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Special Foods – Updated May 2010 Blue = delisted NUTRIENT MODULES
Carbohydrate Supplier Full Pack Subsidy Manufacture’s Medical Condition
subsidy size price
• Bronchopulmonary dysplasia • Chronic renal failure and CAPD
Maltodextrin Morrex 4 5kg $36.50 $36.50
Moducal Nutricia No 368g $1.30 $12.00 • Premature and Post premature • Cancers affecting alimentary
babies tract where there are malabsorption
Polycal Nutricia No 400g $1.30 $5.29 • Failure to thrive problems in patient over 20 years
• Growth deficiency • Cystic fibrosis
Polycose Abbott No 350g $1.14 $7.85 • Cancer in children
Fat
• Failure to thrive • Growth deficiency
Calogen Nutricia 4 500ml $30.75 $30.75
• Bronchopulmonary dysplasia • Inborn errors of metabolism
Calogen (neutral, strawberry) Nutricia 4 200ml $12.30 $12.30 • Lymphangiectasia
• Fat malabsorption
• Short bowel syndrome • Infants with necrotising enterocolitis
Liquigen Nutricia 4 250 ml $28.73 $28.73
• Biliary atresia
MCT Oil Nutricia 4 500ml $30.00 $30.00
CHO and Fat
Duocal Super Soluble Powder Nutricia 4 400g $60.31 $60.31 Guidelines: Only to be used in infants aged four years or under,
with the medical conditions outlined under Carbohydrate (above)
Protein
Promod Abbott 4 275g $12.90 $12.90
• Protein losing enteropathy
• High protein needs (e.g. burns)
Protifar Nutricia 4 225g $7.90 $7.90
Food Thickeners
Karicare Food Thickener Nutricia No 380g $4.56 $7.25 Guidelines: Only available as a subsidy for patients with swallowing
Resource Thicken Up - delisted 12/10 Novartis 4 250g $3.80 $3.80 disorders in motor neurone disease
Paediatric Oral Supplements/Complete Diet
Nutrini Energy RTH Nutricia 4 200ml $1.60 $1.60
Nutrini Energy RTH Nutricia 4 500ml $6.00 $6.00
Nutrini RTH Nutricia 4 200ml $1.07 $1.07
Nutrini RTH Nutricia 4 500ml $2.68 $2.68
Fortini (strawberry, vanilla) Nutricia 4 200ml $1.60 $1.60 Guidelines: Patients aged one to eight years .
NutriniDrink (strawberry, vanilla) Nutricia 4 200ml $1.60 $1.60 Supplement (500ml /day ) or complete diet
Pediasure (chocolate, strawberry) Abbott 4 200ml $1.07 $1.07 • Any condition causing malabsorption
Pediasure (chocolate, strawberry) Abbott 4 237ml $1.27 $1.27 • Increased nutritional requirements
Pediasure (vanilla) Abbott 4 237ml $1.27 $1.27 Failure to thrive
Pediasure RTH Abbott 4 500ml $2.68 $2.68
Resource Just for Kids (chocolate, vanilla) - Novartis 4 200ml $1.27 $1.27
delisted 7/09
Fortini Multifibre (choc, strawberry, vanilla) Nutricia 4 200ml $1.60 $1.60
NutriniDrink Multifibre Nutricia 4 200 ml $1.60 $1.60
Specialised Complete foods
• Children up to 18 years with chronic renal failure
• Initial applications must be made by authorised paediatrician
• Approvals valid for 3 years
Kindergen Nutricia 4 400g $54.00 $54.00
• Reapplications must be made by an authorised Paediatrician
• Prescriptions can be written by any medical practitioner
• Children up to 18 years who are awaiting liver transplant
• Initial applications must be made by a paediatrician
• Approvals valid for 3 years
Generaid Plus Nutricia 4 400g $78.97 $78.97
• Reapplication must be made by a Paediatrician
• Prescriptions can be written by any medical practitioner
ORAL SUPPLEMENTS / COMPLETE DIET
Oral Supplements Supplier Full Pack size Subsidy Manufacture’s Medical Condition
subsidy price
Ensure Powder Abbott No 400g $4.75 $7.22 Guidelines: These products are to be used only as supplements to a person’s
(chocolate, strawberry, vanilla) dietary needs. Subsidy is for up to 500ml/day
Cancer in children
Fortisip Powder (vanilla) - delisted Novartis 4 900g $11.50 $11.50
Cancers affecting alimentary tract where there are malabsorption problems in
Sustagen Hospital Formula patients over the age of 20 years
(chocolate, vanilla) Novartis 4 900g $9.22 $9.22 Inflammatory bowel disease
Malnutrition requiring nutritional support
Cystic fibrosis
Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed)
Ensure Plus (banana, chocolate, Abbott No 200ml $1.12 $1.45
fruit/forest, strawberry, vanilla) Guidelines:
Ensure Plus (choc, s/berry, coffee latte, This product group can be used either as a supplement or as a complete diet.
van) Abbott 4 237ml $1.33 $1.33
Applications must state whether the product is to be used as a complete feed or
Ensure Plus RTH Abbott 4 1,000ml $7.00 $7.00 as a supplement. If a product is being used as a supplement, the limit is 500ml
Fortisip (banana, choc, strawberry, per day.
toffee, tropical fruit, vanilla) Nutricia 4 200ml $1.12 $1.45
Fortisip Multi Fibre (van, choc, Cystic fibrosis patients are exempt the 500ml per day volume restriction when
s/berry) Nutricia 4 200ml $1.12 $1.12 using Ensure Plus, Fortisip, Resource Plus as a supplement.
Resource Plus (choc, strawberry)
vanilla - delisted 12/10 Novartis 4 237ml $1.33 $1.33 Any condition causing malabsorption
IsoSource 1.5 Novartis 4 250ml $1.75 $1.75 Failure to thrive
Increased nutritional requirements
IsoSource 1.5 - delisted 12/10 Novartis 4 1000ml $7.00 $7.00
Nutrison Energy Multi Fibre - delisted Two Cal HN is only to be used as a nutritional supplement after other lower
1/09 Nutricia 4 500 ml $3.50 $3.50 calorie products have been tried and should only be used in patients with
substantially increased metabolic requirements.
Nutrison Energy Multi Fibre Nutricia 4 1,000ml $7.00 $7.00
Two Cal HN (vanilla) Novartis 4 237ml $2.25 $2.25
Applications to be made by renal physicians or gastroenterologists in addition
Suplena Abbott 4 237ml $3.80 $3.80 to the above guidelines
Undialysed end stage renal patients
Nepro (vanilla) Abbott 4 200ml $2.43 $2.43
NovaSource Renal Novartis 4 237ml $2.88 $2.88 Acute or chronic renal failure
Nutrison Concentrated (vanilla) Nutricia 4 500ml $6.08 $6.08
Renilon 7.5 (apricot, caramel) Nutricia 4 125ml $2.88 $2.88
Pulmocare (vanilla) Abbott 4 237ml $1.66 $1.66
Patients who have anorexia and weight loss associated with any of the following
conditions:
Fortimel Regular (vanilla) Nutricia 4 200ml $1.90 $1.90
Decompensating liver disease without encephalopathy
Protein losing gastro-enteropathy
INFANT FORMULA
Infant Formula Supplier Full Pack Subsidy Manufacture’s Medical Condition
subsidy size price
S26LBW Gold RTF Wyeth 4 100ml $0.75 $0.75 • Infants weighing <1.5kg at birth
• For 6 months only
Infant Formula for Williams Syndrome
Locasol BioLab 4 400g $44.40 $44.40 To be used in infants suffering Williams Syndrome and associated
hypercalcaemia.
Infant Formula for Gastrointestinal and Other Malabsorptive Problems
Neocate Nutricia No 400g $63.97 $67.08 To be used in infants suffering from malabsorption and other
Neocate LCP Nutricia No 400g $63.97 $67.08 gastrointestinal problems
Vivonex Paediatric may be a suitable and less expensive alternative for many
Neocate Advance (tropical, unflavoured) Nutricia No 400g $52.90 $56.00 children who would otherwise be eligible for a subsidy for Neocate and should
Pepti-Junior Nutricia No 450g $15.52 $19.01 therefore be tried first in these cases. Neocate should only be used as a last
resort when the infant is unable to absorb any of the other formula in this
Vivonex Pediatric Novartis No 48.5g $5.62 $6.00 section
Other Infant Formula
Delact Nutricia No 900g $5.66 $17.95 For use in infants diagnosed as suffering from congenital lactase deficiency.
S26 Soy Wyeth No 900g $6.34 $19.57 In these cases approval should be given for up to 2 years
Secondary lactose intolerance in children is usually short lasting , and can be
Karicare Goats Milk Infant Formula Nutricia No 900g $9.42 $22.75 controlled by dietary measures and by giving sufficient calories to regenerate
digestive enzymes.
Approvals will not be given beyond 2 years of age
Karicare Soy All Ages Nutricia No 900g $7.27 $16.35 When these products are used for infants with an intolerance to cow’s milk,
approvals will be given for six months only, after which the specialist must
reapply
Special Food Group Products for which Special Authority numbers are Interchangeable
Carbohydrates Moducal, Morrex Maltodextrin, Polycal, Polycose
Fat Calogen neutral, Calogen strawberry, Liquigen Oil, MCT Oil
Protein Promod and Protifar 90
Oral Supplements Ensure Powder, Fortisip Powder and Sustagen Hospital Formula
Oral Supplements / Complete diet Ensure Plus, Fortisip, Resource Plus, Two Cal HN
1.0kcal/ml IsoSource, Nutrison Standard, Osmolite, Fibresource, Jevity, Nutrison Multifibre
1.5kcal/ml IsoSource 1.5, Nutrison Energy, Nutrison Energy Multi Fibre, Ensure Plus RTH
Renal Nepro, NovaSource Renal, Nutrison Concentrated, Renilon 7.5, Suplena
Respiratory Pulmocare
Paediatric (nasogastric/gastrostomy tube feed) Nutrini, Nutrini Energy, Pediasure, Resource Just For Kids, Fortini, Fortini Multifibre
Diabetic (nasogastric/ gastrostomy tube feed) Glucerna, Diason, Resource Diabetic
Food Thickeners Karicare Food Thickener, Resource Thicken Up
Infant Formula Infasoy, Isomil, Karicare Soy Infant Formula, Delact, Neocate, Pepti-Junior
Gluten Free All products listed under Gluten Free Bread and Bake Mixes and Gluten Free Pastas
Phenyl Free All products listed under Phenyl Free Bread Mixes and Phenyl Free Pastas
Protein Supplements Aminogran Mineral Mixture and Metabolic Mineral Mixture
ORAL SUPPLEMENTS / COMPLETE DIET
Nasogastric or Gastrostomy Tubefeeds Supplier Full Pack size Subsidy Manufacture’s Medical Condition
Standard Products subsidy price
Isosource Std Novartis 4 250ml $1.24 $1.24 Inability to take oral food:
Enteral feeding
Isosource HN - delisted 12/10 Novartis 4 250ml $1.24 $1.24
Nasoduodenal
Isosource Std RTH Novartis 4 1,000ml $5.29 $5.29
Gastrostomy / jejunostomy
Isosource HN RTH - delisted 12/10 Novartis 4 1,000ml $5.29 $5.29
Nasogastric
Nutrison Std RTH (vanilla) Nutricia 4 500ml $2.65 $2.65
nasojejunal
Nutrison Std RTH (vanilla) Nutricia 4 1,000ml $5.29 $5.29
Osmolite RTH Abbott 4 1,000ml $5.29 $5.29
Added Fibre Products
Fibresource Novartis 4 250ml $1.24 $1.24
Fibresource HN - delisted 12/10 Novartis 4 250ml $1.24 $1.24
Fibresource RTH - delisted 12/10 Novartis 4 1,000ml $5.29 $5.29
Fibresource HN RTH Novartis 4 1,000ml $5.29 $5.29
Jevity RTH Abbott 4 1,000ml $5.29 $5.29
Nutrison Multi Fibre Nutricia 4 500ml $2.65 $2.65
Nutrison Multi Fibre Nutricia 4 1,000ml $5.29 $5.29
Specialised Foods Complete Diet
Guidelines - Each of these products is highly specialised
Alitraq Abbott 4 76g $7.50 $7.50
and would be prescribed only by an expert for a specific
Elemental 028 Extra disorder. The alternative is hospitalisation.
Nutricia 4 250ml $9.50 $9.50
(grapefruit, p/apple/orange, summer fruit) Malabsorption
Enterocutaneous fistulas
Short bowel syndrome
Peptisorb (neutral) - delisted 4/10 Nutricia 4 500ml $6.02 $6.02
Pancreatitis
Peptisorb (neutral) Nutricia 4 1,000ml $12.04 $12.04
Elemental 028 Extra is more expensive and should only
be used when alternatives have been tried first and/or
Vital HN Abbott 4 79g $4.40 $4.40
are unsuitable.
Vivonex TEN Novartis 4 80.4g $4.00 $4.00
sachet
Complete diet for patients who have metabolic
disorders of fat metabolism, or chylothorax
Monogen Nutricia 4 400g $60.48 $60.48
where Portagen is not appropriate or available
Diabetic
Glucerna Select (vanilla) Abbott 4 250ml $1.88 $1.88
Glucerna Select RTH Abbott 4 1000ml $7.50 $7.50
Diason RTH Nutricia 4 1,000ml $7.50 $7.50
Diasip (vanilla, strawberry) Nutricia 4 200ml $1.50 $1.50
Resource Diabetic TF RTH - delisted 9/09 Novartis 4 1,000ml $7.50 $7.50
Resource Diabetic (choc - delisted 8/09, straw, vanilla) Novartis 4 237ml $1.78 $1.78
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