Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults

Published on 16 Oct 2017
Last Updated on 16 Mar 2023

Guidance Recommendations

The Ministry of Health's Drug Advisory Committee has recommended:

• Clostridium botulinum toxin type A neurotoxin complex (Botox) 50 U and 100 U injection vials for the management of focal spasticity of the upper limbs associated with stroke in adults who:

  • have a score of 2 or more on the Modified Ashworth Scale at the target muscle intended for botulinum toxin A treatment,

  • do not have the affected joint permanently fixed in position due to fibrotic shortening of the target muscle, and

  • are concurrently receiving physiotherapy.

Botulinum toxin A must be administered by either a neurologist trained in movement disorder or a rehabilitation physician who has undergone training to administer botulinum toxin A.

Subsidy status

Clostridium botulinum toxin type A neurotoxin complex (Botox) 50 U and 100 U injection vials are recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication.

MAF assistance does not apply to Botox 200 U injection vial, Dysport 300 U and 500 U injection vials and Xeomin 50 U and 100 U injection vials.

Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults (Updated 16 Mar 23) [PDF, 253 KB]