ࡱ> Oh+'0p   , 8 DPX`h TAX INVOICEAX racpNVOacp Normal.dotDenised7niMicrosoft Word 8.0@V@t@B̌@UXogos$H1Letterheads.Letterheads՜.+,D՜.+,< hp  racpmm    TAX INVOICE Title(RZ _PID_GUID _PID_HLINKSAN{792604B6-65F6-47F3-82ED-7C0FC3A40D78}AH r Proposal for quinapril (Accupril) and quinapril with hydrochlorothiazide (Accuretic) Thank you for the opportunity to comment on this proposal. The Paediatric Society has no comments specific to this proposal. We note that these medications are used infrequently in children, and single preparations are generally preferred to combination preparations. Decisions that result in savings that can be used to improve access to pharmaceuticals are welcomed. We would like to take this opportunity to make some general comments on medications for use in paediatric settings. The importance of having formulations appropriate for use in paediatric settings available cannot be overemphasised. Children, especially infants, children aged less than 6 years and children with disability and swallowing dysfunction, are often unable to take tablets or capsules. Palatable liquid formulations are essential for this group. The number of children requiring liquid formulations of medications more commonly used in adult settings is small; for example very few children are on antihypertensives, diuretics or thyroxine. However those that do need these medications should have access to appropriate paediatric formulations. While retail pharmacies will make up solutions for parents, there are a number of potential problems with this practice: Risk of measurement errors leading to dosage errors Risk that parents/caregivers will not ensure suspensions are adequately shaken prior to administration leading to dosage errors Short shelf life of extemporaneously compounded formulations, so that parents have to collect new supplies on a very frequent basis. This is particularly difficult for families with limited resources, a heavy burden of care or poor organisational skills, and those living in rural or remote areas. Paediatric Society members have particular concerns at present, with formulations of thyroxine (for infants with congenital hypothyroidism) and hydrocortisone (for infants with congenital adrenal hyperplasia). Our diabetes and endocrinology Special Interest Group is developing a position paper on this to assist with future decision making. Rosemary Marks President Paediatric Society of New Zealand 10 September 2008 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  Health of our children: Wealth of our nation  mailto:woodruff@pharmac.govt.nzOMC:\Documents and Settings\Denise\WORK\PSNZ Docs\Letterheads and Logos\RM.JPGosoft Word 8.0@V@t@B̌@UXogos$H1Letterheads.Letterheads ^_? s   t u v  & F" ^_? s   t u v   & 6 J ^ s t u v z ~  4   & 6 J ^ s t u v z $ !n# ! $$ u+#$ $  $ !Sn# $ !Sn# $x$ $ fQhQjQQQQLRbbbbbbcccHcJc d"d$d(d.dddzzzzzzz|{FHJxzPRTX^΍ЍZ\ƼƪƼƪjCJU jUmH5B*CJOJQJB*CJOJQJ5B*CJ(OJQJ5B*CJ$OJQJ 5OJQJj5OJQJUmHjCJUmH5CJCJ0JCJ jCJUjCJU5fhjlʍ̍΍ЍZ\$ ! !  ^   r s t v y p------.......Z/55f5h5j5555L6FFFFGGG@GBGHHH H&HHHQQfQ jCJUCJ0JjU jU jUmH5B*CJOJQJB*CJOJQJ5B*CJ(OJQJ5B*CJ$OJQJ 5OJQJj5OJQJUmH5<(&P . A!"#$%n 10 September, 2008 Stephen Woodruffe Therapeutic Group Manager PHARMAC PO Box 10 254 Wellington 6143 E-mail  HYPERLINK mailto:woodruff@pharmac.govt.nz woodruff@pharmac.govt.nz Proposal for quinapril (Accupril) and quinapril with hydrochlorothiazide (Accuretic) Thank you for the opportunity to comment on this proposal. The Paediatric Society has no comments specific to this proposal. We note that these medications are used infrequently in children, and single preparations are generally preferred to combination preparations. Decisions that result in savings that can be used to improve access to pharmaceuticals are welcomed. We would like to take this opportunity to make some general comments on medications for use in paediatric settings. The importance of having formulations appropriate for use in paediatric settings available cannot be overemphasised. Children, especially infants, children aged less than 6 years and children with disability and swallowing dysfunction, are often unable to take tablets or capsules. Palatable liquid formulations are essential for this group. The number of children requiring liquid formulations of medications more commonly used in adult settings is small; for example very few children are on antihypertensives, diuretics or thyroxine. However those that do need these medications should have access to appropriate paediatric formulations. While retail pharmacies will make up solutions for parents, there are a number of potential problems with this practice: Risk of measurement errors leading to dosage errors Risk that parents/caregivers will not ensure suspensions are adequately shaken prior to administration leading to dosage errors Short shelf life of extemporaneously compounded formulations, so that parents have to collect new supplies on a very frequent basis. This is particularly difficult for families with limited resources, a heavy burden of care or poor organisational skills, and those living in rural or remote areas. Paediatric Society members have particular concerns at present, with formulations of thyroxine (for infants with congenital hypothyroidism) and hydrocortisone (for infants with congenital adrenal hyperplasia). Our diabetes and endocrinology Special Interest Group is developing a position paper on this to assist with future decision making.  Rosemary Marks President 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   Health of our children: Wealth of our nation D3&} [QEQEQEQEQEQEQEQEQY1topqk+fS ?3}3EVNy-m]"3}:9z}Z}P '>S֭EQEQEQEQEQEQEQEQEE412,!A,oX 4Mqypdx\egc N }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz? (((((((((((((((((((((((((((((((((((((((((((((((((((((]^ElQi%!#AoJ&%ot˫{u+֢R GB)QEQEQEQEQEQEQEQEQES8TO =Űn Ԛ 0* AY_/IXwX%'#*VQEQEQEQEQEQEQEQEQEYL>q!>ִ" ɥE&b( 3Fb46 M5ܒK1$ԒjQEQEQEQEW?oEAX\<(((si]D H!wX29봜n:AEQX.KỨl>E[dq/"{PYNP*$b8 _Aǻw8Z(DVTfҤ'^ kd)Y>+JEQEQEQ\i8-5f8WI^frcEQEQEOSK.N$D'ԩv)F&O.pC ߥ+ 7 m٤@A$EC0N1ߥ[Ҵb$ͼst*oaֵrWu&X࠰ <~7k94p 2IU$ھy0mje ai7rs= OH<˞34d=>gA!mZhﱳ2vb2A琠=OZ"+ $S UQwUIi v# ;[Yn%8HMgF y)U 0PFvnIEI߽]$Ȥ+=FIkR(3*)f!T xSb&de =EKE*4=PgT|j:t.$39KdzH((4JB 1\N@ sG~rw4(t(mmlq.ўԟE֊!/%w01Ȑ[@29:?&͗c1!JRMKJfylk#S2 %uؙ$wo6P"e &\Z7V֒vH<5kH.(!0cOrI?Ai:0MFӒp*#!`@8_Ċ."mWPEÃ2)P2܎0$ԓYUc\0!,u#c[\VHmޞ_SF1x--ykX5U.M.>ebq^j~ ]rڄ0$n[KeZAm(BFTwP -JX3vТ}Zy6yF3=QLeVRR0AEgaI'dhA ƚm(6r4q??/KZ))ׇ4^>?Ξc֙5Cѧjn5@?o F?.<-t㡺v@āV Eu(2AdRQETK8Dnm(u^  XG59].qg12aY 4IٰF꾛\u\ʑi0Яfc9ZZ} WH 0ij}ɫp[Al 85 ?Ju ʄP{qTƓw o^"p$X }YsO:,S\_`f?P HR% KEQP;hљzRk';z\aS J쵯EQEQEQEQEQETv^@\IJDUAJ̕ԑʗq z0e'֜\r{"S''ܞ;b=Ks%-:l,>Z((( ?J((((((((Jb:BHr(+ 1$@&500 Heading 2$@&>* Heading 3m$$*$@& \R" b2> Y!r"B%(*-0R3"68;>bA2DGI56@CJ00 Heading 4$@&CJ44 Heading 5$@&5CJ44 Heading 6$@&5CJ88 Heading 7 $$@&5CJ44 Heading 8 $$@&5<A@*H,H.H0H2H4HHHHH,P.PTPVPXP|PPPPPPQQQLRNR6U8U$ ! ! [L@LNormal$*$d @CJOJQJmH 00 Heading 1$@&500 Heading 2$@&>* Heading 3m$$*$@& \R" b2> Y!r"B%(*-0R3"68;>bA2DGI56@CJ00 Heading 4$@&CJ44 Heading 5$@&5CJ44 Heading 6$@&5CJ88 Heading 7 $$@&5CJ44 Heading 8 $$@&5<A@<Default Paragraph Font<<Address$5OJQJhmH nH 0@0Header  !CJ0 0Footer  !CJ(U@!( Hyperlink>*B*8V18FollowedHyperlink>*B* LBBL Body Text$*$1$ p@ @hnH F>RFTitle$*$1$ p@ 5CJ0hnH .Pb. Body Text 2CJXCrXBody Text Indent$*$ 0@CJ2Q2 Body Text 3$CJ W Strong544 No Spacing CJmH nH ; 2; (&P . A!"#$%n 10 September, 2008 Stephen Woodruffe Therapeutic Group Manager PHARMAC PO Box 10 254 Wellington 6143 E-mail  HYPERLINK mailto:woodruff@pharmac.govt.nz woodruff@pharmac.govt.nz Proposal for quinapril (Accupril) and quinapril with hydrochlorothiazide (Accuretic) Thank you for the opportunity to comment on this proposal. The Paediatric Society has no comments specific to this proposal. We note that these medications are used infrequently in children, and single preparations are generally preferred to combination preparations. Decisions that result in savings that can be used to improve access to pharmaceuticals are welcomed. We would like to take this opportunity to make some general comments on medications for use in paediatric settings. The importance of having formulations appropriate for use in paediatric settings available cannot be overemphasised. Children, especially infants, children aged less than 6 years and children with disability and swallowing dysfunction, are often unable to take tablets or capsules. Palatable liquid formulations are essential for this group. The number of children requiring liquid formulations of medications more commonly used in adult settings is small; for example very few children are on antihypertensives, diuretics or thyroxine. However those that do need these medications should have access to appropriate paediatric formulations. While retail pharmacies will make up solutions for parents, there are a number of potential problems with this practice: Risk of measurement errors leading to dosage errors Risk that parents/caregivers will not ensure suspensions are adequately shaken prior to administration leading to dosage errors Short shelf life of extemporaneously compounded formulations, so that parents have to collect new supplies on a very frequent basis. This is particularly difficult for families with limited resources, a heavy burden of care or poor organisational skills, and those living in rural or remote areas. Paediatric Society members have particular concerns at present, with formulations of thyroxine (for infants with congenital hypothyroidism) and hydrocortisone (for infants with congenital adrenal hyperplasia). Our diabetes and endocrinology Special Interest Group is developing a position paper on this to assist with future decision making. Rosemary Marks President 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   Health of our children: Wealth of our nation X4|444444555L6N64969@@ACCFFFFFFFFF$  & F"FGG,G.G0G2G4GBGbGGGGGHHH H(H*H $ !n# ! $$ u+#$ $  $ !Sn# $ !Sn#$  $x$ fQhQjQQQQLRbbbbbbcccHcJc d"d$d(d.dddzzzzzzz|{FHJxzPRTX^΍ЍƼƪƼƪjCJU jUmH5B*CJOJQJB*CJOJQJ5B*CJ(OJQJ5B*CJ$OJQJ 5OJQJj5OJQJUmHjCJUmH5CJCJ0JCJ jCJUjCJU3ccc"d$d&d(d0d2d4d6d8d:d*B*8V@18FollowedHyperlink>*B* LBBL Body Text$*$1$ p@ @hnH F>RFTitle$*$1$ p@ 5CJ0hnH .Pb. Body Text 2CJXCrXBody Text Indent$*$ 0@CJ2Q2 Body Text 3$CJ W@ Strong544 No Spacing CJmH nH < 2< 25< )CKYij03 5 6 7 F P R x y      9 : = " " " @@@@@@@@@@@@@@@@@@@@ fQ\ 3 z D'b.X4F*H8UcyHf\ %&'45GHI UnknownDeniseThe Walker Familyr< Xt  ,R$@yV7e\]{W- *@&  ( =z43 N CE%"  8   BCqDELFVSS?-;lbn2qk\D@ORQ8Q* gw  W <b14\5q<O>B 1 8w1N/ : f 1  y?  u M  4  `6U:LsNA_cknkAehS)8Z' sZ' *b?@25; l)CKYij/2 4 5 6 E O Q w x     8 < (&P . A!"#$%n 10 September, 2008-09-11 Proposal for quinapril (Accupril) and quinapril with hydrochlorothiazide (Accuretic) Thank you for the opportunity to comment on this proposal. The Paediatric Society has no comments specific to this proposal. We note that these medications are used infrequently in children, and single preparations are generally preferred to combination preparations. Decisions that result in savings that can be used to improve access to pharmaceuticals are welcomed. We would like to take this opportunity to make some general comments on medications for use in paediatric settings. The importance of having formulations appropriate for use in paediatric settings available cannot be overemphasised. Children, especially infants, children aged less than 6 years and children with disability and swallowing dysfunction, are often unable to take tablets or capsules. Palatable liquid formulations are essential for this group. The number of children requiring liquid formulations of medications more commonly used in adult settings is small; for example very few children are on antihypertensives, diuretics or thyroxine. However those that do need these medications should have access to appropriate paediatric formulations. While retail pharmacies will make up solutions for parents, there are a number of potential problems with this practice: Risk of measurement errors leading to dosage errors Risk that parents/caregivers will not ensure suspensions are adequately shaken prior to administration leading to dosage errors Short shelf life of extemporaneously compounded formulations, so that parents have to collect new supplies on a very frequent basis. This is particularly difficult for families with limited resources, a heavy burden of care or poor organisational skills, and those living in rural or remote areas. Paediatric Society members have particular concerns at present, with formulations of thyroxine (for infants with congenital hypothyroidism) and hydrocortisone (for infants with congenital adrenal hyperplasia). Our diabetes and endocrinology Special Interest Group is developing a position paper on this to assist with future decision making. Rosemary Marks President 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   Health of our children: Wealth of our nation D'D(**F-H-J-h-|-~-----------.$.B.b. $ !Sn# $ !Sn# $x$ $  & F"" " " @@@@@@@@@@@@@@@@@@@ fQd 3 z D'b.X4F*H8Ucd %&'45 UnknownDeniseThe Walker Familyr; Xtz { | } ~  ,.0bdfhjlnp &D' & F"$ ! !D3&} [QEQEQEQEQEQEQEQEQY1topqk+fS ?3}3EVNy-m]"3}:9z}Z}P '>S֭EQEQEQEQEQEQEQEQEE412,!A,oX 4Mqypdx\egc N }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz? 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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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