ࡱ> QSR'` bjbjDD `2&&J eJJJ$nP4<n-0bbbbb"""+-------------$/hD2Q-J&"!"!&&Q-bb f-P(P(P(&^bb+-P(&+-P(P(/+6{+bV d $K&jG+,t|-0-O+,2L'2{+2J{+<"&#P(#$"""Q-Q-'^"""-&&&&nnnD nnnnnn  Mr Bryce Wigodsky PHARMAC PO Box 10-254 Wellington 6143 RE: PHARMACs Review of Exceptional Circumstances Dear Mr Wigodsky, Thank you for the opportunity to feedback on PHARMACs Review of Exceptional Circumstances. The Pharmacist and Therapeutics SIG of the Paediatric Society of New Zealand have reviewed the document and provide the following feedback. Our views on Exceptional Circumstances are those from a perspective of providing medicines for children. Definition of Exceptional Circumstances The term Exceptional Circumstances in most cases is a good definition and justifiable method of supplying a medicine that is not currently funded on the pharmaceutical schedule. In paediatrics, use of commercial liquid preparations and formulation of extemporaneous compounds are necessary. Dispensing of an unfunded medicine in a liquid form for a paediatric patient which ordinarily is funded in the tablet form for an adult patient should not be defined as an exceptional circumstance. More consideration of the paediatric population is needed here. Criteria for funding There is often limited published evidence available for paediatric sub-specialty medicine. Many clinical decisions are therefore based on clinical experience and case reports. In these cases, the clinical opinion of the paediatric sub-specialist can be most relevant form of evidence. There needs to be a structured, easy to follow process for approval of paediatric medicines particularly in the sub specialty areas which are not listed on the pharmaceutical schedule. When considering applications, PTAC should be encouraged to seek more advice from paediatric medical subspecialists and paediatric pharmacists, acknowledging their role in providing information on medicines for children. A separate paediatric sub-committee feeding into PHARMAC would increase awareness of the funding issues and facilitate quality use of medicines in children. Operational Ideally, there should be one exceptional circumstances scheme for all funding applications. These should be centrally approved and funded, and the approval data stored in an easily accessible central database. This would negate the need for approvals to be faxed to appropriate parties. Any application form should be simple and concise i.e. one page only. Prescribers should also be able to send applications to PHARMAC electronically and in the paper form. Auditing of exceptional circumstances requests should be done periodically and results made available to prescribers and other healthcare professionals. Brenda Hughes (Convenor, Pharmacist & Therapeutics Special Interest Group The Paediatric Society of New Zealand) Andrew Sutton ( Pharmacy Team Leader, Women & Childrens Health, ADHB) This letter was written and supported by members of the Pharmacist & Therapeutics Special Interest Group.     THE PAEDIATRIC SOCIETY OF NEW ZEALAND Secretariat: Email:Denise Tringham P O Box 22 234 Wellington 6441 Tel: (04) 938 4827 Fax: (04) 976 4827 psnz@paradise.net.nz  Re: Consultation/discussion document for possible expansion of PHARMACs role THE PAEDIATRIC SOCIETY OF NEW ZEALAND Secretariat: Email:Denise Tringham P O Box 22 234 Wellington 6441 Tel: (04) 938 4827 Fax: (04) 976 4827 psnz@paradise.net.nz  Re: Consultation/discussion document for possible expansion of PHARMACs role Health of our children: Wealth of our nation Health of our children: Wealth of our nation <oq / n    & ׳ʌqcVL?hjzhGOJQJ^Jhn(OJQJ^JhjzhOJQJ^JhjzhG>*OJQJ^Jhjzh(>*OJQJ^Jhjzh(OJQJ^JhjzhlsmOJQJ^Jhjzh8OJQJ^Jhjzh*>OJQJ^JhjzhpOJQJ^JhO[OJQJ^JhjzhOJQJ^Jhjzh5OJQJ^Jhjzh+5OJQJ^Jhjzh+OJQJ^J+;<opq   7 8 M N  $^a$gdjz$a$gdjzJa& ' ( * + / 9 ; O   *  " # - 6 7 8 = ϵϨܛŽ܎܎܎܄܄܄vi[hjzh+4:>*OJQJ^Jhjzh+4:OJQJ^Jhjzh(>*OJQJ^Jhn(OJQJ^JhjzhpOJQJ^JhjzhGOJQJ^Jhjzh~OJQJ^Jhjzh8OJQJ^Jhjzhk<OJQJ^Jhjzh(OJQJ^Jhjzh(`OJQJ^JhO[OJQJ^JhjzhO[OJQJ^J#= L M N O r #gl)^f|ɼɼ{n`R֯hjzhL>*OJQJ^Jhjzh\>*OJQJ^JhjzhxOJQJ^JhjzhQOJQJ^JhjzhBjOJQJ^Jhjzh*>OJQJ^Jhjzh+YOJQJ^JhjzhcOJQJ^JhjzhpOJQJ^Jhjzh8OJQJ^JhjzhOJQJ^Jhjzh+4:>*OJQJ^Jhjzhp>*OJQJ^J !2=B\`st{ /4DPQ\!/ٿ̘̘̘̋̋~~̋m`hjzhGSOJQJ^J hjzhGSOJQJ^JmH sH hjzh\OJQJ^JhjzhxOJQJ^Jhjzh`&OJQJ^JhjzhAOJQJ^JhjzhLOJQJ^JhjzhlOJQJ^JhjzhOJQJ^Jhjzhc7KOJQJ^JhjzhcOJQJ^JhjzhOJQJ^J% !IJLMOPRSUVX~$ x$Ifa$  $If$a$gdjz $]a$gdJl $^a$gdjz $]a$gdYx$]^a$gdjz/0PkIJKMNPQSTVWX}~  ɻtfVfVRRhphp5B*CJOJQJphhpB*CJOJQJphhp5B*CJ(OJQJphhp5B*CJ$OJQJphhp5OJQJ"jhpUmHnHsH tH uh.jh.UhjzhGS>*OJQJ^J$hjzhGS5B*OJQJ^JphhjzOJQJ^JhjzhGSOJQJ^JhjzhjzOJQJ^J~  $If  !Sn#$If !Sn#$If  $If   YZ[]{yo`o$ x$Ifa$  $Ifgd- $ !n#a$ !lkd$$If\u+#4a Y[\] ^`aɹɛ҇zok]hjzhGS>*OJQJ^Jh.h_h-CJaJh_h-0JCJaJh-h-5B*CJOJQJphh-B*CJOJQJphh-5B*CJ(OJQJphh-5B*CJ$OJQJphh-5OJQJ"jh-UmHnHsH tH uhph_hpCJaJh_hp0JCJaJ  $If  !Sn#$If !Sn#$If    ^_`abc{ywn $ !a$gd- $ !n#a$ !lkd~$$If\u+#4a $a$gdjz $ !a$ !$a$0&P P. 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Submissions

The Paediatric Society believes all children and youth should, by right, attain optimal physical, mental and social health and wellbeing.  By working as a coordinated national network of health professionals the Society dedicates its efforts and resources to making official submissions to both Government and Non-Government organisations on issues that will impact on the health and wellbeing of children and young people.

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