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Pharmac - Te Pātaka Whaioranga. Pharmac - Te Pātaka Whaioranga. Pharmac - Te Pātaka Whaioranga.

  • Te Rārangi Rongoā Pharmaceutical Schedule

    Pharmaceutical Schedule

    All funded medicines in New Zealand.

    • Community Schedule

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    • Hospital Medicines (HML)

    • Schedule Updates

    • Schedule resources

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    • Rules of the Schedule

    • Hospital Medical Devices

  • Te pūtea me ngā umanga rongoā Medicine funding and supply

    Medicine funding and supply

    Ask us to fund a medicine | Check changes to medicines | How do generics work?

    • Make an application

    • Medicine notices (includes supply issues)

      Brand changes, discontinuations and more.

    • The funding process

    • What you need to know about medicines

    • Medicine supply management

      Order condoms and nicotine replacement | About supply management

    • Progress to funding cancer and other medicines

  • Ngā pūrere hauora a te hōhipere Hospital medical devices

    Hospital medical devices

    • The hospital medical devices programme

    • Using the Hospital Medical Devices List

    • Getting devices onto the Hospital Medical Devices List

    • Category Information

      Medical devices we have contracted and the ones we're working on

    • Hospital Medical Devices List

      Download the latest hospital medical devices schedule

    • Hospital medical device supply management

    • The future of hospital medical device management

    • Device Advice

      Read and subscribe to our devices newsletter

  • Treaty of Waitangi Te Tiriti o Waitangi

    Te Tiriti o Waitangi

    • Te Tiriti o Waitangi policy

      Pharmac's Te Tiriti o Waitangi Policy came into effect in November 2022.

    • Te Whaioranga

      Te Pātaka Whaioranga's Māori Responsiveness Strategy

    • Hauora Arotahi

      The Māori health areas of focus

    • Scholarships

      Scholarships for Māori health professionals and students.

    • How we work with Whānau Ora

  • Ngā karere me ngā rauemi News and resources

    News and resources

    • Consultations and decisions

      includes RFPs and tenders.

    • News, stories, and updates

    • Official information releases

      How to make an OIA or Privacy Act request and find information Pharmac has already released.

    • Publications and resources

    • Continuous glucose monitors (CGMs) and insulin pumps

      Funded from 1 October 2024 for eligible people. Find out who qualifies and what is funded.

    • COVID-19

    • Pharmac's research

  • Mō About

    About

    • Strategic Direction

      Our plan to deliver the best health outcomes for New Zealanders

    • Access equity

      Our work to improve equity of access to medicines in New Zealand.

    • The Pharmac Review

    • What we do

    • Who we are

    • How we get advice

      Advice we seek to make decisions

    • Working at Pharmac

      Explore current vacancies

    • Contact us

      How to get in touch

  1. Home
  2. Medicine funding and supply
  3. Make an application
  4. Other exceptional circumstances forms
  • Make an application
    • Make an application
      • Make a medicine funding application
      • NPPA applications
      • Special Authority applications
      • Special Authority waiver
      • Medicines with restrictions in the HML
      • Special access medicines
      • Other exceptional circumstances forms
    • Medicine notices (includes supply issues)
    • The funding process
    • What you need to know about medicines
    • Medicine supply management
    • Progress to funding cancer and other medicines

Other exceptional circumstances forms

A handful of medicines and devices require a different form.

Download the relevant exceptional circumstances form

Alpha tocopheryl acetate (vitamin E) with/or retinol (vitamin A) funding application form [PDF, 221 KB]

Bevacizumab alternative brand allowance form [DOCX, 82 KB]

Bevacizumab alternative brand allowance form [PDF, 112 KB]

Diabetes technology alternative brand allowance application form [DOCX, 82 KB]

Imiglucerase (Cerezyme) renewal form for people with Gaucher disease [PDF, 116 KB]

Multiple sclerosis MS application for grandparented patients [PDF, 105 KB]

Paediatric oncology/haematology notification form [PDF, 292 KB]

Prednisolone oral liquid funding application [PDF, 235 KB]

Trastuzumab (Herceptin) Exceptional Circumstances form [PDF, 111 KB]

First Published: 9 August 2024

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