Special Authority waiver
You can ask PHARMAC to waive certain criteria in a Special Authority.
When to ask for a waiver to access funding
If a person's clinical circumstances meet the spirit or intent of a Special Authority criteria – but not the exact technical requirement – the person prescribing the medicine can ask PHARMAC to waive a criteria.
For example, a Special Authority requires a person to walk a certain distance unaided, however the person has a broken leg, so they cannot meet the requirement. As such, they may be eligible for the waiver.
How to apply for a Special Authority waiver
- Download the PDF Special Authority form (there's no special waiver form)
Where to find the PDF forms
- Complete the form as much as possible
- Where the person does not meet criteria, explain why they can't meet the criteria (include a clinic letter if you have one)
- Email the completed form to email@example.com (or fax 04 380 1409)
You cannot use the Ministry of Health's electronic Special Authority system to apply for a waiver.
- For speedier results, include your email address on the form.
- If you need to refer to a previous Special Authority application or approval, attach it to your application. We do not hold records of previous standard Special Authority applications or approvals.
- We do not hold anyone's SA number (these are issued by the Ministry of Health).
People who've accessed the medicine without funding
If the person has been using the medicine unfunded, they may no longer meet the inital access criteria. If you can show that the person met the initial access criteria before they started taking the medicine, they may be eligible for a waiver.
People in this situation might have:
- been living overseas and has since moved to New Zealand
- self funded the medicine before PHARMAC agreed to fund it
- received compassionate supply from the pharmaceutical company.
How do I find out the result?
If the waiver request is approved:
PHARMAC will usually alert the prescriber (eg doctor). The Ministry of Health will send the prescriber an official notification, which will include a Special Authority (SA) number.
If the waiver request is declined:
PHARMAC will contact the prescriber (eg doctor) explaining why we declined it.
We may ask for more information about an application to help us make a decision.
Who to contact
If you have questions about waivers, email PHARMAC on firstname.lastname@example.org