Decision to enable new people to start treatment with liraglutide for type 2 diabetes

Medicines Decision

What we’re doing

From 1 March 2025, we are removing the restriction, limiting new people from starting treatment with liraglutide (branded as Victoza). This means people with type 2 diabetes who meet eligibility criteria will be able to start treatment.

We have received feedback from the diabetes clinical community that GLP-1 agonists are an important medicine for people with type 2 diabetes and it is a priority that access is restored as soon as possible.

Since 1 May 2024, access to both dulaglutide and liraglutide has been limited to people already taking these medicines. This decision was made to ensure sufficient supply was available for those who had already started treatment due to a worldwide shortage of GLP-1 agonists.

Dulaglutide (Trulicity) and Liraglutide (Victoza): Supply issue

While the supply of these medicines remains an ongoing issue, the supplier of liraglutide, Novo Nordisk, has indicated that supply has stabilised. It has indicated that there is now enough stock available in the country to enable people who have been unable to start treatment since 1 May 2024 to begin treatment. This decision will enable those with the highest unmet health need to begin treatment from 1 March 2025.

As the level of supply for dulaglutide (Trulicity) currently remains uncertain, at this stage the restriction limiting new people from starting this treatment will remain in place at this time. We will continue to review this situation regularly.

More information about the supply issue

What does this mean for people?

Liraglutide is a GLP-1 agonist that is used to treat type 2 diabetes. From 1 March 2025, people with type 2 diabetes who have tried other appropriate treatment options and are at high-risk of experiencing diabetes related complications, will be able to access funded liraglutide.

As supply remains constrained, we are reinstating the same criteria that were in place before access was restricted to only those on treatment from 1 May 2024.

See details about this decision for further details and eligibility criteria.

We continue to work with the suppliers on the supply of GLP-1 agonists. We will update our website with any communications about the supply of these treatments.

Who we think will be interested

  • People with type 2 diabetes and their whānau, families, caregivers and partners.
  • Organisations with an interest in diabetes treatment(s)
  • Healthcare professionals in primary and secondary care who are involved in supporting people with type 2 diabetes
  • Health New Zealand | Te Whatu Ora
  • Pharmaceutical suppliers and wholesalers

Background about this decision

In September 2022, Pharmac was informed by the supplier of dulaglutide (Eli Lilly) of a supply issue affecting dulaglutide. This was due to unanticipated increases in global demand for dulaglutide and other GLP-1 agonists.

Our clinical advisors told us it was important to prioritise available stock for those already taking dulaglutide. They advised that an alternative treatment option should be made available to relieve some pressure on the demand for dulaglutide. Following this, Pharmac funded liraglutide from March 2023.

The global demand for GLP-1 agonists continued to grow rapidly, leading to a global supply shortage of both dulaglutide and liraglutide. In December 2023, access was restricted to those who had tried other treatment options. Unfortunately, this did not alleviate the supply issue and since 1 May 2024, no new people have been able to start treatment with GLP-1 agonists.

We have been working closely with both suppliers to support access to GLP-1 agonists. The supplier of liraglutide has assured us that there is now sufficient stock to enable new people who have tried other appropriate treatment options to start treatment.

Details about this decision

From 1 March 2025, the eligibility criteria for liraglutide will be amended as follows (additions in bold, deletions as strikethrough):

Special Authority for Subsidy

Note: Subsidy for patients with existing approvals prior to 1 May 2024. Approvals valid without further renewal unless notified. No new patients will be granted from 1 May 2024 until further notice.

Initial application from any relevant practitioner. Approvals valid without further renewal unless notified for applications meeting the following criteria:

All of the following:

  1. Patient has type 2 diabetes; and
  2. Target HbA1c (of 53 mmol/mol or less) has not been achieved despite the regular use of ALL of the following funded blood glucose lowering agents for a period of least 6 months, where clinically appropriate: empagliflozin, metformin, and vildagliptin; and
  3. Any of the following:
    1. Patient is Māori or any Pacific ethnicity*; or
    2. Patient has pre-existing cardiovascular disease or risk equivalent (see note a)*; or
    3. Patient has an absolute 5-year cardiovascular disease risk of 15% or greater according to a validated cardiovascular risk assessment calculator*; or
    4. Patient has a high lifetime cardiovascular risk due to being diagnosed with type 2 diabetes during childhood or as a young adult*; or
    5. Patient has diabetic kidney disease (see note b)*.

Notes: * Criteria intended to describe patients at high risk of cardiovascular or renal complications of diabetes.

  1. Pre-existing cardiovascular disease or risk equivalent defined as: prior cardiovascular disease event (i.e. angina, myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, transient ischaemic attack, ischaemic stroke, peripheral vascular disease), congestive heart failure or familial hypercholesterolaemia.
  2. 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 identified.
  3. Funded GLP-1a treatment is not to be given in combination with [empagliflozin / empagliflozin with metformin hydrochloride] unless receiving (empagliflozin or empagliflozin in combination with metformin hydrochloride] for the treatment of heart failure.

The following rule will continue to apply to the funding of liraglutide:

1. Maximum of 1 pack of 3 (6 mg per ml, 3 ml) prefilled pens will be funded per month

Following the decision to fund empagliflozin for the treatment of heart failure with reduced ejection fraction, a note has been added to the eligibility criteria for liraglutide to indicate that access to both treatments can only occur if empagliflozin is being used specifically for the treatment of heart failure.

At this stage there will be no change to the current restrictions for dulaglutide. We will continue to monitor the usage of both medicines and work with the respective suppliers to further secure stock availability and review the eligibility criteria accordingly.

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.