O Box 59-174Mangere BridgeAUCKLAND 51-53 Hastie AvenueMangere BridgeAUCKLAND Manufacturer
14 Pfizer Laboratories Ltd Pfizer 0061 2 858 9444 0061 2 858 1347 P O Box 57West RydeNSW 2114AUSTRALIA 38-42 Wharf RoadWest RydeNSW 2114AUSTRALIA Manufacturer
15 Bayer New Zealand Ltd (Pharmaceutical Division) Bayer 09 443 309309 443 5491C P O Box 2825AUCKLAND 10 3 Argus PlaceGlenfieldAUCKLAND Manufacturer
16 Pharmaceutical Sales and Marketing Ltd PSM 0 9 444 6898 0 9 444 1986 P O Box 40-079GlenfieldAUCKLAND 10 31-39 Hillside RoadGlenfieldAUCKLAND Manufacturer
17 Boehringer Ingelheim (NZ) Ltd Boehringer Ingelheim 0 9 262 1356 0 9 262 1462 P O Box 76-216Manakau CityAUCKLAND 47 Druces RoadWiriAUCKLAND Manufacturer
19 Pharmaco (NZ) Ltd Pharmaco 0 9 377 3336 0 9 307 1307 P O Box 4079ParnellAUCKLAND 49 George Street ParnellAUCKLAND Importer
20 Boehringer Mannheim (NZ) Ltd Boehringer Mannheim 0 9 276 4157 0 9 276 8917 P O Box 62-089Sylvia ParkAUCKLAND 15 Rakino WayMt WellingtonAUCKLAND Manufacturer
21 Procter & Gamble New Zealand (Pharmacia & Upjohn) Procter & Gamble 09 270 032809 276 5209PO Box 11-282EllerslleAUCKLAND 3 Fisher Crescent Mt WellingtonAUCKLAND Manufacturer
22 Bristol-Myers Squibb BMS 0 9 571 5250 0 9 571 5251 P O Box 62 663Central AucklandAUCKLAND Stanaway Business ParkTower 2 Level 1646 Great South RoadEllerslieAUCKLAND Manufacturer
23 Reckitt & Colman Pharmaceuticals Reckitt & Colman 0 9 828 4129 0 9 828 4648 Private Bag 19-990AvondaleAUCKLAND 550 Rosebank RoadAvondaleAUCKLAND Manufacturer
24 REM Systems Limited REM 0 9 570 2033 0 9 570 5389 P O Box 90-147Auckland Mail CentreAUCKLAND 69 Elizabeth Knox PlaceGlen InnesAUCKLAND 6 Importer
25 Ciba VisionCiba Vision0 9 358 4312 0 9 358 4311 P O Box 8061Symonds Street AUCKLAND 47-53 Patiki RoadAvondaleAUCKLAND 7 Manufacturer
26 Resorba Pharmaceuticals Ltd Resorba 0 3 366 3245 P O Box 2781CHRISTCHURCH 171A Wordsworth Street SydenhamCHRISTCHURCH Importer
27 Ciba-Geigy New Zealand Ltd Ciba-Geigy0 9 828 3149 0 9 828 3877 Private Bag 19-999AvondaleAUCKLAND 47-53 Patiki RoadAvondale AUCKLAND Manufacturer
28 Rhone-Poulenc Rorer New Zealand Ltd RPR 09-480-3770 09-480-3799 PO Box 34010BirkenheadAUCKLAND Highpont Shopping CentreLevel Two35 Mokoia RoadBirkenhead AUCKLAND Manufacturer
29 CSL Pharmaceuticals NZ Ltd CSL 0 9 579 8105 0 9 579 8106 P O Box 62-590Central ParkAUCKLAND Level 1, Building 5666 Great South RoadEllerslieAUCKLAND Manufacturer
30 Roche Products (New Zealand) Ltd Roche 0 9 633 0700 0 9 633 0749 P O Box 12-492PenroseAUCKLAND 8 Henderson PlaceTe PapapaAUCKLAND Manufacturer
31 Cyanamid (NZ) Ltd / Lederle Cyanamid 09 276 939309 276 9292Private Bag 92-903OnehungaAUCKLAND 4 Fisher Crescent Mt WellingtonAUCKLAND Importer
33 Russells Pharmaceuticals Ltd Russells 0 9 623 6116 09 623 6155P O Box 9591Newmarket AUCKLAND 110 Mt Eden RoadMt EdenAUCKLAND Importer
34 Salmond Smith Biolab Salmond Smith Biolab 0 9 579 9119 0 9 579 1878 PO Box 1332EllerslieAUCKLAND 4 Sultan Street EllerslieAUCKLAND Manufacturer
35 Douglas Pharmaceuticals Ltd Douglas 09 837 544709 837 5446O Box 45-027LincolnAUCKLAND r Te Pai Place & Central Park DriveHendersonAUCKLAND Manufacturer
36 Sandoz Pharma Ltd Sandoz 0 9 356 1700 0 9 356 1717 O Box 8961Symonds Street AUCKLAND 1 New North RoadEden TerraceAUCKLAND Manufacturer
37 Duncan Flockhart Duncan Flockhart 06 350 179406 356 9064Private BagPALMERSTON NORTH Importer
38 Schering (NZ) Ltd Schering 0 9 415 6342 0 9 415 6497 O Box 65-051AlbanyAUCKLAND 1310 William Pickering DriveNorth HarbourAUCKLAND Manufacturer
39 Ebos Group Ltd Ebos 03 366 219903 379 3248PO Box 411CHRISTCHURCH 4 Cashel Street CHRISTCHURCH Importer
40 Schering-Plough Pty Ltd Schering-Plough 0061 2 852 7444 0061 2 852 7500 PO Box 231Baulkham HillsNSW 2153AUSTRALIA Gibbon RoadBaulkham HillsNSW 2153AUSTRALIA Manufacturer
42 Schwarzkopf NZ Ltd Schwarzkopf 0800 731 137 0 9 309 7512 PO Box 6519Wellesley Street AUCKLAND 1 Khyber Pass RoadNewmarket AUCKLAND Importer
43 EFAMOL (NZ) Ltd Efamol 0 9 415 8477 0 9 415 8478 PO Box 33-118TakapunaNorth Shore CityAUCKLAND atrice Tinsely Crescent North Harbour Industrial EstateAlbanyAUCKLAND Importer
44 Self Care (NZ) Ltd Self Care 0 9 579 5188 0 9 579 7921 PO Box 14-460PenroseAUCKLAND Bassant AvenuePenroseAUCKLAND Importer
45 Eli Lilly & Company (NZ) Limited Eli Lilly 0 9 262 1370 0 9 262 1408 PO Box 97-046South Auckland Mail CentreAUCKLAND Gladding PlaceManukau CitySOUTH AUCKLAND Importer
46 Servier Laboratories (NZ) Servier 0 9 358 1870 0 9 358 1849 PO Box 6675Wellesley Street AUCKLAND 3 Wellesley Street AUCKLAND Manufacturer
47 SmithKline Beecham (NZ) Ltd SKB 0 9 573 1740 0 9 573 1745 O Box 62-043Sylvia ParkAUCKLAND 6a Pacific RosePacific Business CentreMt WellingtonAUCKLAND Manufacturer
48 Faulding Pharmaceuticals Faulding 0 9 570 3206 0 9 570 3208 Private Bag 14-062PanmureAUCKLAND 18 Allright PlaceMt WellingtonAUCKLAND Importer
49 Stafford-Miller (NZ) Ltd Stafford-Miller 0 9 415 8365 0 9 415 9628 P O Box 100-490North Shore Mailing CentreAUCKLAND 2 Rothwell RoadNorth Harbour Industrial EstateAlbanyAUCKLAND Manufacturer
50 Sterling Winthorp (Parmaceuticals) NZ Ltd Sterling Winthorp 0 9 302 0608 0 9 302 0613 Private Bag 93-224ParnellAUCKLAND 60 Stanley Street ParnellAUCKLAND Manufacturer
51 Fisons (NZ) Ltd Fisons 0 9 444 3540 0 9 444 0767 P O Box 31-123MilfordAUCKLAND 235 Archers RoadGlenfieldAUCKLAND Manufacturer
52 Syntex Laboratories (NZ) Ltd Syntex 0 9 622 4000 0 9 622 4049 P O Box 12-492PenroseAUCKLAND 8 Henderson PlaceTe PapapaAUCKLAND Manufacturer
53 The Boots Company (NZ) Ltd Boots 0 4 384 3859 0 4 385 2706 O Box 27-341WELLINGTON 1 d Floor, Sieman House263 Wakefield Street WELLINGTON Manufacturer
54 Upjohn New Zealand Upjohn 0 9 270 0328 0 9 276 5209 P O Box 11-282EllerslieAUCKLAND 3 Fisher Crescent Mt WellingtonAUCKLAND Manufacturer
55 G D Searle (NZ) Ltd Searle 09 376 103209 378 1435P O Box 3872AUCKLAND 316 Richmond RoadGrey LynnAUCKLAND Importer
57 W M Bamford & Co Ltd Bamford 0 4 566 1212 0 4 569 6489 Private Bag 31-346LOWER HUTT 419 Cuba Street AUCKLAND Importer
58 Warner-Lambert (Parke Davis) (NZ) Ltd Warner-Lambert 0 9 270 4170 0 9 276 1172 P O Box 22-071OtahuhuAUCKLAND 731-737 Great South RoadOtahuhuAUCKLAND Manufacturer
59 Healtheries of NZ Ltd Healtheries0 9 573 3730 0 9 573 3731 PO Box 22-045OtahuhuAUCKLAND 505 Mt Wellington HighwayMt WellingtonAUCKLAND Manufacturer
60 Watson Victor Ltd Watson Victor 0 4 385 7699 0 4 384 4651 P O Box 1180WELLINGTON 4 Adelaide RoadAUCKLAND Importer
63 Horley's Health NZ Ltd Horley's 09 570 9389 P O Box 11-131EllerslieAUCKLAND 103-105 Morrin RoadPanmureAUCKLAND Importer
64 Wyeth (NZ) Ltd Wyeth 0800 734 076 0 9 525 6080 P O Box 12-736PenroseAUCKLAND 477 Great South RoadPenroseAUCKLAND Manufacturer
65 ICI New Zealand Limited ICI 0 9 573 2800 0 9 573 2809 P O Box 900Mt WellingtonAUCKLAND Pacific Business Centre8 Pacific RiseMt WellingtonAUCKLAND Manufacturer
66 Zuellig Pharma New Zealand Zuellig 0 9 361 0444 0 9 361 0431 P O Box 413AUCKLAND 316 Richmond RoadGrey LynnAUCKLAND Wholesaler
67 J & W Medical Limited J & W Medical 09 410 5746 PO Box 101-103North Shore Mail CentreAUCKLAND 10 26 Seine RoadMilfordAUCKLAND 9 Importer
68 Jackson Allison Jackson Allison 0 9 303 2859 0 9 309 2132 P O Box 4261AUCKLAND 53 Fort Street AUCKLAND Manufacturer
69 Janssen-Cilag Pty Ltd Janssen-Cilag 0 9 524 5012 0 9 523 1646 P O Box 9222Newmarket AUCKLAND 3 Melrose Street Newmarket AUCKLAND 1 Manufacturer
71 Medica Medica 09 625 5261 09 625 4396P O Box 24-421Royal OakAUCKLAND Importer
72 Merck Sharp & Dohme (NZ) Ltd MSD 0 9 262 3004 0 9 262 2993 P O Box 23-244PapatoetoeAUCKLAND Cnr Wiri Station Rd and Plunkett AveManukau CityAUCKLAND Manufacturer
73 New Zealand Bakels Ltd NZ Bakels 0 9 579 6079 0 9 525 0978 P O Box 12-844PapatoetoeAUCKLAND 6 421-429 Church Street PenroseAUCKLAND Manufacturer
74 New Zealand Diagnostics Ltd NZ Diagnostics 0800 503 060 04 293 1029Private Bag WAIKANAE WAIKANAEManufacturer
75 Edinburgh Pharmaceutical Industries Edinburgh 0 9 367 2933 0 9 367 2910 Division of Allen & Hanburys (NZ) LtdPrivate Bag 106-600DowntownAUCKLAND AUCKLANDManufacturer
76 Allen & Hanbury's Allen & Hanbury's 0 9 367 2934 0 9 367 2910 Private Bag 106-600DowntownAUCKLAND Level 8Quay TowerCnr Customs & Albert StsAUCKLAND Manufacturer
78 Origen Pharmaceuticals Ltd Origen 0 6 356 4373 0 6 356 6726 P O Box 2075PALMERSTON NORTH PALMERSTON NORTH Manufacturer
81 L J Eccles Ltd L J Eccles 0 9 625 4456 0 9 625 9102 Private Bag Mt RoskillAUCKLAND AUCKLANDManufacturer
83 Allied Pharmaceuticals Allied 0 6 350 1749 0 6 356 9064 Private Bag 11-018PALMERSTON NORTH PALMERSTON NORTH Manufacturer
85 Serono Serono 0 9 836 5594 0 9 579 7921 P O Box 45-027AUCKLAND AUCKLANDManufacturer
86 OHL CORPORATION CHL 0 9 828 5145 0 9 528 5938 P O Box 19-129AUCKLAND AUCKLANDManufacturer
87 Smith & Nephew (NZ) Limited Smith & Nephew 0 9 828 4059 0 9 828 0162 P O Box 442AUCKLAND 621 Rosebank RoadAvondaleAUCKLAND Manufacturer
88 Hirst Lens Hirst Lens 0 9 849 5527 0 9 846 2755 Private Bag 9St LukesAUCKLAND AUCKLANDManufacturer
89 Ajax Chemicals Ajax 0 9 573 1479 0 9 5731489PO Box 14-147AUCKLAND 6 AUCKLANDManufacturer
90 Unknown Unknown 00 000 000000 000 0000Unknown Unknown Manufacturer
91 Alpha Pharmaceuticals Ltd Alpha 0 6 355 1066 0 6 356 6293 P O Box 705PALMERSTON NORTH 1st FloorWestpac Building18 Rangitikei Street PALMERSTON NORTH Importer
92 The Asthma and Respiratory Foundation of NZ Asthma Foundation 0 4 499 4592 0 4 499 4594 P O Box 1459WELLINGTON 7th FloorRossmore House123 Molesworth Street WELLINGTON Importer
93 MediSense Australia Pty Ltd MediSense0061 3 836 6111 0061 3 836 6900 P O Box 105BalwynVIC 3103AUSTRALIA 1A Weston Street BalwynVIC 3103AUSTRALIA Manufacturer
94 Scotia Pharmaceuticals (NZ) Ltd Scotia 0 9 415 7310 0 9 415 8478 P O Box 33-118TakapunaAUCKLAND Beatrice Tinsely Crescent North Harbour Industrial EstateAlbanyAUCKLAND Manufacturer
95 Athene International Ltd Athene 0 9 575 6698 0 9 575 8400 PO Box 55-044Mission BayAUCKLAND Mission BayAUCKLAND Importer
96 Medisafe Ltd Medisafe 0 9 302 2637 0 9 358 3607 P O Box 90-346AUCKLAND AUCKLANDImporter
97 Medic Corporation Ltd Medic 04 04 Private BagLOWER HUTT Private BagLOWER HUTT Importer
98 Mondos NZ Ltd Mondos 0 4 232 7847 0 4 232 7847 P O Box 56-059TawaWELLINGTON TawaWELLINGTON Importer
99 Colgate Colgate 0 4 568 6018 0 4 568 8835 P O Box 38-077Wellington Mail Centre Nevis Street Petone Manufacturer
101 Pharmacy Wholesalers Ltd PWL xx xxx xxxxxx xxx xxxxPWL Ltd PWL Ltd Wholesaler
102 Biomed Laboratories Ltd Biomed 0 9 815 2602 0 9 815 2621 P O Box 44-069Pt ChevalierAUCKLAND 52 Carrington RoadPt ChevalierAUCKLAND Manufacturer
103 Intermed Scientific Ltd Intermed 0 9 443 1284 0 9 443 8419 PO Box 101-253AUCKLAND 3A Marken PlaceGlenfieldAUCKLAND Importer
104 Glaxo Wellcome Ltd GlaxoWellcome 0 9 367 2900 0 9 358 1096 Private Bag 106-600DowntownAUCKLAND Level 8Quay TowerCnr Customs & Albert StsAUCKLAND Manufacturer
105 Hoechst Marion Roussel New Zealand Limited HMR 0 9 526 4102 0 9 526 4109 PO Box 112 042PenroseAUCKLAND 101 Station RoadPenroseAUCKLAND Manufacturer
106 Pharmacia & Upjohn New Zealand Pharmacia and Upjohn 0 9 270 0328 0 9 276 5209 PO Box 11-282EllerslieAUCKLAND Fisher Crescent Mt WellingtonAUCKLAND Manufacturer
107 Knoll Australia Pty Limited (Pharmaco) Knoll 0 9 486 4220 0 9 486 4221 O Box 331-486TakapunaAUCKLAND vel 1Soverign Assurance House33-45 Hurstmere RoadTakapunaAUCKLAND Importer
108 Artex Ltd Artex (06) 858-8011 (06) 858-8012 PO Box 249WAIPUKURAU 15 Ruataniwha St WAIPUKURAU Importer
110 Nutralife Nutrallife 999-9999 999-9999 unknown unknown Manufacturer
111 New Zealand Bakels Ltd. NZ Bakels 09-579-6079 09-525-0978 1-2429 Church Street PenroseAUCKLAND 1-2429 Church Street PenroseAUCKLAND Manufacturer
112 Pharmabrokers Sales Ltd Pharmabrokers 09 524 8814 PO Box 9726Newmarket AUCKLAND 1031 Importer
113 Lincoln Pharmaceuticals, A Division of Douglas Lincoln 09 837 544709 837 5446PO Box 45 027AUCKLAND Central Park DriveLincolnAUCKLAND * Importer
114 Medra Services Medra 06 323 857306 323 8573PO Box 115FEILDING Makino RoadFEILDING Importer
115 Health Support Services Ltd HSSL 09 849 220509 815 2634PO Box 44 027Point ChevalierAUCKLAND 2 56 Carrington RoadPoint ChevalierAUCKLAND 2 Importer
116 Novartis New Zealand Limited Novartis 09 828 314909 828 387743-45 Patiki RoadAvondaleAUCKLAND 7 Manufacturer
Trial Version
ParentCodeCode Memoranda
1908063938 1138 <Request To="HealthPAC" For="Subsidy" Form="SA1138"> <Title> <range>Raloxifene</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="indication">History of one significant osteoporotic fracture demonstrated radiologically and documented bone mineral density (BMD) ≥2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Notes)</ci> <ci type="logical" class="indication">History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age</ci> <ci type="logical" class="indication">History of two significant osteoporotic fractures demonstrated radiologically</ci> <ci type="logical" class="indication">Documente
2207023934 1125 <Request To="HealthPAC" For="Subsidy" Form="SA1125"> <Title> <range>Lacosamide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has partial-onset epilepsy</ci> <ci type="logical" class="Trial">Seizures are not adequately controlled by, or patient has experienced unacceptable side effects from, optimal treatment with all of the following: sodium valproate, topiramate, levetiracetam and any two of carbamazepine, lamotrigine and phenytoin sodium (see Note)</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">15</Term> <Note> <Para>"Optimal treatment" is defined as treatment which is indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Women of childbearing age are not re
420202 1376 <Request To="HealthPAC" For="Subsidy" Form="SA1376"> <Title> <range>Carbohydrate and Fat<instance>Duocal Super Soluble Powder</instance></range> </Title> <Case When="Initial application" Category="Cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">Infant or child aged four years or under</ci> <ci type="logical" class="Indication">cystic fibrosis</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">infant or child aged four years or under</ci> <apply> <or/> <ci type="logical" class="Indication">cancer in children</ci> <ci type="logica
310309198707 895 <Request To="HealthPAC" For="Subsidy" Form="SA0895"> <Title> <range>Pilocarpine – Eye drops 2% single dose</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has to use an unpreserved solution due to an allergy to the preservative</ci> <ci type="logical" class="Indication">Patient wears soft contact lenses</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> <Note> <Para>Minims for a general practice are considered to be “tools of trade” and are not approved as special authority items.</Para> </Note> </Case> <Case When="Renewal" Form="SA0121 SA0895"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2<
2207021004 1072 <Request To="HealthPAC" For="Subsidy" Form="SA1072"> <Title> <range>Vigabatrin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Indication">Patient has infantile spasms</ci> <apply> <and/> <ci type="logical" class="Indication">Patient has epilepsy</ci> <apply> <or/> <ci type="logical" class="Indication">Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents</ci> <ci type="logical" class="Indication">Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents</ci> </apply> </apply> </apply> <apply> <or/> <ci type="logical" class="Indication">Patient is, or will be, receiving regular automated visual fiel
2234013793 1408 <Request To="HealthPAC" For="Subsidy" Form="SA1408"> <Title> <range>Naltrexone</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient is currently enrolled in a recognised comprehensive treatment programme for alcohol dependence</ci> <ci type="logical" class="Therapy">Applicant works in or with a community Alcohol and Drug Service contracted to one of the District Health Boards or accredited against the New Zealand Alcohol and Other Drug Sector Standard or the National Mental Health Sector Standard</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA0714 SA0909 SA1397 SA1408"> <math> <apply> <and/> <ci type="logical" class="Indication">Compliance with the medication (prescriber determined)</ci> <apply> <or/> <ci type="log
0407043893 1174 <Request To="HealthPAC" For="Subsidy" Form="SA1174"> <Title> <range>Enoxaparin sodium</range> </Title> <Case When="Initial application" Category="Pregnancy or Malignancy"> <math> <apply> <or/> <ci type="logical" class="Indication">Low molecular weight heparin treatment is required during a patients pregnancy</ci> <ci type="logical" class="Treatment">For the treatment of venous thromboembolism where the patient has a malignancy</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Initial application" Category="Venous thromboembolism other than in pregnancy or malignancy"> <math> <apply> <or/> <ci type="logical" class="Indication">For the short-term treatment of venous thromboembolism prior to establishing a therapeutic INR with oral anti-coagulant treatment</ci> <ci type="logical" class="Treatment">For the prophylaxis and tre
2231013887 1416 <Request To="HealthPAC" For="Subsidy" Form="SA1416"> <Title> <range>Atomoxetine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has ADHD (Attention Deficit and Hyperactivity Disorder) diagnosed according to DSM-IV or ICD 10 criteria</ci> <ci type="logical" class="Indication">Once-daily dosing</ci> <apply> <or/> <ci type="logical" class="Indication">Treatment with a subsidised formulation of a stimulant has resulted in the development or worsening of serious adverse reactions or where the combination of subsidised stimulant treatment with another agent would pose an unacceptable medical risk</ci> <ci type="logical" class="Indication">Treatment with a subsidised formulation of a stimulant has resulted in worsening of co-morbid substance abuse or there is a significant risk of diversion with subsidised stimulant therapy</ci> <ci type="log
0740013975 1263 <Request To="HealthPAC" For="Subsidy" Form="SA1263"> <Title> <range>Nicorandil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has refractory angina</ci> <ci type="logical" class="Trial">Patient is on the maximal tolerated dose of a beta-blocker, a calcium channel blocker and a long acting nitrate</ci> </apply> </math> <Applicant>cardiologist</Applicant> <Applicant>general physician</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA1263"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>cardiologist</Applicant> <Applicant Referring="cardiologist">any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
2222011011 927 <Request To="HealthPAC" For="Subsidy" Form="SA0927"> <Title> <range>Risperidone orally disintegrating tablets</range> </Title> <Case When="Initial application" Category="Acute situations"> <math> <apply> <and/> <ci type="logical" class="Use">For a non-adherent patient on oral therapy with standard risperidone tablets or risperidone oral liquid</ci> <ci type="logical" class="Therapy">The patient is under direct supervision for administration of medicine</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="week">6</Term> </Case> <Case When="Initial application" Category="Chronic situations"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid</ci> <ci type="logical" class="Therapy">The patient is under direct
420632 1195 <Request To="HealthPAC" For="Subsidy" Form="SA1195"> <Title> <range>High Calorie Products<instance>Two Cal HN</instance><instance>Nutrison Concentrated</instance></range> </Title> <Case When="Initial application" Category="Cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">Cystic fibrosis</ci> <ci type="logical" class="Trial">other lower calorie products have been tried</ci> <ci type="logical" class="Indication">patient has substantially increased metabolic requirements</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than cystic fibrosis"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Indication">any cond
1414012062 1199 <Request To="HealthPAC" For="Subsidy" Form="SA1199"> <Title> <range>Propylthiouracil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has hyperthyroidism</ci> <ci type="logical" class="Indication">The patient is intolerant of carbimazole or carbimazole is contraindicated</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA1199"> <math> <ci type="logical" class="Indication">the treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
0115123968 1237 <Request To="PHARMAC" For="Subsidy" Form="SA1237"> <Title> <range>Insulin Pumps</range> </Title> <Case When="Initial application"> <math/> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The IPP Co-ordinator</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para>Facsimile: (04) 974 7806</Para> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Email: <a href="mailto:ipp@pharmac.govt.nz">ipp@pharmac.govt.nz</a></Para> </TD> </TR> <TR> <TD> <Para>Welli
1619053855 829 <Request To="HealthPAC" For="Subsidy" Form="SA0829"> <Title> <range>Adefovir dipivoxil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Trial">Patient has confirmed Hepatitis B infection (HBsAg+)</ci> <mi class="heading">Documented resistance to lamivudine, defined as:</mi> <ci type="logical" class="Trial">Patient has raised serum ALT (> 1 × ULN)</ci> <ci type="logical" class="Trial">Patient has HBV DNA greater than 100,000 copies per mL, or viral load ≥ 10 fold over nadir</ci> <ci type="logical" class="Trial">Detection of M204I or M204V mutation</ci> <apply> <or/> <apply> <and/> <ci type="logical" class="Trial">Patient is cirrhotic</ci> <ci type="logical" class="Trial">adefovir dipivoxil to be used in combination with lamivudine</ci> </apply> <apply> <and/>
1319043902 998 <Request To="HealthPAC" For="Subsidy" Form="SA0998"> <Title> <range>Solifenacin succinate</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has overactive bladder and a documented intolerance of, or is non-responsive to oxybutynin</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
1603103999 1332 <Request To="HealthPAC" For="Subsidy" Form="SA1332"> <Title> <range>Tetracycline</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">For the eradication of helicobacter pylori following unsuccessful treatment with appropriate first-line therapy</ci> <ci type="logical" class="Indication">For use only in combination with bismuth as part of a quadruple therapy regimen</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">3</Term> </Case></Request>
420608 1379 <Request To="HealthPAC" For="Subsidy" Form="SA1379"> <Title> <range>Paediatric Products<instance>Nutrini</instance><instance>Pediasure</instance><instance>Fortini</instance></range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Child is aged one to ten years</ci> <apply> <or/> <ci type="logical" class="Indication">the child is being fed via a tube or a tube is to be inserted for the purposes of feeding</ci> <ci type="logical" class="Indication">any condition causing malabsorption</ci> <ci type="logical" class="Indication">faltering growth in an infant/child</ci> <ci type="logical" class="Indication">increased nutritional requirements</ci> <ci type="logical" class="Indication">the child is being transitioned from TPN or tube feeding to oral feeding</ci> </apply> </apply> </math> <Applicant>dietitian</Applicant>
0407014008 1382 <Request To="HealthPAC" For="Subsidy" Form="SA1382"> <Title> <range>Ticagrelor</range> </Title> <Case When="Initial application" Category="acute coronary syndrome"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has recently been diagnosed with an ST-elevation or a non-ST-elevation acute coronary syndrome</ci> <ci type="logical" class="Indication">Fibrinolytic therapy has not been given in the last 24 hours and is not planned</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Category="subsequent acute coronary syndrome" Form="SA1382"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has recently been diagnosed with an ST-elevation or a non-ST-elevation acute coronary syndrome</ci> <ci type="logical" class="Indication">Fibrinolytic therapy has not been given in the last 24
0122011126 1383 <Request To="HealthPAC" For="Subsidy" Form="SA1383"> <Title> <range>Ursodeoxycholic Acid</range> </Title> <Case When="Initial application" Category="Alagille syndrome or progressive familial intrahepatic cholestasis"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has been diagnosed with Alagille syndrome</ci> <ci type="logical" class="Indication">Patient has progressive familial intrahepatic cholestasis</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Case When="Initial application" Category="Chronic severe drug induced cholestatic liver injury"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has chronic severe drug induced cholestatic liver injury</ci> <ci type="logical" class="Indication">Cholestatic liver injury not due to Total Parenteral Nutrition (TPN) use in adults</ci>
2507043818 1192 <Request To="HealthPAC" For="Subsidy" Form="SA1192"> <Title> <range>Trastuzumab</range> </Title> <Case When="Initial application" Category="metastatic breast cancer"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology)</ci> <ci type="logical" class="Treatment">The patient has not previously received lapatinib treatment for HER 2 positive metastatic breast cancer</ci> <ci type="logical" class="Indication">Trastuzumab not to be given in combination with lapatinib</ci> <ci type="logical" class="Treatment">Trastuzumab to be discontinued at disease progression</ci> </apply> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology
2207021062 1071 <Request To="HealthPAC" For="Subsidy" Form="SA1071"> <Title> <range>Gabapentin</range> </Title> <Case When="Initial application" Category="Epilepsy"> <math> <apply> <or/> <ci type="logical" class="Indication">Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents</ci> <ci type="logical" class="Indication">Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">15</Term> <Note> <Para>"Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance.</Para>
0407073924 1066 <Request To="HealthPAC" For="Subsidy" Form="SA1066"> <Title> <range>Rivaroxaban</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">For the prophylaxis of venous thromboembolism following a total hip replacement</ci> <ci type="logical" class="Use">For the prophylaxis of venous thromboembolism following a total knee replacement</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="week">5</Term> <Note> <Para>Rivaroxaban is only currently indicated and subsidised for up to 5 weeks therapy for prophylaxis of venous thromboembolism following a total hip replacement and up to 2 weeks therapy for prophylaxis of venous thromboembolism following a total knee replacement.</Para> </Note> </Case> <Case When="Renewal" Form="SA1066"> <math> <ci type="logical" class="Indication">Prophylaxis for venous thromboembolism is requir
011515 1240 <Request To="PHARMAC" For="Subsidy" Form="SA1240"> <Title> <range>Insulin pump consumables</range> </Title> <Case When="Initial application"> <math/> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The IPP Co-ordinator</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para>Facsimile: (04) 974 7806</Para> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Email: <a href="mailto:ipp@pharmac.govt.nz">ipp@pharmac.govt.nz</a></Para> </TD> </TR> <TR> <TD>
190501385426 1289 <Request To="HealthPAC" For="Subsidy" Form="SA1289"> <Title> <range>Capsaicin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has osteoarthritis that is not responsive to paracetamol and oral non-steroidal anti-inflammatories are contraindicated</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
190802 1039 <Request To="HealthPAC" For="Subsidy" Form="SA1039"> <Title> <range>Alendronate Tab 70 mg - with or without Cholecalciferol</range> </Title> <Case When="Initial application" Category="Underlying cause -- Osteoporosis"> <math> <apply> <or/> <ci type="logical" class="Indication">History of one significant osteoporotic fracture demonstrated radiologically and documented bone mineral density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note)</ci> <ci type="logical" class="Indication">History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age</ci> <ci type="logical" class="Indication">History of two significant osteoporotic fractures
160310182801 1355 <Request To="HealthPAC" For="Manufacturers Price" Form="SA1355"> <Title> <range>Minocycline hydrochloride Tab 50 mg</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has rosacea</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
1603133998 1324 <Request To="HealthPAC" For="Subsidy" Form="SA1324"> <Title> <range>Paromomycin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">the patient has confirmed cryptosporidium infection</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case> <Case When="Renewal" Form="SA1324"> <math> <ci type="logical" class="Indication">the patient has confirmed cryptosporidium infection</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case></Request>
2231013935 1126 <Request To="HealthPAC" For="Subsidy" Form="SA1126"> <Title> <range>Modavigil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a diagnosis of narcolepsy and has excessive daytime sleepiness associated with narcolepsy occurring almost daily for three months or more</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has a multiple sleep latency test with a mean sleep latency of less than or equal to 10 minutes and 2 or more sleep onset rapid eye movement periods</ci> <ci type="logical" class="Indication">The patient has at least one of: cataplexy, sleep paralysis or hypnagogic hallucinations</ci> </apply> <apply> <or/> <ci type="logical" class="Indication">An effective dose of a subsidised formulation of methylphenidate or dexamphetamine has been trialled and discontinued because of intolerabl
1319013881 928 <Request To="HealthPAC" For="Subsidy" Form="SA0928"> <Title> <range>Finasteride</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has symptomatic benign prostatic hyperplasia</ci> <apply> <or/> <ci type="logical" class="Indication">The patient is intolerant of non-selective alpha blockers or these are contraindicated</ci> <ci type="logical" class="Indication">Symptoms are not adequately controlled with non-selective alpha blockers</ci> </apply> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Patients with enlarged prostates are the appropriate candidates for therapy with finasteride.</Para> </Note></Request>
420607 1099 <Request To="HealthPAC" For="Subsidy" Form="SA1099"> <Title> <range>Paediatric Product For Children With Chronic Renal Failure<instance>Kindergen</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a child (up to 18 years) with acute or chronic kidney disease</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Renewal" Form="SA0606 SA1099"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted</ci> </apply> </mat
1319043977 1272 <Request To="HealthPAC" For="Subsidy" Form="SA1272"> <Title> <range>Tolterodine</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Patient has overactive bladder and a documented intolerance of, or is non-responsive to oxybutynin</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
420604 1381 <Request To="HealthPAC" For="Subsidy" Form="SA1381"> <Title> <range>Fat Modified Products<instance>Monogen</instance></range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has metabolic disorders of fat metabolism</ci> <ci type="logical" class="Indication">Patient has a chyle leak</ci> <ci type="logical" class="Indication">Modified as a modular feed for adults</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0593 SA0615 SA1096 SA1381"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitio
141301172426 782 <Request To="HealthPAC" For="Subsidy" Form="SA0782"> <Title> <range>Levonorgestrel – releasing intrauterine system 20mcg/24 hr</range> </Title> <Case When="Initial application" Category="No previous use"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a clinical diagnosis of heavy menstrual bleeding</ci> <ci type="logical" class="Trial">The patient has failed to respond to or is unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines</ci> <apply> <or/> <apply> <lt/> <ci type="real" class="test">serum ferritin level</ci> <cn>16<mi> mcg/l (within the last 12 months)</mi></cn> </apply> <apply> <lt/> <ci type="real" class="test">haemoglobin level</ci> <cn>120<mi> g/l</mi></cn> </apply> </apply> </apply> </math>
1319023910 1032 <Request To="HealthPAC" For="Subsidy" Form="SA1032"> <Title> <range>Tamsulosin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has symptomatic benign prostatic hyperplasia</ci> <ci type="logical" class="Indication">The patient is intolerant of non-selective alpha blockers or these are contraindicated</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
1019012363 954 <Request To="HealthPAC" For="Subsidy" Form="SA0954"> <Title> <range>Acitretin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice</ci> <ci type="logical" class="Indication">Applicant has an up to date knowledge of the treatment options for psoriasis and of disorders of keratinisation and is aware of the safety issues around acitretin and is competent to prescribe acitretin</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is female and has been counselled and understands the risk of teratogenicity if acitretin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that
2216013899 987 <Request To="HealthPAC" For="Subsidy" Form="SA0987"> <Title> <range>Aprepitant</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA0987"> <math> <ci type="logical" class="Indication">The patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case></Request>
3504083914 1042 <Request To="HealthPAC" For="Subsidy" Form="SA1042"> <Title> <range>Deferiprone</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has been diagnosed with chronic transfusional iron overload due to congenital inherited anaemia</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>For the purposes of this Special Authority, a relevant specialist is defined as a haematologist.</Para> </Note></Request>
010404116809 1155 <Request To="HealthPAC" For="Subsidy" Form="SA1155"> <Title> <range>Budesonide - Cap 3 mg Controlled Release</range> </Title> <Case When="Initial application" Category="Crohn's disease"> <math> <apply> <and/> <ci type="logical" class="Indication">Mild to moderate ileal, ileocaecal or proximal Crohn's disease</ci> <apply> <or/> <ci type="logical" class="Indication">Diabetes</ci> <ci type="logical" class="Indication">Cushingoid habitus</ci> <ci type="logical" class="Indication">Osteoporosis where there is significant risk of fracture</ci> <ci type="logical" class="Indication">Severe acne following treatment with conventional corticosteroid therapy</ci> <ci type="logical" class="Indication">History of severe psychiatric problems associated with corticosteroid treatment</ci> <ci type="logical" class="Indication">History of major mental illness (such as bipolar affective disorder) where
2837043967 1421 <Request To="HealthPAC" For="Subsidy" Form="SA1421"> <Title> <range>Montelukast</range> </Title> <Case When="Initial application" Category="Pre-school wheeze"> <math> <apply> <and/> <ci type="logical" class="Indication">To be used for the treatment of intermittent severe wheezing (possibly viral) in children under 5 years</ci> <ci type="logical" class="Indication">The patient has had at least three episodes in the previous 12 months of acute wheeze severe enough to seek medical attention</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Category="Pre-school wheeze" Form="SA1227 SA1409 SA1421"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case
2207021060 973 <Request To="PHARMAC" For="Subsidy" Form="SA0973"> <Title> <range>Neurontin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Subsidy for patients pre-approved on 1 August 2009</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Subsidy for patients pre-approved by PHARMAC on 1 August 2009. Approvals valid without further renewal unlessnotified.</Para> <Para>No new approvals will be granted from 1 August 2009.</Para> </Note></Request>
420615 1196 <Request To="HealthPAC" For="Subsidy" Form="SA1196"> <Title> <range>Paediatric enteral feed with fibre 0.75 kcal/ml<instance>Nutrini Low Energy Multi Fibre</instance></range> </Title> <Case When="Initial application"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">Child aged one to eight years</ci> <ci type="logical" class="Indication">The child has a low energy requirement but normal protein and micronutrient requirements</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA1196"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement
1017013964 1225 <Request To="HealthPAC" For="Subsidy" Form="SA1225"> <Title> <range>Ivermectin</range> </Title> <Case When="Initial application" Category="Scabies"> <math> <apply> <and/> <ci type="logical" class="Indication">Applying clinician has discussed the diagnosis of scabies with a dermatologist, infectious disease physician or clinical microbiologist</ci> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient is in the community</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has a severe scabies hyperinfestation (Crusted/ Norwegian scabies)</ci> <ci type="logical" class="Indication">The community patient is physically or mentally unable to comply with the application instructions of topical therapy</ci> <ci type="logical" class="Indication">The patient has previously tried and failed to clear infestation
160401280325 1322 <Request To="HealthPAC" For="Subsidy" Form="SA1322"> <Title> <range>Itraconazole</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has a congenital immune deficiency</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Applicant>clinical immunologist</Applicant> <Applicant Referring="infectious disease physician, clinical microbiologist or clinical immunologist">any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA1322"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case></Request>
0707031254 1223 <Request To="HealthPAC" For="Subsidy" Form="SA1223"> <Title> <range>Candesartan</range> </Title> <Case When="Initial application" Category="ACE inhibitor intolerance"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has persistent ACE inhibitor induced cough that is not resolved by ACE inhibitor retrial (same or new ACE inhibitor)</ci> <ci type="logical" class="Indication">Patient has a history of angioedema</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Case When="Initial application" Category="Unsatisfactory response to ACE inhibitor"> <math> <ci type="logical" class="Indication">patient is not adequately controlled on maximum tolerated dose of an ACE inhibitor</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
040101 922 <Request To="HealthPAC" For="Subsidy" Form="SA0922"> <Title> <range>Erythropoietin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <and/> <ci type="logical" class="Indication">patient in chronic renal failure</ci> <apply> <leq/> <ci type="real" class="test">Haemoglobin</ci> <cn>100<mi>g/L</mi></cn> </apply> </apply> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">patient is not diabetic</ci> <apply> <leq/> <ci type="real" class="test">glomerular filtration rate</ci> <cn>30<mi>ml/min</mi></cn> </apply> </apply> <apply> <and/> <ci type="logical" class="Indication">patient is diabetic</ci> <apply> <leq/> <ci type
4218023948 1198 <Request To="HealthPAC" For="Subsidy" Form="SA1198"> <Title> <range>Preterm post-discharge infant formula powder<instance>S-26 Gold Premgro</instance></range> </Title> <Case When="Initial application"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">The infant was born before 33 weeks gestation or weighed less than 1.5 kg at birth</ci> <apply> <or/> <ci type="logical" class="Indication">The infant has faltering growth (downward crossing of percentiles)</ci> <ci type="logical" class="Indication">The infant is not maintaining, or is considered unlikely to maintain, adequate growth on standard infant formula</ci> </apply> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="month">6</Term> </Case></Request>
2501073845 1124 <Request To="HealthPAC" For="Subsidy" Form="SA1124"> <Title> <range>Thalidomide</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="indication">The patient has multiple myeloma</ci> <ci type="logical" class="indication">The patient has systemic AL amyloidosis*</ci> </apply> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1124 SA0817 SA0882"> <math> <ci type="logical" class="indication">The patient has obtained a response from treatment during the initial approval period</ci> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Prescription must be written by a re
074001160401 1321 <Request To="HealthPAC" For="Subsidy" Form="SA1321"> <Title> <range>Hydralazine</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">For the treatment of refractory hypertension</ci> <ci type="logical" class="Indication">For the treatment of heart failure in combination with a nitrate, in patients who are intolerant or have not responded to ACE inhibitors and/or angiotensin receptor blockers</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
0722021949 1260 <Request To="HealthPAC" For="Subsidy" Form="SA1260"> <Title> <range>Perhexiline Maleate</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has refractory angina</ci> <ci type="logical" class="Trial">Patient is on the maximal tolerated dose of a beta-blocker, a calcium channel blocker and a long acting nitrate</ci> </apply> </math> <Applicant>cardiologist</Applicant> <Applicant>general physician</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA0256 SA1260"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>cardiologist</Applicant> <Applicant Referring="cardiologist">any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
1610014002 1326 <Request To="HealthPAC" For="Subsidy" Form="SA1326"> <Title> <range>Primaquine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has vivax or ovale malaria</ci> <ci type="logical" class="Indication">Primaquine is to be given for a maximum of 21 days</ci> </apply> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case></Request>
1604013989 1285 <Request To="HealthPAC" For="Subsidy" Form="SA1285"> <Title> <range>Posaconazole </range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation chemotherapy</ci> <ci type="logical" class="Indication">Patient has received a stem cell transplant and has graft versus host disease and is on significant immunosuppressive therapy*</ci> </apply> </math> <Applicant>haematologist</Applicant> <Applicant>infectious disease specialist</Applicant> <Term Measure="week">6</Term> </Case> <Case When="Renewal" Form="SA1285"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation therapy</ci> <ci type="logical" c
2228011956 1386 <Request To="HealthPAC" For="Subsidy" Form="SA1386"> <Title> <range>Phenobarbitone</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">For the treatment of terminal agitation that is unresponsive to other agents</ci> <ci type="logical" class="Indication">The applicant is part of a multidisciplinary team working in palliative care</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
074007 1293 <Request To="HealthPAC" For="Subsidy" Form="SA1293"> <Title> <range>Sildenafil</range> </Title> <Case When="Initial application" Category="Raynaud’s Phenomenon* - for Pulmonary Arterial Hypertension see note below)"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has Raynaud’s Phenomenon*</ci> <ci type="logical" class="Indication">Patient has severe digital ischaemia (defined as severe pain requiring hospital admission or with a high likelihood of digital ulceration; digital ulcers; or gangrene)</ci> <ci type="logical" class="Indication">Patient is following lifestyle management (avoidance of cold exposure, sufficient protection, smoking cessation support, avoidance of sympathomimetic drugs) </ci> <ci type="logical" class="Indication">Patient is being treated with calcium channel blockers and nitrates (or these are contraindicated/not tolerated)</ci> </apply> </math> <Applicant>any relevant
2205093785 1061 <Request To="HealthPAC" For="Subsidy" Form="SA1061"> <Title> <range>Venlafaxine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has 'treatment-resistant' depression</ci> <apply> <or/> <ci type="logical" class="Trial">The patient must have had a trial of two different antidepressants and have had an inadequate response from an adequate dose over an adequate period of time (usually at least four weeks)</ci> <apply> <and/> <ci type="logical" class="Indication">The patient is currently a hospital in-patient as a result of an acute depressive episode</ci> <ci type="logical" class="Trial">The patient must have had a trial of one other antidepressant and have had an inadequate response from an adequate dose over an adequate period of time</ci> </apply> </apply> </apply> </math> <Appl
2501093916 1411 <Request To="HealthPAC" For="Subsidy" Form="SA1411"> <Title> <range>Erlotinib</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">Patient has locally advanced or metastatic, unresectable, non-squamous Non Small Cell Lung Cancer (NSCLC)</ci> <ci type="logical" class="Indication">There is documentation confirming that the disease expresses activating mutations of EGFR tyrosine kinase</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is treatment naive</ci> <apply> <and/> <ci type="logical" class="Indication">Patient has documented disease progression following treatment with first line platinum based chemotherapy</ci> <ci type="logical" class="Indication">Patient has not received prior treatment with gefitinib</ci> </apply> </apply>
1411 1018 <Request To="HealthPAC" For="Alternate Subsidy" Form="SA1018"> <Title> <range>Hormone Replacement Therapy - Systemic</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">acute or significant liver disease - where oral oestrogens are contraindicated as determined by a gastroenterologist or general physician. The applicant must keep written confirmation from such a specialist with the patient's record</ci> <ci type="logical" class="Indication">oestrogen induced hypertension requiring antihypertensive therapy - documented evidence must be kept on file that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens</ci> <ci type="logical" class="Indication">hypertriglyceridaemia - documented evidence must be kept on file that triglyceride levels increased to at least 2 × normal triglyceride levels post oral oestrogens</ci> <ci type=
0113013996 1320 <Request To="HealthPAC" For="Subsidy" Form="SA1320"> <Title> <range>Diazoxide</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">used for the treatment of confirmed hypoglycaemia caused by hyperinsulinism</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1320"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
1601013990 1318 <Request To="HealthPAC" For="Subsidy" Form="SA1318"> <Title> <range>Albendazole</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has hydatids</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA1318"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">6</Term> </Case></Request>
0740012451 1271 <Request To="HealthPAC" For="Subsidy" Form="SA1271"> <Title> <range>Minoxidil</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">patient has severe refractory hypertension which has failed to respond to extensive multiple therapies</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
420603 1095 <Request To="HealthPAC" For="Subsidy" Form="SA1095"> <Title> <range>Diabetic products<instance>Diason RTH</instance><instance>Glucerna Select RTH</instance><instance>Diasip</instance><instance>Glucerna Select</instance><instance>Resource Diabetic</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a type I or and II diabetic who is suffering weight loss and malnutrition that requires nutritional support</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0594 SA1095"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must includ
190401 1038 <Request To="PHARMAC" For="Manufacturers Price" Form="SA1038"> <Title> <range>Anti-inflammatory Non Steroidal Drugs (NSAIDs)</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Subsidy for patients with existing approvals prior to 1 September 2010</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Subsidy for patients with existing approvals prior to 1 September 2010. Approvals valid without further renewal unlessnotified. No new approvals will be granted from 1 September 2010.</Para> </Note></Request>
013719233025 1002 <Request To="HealthPAC" For="Subsidy" Form="SA1002"> <Title> <range>Vitabdeck</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has cystic fibrosis with pancreatic insufficiency</ci> <ci type="logical" class="Indication">Patient is an infant or child with liver disease or short gut syndrome</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
2507043836 1449 <Request To="HealthPAC" For="Subsidy" Form="SA1449"> <Title> <range>Adalimumab</range> </Title> <Case When="Initial application" Category="rheumatoid arthritis"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient has had an initial Special Authority approval for etanercept for rheumatoid arthritis</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has experienced intolerable side effects from etanercept</ci> <ci type="logical" class="Indication">The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for rheumatoid arthritis</ci> </apply> </apply> <apply> <and/> <ci type="logical" class="Indication">Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer</ci> <ci type="logical" class="Treatmen
310315 1388 <Request To="HealthPAC" For="Subsidy" Form="SA1388"> <Title> <range>Preservative Free Ocular Lubricants</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Confirmed diagnosis by slit lamp of severe secretory dry eye</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is using eye drops more than four times daily on a regular basis</ci> <ci type="logical" class="Indication">Patient has had a confirmed allergic reaction to preservative in eye drop</ci> </apply> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1388"> <math> <ci type="logical" class="Indication">The patient continues to require lubricating eye drops and has benefited from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant>
0407013945 1201 <Request To="HealthPAC" For="Subsidy" Form="SA1201"> <Title> <range>Prasugrel</range> </Title> <Case When="Initial application" Category="coronary angioplasty and bare metal stent"> <math> <ci type="logical" class="Treatment">The patient has undergone coronary angioplasty in the previous 4 weeks and is clopidogrel-allergic*</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Initial application" Category="drug eluting stent"> <math> <ci type="logical" class="Treatment">The patient has had a drug-eluting cardiac stent inserted in the previous 4 weeks and is clopidogrel-allergic*</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Initial application" Category="stent thromobosis"> <math> <ci type="logical" class="Treatment">patient has experienced cardiac stent thrombosis whilst on clopidogrel</ci>
2501074005 1325 <Request To="HealthPAC" For="Subsidy" Form="SA1325"> <Title> <range>Pegaspargase</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has newly diagnosed acute lymphoblastic leukaemia</ci> <ci type="logical" class="Indication">Pegaspargase to be used with a contemporary intensive multi-agent chemotherapy treatment protocol</ci> <ci type="logical" class="Indication">Treatment is with curative intent</ci> </apply> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1325"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has relapsed acute lymphoblastic leukaemia</ci> <ci type="logical" class="Indication">Pegaspargase to be used with a contemporar
130802 500 <Request To="HealthPAC" For="Alternate Subsidy" Form="SA0500"> <Title><range>Combined oral contraceptives</range><range>Progestogen-only contraceptives</range> (Circle one)</Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Target">Patient is on a Social Welfare benefit</ci> <ci type="logical" class="Target">Patient has an income no greater than the benefit</ci> </apply> <ci type="logical" class="Trial">Has tried at least one of the fully funded options and has been unable to tolerate it</ci> </apply> </math> <Applicant>medical practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA0265 SA0500"> <math> <apply> <or/> <ci type="logical" class="Target">Patient is on a Social Welfare benefit</ci> <ci type="logical" class="Target">Patient has an income no greater than the be
420203 1374 <Request To="HealthPAC" For="Subsidy" Form="SA1374"> <Title> <range>Fat<instance>Calogen</instance><instance>Liquigen</instance><instance>MCT oil (Nutricia)</instance></range> </Title> <Case When="Initial application" Category="Inborn errors of metabolism"> <math> <ci type="logical" class="Indication">The patient has inborn errors of metabolism</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than inborn errors of metabolism"> <math> <apply> <or/> <ci type="logical" class="Indication">faltering growth in an infant/child</ci> <ci type="logical" class="Indication">bronchopulmonary dysplasia</ci> <ci type="logical" class="Indication">fat malabsorption</ci> <ci type="logical" class="Indication">lym
420204 1375 <Request To="HealthPAC" For="Subsidy" Form="SA1375"> <Title> <range>Protein<instance>Protifar</instance><instance>Promod</instance><instance>Resource Beneprotein</instance></range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">protein losing enteropathy</ci> <ci type="logical" class="Indication">high protein needs</ci> <ci type="logical" class="Indication">for use as a component in a modular formula</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0582 SA1093 SA1375"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endor
2501093921 1266 <Request To="HealthPAC" For="Subsidy" Form="SA1266"> <Title> <range>Sunitinib</range> </Title> <Case When="Initial application" Category="RCC"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic renal cell carcinoma</ci> <apply> <or/> <ci type="logical" class="Trial">The patient is treatment naive</ci> <ci type="logical" class="Trial">The patient has only received prior cytokine treatment</ci> <ci type="logical" class="Trial">The patient has only received prior treatment with an investigational agent within the confines of a bona fide clinical trial which has Ethics Committee approval</ci> <apply> <and/> <ci type="logical" class="Trial">The patient has discontinued pazopanib within 3 months of starting treatment due to intolerance</ci> <ci type="logical" class="Trial">The cancer did not progress whilst on pazopanib</ci>
1604013978 1273 <Request To="HealthPAC" For="Subsidy" Form="SA1273"> <Title> <range>Voriconazole</range> </Title> <Case When="Initial application" Category="invasive fungal infection"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient is immunocompromised</ci> <ci type="logical" class="Indication">Applicant is part of a multidisciplinary team including an infectious disease specialist</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has proven or probable invasive aspergillus infection</ci> <ci type="logical" class="Indication">Patient has possible invasive aspergillus infection</ci> <ci type="logical" class="Indication">Patient has fluconazole resistant candidiasis</ci> <ci type="logical" class="Indication">Patient has mould strain such as Fusarium spp. and Scedosporium spp</ci> </apply> </apply> </math> <Applicant>haematologist</Applicant> <App
420631 1228 <Request To="HealthPAC" For="Subsidy" Form="SA1228"> <Title> <range>Standard Supplements<instance>Ensure</instance><instance>Fortisip</instance><instance>Isosource</instance><instance>Jevity</instance><instance>Nutrison</instance><instance>Osmolite</instance><instance>Sustagen</instance></range> </Title> <Case When="Initial application" Category="Children"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient is under 18 years of age</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has a condition causing malabsorption</ci> <ci type="logical" class="Indication">The patient has failure to thrive</ci> <ci type="logical" class="Indication">The patient has increased nutritional requirements</ci> </apply> <ci type="logical" class="Indication">Nutrition goal has been set (eg reach a specific weight or BMI)</ci> </apply> </math> <Applicant>dietitia
0732083853 1046 <Request To="HealthPAC" For="Subsidy" Form="SA1046"> <Title> <range>Ezetimibe with Simvastatin<instance>Vytorin</instance></range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 year</ci> <ci type="logical" class="Trial">Patient's LDL cholesterol is 2.0 mmol/litre or greater</ci> <ci type="logical" class="Trial">The patient has not reduced their LDL cholesterol to less than 2.0 mmol/litre with the use of the maximal tolerated dose of atorvastatin</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> <Note> <Para>A patient who has failed to reduce their LDL cholesterol to ≤ 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapi
2849021010 611 <Request To="Cystic Fibrosis Advisory Panel" For="Subsidy" Form="SA0611"> <Title> <range>Dornase Alfa</range> </Title> <Case When="Initial application"> <math> <ci/> </math> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The Co-ordinator, Cystic Fibrosis Advisory Panel</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC, PO Box 10 254</Para> </TD> <TD> <Para>Facsimile: (04) 916 7571</Para> </TD> </TR> <TR> <TD> <Para>Wellington</Para> </TD> <TD> <Para>Email: <a href="mailto:CFPanel@pharmac.govt.nz">CFPanel@pharmac.
1416022509 1451 <Request To="HealthPAC" For="Subsidy" Form="SA1451"> <Title> <range>Somatropin</range> </Title> <Case When="Initial application" Category="growth hormone deficiency in children"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">Growth hormone deficiency causing symptomatic hypoglycaemia, or with other significant growth hormone deficient sequelae (e.g. cardiomyopathy, hepatic dysfunction) and diagnosed with GH < 5 mcg/l on at least two random blood samples in the first 2 weeks of life, or from samples during established hypoglycaemia (whole blood glucose < 2 mmol/l using a laboratory device)</ci> </apply> <apply> <and/> <ci type="logical" class="Indication">Height velocity < 25th percentile for age adjusted for bone age/pubertal status if appropriate over 6 or 12 months using the standards of Tanner and Davies (1985)</ci> <ci type="logical" class="Indication
1908063939 1139 <Request To="HealthPAC" For="Subsidy" Form="SA1139"> <Title> <range>Teriparatide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="indication">The patient has severe, established osteoporosis</ci> <ci type="logical" class="indication">The patient has a documented T-score less than or equal to -3.0 (see Notes)</ci> <ci type="logical" class="indication">The patient has had two or more fractures due to minimal trauma</ci> <ci type="logical" class="indication">The patient has experienced at least one symptomatic new fracture after at least 12 months’ continuous therapy with a funded antiresorptive agent at adequate doses (see Notes)</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">18</Term> </Case> <Note> <List Type="Alpha"> <Item> <Para>The bone mineral density (BMD) measurement used to derive the
011507380225281291 <Request To="PHARMAC" For="Subsidy" Form="SA1291"> <Title> <range>Optium blood glucose test strips</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Patient identified as eligible for subsidy for FreeStyle Optium blood glucose test strips</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz and can be sent to:</Para> <Table> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para/> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Facsimile: (04) 974 4788</Para> </TD> </TR> <TR> <TD> <Para>Wellington</Para> </TD> <TD> <Para>Email: <a href="mailto:bgstrip
420606 1098 <Request To="HealthPAC" For="Subsidy" Form="SA1098"> <Title> <range>Paediatric Product For Children Awaiting Liver Transplant<instance>Heparon Junior</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a child (up to 18 years) who requires a liver transplant</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Renewal" Form="SA0607 SA1098"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted</ci> </apply> </math
1621033859 845 <Request To="HealthPAC" For="Subsidy" Form="SA0845"> <Title> <range>Enfuvirtide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Confirmed HIV infection</ci> <ci type="logical" class="Indication">Enfuvirtide to be given in combination with optimized background therapy (including at least 1 other antiretroviral drug that the patient has never previously been exposed to) for treatment failure</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has evidence of HIV replication, despite ongoing therapy</ci> <ci type="logical" class="Indication">Patient has treatment-limiting toxicity to previous antiretroviral agents</ci> </apply> <ci type="logical" class="Indication">Previous treatment with 3 different antiretroviral regimens has failed</ci> <apply> <and/> <ci type="logical" class="Indication">Prev
1001011688 955 <Request To="HealthPAC" For="Subsidy" Form="SA0955"> <Title> <range>Isotretinoin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has had an adequate trial on other available treatments and has received an inadequate response from these treatments or these are contraindicated</ci> <ci type="logical" class="Indication">Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice</ci> <ci type="logical" class="Indication">Applicant has an up to date knowledge of the treatment options for acne and is aware of the safety issues around isotretinoin and is competent to prescribe isotretinoin</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is female and has been counselled and understands the risk of teratogenicity if isotretinoin is used d
2205093901 994 <Request To="HealthPAC" For="Subsidy" Form="SA0994"> <Title> <range>Mirtazapine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a severe major depressive episode</ci> <apply> <or/> <ci type="logical" class="Trial">The patient must have had a trial of two different antidepressants and was unable to tolerate the treatments or failed to respond to an adequate dose over an adequate period of time (usually at least four weeks)</ci> <apply> <and/> <ci type="logical" class="Indication">The patient is currently a hospital in-patient as a result of an acute depressive episode</ci> <ci type="logical" class="Trial">The patient must have had a trial of one other antidepressant and either could not tolerate it or failed to respond to an adequate dose over an adequate period of time</ci> </apply> </appl
1619073979 1404 <Request To="HealthPAC" For="Subsidy" Form="SA1404"> <Title> <range>Valganciclovir</range> </Title> <Case When="Initial application" Category="transplant cytomegalovirus prophylaxis"> <math> <ci type="logical" class="Indication">the patient has undergone a solid organ transplant and requires valganciclovir for CMV prophylaxis</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="month">3</Term> </Case> <Case When="Renewal" Form="SA1274 SA1404" Category="transplant cytomegalovirus prophylaxis"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has undergone a solid organ transplant and received anti-thymocyte globulin and requires valganciclovir therapy for CMV prophylaxis</ci> <ci type="logical" class="Indication">Patient is to receive a maximum of 90 days of valganciclovir prophylaxis following anti-thymocyte globulin</ci> </apply> </math> <Applicant>relevant specialist</A
Trial Version
<Request To="HealthPAC" For="Subsidy" Form="SA1138"> <Title> <range>Raloxifene</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="indication">History of one significant osteoporotic fracture demonstrated radiologically and documented bone mineral density (BMD) ≥2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Notes)</ci> <ci type="logical" class="indication">History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age</ci> <ci type="logical" class="indication">History of two significant osteoporotic fractures demonstrated radiologically</ci> <ci type="logical" class="indication">Documente
<Request To="HealthPAC" For="Subsidy" Form="SA1125"> <Title> <range>Lacosamide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has partial-onset epilepsy</ci> <ci type="logical" class="Trial">Seizures are not adequately controlled by, or patient has experienced unacceptable side effects from, optimal treatment with all of the following: sodium valproate, topiramate, levetiracetam and any two of carbamazepine, lamotrigine and phenytoin sodium (see Note)</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">15</Term> <Note> <Para>"Optimal treatment" is defined as treatment which is indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight and other features affecting the pharmacokinetics of the drug with good evidence of compliance. Women of childbearing age are not re
<Request To="HealthPAC" For="Subsidy" Form="SA1376"> <Title> <range>Carbohydrate and Fat<instance>Duocal Super Soluble Powder</instance></range> </Title> <Case When="Initial application" Category="Cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">Infant or child aged four years or under</ci> <ci type="logical" class="Indication">cystic fibrosis</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">infant or child aged four years or under</ci> <apply> <or/> <ci type="logical" class="Indication">cancer in children</ci> <ci type="logica
<Request To="HealthPAC" For="Subsidy" Form="SA0895"> <Title> <range>Pilocarpine – Eye drops 2% single dose</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has to use an unpreserved solution due to an allergy to the preservative</ci> <ci type="logical" class="Indication">Patient wears soft contact lenses</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> <Note> <Para>Minims for a general practice are considered to be “tools of trade” and are not approved as special authority items.</Para> </Note> </Case> <Case When="Renewal" Form="SA0121 SA0895"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2<
<Request To="HealthPAC" For="Subsidy" Form="SA1072"> <Title> <range>Vigabatrin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Indication">Patient has infantile spasms</ci> <apply> <and/> <ci type="logical" class="Indication">Patient has epilepsy</ci> <apply> <or/> <ci type="logical" class="Indication">Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents</ci> <ci type="logical" class="Indication">Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents</ci> </apply> </apply> </apply> <apply> <or/> <ci type="logical" class="Indication">Patient is, or will be, receiving regular automated visual fiel
<Request To="HealthPAC" For="Subsidy" Form="SA1408"> <Title> <range>Naltrexone</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient is currently enrolled in a recognised comprehensive treatment programme for alcohol dependence</ci> <ci type="logical" class="Therapy">Applicant works in or with a community Alcohol and Drug Service contracted to one of the District Health Boards or accredited against the New Zealand Alcohol and Other Drug Sector Standard or the National Mental Health Sector Standard</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA0714 SA0909 SA1397 SA1408"> <math> <apply> <and/> <ci type="logical" class="Indication">Compliance with the medication (prescriber determined)</ci> <apply> <or/> <ci type="log
<Request To="HealthPAC" For="Subsidy" Form="SA1174"> <Title> <range>Enoxaparin sodium</range> </Title> <Case When="Initial application" Category="Pregnancy or Malignancy"> <math> <apply> <or/> <ci type="logical" class="Indication">Low molecular weight heparin treatment is required during a patients pregnancy</ci> <ci type="logical" class="Treatment">For the treatment of venous thromboembolism where the patient has a malignancy</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Initial application" Category="Venous thromboembolism other than in pregnancy or malignancy"> <math> <apply> <or/> <ci type="logical" class="Indication">For the short-term treatment of venous thromboembolism prior to establishing a therapeutic INR with oral anti-coagulant treatment</ci> <ci type="logical" class="Treatment">For the prophylaxis and tre
<Request To="HealthPAC" For="Subsidy" Form="SA1416"> <Title> <range>Atomoxetine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has ADHD (Attention Deficit and Hyperactivity Disorder) diagnosed according to DSM-IV or ICD 10 criteria</ci> <ci type="logical" class="Indication">Once-daily dosing</ci> <apply> <or/> <ci type="logical" class="Indication">Treatment with a subsidised formulation of a stimulant has resulted in the development or worsening of serious adverse reactions or where the combination of subsidised stimulant treatment with another agent would pose an unacceptable medical risk</ci> <ci type="logical" class="Indication">Treatment with a subsidised formulation of a stimulant has resulted in worsening of co-morbid substance abuse or there is a significant risk of diversion with subsidised stimulant therapy</ci> <ci type="log
<Request To="HealthPAC" For="Subsidy" Form="SA1263"> <Title> <range>Nicorandil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has refractory angina</ci> <ci type="logical" class="Trial">Patient is on the maximal tolerated dose of a beta-blocker, a calcium channel blocker and a long acting nitrate</ci> </apply> </math> <Applicant>cardiologist</Applicant> <Applicant>general physician</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA1263"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>cardiologist</Applicant> <Applicant Referring="cardiologist">any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA0927"> <Title> <range>Risperidone orally disintegrating tablets</range> </Title> <Case When="Initial application" Category="Acute situations"> <math> <apply> <and/> <ci type="logical" class="Use">For a non-adherent patient on oral therapy with standard risperidone tablets or risperidone oral liquid</ci> <ci type="logical" class="Therapy">The patient is under direct supervision for administration of medicine</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="week">6</Term> </Case> <Case When="Initial application" Category="Chronic situations"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient is unable to take standard risperidone tablets or oral liquid, or once stabilized refuses to take risperidone tablets or oral liquid</ci> <ci type="logical" class="Therapy">The patient is under direct
<Request To="HealthPAC" For="Subsidy" Form="SA1195"> <Title> <range>High Calorie Products<instance>Two Cal HN</instance><instance>Nutrison Concentrated</instance></range> </Title> <Case When="Initial application" Category="Cystic fibrosis"> <math> <apply> <and/> <ci type="logical" class="Indication">Cystic fibrosis</ci> <ci type="logical" class="Trial">other lower calorie products have been tried</ci> <ci type="logical" class="Indication">patient has substantially increased metabolic requirements</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than cystic fibrosis"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Indication">any cond
<Request To="HealthPAC" For="Subsidy" Form="SA1199"> <Title> <range>Propylthiouracil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has hyperthyroidism</ci> <ci type="logical" class="Indication">The patient is intolerant of carbimazole or carbimazole is contraindicated</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA1199"> <math> <ci type="logical" class="Indication">the treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
<Request To="PHARMAC" For="Subsidy" Form="SA1237"> <Title> <range>Insulin Pumps</range> </Title> <Case When="Initial application"> <math/> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The IPP Co-ordinator</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para>Facsimile: (04) 974 7806</Para> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Email: <a href="mailto:ipp@pharmac.govt.nz">ipp@pharmac.govt.nz</a></Para> </TD> </TR> <TR> <TD> <Para>Welli
<Request To="HealthPAC" For="Subsidy" Form="SA0829"> <Title> <range>Adefovir dipivoxil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Trial">Patient has confirmed Hepatitis B infection (HBsAg+)</ci> <mi class="heading">Documented resistance to lamivudine, defined as:</mi> <ci type="logical" class="Trial">Patient has raised serum ALT (> 1 × ULN)</ci> <ci type="logical" class="Trial">Patient has HBV DNA greater than 100,000 copies per mL, or viral load ≥ 10 fold over nadir</ci> <ci type="logical" class="Trial">Detection of M204I or M204V mutation</ci> <apply> <or/> <apply> <and/> <ci type="logical" class="Trial">Patient is cirrhotic</ci> <ci type="logical" class="Trial">adefovir dipivoxil to be used in combination with lamivudine</ci> </apply> <apply> <and/>
<Request To="HealthPAC" For="Subsidy" Form="SA0998"> <Title> <range>Solifenacin succinate</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has overactive bladder and a documented intolerance of, or is non-responsive to oxybutynin</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1332"> <Title> <range>Tetracycline</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">For the eradication of helicobacter pylori following unsuccessful treatment with appropriate first-line therapy</ci> <ci type="logical" class="Indication">For use only in combination with bismuth as part of a quadruple therapy regimen</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">3</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1379"> <Title> <range>Paediatric Products<instance>Nutrini</instance><instance>Pediasure</instance><instance>Fortini</instance></range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Child is aged one to ten years</ci> <apply> <or/> <ci type="logical" class="Indication">the child is being fed via a tube or a tube is to be inserted for the purposes of feeding</ci> <ci type="logical" class="Indication">any condition causing malabsorption</ci> <ci type="logical" class="Indication">faltering growth in an infant/child</ci> <ci type="logical" class="Indication">increased nutritional requirements</ci> <ci type="logical" class="Indication">the child is being transitioned from TPN or tube feeding to oral feeding</ci> </apply> </apply> </math> <Applicant>dietitian</Applicant>
<Request To="HealthPAC" For="Subsidy" Form="SA1382"> <Title> <range>Ticagrelor</range> </Title> <Case When="Initial application" Category="acute coronary syndrome"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has recently been diagnosed with an ST-elevation or a non-ST-elevation acute coronary syndrome</ci> <ci type="logical" class="Indication">Fibrinolytic therapy has not been given in the last 24 hours and is not planned</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Category="subsequent acute coronary syndrome" Form="SA1382"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has recently been diagnosed with an ST-elevation or a non-ST-elevation acute coronary syndrome</ci> <ci type="logical" class="Indication">Fibrinolytic therapy has not been given in the last 24
<Request To="HealthPAC" For="Subsidy" Form="SA1383"> <Title> <range>Ursodeoxycholic Acid</range> </Title> <Case When="Initial application" Category="Alagille syndrome or progressive familial intrahepatic cholestasis"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has been diagnosed with Alagille syndrome</ci> <ci type="logical" class="Indication">Patient has progressive familial intrahepatic cholestasis</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Case When="Initial application" Category="Chronic severe drug induced cholestatic liver injury"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has chronic severe drug induced cholestatic liver injury</ci> <ci type="logical" class="Indication">Cholestatic liver injury not due to Total Parenteral Nutrition (TPN) use in adults</ci>
<Request To="HealthPAC" For="Subsidy" Form="SA1192"> <Title> <range>Trastuzumab</range> </Title> <Case When="Initial application" Category="metastatic breast cancer"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology)</ci> <ci type="logical" class="Treatment">The patient has not previously received lapatinib treatment for HER 2 positive metastatic breast cancer</ci> <ci type="logical" class="Indication">Trastuzumab not to be given in combination with lapatinib</ci> <ci type="logical" class="Treatment">Trastuzumab to be discontinued at disease progression</ci> </apply> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic breast cancer expressing HER-2 IHC 3+ or ISH+ (including FISH or other current technology
<Request To="HealthPAC" For="Subsidy" Form="SA1071"> <Title> <range>Gabapentin</range> </Title> <Case When="Initial application" Category="Epilepsy"> <math> <apply> <or/> <ci type="logical" class="Indication">Seizures are not adequately controlled with optimal treatment with other antiepilepsy agents</ci> <ci type="logical" class="Indication">Seizures are controlled adequately but the patient has experienced unacceptable side effects from optimal treatment with other antiepilepsy agents</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">15</Term> <Note> <Para>"Optimal treatment with other antiepilepsy agents" is defined as treatment with other antiepilepsy agents which are indicated and clinically appropriate for the patient, given in adequate doses for the patient's age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance.</Para>
<Request To="HealthPAC" For="Subsidy" Form="SA1066"> <Title> <range>Rivaroxaban</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">For the prophylaxis of venous thromboembolism following a total hip replacement</ci> <ci type="logical" class="Use">For the prophylaxis of venous thromboembolism following a total knee replacement</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="week">5</Term> <Note> <Para>Rivaroxaban is only currently indicated and subsidised for up to 5 weeks therapy for prophylaxis of venous thromboembolism following a total hip replacement and up to 2 weeks therapy for prophylaxis of venous thromboembolism following a total knee replacement.</Para> </Note> </Case> <Case When="Renewal" Form="SA1066"> <math> <ci type="logical" class="Indication">Prophylaxis for venous thromboembolism is requir
<Request To="PHARMAC" For="Subsidy" Form="SA1240"> <Title> <range>Insulin pump consumables</range> </Title> <Case When="Initial application"> <math/> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The IPP Co-ordinator</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para>Facsimile: (04) 974 7806</Para> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Email: <a href="mailto:ipp@pharmac.govt.nz">ipp@pharmac.govt.nz</a></Para> </TD> </TR> <TR> <TD>
<Request To="HealthPAC" For="Subsidy" Form="SA1289"> <Title> <range>Capsaicin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has osteoarthritis that is not responsive to paracetamol and oral non-steroidal anti-inflammatories are contraindicated</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1039"> <Title> <range>Alendronate Tab 70 mg - with or without Cholecalciferol</range> </Title> <Case When="Initial application" Category="Underlying cause -- Osteoporosis"> <math> <apply> <or/> <ci type="logical" class="Indication">History of one significant osteoporotic fracture demonstrated radiologically and documented bone mineral density (BMD) ≥ 2.5 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ -2.5) (see Note)</ci> <ci type="logical" class="Indication">History of one significant osteoporotic fracture demonstrated radiologically, and either the patient is elderly, or densitometry scanning cannot be performed because of major logistical, technical or pathophysiological reasons. It is unlikely that this provision would apply to many patients under 75 years of age</ci> <ci type="logical" class="Indication">History of two significant osteoporotic fractures
<Request To="HealthPAC" For="Manufacturers Price" Form="SA1355"> <Title> <range>Minocycline hydrochloride Tab 50 mg</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has rosacea</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1324"> <Title> <range>Paromomycin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">the patient has confirmed cryptosporidium infection</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case> <Case When="Renewal" Form="SA1324"> <math> <ci type="logical" class="Indication">the patient has confirmed cryptosporidium infection</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1126"> <Title> <range>Modavigil</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a diagnosis of narcolepsy and has excessive daytime sleepiness associated with narcolepsy occurring almost daily for three months or more</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has a multiple sleep latency test with a mean sleep latency of less than or equal to 10 minutes and 2 or more sleep onset rapid eye movement periods</ci> <ci type="logical" class="Indication">The patient has at least one of: cataplexy, sleep paralysis or hypnagogic hallucinations</ci> </apply> <apply> <or/> <ci type="logical" class="Indication">An effective dose of a subsidised formulation of methylphenidate or dexamphetamine has been trialled and discontinued because of intolerabl
<Request To="HealthPAC" For="Subsidy" Form="SA0928"> <Title> <range>Finasteride</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has symptomatic benign prostatic hyperplasia</ci> <apply> <or/> <ci type="logical" class="Indication">The patient is intolerant of non-selective alpha blockers or these are contraindicated</ci> <ci type="logical" class="Indication">Symptoms are not adequately controlled with non-selective alpha blockers</ci> </apply> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Patients with enlarged prostates are the appropriate candidates for therapy with finasteride.</Para> </Note></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1099"> <Title> <range>Paediatric Product For Children With Chronic Renal Failure<instance>Kindergen</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a child (up to 18 years) with acute or chronic kidney disease</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Renewal" Form="SA0606 SA1099"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted</ci> </apply> </mat
<Request To="HealthPAC" For="Subsidy" Form="SA1272"> <Title> <range>Tolterodine</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Patient has overactive bladder and a documented intolerance of, or is non-responsive to oxybutynin</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1381"> <Title> <range>Fat Modified Products<instance>Monogen</instance></range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has metabolic disorders of fat metabolism</ci> <ci type="logical" class="Indication">Patient has a chyle leak</ci> <ci type="logical" class="Indication">Modified as a modular feed for adults</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0593 SA0615 SA1096 SA1381"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitio
<Request To="HealthPAC" For="Subsidy" Form="SA0782"> <Title> <range>Levonorgestrel – releasing intrauterine system 20mcg/24 hr</range> </Title> <Case When="Initial application" Category="No previous use"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a clinical diagnosis of heavy menstrual bleeding</ci> <ci type="logical" class="Trial">The patient has failed to respond to or is unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines</ci> <apply> <or/> <apply> <lt/> <ci type="real" class="test">serum ferritin level</ci> <cn>16<mi> mcg/l (within the last 12 months)</mi></cn> </apply> <apply> <lt/> <ci type="real" class="test">haemoglobin level</ci> <cn>120<mi> g/l</mi></cn> </apply> </apply> </apply> </math>
<Request To="HealthPAC" For="Subsidy" Form="SA1032"> <Title> <range>Tamsulosin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has symptomatic benign prostatic hyperplasia</ci> <ci type="logical" class="Indication">The patient is intolerant of non-selective alpha blockers or these are contraindicated</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA0954"> <Title> <range>Acitretin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice</ci> <ci type="logical" class="Indication">Applicant has an up to date knowledge of the treatment options for psoriasis and of disorders of keratinisation and is aware of the safety issues around acitretin and is competent to prescribe acitretin</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is female and has been counselled and understands the risk of teratogenicity if acitretin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that
<Request To="HealthPAC" For="Subsidy" Form="SA0987"> <Title> <range>Aprepitant</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA0987"> <math> <ci type="logical" class="Indication">The patient is undergoing highly emetogenic chemotherapy and/or anthracycline-based chemotherapy for the treatment of malignancy</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1042"> <Title> <range>Deferiprone</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has been diagnosed with chronic transfusional iron overload due to congenital inherited anaemia</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>For the purposes of this Special Authority, a relevant specialist is defined as a haematologist.</Para> </Note></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1155"> <Title> <range>Budesonide - Cap 3 mg Controlled Release</range> </Title> <Case When="Initial application" Category="Crohn's disease"> <math> <apply> <and/> <ci type="logical" class="Indication">Mild to moderate ileal, ileocaecal or proximal Crohn's disease</ci> <apply> <or/> <ci type="logical" class="Indication">Diabetes</ci> <ci type="logical" class="Indication">Cushingoid habitus</ci> <ci type="logical" class="Indication">Osteoporosis where there is significant risk of fracture</ci> <ci type="logical" class="Indication">Severe acne following treatment with conventional corticosteroid therapy</ci> <ci type="logical" class="Indication">History of severe psychiatric problems associated with corticosteroid treatment</ci> <ci type="logical" class="Indication">History of major mental illness (such as bipolar affective disorder) where
<Request To="HealthPAC" For="Subsidy" Form="SA1421"> <Title> <range>Montelukast</range> </Title> <Case When="Initial application" Category="Pre-school wheeze"> <math> <apply> <and/> <ci type="logical" class="Indication">To be used for the treatment of intermittent severe wheezing (possibly viral) in children under 5 years</ci> <ci type="logical" class="Indication">The patient has had at least three episodes in the previous 12 months of acute wheeze severe enough to seek medical attention</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Category="Pre-school wheeze" Form="SA1227 SA1409 SA1421"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case
<Request To="PHARMAC" For="Subsidy" Form="SA0973"> <Title> <range>Neurontin</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Subsidy for patients pre-approved on 1 August 2009</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Subsidy for patients pre-approved by PHARMAC on 1 August 2009. Approvals valid without further renewal unlessnotified.</Para> <Para>No new approvals will be granted from 1 August 2009.</Para> </Note></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1196"> <Title> <range>Paediatric enteral feed with fibre 0.75 kcal/ml<instance>Nutrini Low Energy Multi Fibre</instance></range> </Title> <Case When="Initial application"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">Child aged one to eight years</ci> <ci type="logical" class="Indication">The child has a low energy requirement but normal protein and micronutrient requirements</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA1196"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement
<Request To="HealthPAC" For="Subsidy" Form="SA1225"> <Title> <range>Ivermectin</range> </Title> <Case When="Initial application" Category="Scabies"> <math> <apply> <and/> <ci type="logical" class="Indication">Applying clinician has discussed the diagnosis of scabies with a dermatologist, infectious disease physician or clinical microbiologist</ci> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient is in the community</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has a severe scabies hyperinfestation (Crusted/ Norwegian scabies)</ci> <ci type="logical" class="Indication">The community patient is physically or mentally unable to comply with the application instructions of topical therapy</ci> <ci type="logical" class="Indication">The patient has previously tried and failed to clear infestation
<Request To="HealthPAC" For="Subsidy" Form="SA1322"> <Title> <range>Itraconazole</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has a congenital immune deficiency</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Applicant>clinical immunologist</Applicant> <Applicant Referring="infectious disease physician, clinical microbiologist or clinical immunologist">any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA1322"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1223"> <Title> <range>Candesartan</range> </Title> <Case When="Initial application" Category="ACE inhibitor intolerance"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has persistent ACE inhibitor induced cough that is not resolved by ACE inhibitor retrial (same or new ACE inhibitor)</ci> <ci type="logical" class="Indication">Patient has a history of angioedema</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Case When="Initial application" Category="Unsatisfactory response to ACE inhibitor"> <math> <ci type="logical" class="Indication">patient is not adequately controlled on maximum tolerated dose of an ACE inhibitor</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA0922"> <Title> <range>Erythropoietin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <and/> <ci type="logical" class="Indication">patient in chronic renal failure</ci> <apply> <leq/> <ci type="real" class="test">Haemoglobin</ci> <cn>100<mi>g/L</mi></cn> </apply> </apply> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">patient is not diabetic</ci> <apply> <leq/> <ci type="real" class="test">glomerular filtration rate</ci> <cn>30<mi>ml/min</mi></cn> </apply> </apply> <apply> <and/> <ci type="logical" class="Indication">patient is diabetic</ci> <apply> <leq/> <ci type
<Request To="HealthPAC" For="Subsidy" Form="SA1198"> <Title> <range>Preterm post-discharge infant formula powder<instance>S-26 Gold Premgro</instance></range> </Title> <Case When="Initial application"> <math overflow="scroll"> <apply> <and/> <ci type="logical" class="Indication">The infant was born before 33 weeks gestation or weighed less than 1.5 kg at birth</ci> <apply> <or/> <ci type="logical" class="Indication">The infant has faltering growth (downward crossing of percentiles)</ci> <ci type="logical" class="Indication">The infant is not maintaining, or is considered unlikely to maintain, adequate growth on standard infant formula</ci> </apply> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="month">6</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1124"> <Title> <range>Thalidomide</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="indication">The patient has multiple myeloma</ci> <ci type="logical" class="indication">The patient has systemic AL amyloidosis*</ci> </apply> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1124 SA0817 SA0882"> <math> <ci type="logical" class="indication">The patient has obtained a response from treatment during the initial approval period</ci> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Prescription must be written by a re
<Request To="HealthPAC" For="Subsidy" Form="SA1321"> <Title> <range>Hydralazine</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">For the treatment of refractory hypertension</ci> <ci type="logical" class="Indication">For the treatment of heart failure in combination with a nitrate, in patients who are intolerant or have not responded to ACE inhibitors and/or angiotensin receptor blockers</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1260"> <Title> <range>Perhexiline Maleate</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has refractory angina</ci> <ci type="logical" class="Trial">Patient is on the maximal tolerated dose of a beta-blocker, a calcium channel blocker and a long acting nitrate</ci> </apply> </math> <Applicant>cardiologist</Applicant> <Applicant>general physician</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA0256 SA1260"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>cardiologist</Applicant> <Applicant Referring="cardiologist">any relevant practitioner</Applicant> <Term Measure="year">2</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1326"> <Title> <range>Primaquine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has vivax or ovale malaria</ci> <ci type="logical" class="Indication">Primaquine is to be given for a maximum of 21 days</ci> </apply> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">1</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1285"> <Title> <range>Posaconazole </range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation chemotherapy</ci> <ci type="logical" class="Indication">Patient has received a stem cell transplant and has graft versus host disease and is on significant immunosuppressive therapy*</ci> </apply> </math> <Applicant>haematologist</Applicant> <Applicant>infectious disease specialist</Applicant> <Term Measure="week">6</Term> </Case> <Case When="Renewal" Form="SA1285"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has acute myeloid leukaemia and is to be treated with high dose remission induction, re-induction or consolidation therapy</ci> <ci type="logical" c
<Request To="HealthPAC" For="Subsidy" Form="SA1386"> <Title> <range>Phenobarbitone</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">For the treatment of terminal agitation that is unresponsive to other agents</ci> <ci type="logical" class="Indication">The applicant is part of a multidisciplinary team working in palliative care</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1293"> <Title> <range>Sildenafil</range> </Title> <Case When="Initial application" Category="Raynaud’s Phenomenon* - for Pulmonary Arterial Hypertension see note below)"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has Raynaud’s Phenomenon*</ci> <ci type="logical" class="Indication">Patient has severe digital ischaemia (defined as severe pain requiring hospital admission or with a high likelihood of digital ulceration; digital ulcers; or gangrene)</ci> <ci type="logical" class="Indication">Patient is following lifestyle management (avoidance of cold exposure, sufficient protection, smoking cessation support, avoidance of sympathomimetic drugs) </ci> <ci type="logical" class="Indication">Patient is being treated with calcium channel blockers and nitrates (or these are contraindicated/not tolerated)</ci> </apply> </math> <Applicant>any relevant
<Request To="HealthPAC" For="Subsidy" Form="SA1061"> <Title> <range>Venlafaxine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has 'treatment-resistant' depression</ci> <apply> <or/> <ci type="logical" class="Trial">The patient must have had a trial of two different antidepressants and have had an inadequate response from an adequate dose over an adequate period of time (usually at least four weeks)</ci> <apply> <and/> <ci type="logical" class="Indication">The patient is currently a hospital in-patient as a result of an acute depressive episode</ci> <ci type="logical" class="Trial">The patient must have had a trial of one other antidepressant and have had an inadequate response from an adequate dose over an adequate period of time</ci> </apply> </apply> </apply> </math> <Appl
<Request To="HealthPAC" For="Subsidy" Form="SA1411"> <Title> <range>Erlotinib</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">Patient has locally advanced or metastatic, unresectable, non-squamous Non Small Cell Lung Cancer (NSCLC)</ci> <ci type="logical" class="Indication">There is documentation confirming that the disease expresses activating mutations of EGFR tyrosine kinase</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is treatment naive</ci> <apply> <and/> <ci type="logical" class="Indication">Patient has documented disease progression following treatment with first line platinum based chemotherapy</ci> <ci type="logical" class="Indication">Patient has not received prior treatment with gefitinib</ci> </apply> </apply>
<Request To="HealthPAC" For="Alternate Subsidy" Form="SA1018"> <Title> <range>Hormone Replacement Therapy - Systemic</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">acute or significant liver disease - where oral oestrogens are contraindicated as determined by a gastroenterologist or general physician. The applicant must keep written confirmation from such a specialist with the patient's record</ci> <ci type="logical" class="Indication">oestrogen induced hypertension requiring antihypertensive therapy - documented evidence must be kept on file that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens</ci> <ci type="logical" class="Indication">hypertriglyceridaemia - documented evidence must be kept on file that triglyceride levels increased to at least 2 × normal triglyceride levels post oral oestrogens</ci> <ci type=
<Request To="HealthPAC" For="Subsidy" Form="SA1320"> <Title> <range>Diazoxide</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">used for the treatment of confirmed hypoglycaemia caused by hyperinsulinism</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1320"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1318"> <Title> <range>Albendazole</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient has hydatids</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Renewal" Form="SA1318"> <math> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefitting from the treatment</ci> </math> <Applicant>infectious disease specialist</Applicant> <Applicant>clinical microbiologist</Applicant> <Term Measure="month">6</Term> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1271"> <Title> <range>Minoxidil</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">patient has severe refractory hypertension which has failed to respond to extensive multiple therapies</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1095"> <Title> <range>Diabetic products<instance>Diason RTH</instance><instance>Glucerna Select RTH</instance><instance>Diasip</instance><instance>Glucerna Select</instance><instance>Resource Diabetic</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a type I or and II diabetic who is suffering weight loss and malnutrition that requires nutritional support</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0594 SA1095"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must includ
<Request To="PHARMAC" For="Manufacturers Price" Form="SA1038"> <Title> <range>Anti-inflammatory Non Steroidal Drugs (NSAIDs)</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Subsidy for patients with existing approvals prior to 1 September 2010</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Subsidy for patients with existing approvals prior to 1 September 2010. Approvals valid without further renewal unlessnotified. No new approvals will be granted from 1 September 2010.</Para> </Note></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1002"> <Title> <range>Vitabdeck</range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">Patient has cystic fibrosis with pancreatic insufficiency</ci> <ci type="logical" class="Indication">Patient is an infant or child with liver disease or short gut syndrome</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case></Request>
<Request To="HealthPAC" For="Subsidy" Form="SA1449"> <Title> <range>Adalimumab</range> </Title> <Case When="Initial application" Category="rheumatoid arthritis"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">The patient has had an initial Special Authority approval for etanercept for rheumatoid arthritis</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has experienced intolerable side effects from etanercept</ci> <ci type="logical" class="Indication">The patient has received insufficient benefit from etanercept to meet the renewal criteria for etanercept for rheumatoid arthritis</ci> </apply> </apply> <apply> <and/> <ci type="logical" class="Indication">Patient has had severe and active erosive rheumatoid arthritis for six months duration or longer</ci> <ci type="logical" class="Treatmen
<Request To="HealthPAC" For="Subsidy" Form="SA1388"> <Title> <range>Preservative Free Ocular Lubricants</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Confirmed diagnosis by slit lamp of severe secretory dry eye</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is using eye drops more than four times daily on a regular basis</ci> <ci type="logical" class="Indication">Patient has had a confirmed allergic reaction to preservative in eye drop</ci> </apply> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1388"> <math> <ci type="logical" class="Indication">The patient continues to require lubricating eye drops and has benefited from treatment</ci> </math> <Applicant>any relevant practitioner</Applicant>
<Request To="HealthPAC" For="Subsidy" Form="SA1201"> <Title> <range>Prasugrel</range> </Title> <Case When="Initial application" Category="coronary angioplasty and bare metal stent"> <math> <ci type="logical" class="Treatment">The patient has undergone coronary angioplasty in the previous 4 weeks and is clopidogrel-allergic*</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">6</Term> </Case> <Case When="Initial application" Category="drug eluting stent"> <math> <ci type="logical" class="Treatment">The patient has had a drug-eluting cardiac stent inserted in the previous 4 weeks and is clopidogrel-allergic*</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Initial application" Category="stent thromobosis"> <math> <ci type="logical" class="Treatment">patient has experienced cardiac stent thrombosis whilst on clopidogrel</ci>
<Request To="HealthPAC" For="Subsidy" Form="SA1325"> <Title> <range>Pegaspargase</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has newly diagnosed acute lymphoblastic leukaemia</ci> <ci type="logical" class="Indication">Pegaspargase to be used with a contemporary intensive multi-agent chemotherapy treatment protocol</ci> <ci type="logical" class="Indication">Treatment is with curative intent</ci> </apply> </math> <Applicant>relevant specialist</Applicant> <Applicant Referring="relevant specialist">medical practitioner</Applicant> <Term Measure="month">12</Term> </Case> <Case When="Renewal" Form="SA1325"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has relapsed acute lymphoblastic leukaemia</ci> <ci type="logical" class="Indication">Pegaspargase to be used with a contemporar
<Request To="HealthPAC" For="Alternate Subsidy" Form="SA0500"> <Title><range>Combined oral contraceptives</range><range>Progestogen-only contraceptives</range> (Circle one)</Title> <Case When="Initial application"> <math> <apply> <and/> <apply> <or/> <ci type="logical" class="Target">Patient is on a Social Welfare benefit</ci> <ci type="logical" class="Target">Patient has an income no greater than the benefit</ci> </apply> <ci type="logical" class="Trial">Has tried at least one of the fully funded options and has been unable to tolerate it</ci> </apply> </math> <Applicant>medical practitioner</Applicant> <Term Measure="year">2</Term> </Case> <Case When="Renewal" Form="SA0265 SA0500"> <math> <apply> <or/> <ci type="logical" class="Target">Patient is on a Social Welfare benefit</ci> <ci type="logical" class="Target">Patient has an income no greater than the be
<Request To="HealthPAC" For="Subsidy" Form="SA1374"> <Title> <range>Fat<instance>Calogen</instance><instance>Liquigen</instance><instance>MCT oil (Nutricia)</instance></range> </Title> <Case When="Initial application" Category="Inborn errors of metabolism"> <math> <ci type="logical" class="Indication">The patient has inborn errors of metabolism</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Initial application" Category="Indications other than inborn errors of metabolism"> <math> <apply> <or/> <ci type="logical" class="Indication">faltering growth in an infant/child</ci> <ci type="logical" class="Indication">bronchopulmonary dysplasia</ci> <ci type="logical" class="Indication">fat malabsorption</ci> <ci type="logical" class="Indication">lym
<Request To="HealthPAC" For="Subsidy" Form="SA1375"> <Title> <range>Protein<instance>Protifar</instance><instance>Promod</instance><instance>Resource Beneprotein</instance></range> </Title> <Case When="Initial application"> <math> <apply> <or/> <ci type="logical" class="Indication">protein losing enteropathy</ci> <ci type="logical" class="Indication">high protein needs</ci> <ci type="logical" class="Indication">for use as a component in a modular formula</ci> </apply> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Case When="Renewal" Form="SA0582 SA1093 SA1375"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endor
<Request To="HealthPAC" For="Subsidy" Form="SA1266"> <Title> <range>Sunitinib</range> </Title> <Case When="Initial application" Category="RCC"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has metastatic renal cell carcinoma</ci> <apply> <or/> <ci type="logical" class="Trial">The patient is treatment naive</ci> <ci type="logical" class="Trial">The patient has only received prior cytokine treatment</ci> <ci type="logical" class="Trial">The patient has only received prior treatment with an investigational agent within the confines of a bona fide clinical trial which has Ethics Committee approval</ci> <apply> <and/> <ci type="logical" class="Trial">The patient has discontinued pazopanib within 3 months of starting treatment due to intolerance</ci> <ci type="logical" class="Trial">The cancer did not progress whilst on pazopanib</ci>
<Request To="HealthPAC" For="Subsidy" Form="SA1273"> <Title> <range>Voriconazole</range> </Title> <Case When="Initial application" Category="invasive fungal infection"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient is immunocompromised</ci> <ci type="logical" class="Indication">Applicant is part of a multidisciplinary team including an infectious disease specialist</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has proven or probable invasive aspergillus infection</ci> <ci type="logical" class="Indication">Patient has possible invasive aspergillus infection</ci> <ci type="logical" class="Indication">Patient has fluconazole resistant candidiasis</ci> <ci type="logical" class="Indication">Patient has mould strain such as Fusarium spp. and Scedosporium spp</ci> </apply> </apply> </math> <Applicant>haematologist</Applicant> <App
<Request To="HealthPAC" For="Subsidy" Form="SA1228"> <Title> <range>Standard Supplements<instance>Ensure</instance><instance>Fortisip</instance><instance>Isosource</instance><instance>Jevity</instance><instance>Nutrison</instance><instance>Osmolite</instance><instance>Sustagen</instance></range> </Title> <Case When="Initial application" Category="Children"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient is under 18 years of age</ci> <apply> <or/> <ci type="logical" class="Indication">The patient has a condition causing malabsorption</ci> <ci type="logical" class="Indication">The patient has failure to thrive</ci> <ci type="logical" class="Indication">The patient has increased nutritional requirements</ci> </apply> <ci type="logical" class="Indication">Nutrition goal has been set (eg reach a specific weight or BMI)</ci> </apply> </math> <Applicant>dietitia
<Request To="HealthPAC" For="Subsidy" Form="SA1046"> <Title> <range>Ezetimibe with Simvastatin<instance>Vytorin</instance></range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has a calculated absolute risk of cardiovascular disease of at least 15% over 5 year</ci> <ci type="logical" class="Trial">Patient's LDL cholesterol is 2.0 mmol/litre or greater</ci> <ci type="logical" class="Trial">The patient has not reduced their LDL cholesterol to less than 2.0 mmol/litre with the use of the maximal tolerated dose of atorvastatin</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="year">2</Term> <Note> <Para>A patient who has failed to reduce their LDL cholesterol to ≤ 2.0 mmol/litre with the use of a less potent statin should use a more potent statin prior to consideration being given to the use of non-statin therapi
<Request To="Cystic Fibrosis Advisory Panel" For="Subsidy" Form="SA0611"> <Title> <range>Dornase Alfa</range> </Title> <Case When="Initial application"> <math> <ci/> </math> <Applicant>medical practitioner</Applicant> <Term Measure="year">1</Term> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website <a href="http://www.pharmac.govt.nz/">http://www.pharmac.govt.nz</a> or:</Para> <Table> <TR> <TD> <Para>The Co-ordinator, Cystic Fibrosis Advisory Panel</Para> </TD> <TD> <Para>Phone: (04) 460 4990</Para> </TD> </TR> <TR> <TD> <Para>PHARMAC, PO Box 10 254</Para> </TD> <TD> <Para>Facsimile: (04) 916 7571</Para> </TD> </TR> <TR> <TD> <Para>Wellington</Para> </TD> <TD> <Para>Email: <a href="mailto:CFPanel@pharmac.govt.nz">CFPanel@pharmac.
<Request To="HealthPAC" For="Subsidy" Form="SA1451"> <Title> <range>Somatropin</range> </Title> <Case When="Initial application" Category="growth hormone deficiency in children"> <math> <apply> <or/> <apply> <and/> <ci type="logical" class="Indication">Growth hormone deficiency causing symptomatic hypoglycaemia, or with other significant growth hormone deficient sequelae (e.g. cardiomyopathy, hepatic dysfunction) and diagnosed with GH < 5 mcg/l on at least two random blood samples in the first 2 weeks of life, or from samples during established hypoglycaemia (whole blood glucose < 2 mmol/l using a laboratory device)</ci> </apply> <apply> <and/> <ci type="logical" class="Indication">Height velocity < 25th percentile for age adjusted for bone age/pubertal status if appropriate over 6 or 12 months using the standards of Tanner and Davies (1985)</ci> <ci type="logical" class="Indication
<Request To="HealthPAC" For="Subsidy" Form="SA1139"> <Title> <range>Teriparatide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="indication">The patient has severe, established osteoporosis</ci> <ci type="logical" class="indication">The patient has a documented T-score less than or equal to -3.0 (see Notes)</ci> <ci type="logical" class="indication">The patient has had two or more fractures due to minimal trauma</ci> <ci type="logical" class="indication">The patient has experienced at least one symptomatic new fracture after at least 12 months’ continuous therapy with a funded antiresorptive agent at adequate doses (see Notes)</ci> </apply> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="month">18</Term> </Case> <Note> <List Type="Alpha"> <Item> <Para>The bone mineral density (BMD) measurement used to derive the
<Request To="PHARMAC" For="Subsidy" Form="SA1291"> <Title> <range>Optium blood glucose test strips</range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">Patient identified as eligible for subsidy for FreeStyle Optium blood glucose test strips</ci> </math> <Applicant>any relevant practitioner</Applicant> <Term Measure="patient's lifetime"/> </Case> <Note> <Para>Application details may be obtained from PHARMAC's website http://www.pharmac.govt.nz and can be sent to:</Para> <Table> <TR> <TD> <Para>PHARMAC</Para> </TD> <TD> <Para/> </TD> </TR> <TR> <TD> <Para>PO Box 10 254</Para> </TD> <TD> <Para>Facsimile: (04) 974 4788</Para> </TD> </TR> <TR> <TD> <Para>Wellington</Para> </TD> <TD> <Para>Email: <a href="mailto:bgstrip
<Request To="HealthPAC" For="Subsidy" Form="SA1098"> <Title> <range>Paediatric Product For Children Awaiting Liver Transplant<instance>Heparon Junior</instance></range> </Title> <Case When="Initial application"> <math> <ci type="logical" class="Indication">The patient is a child (up to 18 years) who requires a liver transplant</ci> </math> <Applicant>dietitian</Applicant> <Applicant>relevant specialist</Applicant> <Applicant>vocationally registered general practitioner</Applicant> <Term Measure="year">3</Term> </Case> <Case When="Renewal" Form="SA0607 SA1098"> <math> <apply> <and/> <ci type="logical" class="Indication">The treatment remains appropriate and the patient is benefiting from treatment</ci> <ci type="text" class="Endorsement">General Practitioners must include the name of the dietitian, relevant specialist or vocationally registered general practitioner and date contacted</ci> </apply> </math
<Request To="HealthPAC" For="Subsidy" Form="SA0845"> <Title> <range>Enfuvirtide</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Confirmed HIV infection</ci> <ci type="logical" class="Indication">Enfuvirtide to be given in combination with optimized background therapy (including at least 1 other antiretroviral drug that the patient has never previously been exposed to) for treatment failure</ci> <apply> <or/> <ci type="logical" class="Indication">Patient has evidence of HIV replication, despite ongoing therapy</ci> <ci type="logical" class="Indication">Patient has treatment-limiting toxicity to previous antiretroviral agents</ci> </apply> <ci type="logical" class="Indication">Previous treatment with 3 different antiretroviral regimens has failed</ci> <apply> <and/> <ci type="logical" class="Indication">Prev
<Request To="HealthPAC" For="Subsidy" Form="SA0955"> <Title> <range>Isotretinoin</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has had an adequate trial on other available treatments and has received an inadequate response from these treatments or these are contraindicated</ci> <ci type="logical" class="Indication">Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice</ci> <ci type="logical" class="Indication">Applicant has an up to date knowledge of the treatment options for acne and is aware of the safety issues around isotretinoin and is competent to prescribe isotretinoin</ci> <apply> <or/> <ci type="logical" class="Indication">Patient is female and has been counselled and understands the risk of teratogenicity if isotretinoin is used d
<Request To="HealthPAC" For="Subsidy" Form="SA0994"> <Title> <range>Mirtazapine</range> </Title> <Case When="Initial application"> <math> <apply> <and/> <ci type="logical" class="Indication">The patient has a severe major depressive episode</ci> <apply> <or/> <ci type="logical" class="Trial">The patient must have had a trial of two different antidepressants and was unable to tolerate the treatments or failed to respond to an adequate dose over an adequate period of time (usually at least four weeks)</ci> <apply> <and/> <ci type="logical" class="Indication">The patient is currently a hospital in-patient as a result of an acute depressive episode</ci> <ci type="logical" class="Trial">The patient must have had a trial of one other antidepressant and either could not tolerate it or failed to respond to an adequate dose over an adequate period of time</ci> </apply> </appl
<Request To="HealthPAC" For="Subsidy" Form="SA1404"> <Title> <range>Valganciclovir</range> </Title> <Case When="Initial application" Category="transplant cytomegalovirus prophylaxis"> <math> <ci type="logical" class="Indication">the patient has undergone a solid organ transplant and requires valganciclovir for CMV prophylaxis</ci> </math> <Applicant>relevant specialist</Applicant> <Term Measure="month">3</Term> </Case> <Case When="Renewal" Form="SA1274 SA1404" Category="transplant cytomegalovirus prophylaxis"> <math> <apply> <and/> <ci type="logical" class="Indication">Patient has undergone a solid organ transplant and received anti-thymocyte globulin and requires valganciclovir therapy for CMV prophylaxis</ci> <ci type="logical" class="Indication">Patient is to receive a maximum of 90 days of valganciclovir prophylaxis following anti-thymocyte globulin</ci> </apply> </math> <Applicant>relevant specialist</A

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