Title: Key Issues Document for Conversion of Ventolin to Salamol

 

Author: Dr Shane Reti

 

Date: Created 9 May 2005; Updated With Study Data 11 Oct 2005

 

Main Points

 

1. Provisional study data by this author suggests Salamol is both objectively and subjectively less effective than Ventolin (for publication)

 

2. This particular PHARMAC decision singly affects more people than any other previous decisions

 

3. Estimated Ventolin users affected are 500,000, with demographics across all age groups from infants to the elderly. The highest incidence of hospital admissions for asthma is in children less than 5, followed by children 5-14. Maori and Pacific Island are at higher risk

 

4. The introduction of the conversion during winter months would coincide with the peak asthma period

 

5. Asthma has well recognised psychological dependency/reassurance factors. People rely on the historical reassurance that their inhaler will work when they need it. This argument is difficult to scientifically assess, and is best managed by slow but sure application to education and promotion

 

6. To date nearly all consumers and providers do not like the product. This includes doctors, pharmacists, and consumers

 

7. The fiscal gains have been reported at $1.7 million over 18 months. On a PHARMAC budget 2004-2005 of $565 million this is 0.2% savings

 

 

Suggested Strategy

 

1. Slow down the roll out to Jan 1 2006

 

2. Set-up impact studies

 

3. Put in place special authority arrangements with PHARMAC