Decision to widen access to a brand of long-acting methylphenidate

23 October 2020

Decision

We're widening access to a brand of long-acting methylphenidate and allowing nurse practitioners to apply for a Special Authority for all methylphenidate presentations.

What we’re doing

We're pleased to announce widening of access to one brand of extended-release methylphenidate, Methylphenidate ER – Teva, from 1 November 2020.

This means that the longer-acting Methylphenidate ER – Teva brand will be funded as a first-line treatment for attention deficit hyperactivity disorder (ADHD) alongside the shorter-acting versions of methylphenidate (immediate-release and sustained-release). This change results from a price reduction for Methylphenidate ER – Teva.

Also from 1 November 2020, the Special Authority criteria for all presentations of methylphenidate hydrochloride will be amended to enable applications from nurse practitioners on the recommendation of a paediatrician or psychiatrist in writing.

There are no changes to the funding of the other two funded brands of extended-release methylphenidate, Ritalin LA and Concerta, which will remain funded as a second-line treatment option.

What does this mean for people?

People who are being started on methylphenidate will be able to access an extended-release formulation as a first line treatment option. Previously, people had to try an immediate or sustained-release formulation to be eligible for a funded extended-release formulation, but this requirement is being removed for the Methylphenidate ER – Teva brand, to enable access for people who would benefit from an extended release formulation.

People currently taking sustained-release or immediate-release formulations of methylphenidate (Rubifen, Ritalin, Rubifen SR, Ritalin SR) will be able to access the Methylphenidate ER – Teva brand of methylphenidate hydrochloride extended release under their current approval for Special Authority SA1150. Prescribers will not need to reapply for the new Special Authority SA1964(external link) but a new prescription will be needed for this formulation change.

Those people currently taking the Methylphenidate ER – Teva brand (under the Special Authority SA1151 criteria) will be issued a new Special Authority number. This means that prescribers will not need to apply for a new Special Authority for these patients. Prescribers and pharmacists will need to look up this number via the electronic special authority system.

Access to Ritalin LA and Concerta brands of methylphenidate hydrochloride extended release has not changed and they remain funded as second-line treatments under Special Authority SA1965(external link).

Please note that unlike the immediate and sustained-release formulations of methylphenidate, Methylphenidate ER – Teva is not indicated for the treatment of narcolepsy.

Who we think will be most interested?

• People with ADHD and their whānau
• Nurse practitioners with a relevant scope of practice
• Psychiatrists, paediatricians, general practitioners, pharmacists and other clinicians involved in the management of ADHD and narcolepsy

Detail about this decision

The following changes will occur in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 November 2020.

Methylphenidate ER – Teva (methylphenidate hydrochloride extended release 18 mg, 27 mg, 36 mg and 54 mg tablets), will be moved in the Pharmaceutical Schedule, such that Special Authority SA1964(external link) will apply and Special Authority SA1965 will not apply.

The price and subsidy of Teva Pharma New Zealand Ltd’s brand of methylphenidate hydrochloride extended- release tabs in the Nervous System therapeutic group in Section B and in Part II of Section H of the Pharmaceutical Schedule will reduce as follows:

The Special Authority criteria for all presentations of methylphenidate will be amended to allow Special Authority applications from nurse practitioners on the recommendation of a paediatrician or psychiatrist in writing.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.