Pharmac reverses drug swap
Pharmac has backed down on a controversial drug brand switch affecting patients with epilepsy and mental health conditions after three people died following the change.
The drug buying agency said yesterday it would widen access to the Lamictal and Arrow brands of the medicine Lamotrigine, which Pharmac stopped funding on October 1 other than in exceptional circumstances.
About 11,000 people who mainly have epilepsy – although some have bi-polar – were being switched from Lamictal and Arrow to a generic form of Lamotrigine, Logem.
Pharmac’s medical director Dr Ken Clark said: ‘‘We understand the news of the three deaths of patients taking Lamotrigine will concern people. We don’t know if this is linked to the brand change – and we don’t want people to stop taking their medication out of fear, so we are making it easier for people to stay on their current brand if their doctor believes it is the right thing for them.’’ The agency will now continue to fund the brand people are currently on, or were originally on before being forced to change.
‘‘If people have concerns, we encourage them to talk to their doctor. Their doctor can apply to Pharmac, through our exceptional circumstances process, for continued funding of the brand they took before the funding change,’’ Clark said.
Pharmac said doctors could consider making an application for people who had not tolerated the change, were experiencing breakthrough seizures, had suffered mood destabilisation or had concerns about their ability to drive.
The back-down comes after three deaths were reported to the Centre for Adverse Reactions Monitoring (CARM) because of suspicions they could be linked to the medication switch. The deaths were referred to the coroner. Pharmac was also under pressure from Epilepsy NZ to halt the brand switch.
It would have saved Pharmac $30 million over five years, and came after the agency struck a deal with the company Mylan over Logem, which was the least popular of three Lamotrigine brands, with just 5 per cent of epilepsy patients using it. Pharmac made the Logem drug switch against the advice of MedSafe, which warned it went ‘‘against international consensus on switching brands of anti-epileptic medicines’’.
MedSafe said the move posed ‘‘a potential significant safety issue’’.
It warned the brand switch ‘‘could result in the loss of seizure control’’ for patients. ‘‘A single seizure can be extremely detrimental to a patient’s life and all measures should be taken to ensure this risk is minimised.’’
MedSafe also advised Pharmac that if the agency did go ahead with the brand switch, each patient should be given an information leaflet and should first be reviewed by their GP. GPs should then refer the most vulnerable patients for specialist intervention and for monitoring during the switch.
Pharmac rejected the idea of referring patients to specialists, and disagreed that patients should be given too much information for fear of causing ‘‘unnecessary anxiety’’ about the change.
Many patients and family members of patients later said they knew nothing of the brand switch until they collected their usual prescription and were handed Logem instead. Some said a small sticker was stuck to their prescription saying the medication was the same but was a different size, shape and colour.