View / Download pdf version of this article

At present there are multiple brands of some of the fully subsidised antipsychotics on the Pharmaceutical Schedule. For some medicines, a single brand is to become the only fully subsidised brand. The first medicines to change are: olanzapine tablets and orodispersible tablets, quetiapine tablets and risperidone oral liquid (Table 1). Risperidone tablets will be changing to a sole-subsidised brand later in the year or early next year; this will be notified closer to the time.

From 1 July 2014, patients should begin to be changed to the sole subsidised brand (Table 1). The other brands will also remain on the Schedule for a five month transition period. However, from 1 September 2014, patients who have not changed to the fully subsidised brand may be charged a part payment to continue with their chosen brand. From 1 December 2014, only the sole supply brand will be subsidised.

These changes only apply to the specific brands listed and patients will have access to the same range of fully subsidised atypical antipsychotic medicines as they did previously.

Patients taking antipsychotic medicines, e.g. patients with schizophrenia or bipolar disorder, often benefit from stable routines that include daily administration of medicines. Disturbances to this routine may be concerning to some patients. Patients should continue to be prescribed their usual dose and regimen. Rarely, dose adjustments may be required if the patient reports adverse effects or a reduction in efficacy. There may be changes in the appearance of some formulations. For example, the sole subsidised brand of quetiapine 25 mg tablets is pink, whereas other formulations of quetiapine 25 mg tablets are red.

Clinicians should discuss this up-coming change in brand with patients before they are confronted with it, to allow patients to consider the issue and voice any concerns or ask questions. Referring to the treatment by the medicines name, rather than by its brand name, e.g. quetiapine rather than Seroquel, is a good way to prepare patients for the change and is best practice when discussing any medicine with a patient. Clinicians can reassure patients that the new brand that they will be taking has been registered with Medsafe and contains the same amount of the medicine as the previous brand. This means that patients can expect to receive the same clinical effect from any subsidised brand.

There is frequently an initial peak in reports of adverse effects to the Centre for Adverse Reactions Monitoring (CARM) following a subsidised brand change. Often these reports decline over time, which suggests the adverse effects are largely due to the process of change, rather than the medicine per se. An international report suggests that when patients taking atypical antipsychotics are required to make a brand change a deterioration in the patient’s condition should not be expected.2

Table 1: Changes in subsidy to atypical antipsychotic medicines available on the Community Pharmaceutical Schedule from 1 December, 20141

Medicine Formulation Sole supply brand Current brands
Olanzapine Tablets (2.5 mg, 5 mg, 10 mg) Zypine Dr Reddy’s Olanzapine, Zyprexa, Olanzine, Zypine
Orodispersible tablets (5 mg, 10 mg) Zypine ODT Olanzine-D, Dr Reddy’s Olanzapine, Zyprexa Zydis, Zypine ODT
Quetiapine Tablets (25 mg, 100 mg, 200 mg, 300 mg) Quetapel Seroquel, Dr Reddy’s Quetiapine, Quetapel
Risperidone Oral liquid 1mg/mL Risperon Apo-Risperidone, Risperdal, Risperon

Patient information about this change is available from: www.pharmac.health.nz/medicines/my-medicine-has-changed/

References

  1. PHARMAC. Antipsychotic medicines. 2014. www.pharmac.health.nz/medicines/my-medicine-has-changed/antipsychotic-medicines/ (Accessed Jul, 2014).
  2. Lenderts S, Kalali AH, Buckley P. Generic penetration in the retail atypical antipsychotic market. Psychiatry Edgmont Pa Townsh 2010;7:9–10.