National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2014 (No. 6) (No. PB 48 of 2014) (Cth)

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PB 48 of 2014

National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2014 (No. 6)

National Health Act 1953

___________________________________________________________________________

I, KIM BESSELL, Assistant Secretary, Pharmaceutical Access Branch, Pharmaceutical Benefits Division, Department of Health, delegate of the Minister for Health, make this Amendment Instrument under subsections 100(1) and 100(2) of the National Health Act 1953.

Dated 16 June 2014

KIM BESSELL

Assistant Secretary

Pharmaceutical Access Branch

Pharmaceutical Benefits Division

Department of Health

___________________________________________________________________________

1       Name of Instrument

(1)This Instrument is the National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2014 (No.6).

(2)This Instrument may also be cited as PB 48 of 2014.

2              Commencement

This Instrument commences on 1 July 2014.

3              Amendments to PB 116 of 2010

Schedule 1 amends the National Health (Highly specialised drugs program for hospitals) Special Arrangement 2010 (PB 116 of 2010).

Schedule 1       Amendments

  1. Schedule 1, entry for Lanreotide in the form Powder for suspension for injection 30 mg (as acetate) with diluent

omit from the column headed “Circumstances”:            C2619  C3387           substitute:     C4559 C4567

  1. Schedule 1, entry for Lanreotide in the form Injection 60 mg (as acetate) in single dose pre-filled syringe

(a)omit from the column headed “Circumstances”: C2620  C2621  C3388  C3389                 substitute:     C4569  C4570  C4574  C4575

(b)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 1, entry for Lanreotide in the form Injection 90 mg (as acetate) in single dose pre-filled syringe

(a)omit from the column headed “Circumstances”: C2620  C2621  C3388  C3389                 substitute:     C4569  C4570  C4574  C4575

(b)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 1, entry for Lanreotide in the form Injection 120 mg (as acetate) in single dose pre-filled syringe

(a)omit from the column headed “Circumstances”: C2620  C2621  C3388  C3389                 substitute:     C4569  C4570  C4574  C4575

(b)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 1, entry for Octreotide in the form Injection (modified release) 10 mg (as acetate), vial and diluent syringe

(a)omit from the column headed “Circumstances”:        C2624  C2625  C3409  C3410          substitute:       C4560 C4561 C4563 C4564 C4568 C4571

(b)omit from the column headed “Maximum Quantity”:      1          substitute:      2

(c)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 1, entry for Octreotide in the form Injection (modified release) 20 mg (as acetate), vial and diluent syringe

(a)omit from the column headed “Circumstances”:        C2624  C2625  C3409  C3410           substitute:       C4560 C4561 C4563 C4564 C4568 C4571

(b)omit from the column headed “Maximum Quantity”:      1          substitute:      2

(c)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 1, entry for Octreotide in the form Injection (modified release) 30 mg (as acetate), vial and diluent syringe

(a)omit from the column headed “Circumstances”:        C2624  C2625  C3409  C3410           substitute:       C4560 C4561 C4563 C4564 C4568 C4571

(b)omit from the column headed “Maximum Quantity”:      1          substitute:      2

(c)omit from the column headed “Number of Repeats”:      11        substitute:      5

  1. Schedule 3, entry for Lanreotide

substitute:

Lanreotide C4559

Where the patient is receiving treatment at/from a private hospital

Acromegaly
The condition must be active; AND
Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre; AND
The treatment must be after failure of other therapy including dopamine agonists; OR
The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR
The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated; AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (6 weeks after the last dose); AND
The treatment must cease if IGF1 is not lower after 3 months of treatment
In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written or Telephone Authority Required procedures


C4567

Where the patient is receiving treatment at/from a public hospital

Acromegaly
The condition must be active; AND
Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre; AND
The treatment must be after failure of other therapy including dopamine agonists; OR
The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR
The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated; AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (6 weeks after the last dose); AND
The treatment must cease if IGF1 is not lower after 3 months of treatment
In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written or Telephone Authority Required procedures - Streamlined Authority Code 4567

C4569

Where the patient is receiving treatment at/from a private hospital

Functional carcinoid tumour
The condition must be causing intractable symptoms; AND
Patient must have experienced on average over 1 week, 3 or more episodes per day of diarrhoea and/or flushing, which persisted despite the use of anti-histamines, anti-serotonin agents and anti-diarrhoea agents; AND
Patient must be one in whom surgery or antineoplastic therapy has failed or is inappropriate; AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 120 mg every 28 days
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose

Compliance with Written or Telephone Authority Required procedures

C4570

Where the patient is receiving treatment at/from a public hospital

Acromegaly
The condition must be active; AND
Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre; AND
The treatment must be after failure of other therapy including dopamine agonists; OR
The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR
The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated; AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose); AND
The treatment must cease if IGF1 is not lower after 3 months of treatment
In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written or Telephone Authority Required procedures - Streamlined Authority Code 4570

C4574

Where the patient is receiving treatment at/from a private hospital

Acromegaly
The condition must be active; AND
Patient must have persistent elevation of mean growth hormone levels of greater than 2.5 micrograms per litre; AND
The treatment must be after failure of other therapy including dopamine agonists; OR
The treatment must be as interim treatment while awaiting the effects of radiotherapy and where treatment with dopamine agonists has failed; OR
The treatment must be in a patient who is unfit for or unwilling to undergo surgery and where radiotherapy is contraindicated; AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after lanreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose); AND
The treatment must cease if IGF1 is not lower after 3 months of treatment
In a patient treated with radiotherapy, lanreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written or Telephone Authority Required procedures
C4575

Where the patient is receiving treatment at/from a public hospital

Functional carcinoid tumour
The condition must be causing intractable symptoms; AND
Patient must have experienced on average over 1 week, 3 or more episodes per day of diarrhoea and/or flushing, which persisted despite the use of anti-histamines, anti-serotonin agents and anti-diarrhoea agents; AND
Patient must be one in whom surgery or antineoplastic therapy has failed or is inappropriate; AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 120 mg every 28 days
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose

Compliance with Written or Telephone Authority Required procedures - Streamlined Authority Code 4575
  1. Schedule 3, entry for Octreotide

(a)omit:

C2624

Where the patient is receiving treatment at/from a private hospital

Acromegaly 
Acromegaly in a patient controlled on Sandostatin subcutaneous injections. 
In a patient treated with radiotherapy, treatment must cease if there is biochemical evidence of remission (normal IGF1) after octreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose). Octreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission. 
Treatment must cease if IGF1 is not lower after 3 months of treatment

Compliance with Written or Telephone Authority Required procedures
C2625

Where the patient is receiving treatment at/from a private hospital

Functional carcinoid tumour or VIPoma 
Functional carcinoid tumour or vasoactive intestinal peptide secreting tumour (VIPoma) with symptom control on Sandostatin subcutaneous injections. 
Treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with Sandostatin subcutaneous injections. Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose

Compliance with Written or Telephone Authority Required procedures

(b)omit:

C3409              

Where the patient is receiving treatment at/from a public hospital

Acromegaly 
Acromegaly in a patient controlled on Sandostatin subcutaneous injections. 
In a patient treated with radiotherapy, treatment must cease if there is biochemical evidence of remission (normal IGF1) after octreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose). Octreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission. 
Treatment must cease if IGF1 is not lower after 3 months of treatment

Compliance with Written or Telephone Authority Required procedures - Streamlined Authority Code 3409
C3410

Where the patient is receiving treatment at/from a public hospital

Functional carcinoid tumour or VIPoma 
Functional carcinoid tumour or vasoactive intestinal peptide secreting tumour (VIPoma) with symptom control on Sandostatin subcutaneous injections. 
Treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with Sandostatin subcutaneous injections. Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose

Compliance with Written or Telephone Authority Required procedures - Streamlined Authority Code 3410

(c)insert in numerical order following existing text:

C4560

Where the patient is receiving treatment at/from a private hospital

Vasoactive intestinal peptide secreting tumour (VIPoma)
Patient must have achieved symptom control on octreotide immediate release injections, AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with octreotide immediate release injections.
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.

Compliance with Written and Telephone Authority Required procedures
C4561

Where the patient is receiving treatment at/from a public hospital

Functional carcinoid tumour
Patient must have achieved symptom control on octreotide immediate release injections, AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with octreotide immediate release injections.
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.

Compliance with Written and Telephone Authority Required procedures - Streamlined Authority Code 4561
C4563

Where the patient is receiving treatment at/from a public hospital

Acromegaly
The condition must be controlled with octreotide immediate release injections, AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after octreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose), AND
The treatment must cease if IGF1 is not lower after 3 months of treatment.
In a patient treated with radiotherapy, octreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written and Telephone Authority Required procedures - Streamlined Authority Code 4563
C4564

Where the patient is receiving treatment at/from a public hospital

Vasoactive intestinal peptide secreting tumour (VIPoma)
Patient must have achieved symptom control on octreotide immediate release injections, AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with octreotide immediate release injections.
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.

Compliance with Written and Telephone Authority Required procedures - Streamlined Authority Code 4564
C4568

Where the patient is receiving treatment at/from a private hospital

Functional carcinoid tumour
Patient must have achieved symptom control on octreotide immediate release injections, AND
The treatment must cease if there is failure to produce a clinically significant reduction in the frequency and severity of symptoms after 3 months' therapy at a dose of 30 mg every 28 days and having allowed adequate rescue therapy with octreotide immediate release injections.
Dosage and tolerance to the drug should be assessed regularly and the dosage should be titrated slowly downwards to determine the minimum effective dose.

Compliance with Written and Telephone Authority Required procedures
C4571

Where the patient is receiving treatment at/from a private hospital

Acromegaly
The condition must be controlled with octreotide immediate release injections, AND
The treatment must cease in a patient treated with radiotherapy if there is biochemical evidence of remission (normal IGF1) after octreotide has been withdrawn for at least 4 weeks (8 weeks after the last dose), AND
The treatment must cease if IGF1 is not lower after 3 months of treatment.
In a patient treated with radiotherapy, octreotide should be withdrawn every 2 years in the 10 years after radiotherapy for assessment of remission

Compliance with Written and Telephone Authority Required procedures
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