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Consultations

Revised: 27 May 2013

Request for comments on the proposal to widen prescriber access to clozapine

26 February 2010

To: Healthcare Practitioners

Clozapine is an atypical antipsychotic used in the treatment of schizophrenia in patients intolerant of or unresponsive to ≥ two classic antipsychotics.

Clozapine is a prescription medicine approved under section 23 of the Medicines Act 1981. The following conditions regarding prescriber access to this medicine apply. Please note that other conditions exist regarding the dispensing and sale of clozapine which are unaffected by this proposal.

Current Prescribing Conditions

  1. The medicine may only be prescribed by:
    • registered medical practitioners as defined in the Health Practitioners Competence Assurance Act 2003 who are certified by the Medical Council of New Zealand as competent in the scope of practice of psychiatry
    • medical practitioners employed as registrars in the branch of psychiatry who are under the supervision of persons of the kind referred to above
    • medical officers of special scale who:
      • work solely in the field of psychiatry
      • are in the employment of a District Health Board
      • are under the supervision of persons who are registered medical practitioners as defined in the Health Practitioners Competence Assurance Act 2003 who are certified by the Medical Council of New Zealand as competent in the scope of practice of psychiatry.
  2. Persons prescribing the medicine must comply with appropriate local treatment guidelines.

Background to the proposal

Recent discussions with representatives of the mental health sector have highlighted:

Proposal

Medsafe proposes to revise the prescribing conditions for clozapine and seeks an opinion on the wording of the revision.

Proposed Prescribing Conditions
  1. The medicine may only be prescribed by:
    • registered medical practitioners as defined in the Health Practitioners Competence Assurance Act 2003 who are certified by the Medical Council of New Zealand as competent in the scope of practice of psychiatry
    • medical practitioners employed as registrars in the branch of psychiatry who are under the supervision of the persons referred to above
    • medical officers of special scale who:
      • work solely in the field of psychiatry
      • are in the employment of a District Health Board
      • are under the supervision of persons who are registered medical practitioners as defined in the Health Practitioners Competence Assurance Act 2003 who are certified by the Medical Council of New Zealand as competent in the scope of practice of psychiatry
    • general practitioners continuing the prescribing of clozapine for a specific patient in collaboration or following consultation with a Community Mental Health Team.
  2. Persons prescribing the medicine must comply with appropriate local treatment guidelines.

Benefits of change

General practitioners will be able to continue the prescribing of clozapine. This revision of the conditions also supports initiatives to provide more mental health services in a primary care setting.

Process for comments

Medsafe welcomes feedback on the proposed prescribing conditions of clozapine. The deadline for comment is Friday 26 March 2010.

Please address your comments to the:

Secretary
Medicines Classification Committee
Medsafe
PO Box 5013
Wellington 6145

OR

Andrea_Kerridge@moh.govt.nz with 'Clozapine consultation' in the subject line.

Yours sincerely

Stewart Jessamine
Group Manager
Medsafe

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