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Some patients may be allowed to remain on their existing medication under a new proposal by Pharmac on drug-switching.
The Government agency is seeking to alter its tendering process for new contracts so up to 1 per cent of patients can remain on their old drugs, even if Pharmac switches to alternative brands.
Under present rules, all patients have to change to a new drug under the sole-provider contracts Pharmac favours for its cost savings.
But the policy has drawn criticism from medical quarters, most recently because of adverse reactions among some children with attention deficit hyperactivity disorder (ADHD) after a switch from ritalin to a cheaper alternative, rubifen.
But the change is not being applied retrospectively, meaning parents of ADHD children for whom rubifen does not work will have to continue paying the full market price for ritalin.
But the agency says it is negotiating with rubifen supplier AFT Pharmaceuticals, which has a three-year sole-supplier contract, to allow for a small supply of ritalin.
Pharmac had earlier claimed that swapping from ritalin for rubifen, which brought a saving of $1 million a year, would carry no noticeable difference for patients as they both contain the same active ingredient, methylphenidate.
Yesterday, acting chief executive Matthew Brougham accepted that some patients experienced problems.
"We do appear to have a number of patients with genuine clinical difficulties switching between the brands."
Torbay resident Di Celliers, whose 9-year-old son Grant was affected by the ADHD drug switch, welcomed the move but thought the 1 per cent limit was "ridiculously low".
She has lobbied Pharmac to reinstate subsidies for ritalin, but in the meantime continues to pay $50 a month for Grant's supply.
Other parents pay more, depending on the dosage their children require.
"At least some good's going to come out of it. I'm still hopeful we can work something out for those with the ritalin issue, because I still get emails daily from parents in an absolute desperate situation."
Mr Brougham said the figure of 1 per cent was a best estimate of what was likely to be "reasonable". A fixed amount was also needed to give bidding drug suppliers certainty.
"We expect that 1 per cent will be enough in most instances.
"But in those cases where it isn't, it is not proposed that it will be absolutely hard and fast."
Patients wanting to remain on their old drug would need to produce significant evidence from their doctors of problems.
