From application to funded medicine: Pharmac's process
We have a process for all funding applications to ensure that every application is treated fairly. Our job is to prioritise which new medicines will deliver the best possible health outcomes for New Zealanders.
How Pharmac assesses a medicine for funding.
A supplier, health professional, or an everyday New Zealander can apply for a medicine or related product to be funded.
Prepare your application by collating all relevant information.
Discuss your application with someone from Pharmac.
Submit your application via PharmConnect.
Review: Pharmac reviews and evaluates the evidence, including others' submissions on the same medicine.
Advice: Pharmac receives recommendations from independent clinical experts from across New Zealand's healthcare sector who sit on the Pharmacology and Therapeutic Advisory Committee (PTAC) and its subcommittees.
Assess: Pharmac considers the clinical advice and assesses the medicine. Reasearch and economic analysis take place.
Compare options: Pharmac compares and ranks medicines, high to low.
Prioritise: A prioritised list of medicines for funding is created.
Identify: Pharmac identifies which medicines on the list to take forward.
Negotiate: Pharmac negotiates price with suppliers. The Minister sets a fixed budget, so the agreed price must be affordable.
Provisional agreement: Pharmac and the supplier confirm a provisional agreement.
Consult: We ask New Zealanders what they think.
Consider submissions.
Final changes: Pharmac staff make any changes necessary following the consultation submissions.
Final decision: The Pharmac board or delegate makes a final decision.
Notification: Pharmac notifies the decision to health professionals and the public.
Listed: If approved, the medicine or medical device is listed on the Pharmaceutical Schedule.
Pharmac's Factors for Consideration are used throughout this process.
You can see the status of your application in the Application Tracker
Disclaimer: The process set out in this diagram is intended to be indicative of the process that may follow where a supplier or other applicant wishes a pharmaceutical to be funding on the Pharmaceutical Schedule. Pharmac may, at its discretion, adopt a different process or variations of the process. For example, we decide whether or not it is appropriate to undertake consultation on a case-by-case basis.
Note that implementation of a decision includes both positive and negative funding decisions. These may include notification of a Schedule listing or listing that an application has been declined.
We can't give a definitive timeframe for how long it takes for an application to be lodged until its funded. There are many factors that influence when or if we fund a medicine.
Before we can fund a medicine, we need:
a clear health benefit for New Zealanders
a deal with a medicine supplier
enough money in the budget to fund it this year, and future years
to consult on our proposal with everyone who may be interested.
Once these align, Pharmac works quickly to fund a medicine for New Zealanders.
