Decision to fund the diabetes treatment liraglutide (Victoza) in response to a dulaglutide supply issue
What we’re doing
In response to a global supply issue for dulaglutide(external link) (brand name Trulicity), a treatment for type 2 diabetes, we are pleased to announce that Pharmac has made a decision to fund liraglutide (brand name Victoza) as an alternative treatment.
Liraglutide is a GLP-1 agonist that is used to treat type 2 diabetes and is from the same class of medicine as dulaglutide. While dulaglutide remains available for people eligible for funding, we have been advised that the current uncertainties around its supply are likely to remain for some time. This is the result of a global increase in demand for GLP-1 agonists.
As a part of a supply agreement with Novo Nordisk New Zealand Limited, liraglutide will be funded for people with type 2 diabetes who meet the current eligibility criteria(external link) for GLP-1 agonists. Initial applications for the funding of liraglutide can be made for the duration of the supply issue impacting dulaglutide. Once the dulaglutide supply issue has resolved, people who have already started treatment on liraglutide will continue to be able to receive funded liraglutide.
This decision will help to ensure that funded GLP-1 agonists will remain available for existing and new people who need them. Like dulaglutide, liraglutide has beneficial cardiovascular effects in people with type 2 diabetes.
Supply of liraglutide will be available from early-to-mid March 2023. From 1 March 2023, liraglutide will be listed on the Pharmaceutical Schedule to enable funded access to occur as soon as supply is available.
Further details about this decision can be found below. We will continue to update our website with any updates regarding the supply of dulaglutide and we continue to work with its supplier, Eli Lilly, on stock availability.
Liraglutide for the treatment of type 2 diabetes mellitus
What does this mean for people?
From 1 March 2023 liraglutide will be funded for people with type 2 diabetes who meet eligibility criteria for GLP-1 agonists.
Our clinical advisors have told us that is it important to secure supply of an alternative GLP-1 receptor agonist for the duration of the supply issue impacting dulaglutide and consider that liraglutide is an appropriate alternative.
Liraglutide (Victoza) is a once daily preparation in a titratable pen. Our advisors have told us that liraglutide, as a titratable pen, would be easy to use for patients who do not require the maximum daily dose (1.8mg), and that the once daily preparation may be easier to tolerate for those patients who have experienced gastrointestinal side effects with other GLP-1 agonists.
Full details of the clinical advice we have received about liraglutide [PDF, 173 KB] is available on our website.
Who we think will be interested
- People with type 2 diabetes and their whānau
- Organisations with an interest in diabetes treatment
- All healthcare professionals in primary and secondary care who are involved in supporting people with type 2 diabetes
- Pharmaceutical suppliers
Details about this decision
Liraglutide will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 March 2023 at the following prices and subsidies (ex-manufacturer, excluding GST):
|
Chemical |
Formulation |
Brand |
Pack size |
Price and subsidy |
|---|---|---|---|---|
|
Liraglutide |
Inj 6 mg per ml, 3 ml prefilled pen |
Victoza |
3 |
$383.72 |
A confidential rebate will apply to liraglutide (Victoza) that will reduce its net price.
Liraglutide will be listed on the Pharmaceutical Schedule for the duration of the supply issue impacting dulaglutide. Liraglutide (Victoza) will have subsidy and delisting protection until June 2024, or until certainty of supply of dulaglutide recommences, whichever occurs first. In line with the clinical advice we have received, once the normal supply of dulaglutide is resumed, liraglutide will only be funded for patients who have started on liraglutide before that time.
Liraglutide will be listed in Section B and Part II of Section H subject to the following eligibility criteria:
Special Authority for Subsidy
Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria:
Either:
- Patient has previously received an initial Special Authority approval for either an SGLT-2 inhibitor or GLP-1 agonist; or
- All of the following:
- Patient has type 2 diabetes; and
- Any of the following:
- Patient is Māori or any Pacific ethnicity*; or
- Patient has pre-existing cardiovascular disease or risk equivalent (see note a)*; or
- Patient has an absolute 5-year cardiovascular disease risk of 15% or greater according to a validated cardiovascular risk assessment calculator*; or
- Patient has a high lifetime cardiovascular risk due to being diagnosed with type 2 diabetes during childhood or as a young adult*; or
- Patient has diabetic kidney disease (see note b)*; and
- Target HbA1c (of 53 mmol/mol or less) has not been achieved despite the regular use of at least one blood-glucose lowering agent eg metformin, vildagliptin, or insulin) for at least 3 months.
Notes: * Criteria intended to describe patients at high risk of cardiovascular or renal complications of diabetes.
- Pre-existing cardiovascular disease or risk equivalent defined as: prior cardiovascular disease event (ie angina, myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, transient ischaemic attack, ischaemic stroke, peripheral vascular disease), congestive heart failure or familial hypercholesterolaemia.
- Diabetic kidney disease defined as: persistent albuminuria (albumin:creatinine ratio greater than or equal to 3 mg/mmol, in at least two out of three samples over a 3-6 month period) and/or eGFR less than 60 mL/min/1.73m2 in the presence of diabetes, without alternative cause
The following rules will apply to the funding of liraglutide:
- Not to be given in combination with a funded SGLT-2 inhibitor or other GLP-1 agonist.
- Maximum of 1 pack of 3 (6 mg per ml, 3 ml) prefilled pens will be funded per month
As liraglutide is administered via a reusable prefilled pen, from 1 March 2023 the restrictions applying to the funded pen needles will be amended to include liraglutide.
If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.