KEY POINTS:
Government drug agency Pharmac is phasing out a widely used antidepressant in favour of a generic brand in a move it says will save $45 million over the next three years.
But the move to phase out the Aropax brand of paroxetine in favour of generic alternative Loxamine
has drawn criticism from the organisation representing psychiatrists in Australasia.
"What concerns the college is the insistence in this process that patients currently on paroxetine, the Aropax form, must either pay for it, or be changed to the new form," said Dr Allen Fraser, chairman of the New Zealand national committee of the Royal Australian and New Zealand College of Psychiatrists.
He said some patients got "very, very distressed" if they thought they were receiving different medication.
Dr Fraser said the college had made its position clear to Pharmac, although not specifically in the case of paroxetine.
"We had advocated that where the clinician prescribing the medication believed it was in the patient's interest to remain on their current medication, it should remain fully subsidised for those persons. They clearly have not accepted that as a standard.
"We will still be pursuing that because that's the major issue for us. If a patient is starting fresh it doesn't really matter. For some patients transferring from their current form of paroxetine to another one, it is not going to be a major problem. For some it will. If they've been doing well on their current medication, they deserve to still have access to it."
Aropax is currently used by about 49,000 New Zealanders, and accounts for more than half the $29 million spent on antidepressants last year. A year's supply of Aropax is estimated to cost between $400 and $800, depending on the prescription.
From April 1, Pharmac will begin phasing in the Loxamine brand, making it the only subsidised brand after September 1.
Pharmac deputy medical director Dr Dilky Rasiah said the change would mean people had easier access to this widely used antidepressant.
"At present, people prescribed paroxetine for the first time need to have previously had a trial of fluoxetine, another antidepressant. Once Loxamine is funded, it will not be subject to this requirement, which will give people easier access to it."
Dr Rasiah said that tests had shown the Loxamine brand to be as effective as Aropax.