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Published: 16 October, 2020


Update on oral contraception supply issues and replacement options

Ongoing global manufacturing and distribution constraints on all ethinylestradiol and norethisterone products has led to oral contraceptive supply issues in New Zealand. We have reported on this evolving situation in several bulletins.

Norimin (ethinylestradiol 35 micrograms + norethisterone 500 micrograms), a combined oral contraceptive (COC), is currently out of stock. Supply is now not expected to be restored until mid-February, 2021. PHARMAC listed equivalent alternative brands, Necon and Brevinor 28, to cover the out-of-stock period, however, supplies of these medicines are expected to run out by mid-October, 2020, and availability is variable across the country. PHARMAC are working with suppliers to seek a further alternative to Norimin.

Another COC, Brevinor-1 28 (ethinylestradiol 35 micrograms + norethisterone 1 mg), is also now out of stock. Supply is not expected to be restored until mid-February, 2021. There are currently no equivalent alternative brands.

Be aware of psoriasis exacerbations in people taking bupropion

Medsafe has issued a monitoring alert regarding a possible risk of exacerbation of psoriasis in people using bupropion. This is based on one case report from CARM of a patient with pre-existing psoriasis who experienced a flare of psoriasis 15 days after he began taking bupropion for smoking cessation. There are several published case reports from other countries detailing similar reactions. Other medicines already known to exacerbate psoriasis include beta-blockers, ACE inhibitors, lithium, anti-malarials and NSAIDs.

If a patient with psoriasis experiences an exacerbation while taking bupropion, or a patient experiences new-onset psoriasis, consider stopping bupropion to observe if the reaction improves, and report the case to CARM.

PHARMAC announces new Principal Supply Status

PHARMAC is changing its competitive procurement policy, for contracts commencing from July, 2021, to allow for more than one brand of a medicine to be funded; this already occurs in some cases, but the new policy will allow consistency to this approach. Sole Supply Status (and Hospital Supply Status) will be replaced by Principal Supply Status. This means that there would be a main brand of a medicine funded, but flexibility in allowing a small volume of other brands of that medicine to also be funded. Patients who were unable to take the main funded brand could have access to another brand that may be listed with Special Authority approval or funded through the exceptional circumstances framework. It appears that the main reason underlying this decision is to improve the brand change process.

Read the full statement from PHARMAC here.

Pharmacist Prescribers can now apply for Special Authority approvals

As of 1 October, 2020, registered pharmacist prescribers can apply for Special Authority approvals for specific restricted medicines. Previously, applications could only be made by medical practitioners, dieticians, nurse practitioners and optometrists (depending on the medicine). In rural areas in particular, this may mean that patients are able to access medicines faster and at a lower cost, e.g. if they no longer need to consult with another prescriber in a different location for a prescription renewal. There are currently 36 practising pharmacist prescribers in New Zealand. Read more here.

Readership survey

Colmar Brunton are conducting a survey on our behalf, to ask our readers about what they like about our products and what they would like to see improved. You should have received an email and reminder about doing this survey, containing your unique survey link. If you did not receive the email, or it's lost in a full inbox, and you would still like to have your say, you can do the survey here.

N.B. The survey takes around 10 minutes to complete; using the general link above you will not be able to return to complete the survey later if you run out of time. Responses close on Tuesday, October 20th.

Paper of the week: COVID-19 in healthcare and support workers in New Zealand

The Ministry of Health has just released a report detailing the demographics of health care and support workers diagnosed with COVID-19 during the first wave of the pandemic in New Zealand. The report provides some insights into the pathways of transmission in health workplaces. It is reported that 11% of COVID-19 cases in New Zealand (excluding the Auckland August Cluster) were among health care and support workers. Of the cases that were acquired in health care workplaces, only 10% (10) occurred in a community health care setting, which suggests that effective infection prevention control measures were in place.

This Bulletin is supported by the South Link Education Trust

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