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Potential Lamotrigine Drug Switch Deaths

Patient Voice Aotearoa are deeply saddened by the loss of four lives that are potentially related to Pharmac switching 10,000 epilepsy patients from the drugs Lamictal and Arrow-Venlafaxine to Logem for a savings of $30 million dollars. Also of concern is the response from the Minister of Health who commented when asked about the deaths “We have robust processes and politicians undermining those clinical decisions is not a world I want to be in.” In response, patient advocate Arabella Gubay stated “At some point a brand change like this crosses over into a public safety issue and the Minister cannot just wipe his hands of it.”

Again, sadly, the most recent drug switch could be a repeat of what occurred with the switching of 45,000 patients from the antidepressant drugs Effexor XR and Arrow-Venlafaxine to Enlafax XR in 2017 for a savings of $5 million dollars. It was reported that some patients had suicidal thoughts and it is unknown if the switch resulted in suicides. Next year Pharmac is scheduled to switch the antidepressants Apo-Paroxetine to Loxamine, Arrow-Sertraline to Setrona, and Arrow-Fluoxetine to Fluox for 167,000 patients. These switches are scheduled to take place despite a peer-reviewed article in a 2017 medical journal stating that switching Apo-Paroxetine can result in increased psychiatric symptoms, that switching Arrow-Sertraline can result in adverse reactions, and that switching Fluoxetine can result in relapses of depression[i]. The warnings in the article also stated that switching Lamotrigine can result in increased seizures which lead to increased hospitalisations and death.

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States Chair of Patient Voice Aotearoa Malcolm Mulholland “Drug switching is done regularly by Pharmac in an attempt to free up money to purchase other drugs because their budget is so small. It’s a classic case of robbing Peter to pay Paul. Sadly, Pharmac are now switching psychotropic drugs despite international experts warning against the practise. “

“We don’t know the number of patients that committed suicide as a result of the venlafaxine drug switch. Potentially there have been four deaths related to the lamotrigine drug switch. How many deaths will there be as a result of the pending three antidepressant drug switches?”

“The latest heart-breaking drug switch raises more questions than answers. Who will be held accountable if the coroner rules that the lamotrigine drug switch contributed towards the deaths of the four epilepsy patients? Why did Pharmac go ahead with the drug switch despite the warnings of Medsafe? Will the Minister of Health resign as he was approached by patients to intervene months before the switch took place? What has been the cost for Pharmac to continue to fund Lamictal and Arrow-Venlafaxine and break an exclusive deal with Mylan? Will Pharmac push ahead with switching the three antidepressants?”

“The biggest question that remains unanswered is will this Government finally admit that Pharmac is severally underfunded which is why Pharmac switch innovator drugs to generic brands and take risks that affect the health of New Zealanders and, potentially, claim lives? If we doubled the Pharmac budget, we would fund Pharmac to a similar level per capita as Australia’s drug agency PBS. This is the reason why Pharmac takes over four years on average to fund a drug, does not follow international guidelines when it comes to the funding of medicines, and has over one hundred treatments on their waiting list. The big problems confronting Pharmac all stem from being underfunded, which in turn, creates a bigger problem for New Zealand; early or unnecessary deaths or a poorer quality of life.”

“One action everyone can do to change Pharmac for the better is to sign the Patient Voice Aotearoa petition to double the Pharmac budget and reform the agency. This would give the Government a clear message to fund and reform Pharmac so that it can do its job properly and provide positive health outcomes for New Zealanders. Pharmac cannot fix itself and the Minister is responsible for the agency. Only the Government can fix Pharmac.”

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