EmailHospital Circular 10/1999
Date Issued: 9 September 1999
Publication: 10/1999
Contact: Head Office
Distribution: Public Hospitals
Subjects: Highly Specialised Drugs Program
Purpose: The purpose of this circular is to advise hospitals involved with the Highly Specialised Drugs Program of a number of changes to the Program
We have had recent advice from the Commonwealth on a number changes concerning drugs on the Highly Specialised Drugs Program. Details of the changes are set out below.
1.New Drugs on Program
Ribavirin and interferon alfa-2b (Rebetron COMBINATION THERAPY)
| Code | Pack size | Price | |
|---|---|---|---|
| 6261M | Pack containing 84 capsules ribavirin 200mg and 2 multi-dose cartridges interferon alfa-2b solution for injection 18,000,000 iu in 1.2 ml | 1 | $1,028.93 |
| 6262N | Pack containing 140 capsules ribavirin 200mg and 2 multi-dose cartridges interferon alfa-2b for injection 18,000,000 iu in 1.2 ml | 1 | $1,504.93 |
| 6263P | Pack containing 168 capsules ribavirin 200mg and 2 multi-dose cartridges interferon alfa-2b for injection 18,000,000 iu in 1.2 ml | 1 | $1,742.93 |
Indication:
Treatment of chronic hepatitis C in patients who have relapsed following interferon alfa-2a/2b monotherapy supplied as a Highly Specialised Drug under these arrangements.
Treatment is to cease if plasma HCV RNA remains detectable after 12 weeks therapy.
The treatment course is limited to 24 weeks.
Effective Subsidy Date:1 October, 1999
Abacavir sulphate (Ziagen)
| 6264Q | Tablet 300mg (base) | 60 | $423.00 |
| 6265R | Oral Solution 20mg (base) per mL | 1 x 240 ml | $75.20 |
Indication:
Treatment of HIV infection in patients with CD4 cell counts of less than 500 per mm3, or viral load of greater than 10,000 copies per ml.
Effective Subsidy Date:1 October, 1999
Efavirenz (Stocrin)
| 6258J | Capsule 50mg | 30 | $37.50 |
| 6259K | Capsule 100mg | 30 | $75.50 |
| 6260L | Capsule 200mg | 42 | $211.23 |
Indication:
Treatment of HIV infection in patients with CD4 cell counts of less than 500 per mm3, or viral load of greater than 10,000 copies per ml.
Effective Subsidy Date:1 October, 1999
2.Changes to Indications
Clarithromycin (Klacid)
Change to indication: These criteria extend the indication to include treatment of all patients with MAC infections. The revised indication will now specify Clarithromycin's use for:
Treatment of mycobacterium avium complex infections.
Effective Subsidy Date:1 October, 1999
INTERFERON ALFA 2A AND 2B
Change to indication: These criteria modify the indication for both interferon alfa 2A and 2B such that:
- Patients with chronic active hepatitis B who have used illicit injectable drugs within the previous 12 months are no longer excluded; and
- Patients with chronic hepatitis C who have abnormal ALT levels in conjunction with demonstration of viral infection (HCV RNA positive and /or anti-HCV positive) are included.
Effective Subsidy Date:1 October, 1999
LAMIVUDINE (ZEFFIX)
Change to indication: The criteria for Lamivudine (Zeffix) has previously included:
- patients who have ALT greater than twice the upper limit of the laboratory reference range on three occasions over 6 months.
This has been altered to include:
- patients with hepatitis B who have elevated ALT levels on 2 occasions over a period of 3 months.
In addition, persons with Child’s class B or C cirrhosis (ascites, variceal bleeding, encephalopathy, albumin < 30 g/L, bilirubin > 30 micromoles/L) may be included for treatment upon discussion with a transplant unit prior to initiating therapy
Effective Subsidy Date:1 October, 1999
3.CHANGE IN PACK SIZE
Zidovudine (Retrovir)
| 6154X | Capsule 250mg | 60 | $308.19 |
Effective Subsidy Date:1 October, 1999
Interferon gamma-1b (Imukin)
| 6148N | Injection 2,000,000 iu in 0.5ml | 6 | $1,052.00 |
NB: PLEASE NOTE THIS IS NOT A CHANGE OF FORMULATION. THE INTERNATIONAL REFERENCE STANDARD HAS BEEN REDEFINED AND THE DESCRIPTION CHANGED TO REFLECT THE NEW STANDARD
Effective Subsidy Date:1 October, 1999
4.DELETIONS - ADVANCE NOTICE - Effective from 1 February,1999
Stavudine (Zerit)
| 6185M | Capsule 15mg | 60 | $250.00 |
INDINAVIR SULPHATE (CRIXIVAN)
| 6202K | Capsule 400mg (base) | 180 | $455.00 |
Please find attached the relevant pages to revise Appendices 2, 3 and 8 of the Commonwealth/State Highly Specialised Drugs Program Guidelines. Please update your guidelines with the attached pages.
Please note Commonwealth/State Highly Specialised Drugs Program Guidelines can be found on the internet either through the Department of Human Services Home page (Acute Health), or directly on Commonwealth/State Highly Specialised Drugs Program Guidelines website. Any changes notified by hospital circular will be immediately updated in the Guidelines on the internet.
PLEASE NOTE: WE WISH TO REMIND YOU THAT AS FROM 30 SEPTEMBER, 1999 THE DEPARTMENT WILL CEASE CIRCULATION OF ALL HARD COPY HOSPITAL CIRCULARS. PRIVATE HOSPITALS, PRIVATE DAY PROCEDURE CENTRES AND PUBLIC HOSPITAL PHARMACY DEPARTMENTS HAVE BEEN GRANTED AN EXEMPTION PERIOD. THIS EXEMPTION PERIOD WILL CEASE ON 31 MARCH 2000. FROM 1 APRIL 2000 HOSPITALS MUST ACCESS CIRCULARS VIA THE DIVISION'S WEB SITE.
TO BE NOTIFIED ELECTRONICALLY WHEN A HOSPITAL CIRCULAR IS POSTED TO THE DIVISION'S WEB SITE PLEASE E-MAIL YOUR NAME, TITLE, ORGANISATION, WORK ADDRESS AND E-MAIL ADDRESS TO karen.reilly@dhs.vic.gov.au
DR C W BROOK
DIRECTOR
