7 April 2020
Belinda Hodson
Via Email: [FYI request #12263 email]
Dear Belinda
REQUEST FOR INFORMATION: PTAC’s RECORD OF CONSIDERATION FOR
HYPOTHYROIDISM DISCUSSION AT ITS MEETING OF 1-2 NOVEMBER 2018
Thank you for your email of 18 February 2020, in which you asked for:
Supporting papers/supplementary papers and other documentation – including
costings, cost benefit analysis, notes, written records of phone calls and emails
between PHARMAC staff and other external parties – written and held by the PTAC
endocrine subcommittee and PTAC committee members, which support PTAC’s
Record of the Pharmacology and Therapeutics Advisory Committee Meeting Held On
1 & 2 November 2018 minutes at: https://www.pharmac.govt.nz/assets/ptac-minutes-
2018-11.pdf, page 32-34 titled: 11 Whole thyroid extract and normal and extended
release T3 for the treatment of hypothyroidism.
Your request for this information has been considered under the Official Information Act 1982
(OIA).
At its meeting on 1-2 November 2018, the Pharmacology and Therapeutics Advisory
Committee (PTAC) considered the Thyroid Association of New Zealand’s application for
funding of whole thyroid extract, and normal and extended release T3 for the treatment of
hypothyroidism. The report of the meeting indicates that PTAC’s decision was formed by
consideration of three documents, these being:
• The application and supporting documentation supplied by the Thyroid Association of
New Zealand Incorporated
• PHARMAC’s Pharmaceutical Schedule Application (November 2018), titled
Whole
thyroid extract, normal and extended release T3 for hypothyroidism, prepared by
PHARMAC’s Funding Application Advisor
• PHARMAC’s decision-making framework, as relevant.
Each of these documents is discussed below.
The application and supporting documentation supplied by the Thyroid Association of
New Zealand Incorporated
The application from the Thyroid Association of New Zealand identifies you as the contact
person for the Association. We therefore understand that you have access to the
Association’s application and its supporting documents. Accordingly, we have interpreted
your request as excluding this material.
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PHARMAC’s Pharmaceutical Schedule Application (November 2018), titled Whole
thyroid extract, normal and extended release T3 for hypothyroidism, prepared by
PHARMAC’s Funding Application Advisor
PHARMAC’s Pharmaceutical Schedule Application of November 2018, excluding the
Appendix, is attached with this response.
The contents of the Appendix to the Pharmaceutical Schedule Application report are
provided in Table 1 below. Studies 1-6 were provided in full to PTAC. Study 7 was cited to
PTAC, but our records are inconclusive about it being supplied in full to PTAC members.
These cited studies are publicly available documents and are withheld in accordance with
section 18(d) of the OIA. Copyright provisions also apply.
Table 1: Supplied publications
Study
Citation
1
Thyroxine-triiodothyronine combination therapy
Grozinsky-Glasberg, et al. J
versus thyroxine monotherapy for clinical
Clin Endocrinol
hypothyroidism: meta-analysis of randomised
Metab. 2006;91(7):2592
controlled trials
2
Systematic review of all the published controlled
Escobar-Morreale et al. J Clin
studies comparing treatment with levothyroxine alone
Endocrinol
with combinations of levothyroxine plus
Metab. 2005;90(8):4946
liothyronine in hypothyroid patients
3
Desiccated thyroid extract compared with
Hoang, et al. J Clin
levothyroxine in the treatment of hypothyroidism: a
Endocrinol
randomized, double-blind, crossover study
Metab. 2013;98(5):1982-90
4
Current evidence for the treatment of hypothyroidism
Hennessey, et al. Int J Clin
with levothyroxine/levotriiodothyronine
Pract. 2018;72(2).
combination therapy versus levothyroxine
doi: 10.1111/ijcp.13062
monotherapy.
5
Common variation in the DIO2 gene predicts baseline
Panicker, et al., J Clin
psychological wellbeing and response to combination
Endocrinol Metab.
thyroxine plus triiodothyronine therapy in hypothyroid
2009;94(5):1623
patients
6
Polymorphisms in type 2 deiodinase are not associated
Appelhof, et al. J Clin
with well-being, neurocognitive functioning, and
Endocrinol Metab.
preference for combined thyroxine/3,5,3'-
2005;90(11):6296
triiodothyronine therapy
7
No Effect of the Thr92Ala Polymorphism of Deiodinase-
Wouters, et al. Thyroid.
2 on Thyroid Hormone Parameters, Health-Related
2017;27(2):147
Quality of Life, and Cognitive Functioning in a Large
Population-Based Cohort Study
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PHARMAC’s decision-making framework, as relevant
PHARMAC’s decision-making framework is available publicly on its website, at:
www.pharmac.govt.nz/medicines/how-medicines-are-funded/factors-for-consideration/
Please note you have the right, by way of complaint under section 28(3) of the OIA to an
Ombudsman, to seek an investigation and review of our decision under this OIA.
We trust that this information answers your queries. We are making our information more
freely available, so we will now publish selected OIA responses (excluding personal details)
on our website. Please get in touch with us if you have any questions about this.
Yours sincerely
Rachel Read
Policy Manager, Engagement and Implementation
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