Dear Pharmaceutical Management Agency,

This is an urgent request regarding the discontinuation of Phenelzine (announced 22 April 2020).

The supplier, Link Medical Products, has advised they are unable to continue supplying Phenelzine.

Please provide all information and documentation, including email or other correspondence documents with both internal and external parties, for the following:

1) What other alternative suppliers have been contacted or considered, what was the outcome?

Please provide documentation relating to the attempt to find an alternative suppliers. Australia's supplier has switched from Link Medical to Medsurge who are currently attempting to confirm an ongoing supply of phenelzine for Australians; why is NZ not doing the same?

2) Is the discontinuation of phenelzine related to the current cost of alternatives?

Currently, the only brand available in Australia under the special access scheme is $398+GST for a bottle. Please provide all information and documentation regarding the cost for supply of phenelzine, especially relating to decisions by those within Pharmac.

3) Has phenelzine been permanently discontinued in NZ? Or will it be available when the supply has stabilised?

Please provide anything related to future of phenelzine in NZ.

4) Phenelzine is a last resort for everyone who takes it. Given there are currently 100 people in NZ on it, what sort of risk analysis and discussion has taken place regarding the ongoing management of these New Zealanders?

Please provide all available documentation, including but not limited to reports, briefing, correspondence, transcripts of meetings or phone calls with all internal and external parties, including but not limited to Mental Health Subcommittee of the Pharmacology, Therapeutics Advisory Committee, Department of Health, Local DHBs, MPs. Specifically, I am interested in any estimations around the suicide risk (and management) of these 100 New Zealanders, the potential cost to the health and welfare system given the extremely high likelihood of relapse.

5) Please provide all information related to the suggestion of using tranylcypromine sulphate (Parnate) as "appropriate alternative MAOI for patients", including all reports, correspondence, transcripts, and a list detailing the qualifications and professional experience regarding MAOI and treatment resistant depression of those on the Mental Health Subcommittee of the Pharmacology and Therapeutics Advisory Committee. I would specifically expect to see discussion and acknowledgement from these members that the two MAOI are not interchangeable. Please also include any studies cited or external professionals who were consulted.

I look forward to your response but am greatly disappointed given that on 18 September 2019 Pharmac responded to my OIA request with the following: "In response to your first four questions, the supplier of Nardil and Nardil s29, has advised PHARMAC that it expects to be able to ensure the on-going supply of phenelzine sulphate."

Ngā Mihi,
Megs