Phenelzine discontinuation working group minutes
14 April 2020 1.15 pm (via zoom)
Attendees
Adam McRae (TGM), Heather Milne (Implementation Lead), Michelle Ashley (Contract
Manager), Nerissa Ramlall (Contract Manager)
Apologies
Tristan Gardiner (Clinical Advisor, Primary Care)
1. Overview (Nerissa)
In late March 2020 Link Healthcare informed PHARMAC of a supply issue for phenelzine
and proposed an alternative brand. They are under an old contract and have used multiple
brands of phenelzine to continue supply over the years. Since then they have communicated
that they cannot find a long term supplier and stated they are going to discontinue
phenelzine. Link are continuing to look for another supplier but do not think they will be able
to find one.
Link have informed PHARMAC they have one months supply on hand. Uncertain how much
stock is in the supply chain currently.
In the 2019 FYR there were 99 patients on phenelzine. Phenelzine is an old antidepressant
(monoamine oxidase inhibitor (MAOI)) with patients expected to have been using phenelzine
for a long period of time.
2. Suitable alternative – Parnate (Adam + Michelle)
Tranylcypromine sulphate (Parnate) is the only other non-selective MAOI and is a suitable
alternative to phenelzine. The dose equivalence is not known currently.
In the 2019 FYR there were 219 patients on Parnate, supplied by Boucher with currently
eight months stock on hand but they are unsure on when the next delivery will be.
They have requested information on what the impact of patients being transitioned from
phenelzine to Parnate will mean for their stock.
3. Clinical advice (Adam)
Giles Newton-Howes from PTAC has provided advice that switching patients to
tranylcypromine or another antidepressant will be doable but will require prescribers being
notified.
More clinical advice may be required around dose equivalence and from the Mental Health
Subcommittee about changing patients.
4. Next steps (All)
-
Request to analysts to produce list of prescribers for phenelzine so that communication
can be directed to these prescribers –
Heather
-
Draft letter to prescribers and information for PHARMAC website –
Heather
-
Confirm what clinical advice is needed with Clinical Advisor, Primary Care –
Heather
Released under the Official Information Act
-
Seek further clinical advice if required –
Adam
-
Confirm stock of phenelzine currently in the supply chain –
Nerissa
-
Communicate with supplier of Parnate once dose equivalence and clinical advice is
finalised -
Michelle
Released under the Official Information Act