For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
21,000 to benefit from Mirena and Jaydess
21,000 to benefit from Mirena and Jaydess

PHARMAC is widening funded access to Mirena, as well as listing a new long-acting reversible contraceptive option, Jaydess, which will benefit around 21,000 New Zealand women.
The Mirena and Jaydess are both levonorgestrel intrauterine systems (LIUS), supplied by Bayer Group who will have sole supply until October 2022.
“We heard from New Zealanders that this was something they wanted us to fund,” says PHARMAC’s acting medical director and practicing obstetrician and gynaecologist Dr Ken Clark.
“This gives people a broader range of choices around the contraceptives they can use and provides a treatment option for those who suffer from heavy menstrual bleeding, endometriosis or endometrial hyperplasia.
“PHARMAC works hard to make more medicines available for more New Zealanders, and today’s announcement is a great example of this. Since 1 July this year PHARMAC has already funded nine new medicines and widened access to 18.”
Mirena and Jaydess will be fully funded without any restrictions from 1 November 2019. More information can be found on the PHARMAC website at https://pharmac.govt.nz/news-and-resources/