Accuretic recall and supply issue

Accuretic is a medicine used to treat 36,000 New Zealanders with high blood pressure and heart failure. Pharmac have informed us supply in New Zealand is about to be disrupted.

People using Accuretic will need to get a new prescription to change to an alternative medicine as soon as possible.

We know our sector is currently under a huge amount of strain, and changing this many people to alternative treatments will add to that strain.

Our data team have done some preliminary work, based on a business rule of a patient having two or more scripts for Accuretic in the last year. We know:

• there are 3,928 current patients in the Pinnacle network who appear impacted
• we have contact information for all those patients (email / phone)
• we have delivered patient lists to your healthlink folders to help with making contact.

A straight switch from Accuretic to another combination of quinapril and hydrochlorothiazide is not possible. There is no other quinapril + hydrochlorothiazide (or alternative thiazide or thiazide-like diuretic) combination tablet available In New Zealand.

Patients will need to be switched to a different medication, the choice of medication will need to be individually assessed and agreed with the patient.

He Ako Hiringa has produced a clinical guide to switching medication. 

Pharmac and GPNZ are in discussions currently, with a view to creating a funded recall, review and follow up process. More details are expected to be released early July 2022.

We’ve received a funding letter to formalise Pharmac’s contribution towards the cost of transitioning patients from Accuretic to a suitable alternative medicine as soon as possible, ideally before 31 August 2022.

Eligibility 

An eligible patient is someone who:

• is currently using the Accuretic brand of medication
• is transitioning to a suitable alternative treatment
• has not paid for the consultation or the patient is reimbursed for their consultation
• requires an extra appointment with a prescriber in primary care to support the change from Accuretic to an alternative medicine(s).

Covering the cost of a primary care consultation 

Pharmac want to ensure patients currently using Accuretic don’t face a financial barrier to transitioning to an alternative treatment, therefore will pay for patients to access an initial consultation with their primary care prescriber (virtual or in-person) at $100 per patient per initial consultation.

Pharmac are seeking further advice about funding for patients who need a follow-up appointment and will provide a further update.  

Payment

Payment will be made from Pharmac to Pinnacle by 20 August. We will then process this payment to you as one bulk payment, based on Pharmac’s numbers. You are not required to submit an invoice to us.

Pharmac have made it clear that any funding not applied for this purpose must be refunded to Pharmac within 90 days.  

Our data team are working with Dr Jo Scott-Jones to determine the best way we can give assurance to Pharmac that all patients have been appropriately followed up/funding has been appropriately applied with the aim of no-to-minimal reporting requirements at the practice level.  

Recent batches of Accuretic, quinapril with hydrochlorothiazide, have been found to have small amounts of a contaminant, called N-nitroso-quinapril. Medicine safety regulators have determined that exposure to this substance over a long time may increase a person’s risk of getting cancer.

There is no immediate risk to patients taking this medicine. People should keep taking Accuretic until they have spoken to a medical professional, but should make the changes as soon as practically possible.

This is a global issue. Pfizer, the supplier of Accuretic, has been undertaking voluntary recalls of the medicine around the world, including in Australia, Europe, the United States of America, and Canada.

The following information can be used as key messaging to help reception staff answer patient enquiries. 

• Pharmac has issued a recall of Accuretic, a common blood pressure medication.
• People using Accuretic will need to get a new prescription to change to a different medicine as soon as possible.
• Please advise patients:
  • you need to continue to take Accuretic until you have been prescribed a new medication
  • there is no immediate risk in continuing to take Accuretic, but there is risk in coming off your blood pressure medication without a replacement organised
  • if you are taking Accuretic you need to book a GP appointment to change your medication as soon as possible
  • there will be no charge for the GP appointment.

For people who ask why there has been a recall

Recent batches of Accuretic have been found to contain small amounts of a contaminant, and medicine safety regulators have determined that long-term exposure to this substance may increase a person’s risk of getting cancer.

The risk is similar to that of regularly eating burnt toast so nothing to panic about, but your doctor will change you to a better option.

There is more information on Pharmac’s website about the issue and what support is available.

We will continue to keep you informed with all new information as it comes to hand, through updating this page and via our newsletters and Facebook groups.