Decision to fund new medicines for cancer and infections, and to change the funded brand of palbociclib

12 March 2025

Medicines Decision

What we’re doing

We’re pleased to announce a decision to fund four new treatments for cancer and infections through an agreement with Pfizer New Zealand Ltd (Pfizer).

From 1 April 2025 the following treatments will be funded:

inotuzumab ozogamicin (branded as Besponsa) for the treatment of relapsed or refractory B-cell acute lymphoblastic leukaemia (ALL).
crizotinib (branded as Xalkori) for the treatment of ROS1 mutated locally advanced or metastatic non-small cell lung cancer.
ceftazidime with avibactam (branded as Zavicefta) for infections caused by carbapenem resistant enterobacterales (CRE).
axitinib (branded as Inlyta) for the second line treatment of metastatic renal cell carcinoma.

As part of this decision, from 1 July 2025:

a new brand of palbociclib (Palbociclib Pfizer) will be funded and people will need to change to this brand or palbociclib by 1 December 2025.

Brand changes like this for palbociclib allow us to get a better price so we can fund more medicines from our budget.

Also as part of this decision, we will be amending the eligibility criteria for ursodeoxycholic acid to enable access for people with leukaemia/lymphoma receiving medicines with a high risk of sinusoidal obstruction syndrome (which would include inotuzumab ozogamicin).

This decision was subject to a consultation letter dated 19 December 2024. We received feedback from a wide range of stakeholders including consumers, their whānau and families, clinicians and patient support groups. We’re grateful to everyone for their feedback and have made several changes to the original proposal as a result. A summary of the main themes raised for each part of this proposal, and our responses to feedback are at the end of each section.

The Government provided additional funding to Pharmac in June 2024 to fund new medicines and widen access to medicines that are already funded. The funding increase covers medicines for both cancer and non-cancer health conditions. This decision is one of many that we’re working on to put our budget increase into action.

Media release: Funding boost means more medicines for more New Zealanders

Who we think will be interested

People with ALL, lung cancer, kidney cancer, multidrug resistant infections and breast cancer, and their families and caregivers.
Haem-oncologists, oncologists, haematologists, clinical nurse specialists, hospital pharmacists, radiologists, pathologists, primary care practitioners, clinical microbiologists, infectious disease physicians, and other health professionals involved in the care of people with these conditions.
Groups who support and advocate for people with ALL, lung cancer, kidney cancer, multidrug resistant infections and breast cancer.
Health New Zealand | Te Whatu Ora and Te Aho o Te Kahu | The Cancer Control Agency.
Hei Āhuru Mōwai | Māori Cancer Leadership Aotearoa.
Iwi Māori Partnership Boards, Iwi, hapū and whānau.
Hospital pharmacies, community pharmacies and wholesalers
Pharmaceutical suppliers and wholesalers.

Inotuzumab ozogamicin for the treatment of relapsed or refractory acute lymphoblastic leukaemia/lymphoblastic lymphoma

What does this mean for people?

From 1 April 2025, inotuzumab ozogamicin (Besponsa) will be funded for the treatment of relapsed or refractory (including minimal residual disease), CD22-positive, B-cell precursor acute lymphoblastic leukaemia/lymphoma (ALL).

We estimate that around 15 people will receive inotuzumab ozogamicin each year. We hope that by funding this medication these people will benefit from experiencing disease remission and improved health-related quality of life.

We note there will be a reduction in infusion hours needed each year to administer this treatment for eligible people compared to currently funded treatments.

Access to ursodeoxycholic acid will also be widened to include all patients with leukaemia/lymphoma receiving medicine with a high risk of sinusoidal obstruction syndrome(external link), affecting the liver.

Any changes to the original proposal?

We received feedback from clinicians, patient support groups and consumers. We want to thank everyone for their feedback.

Overall, feedback was supportive of the proposal, however responses requested clarification regarding access to blinatumomab though the Named Patient Pharmaceutical Assessment (NPPA) pathway. As a result of this feedback and subsequent clinical advice, we would not be making any changes to access to blinatumomab though the Named Patient Pharmaceutical Assessment (NPPA) pathway as a result of this decision.

We have not made any other changes to inotuzumab ozogamicin criteria in response to consultation feedback, but we have amended the eligibility criteria for ursodeoxycholic acid to include prevention of sinusoidal obstruction syndrome (ie. hepatic veno-occlusive disease) to enable access to it for all people who are at high risk (such as those who receive inotuzumab for ALL). A summary of the feedback and our response to this is detailed below.

Details about our decision

Inotuzumab ozogamicin

From 1 April 2025, inotuzumab ozogamicin would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical	Formulation	Brand	Pack size	Price and subsidy
Inotuzumab ozogamicin	Inj 1 mg, vial	Besponsa	1	$14,457.00
Inotuzumab ozogamicin	Inj 1 mg for ECP	Baxter	1	$14,457.00

A confidential rebate will apply to Besponsa that would reduce its net price. It will have protection from delisting and subsidy reduction until 30 September 2028.

Inotuzumab ozogamicin will be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Initial application – only from a relevant specialist or any relevant practitioner on the recommendation of a relevant specialist. Approvals valid for 4 months for patients meeting the following criteria:

All of the following:

Patient has relapsed or refractory CD22-positive B-cell acute lymphoblastic leukaemia/lymphoma, including minimal residual disease; and
Patient has ECOG performance status of 0-2; and
Either:
1. Both:
  1. Patient has Philadelphia chromosome positive B-Cell ALL; and
  2. Patient has previously received a tyrosine kinase inhibitor; or
2. Patient has received one prior line of treatment involving intensive chemotherapy; and
Treatment is to be administered for a maximum of 3 cycles.

Renewal – only from a relevant specialist or any relevant practitioner on the recommendation of a relevant specialist. Approvals valid for 4 months for patients meeting the following criteria:

All of the following:

Patient is not proceeding to a stem cell transplant; and
Either:
1. Patient has experienced complete disease response; or
2. Patient has experienced complete remission with incomplete haematological recovery; and
Treatment with inotuzumab is to cease after a total duration of 6 cycles.

Similar eligibility criteria will apply in Part II of Section H of the Pharmaceutical Schedule.

Inotuzumab ozogamicin will be listed in Section B of the Pharmaceutical Schedule as a PCT only pharmaceutical. This means that only Health NZ hospitals will be able to make subsidy claims.

Ursodeoxycholic acid

From 1 April 2025, access to ursodeoxycholic acid will be widened to include all people with leukaemia/lymphoma receiving medicines with a high risk of sinusoidal obstruction syndrome (previously termed ‘hepatic veno-occlusive disease’). Inotuzumab ozogamicin is one such high-risk therapy.

Sinusoidal obstruction syndrome | National Library of Medicine website(external link)

Ursodeoxycholic acid will be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Initial application - (prevention of sinusoidal obstruction syndrome) from any relevant practitioner. Approvals valid without further renewal unless notified where the individual has leukaemia/lymphoma and requires prophylaxis for medications/therapies with a high risk of sinusoidal obstruction syndrome.

Similar eligibility criteria will apply in Part II of Section H of the Pharmaceutical Schedule.

Our responses to what you told us:

Theme	Pharmac Comment
Supportive of the proposal, highlighting the improvement in health outcomes that would be expected.	We are pleased to be able to progress a proposal for four new medicines that would improve the health outcomes of New Zealanders.
Requested that blinatumomab remain available through the NPPA pathway for people with measurable residual disease positive disease seeking treatment as a bridge to transplant.	We appreciate this feedback and sought advice from our clinical advisors on the Cancer Treatments Advisory Committee (CTAC). As a result of the feedback and the clinical advice we received, we can confirm that the current access to blinatumomab for the small group of people with B-cell ALL and measurable residual disease seeking treatment as a bridge to transplant will remain unchanged as a result of this decision.
Requested access to blinatumomab for people with CD22 negative B-cell ALL. Noting that, this proposal does not negate the need to fund blinatumomab, which was also identiﬁed in the Te Aho o te Kahu \| Cancer Control Agency’s publication Understanding Blood Cancer Medicine(external link).	We appreciate the desire for blinatumomab to be funded for people with B-cell ALL. We have received a funding application for blinatumomab (Application Tracker)(external link) for the treatment of measurable residual disease for people with B cell ALL. This application was considered by CTAC at its October 2024 meeting, the records of this meeting are in progress. Medsafe is yet to receive an application for this treatment. Until blinatumomab is granted Medsafe approval Pharmac is unable to progress this application any further. However, we can confirm that the application will remain under consideration for funding in the future.
Requested that access to inotuzumab ozogamicin be widened for previously untreated people considered unfit for intensive remission induction chemotherapy.	We acknowledge the recently published INITIAL-1 non-comparative case series (Stelljes et al. J Clin Oncol. 2024;42:273-82(external link)). We note this appears to be for a different patient group to those with relapsed or refractory disease, who will now have funded access. We have not received a funding application for this group who have untreated disease and are considered unfit for intensive induction chemotherapy. We intend to seek further information to inform consideration of funding for this patient group.
Noted that people need to be able to access ursodeoxycholic acid and defibrotide readily should inotuzumab ozogamicin be funded, due to the risk of hepatic veno-occlusive disease (HVOD) / or sinusoidal obstruction syndrome. Also requested that access to ursodeoxycholic acid in this setting include the option for renewal.	We note that defibrotide is already listed on the Hospital Medicines List for moderate or severe sinusoidal obstruction syndrome (ie HVOD). We acknowledge the need for access to ursodeoxycholic acid and sought advice from our advisors on CTAC. Based on the advice received, we have amended the eligibility criteria for ursodeoxycholic acid to include all patients with leukaemia/lymphoma requiring prophylaxis for medications/therapies with a high risk of sinusoidal obstruction syndrome. We have also made initial approvals valid without further renewal so that people will be able to access this when they need it.
Feedback noted the positive funding recommendation from CTAC to fund inotuzumab ozogamicin was made back in November 2021, highlighting the delay in actioning this funding recommendation. Raised concerns for people with blood cancers waiting for other treatments on the Pharmac Options for Investment List to be funded.	We acknowledge this feedback and understand people with blood cancer have significant unmet health needs and want timely access to effective treatments. We also, appreciate that treatments may be funded in other countries prior to their funding in New Zealand. Which proposals Pharmac intends to progress from our OFI list, and when, can change over time due to the dynamic nature of the Options for Investment list. We are always adding new funding applications and updating ranked assessments with new information. As we work within a fixed budget, we are not able to fund all the medicines that we would like to fund, at any given time.

Theme

Pharmac Comment

Supportive of the proposal, highlighting the improvement in health outcomes that would be expected.

We are pleased to be able to progress a proposal for four new medicines that would improve the health outcomes of New Zealanders.

Requested that blinatumomab remain available through the NPPA pathway for people with measurable residual disease positive disease seeking treatment as a bridge to transplant.

We appreciate this feedback and sought advice from our clinical advisors on the Cancer Treatments Advisory Committee (CTAC).

As a result of the feedback and the clinical advice we received, we can confirm that the current access to blinatumomab for the small group of people with B-cell ALL and measurable residual disease seeking treatment as a bridge to transplant will remain unchanged as a result of this decision.

Requested access to blinatumomab for people with CD22 negative B-cell ALL.

Noting that, this proposal does not negate the need to fund blinatumomab, which was also identiﬁed in the Te Aho o te Kahu | Cancer Control Agency’s publication Understanding Blood Cancer Medicine(external link).

We appreciate the desire for blinatumomab to be funded for people with B-cell ALL.

We have received a funding application for blinatumomab (Application Tracker)(external link) for the treatment of measurable residual disease for people with B cell ALL. This application was considered by CTAC at its October 2024 meeting, the records of this meeting are in progress.

Medsafe is yet to receive an application for this treatment. Until blinatumomab is granted Medsafe approval Pharmac is unable to progress this application any further. However, we can confirm that the application will remain under consideration for funding in the future.

Requested that access to inotuzumab ozogamicin be widened for previously untreated people considered unfit for intensive remission induction chemotherapy.

We acknowledge the recently published INITIAL-1 non-comparative case series (Stelljes et al. J Clin Oncol. 2024;42:273-82(external link)). We note this appears to be for a different patient group to those with relapsed or refractory disease, who will now have funded access.

We have not received a funding application for this group who have untreated disease and are considered unfit for intensive induction chemotherapy. We intend to seek further information to inform consideration of funding for this patient group.

Noted that people need to be able to access ursodeoxycholic acid and defibrotide readily should inotuzumab ozogamicin be funded, due to the risk of hepatic veno-occlusive disease (HVOD) / or sinusoidal obstruction syndrome.

Also requested that access to ursodeoxycholic acid in this setting include the option for renewal.

We note that defibrotide is already listed on the Hospital Medicines List for moderate or severe sinusoidal obstruction syndrome (ie HVOD).

We acknowledge the need for access to ursodeoxycholic acid and sought advice from our advisors on CTAC. Based on the advice received, we have amended the eligibility criteria for ursodeoxycholic acid to include all patients with leukaemia/lymphoma requiring prophylaxis for medications/therapies with a high risk of sinusoidal obstruction syndrome. We have also made initial approvals valid without further renewal so that people will be able to access this when they need it.

Feedback noted the positive funding recommendation from CTAC to fund inotuzumab ozogamicin was made back in November 2021, highlighting the delay in actioning this funding recommendation.

Raised concerns for people with blood cancers waiting for other treatments on the Pharmac Options for Investment List to be funded.

We acknowledge this feedback and understand people with blood cancer have significant unmet health needs and want timely access to effective treatments. We also, appreciate that treatments may be funded in other countries prior to their funding in New Zealand.

Which proposals Pharmac intends to progress from our OFI list, and when, can change over time due to the dynamic nature of the Options for Investment list. We are always adding new funding applications and updating ranked assessments with new information. As we work within a fixed budget, we are not able to fund all the medicines that we would like to fund, at any given time.

Crizotinib for advanced ROS1 mutated NSCLC

What does this mean for people?

From 1 April 2025 crizotinib (branded as Xalkori) will be funded for people with advanced ROS1 mutated non-small cell lung cancer (NSCLC).

We estimate that around 20 people will receive crizotinib in the first year of funding, and this will decrease to around 10 people each year after five years of funding.

Crizotinib is an oral treatment. As these people will not be receiving intravenous treatments, such as immune checkpoint inhibitors, we estimate there will be a reduction of around 460 infusion hours in the first year of funding, plateauing around 200 hours each year after five years of funding.

We estimate that there will be around 1000 people requiring testing to establish ROS1 status. Of these, we expect only 1% to 2% to have a ROS1 mutation. We have been informed by Health NZ | Te Whatu Ora that this testing will be available by April.

Both pembrolizumab and atezolizumab have Principal Supply Status until 31 March 2026. As part of this decision, we will amend the criteria to limit access to pembrolizumab and atezolizumab for only those without a ROS1 mutation (in addition to EGFR and ALK mutations) from 1 April 2026.

Any changes to the original proposal?

We received feedback from clinicians, patient support groups, suppliers, and consumers. We want to thank everyone for their feedback. Overall, the feedback was supportive.

After considering feedback and seeking further advice from our expert clinical advisors, we have amended the eligibility criteria for access to this medicine, enabling people with an ECOG score(external link) of 3 to be able to access treatment.

A summary of the feedback received and our response to this is detailed below.

Details about our decision

From 1 April 2025, crizotinib (Xalkori) will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical	Formulation	Brand	Pack size	Price and subsidy
Crizotinib	Cap 200 mg	Xalkori	60	$7,250.00
Crizotinib	Cap 250 mg	Xalkori	60	$7,250.00

A confidential rebate will apply to Xalkori that would reduce its net price. It will have protection from delisting and subsidy reduction until 30 September 2028.

Crizotinib will be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Initial application - from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria:

All of the following:

Patient has locally advanced or metastatic, unresectable, non-squamous non-small cell lung cancer; and
There is documentation confirming that the patient has a ROS1 rearrangement using an appropriate ROS1 test; and
Patient has ECOG performance status 0-3; and
Baseline measurement of overall tumour burden is documented clinically and radiologically.

Renewal - from any relevant practitioner. Approvals valid for 6 months for applications meeting the following criteria:

Both:

Response to treatment has been determined by comparable radiological assessment following the most recent treatment period; and
No evidence of disease progression.

Similar eligibility criteria will apply in Part II of Section H of the Pharmaceutical Schedule.

From 1 April 2026 access to pembrolizumab and atezolizumab will be limited to those without a ROS1 mutation (in addition to EGFR and ALK mutations). This would be outlined in the relevant criteria as follows:

For patients with non-squamous histology there is documentation confirming that the disease does not express activating mutations of EGFR, ROS-1 or ALK tyrosine kinase unless not possible to ascertain

Our response to what you told us

Theme	Pharmac Comment
Supportive of proposal, highlighting the improvement in health outcomes that would be expected.	We are pleased to be able to fund crizotinib and improve health outcomes of New Zealanders with this type of lung cancer.
Considered that people with ECOG 0-3 be eligible for crizotinib therapy.	We appreciate this feedback, and as a result of this and the clinical advice we have received we have amended the originally proposed eligibility criteria for crizotinib (previously ECOG 0-2) to enable access for people with an ECOG score(external link) of 3.
Endorses national access to routine next generation sequencing (NGS) for all patients diagnosed with non-squamous small cell lung cancer.	We have worked closely with Health NZ \| Te Whatu Ora on the testing requirements and impacts of this proposal. Health NZ \| Te Whatu Ora has advised that all regions would have testing capability by 1 April 2025 using FISH and PCR assays. We understand that NGS is under consideration in certain regions.
Associated testing requires an increase in laboratory workload to screen patient samples for “eligibility” for crizotinib.	We appreciate the increase in testing that would occur from the funding of crizotinib. As noted above, we have worked with Health NZ \| Te Whatu Ora on the testing requirements and impacts of this proposal. We have been advised that all regions would have testing capacity available by 1 April 2025.
Would like Pharmac to consider funding Rozlytrek (entrectinib) as an alternative to Xalkori (crizotinib)	We note there is a funding application for entrectinib(external link) that has been assessed and is ranked on our Options for Investment list. We will continue to engage with the supplier regarding the potential progression of entrectinib.

Axitinib for the subsequent treatment of renal cell carcinoma (RCC)

What does this mean for people?

From 1 April 2025 axitinib (branded as Inlyta) will be funded as a second-line treatment (previously treated) for eligible people with locally advanced or metastatic renal cell carcinoma (RCC).

This follows on from recent decisions to fund nivolumab and lenvatinib with everolimus for those with previously treated RCC. These provide additional treatment options for around 90 eligible people a year who progress after their initial treatment.

Based on our recent decision to fund nivolumab in combination with ipilimumab in the first line setting for RCC, we estimate that around 35 people a year will receive axitinib as a second line treatment.

Any changes to the original proposal?

We received feedback from clinicians and consumers. We want to thank everyone for their feedback. Overall, feedback was supportive.

We have not made any changes to this part of the proposal following consultation feedback. A summary of the feedback and our response to this is detailed below.

Details about our decision

From 1 April 2025 axitinib will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical	Formulation	Brand	Pack size	Price and subsidy
Axitinib	Tab 1 mg	Inlyta	28	$536.40
Axitinib	Tab 5 mg	Inlyta	28	$2,682.00

A confidential rebate will apply to Inlyta that would reduce its net price. Inlyta will have protection from delisting and subsidy reduction until 30 September 2028.

Axitinib will be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Initial application - from any relevant practitioner. Approvals valid for 4 months for applications meeting the following criteria:

All of the following:

The patient has metastatic renal cell carcinoma; and
The disease is of predominant clear cell histology; and
The patient has documented disease progression following one previous line of treatment; and
The patient has ECOG performance status 0-2.

Renewal - only from a relevant specialist or any relevant practitioner on the recommendation of a relevant specialist. Approvals valid for 4 months where there is no evidence of disease progression.

Similar eligibility criteria will apply in Part II of Section H of the Pharmaceutical Schedule.

Our response to what you told us

Theme	Pharmac Comment
Supportive of proposal, referencing the improvement in health outcomes that would be expected.	We are pleased to be able to progress funding for axitinib to improve the health outcomes of New Zealanders with kidney cancer.

Ceftazidime with avibactam for drug resistant infections

What will this mean for people?

From 1 April 2025 ceftazidime with avibactam (Zavicefta) will be funded for people with infections caused by carbapenem resistant enterobacterales (CRE) or multi-drug resistant organisms that have very limited remaining treatment options. Ceftazidime with avibactam will only be funded for use in Health NZ | Te Whatu Ora hospitals.

We estimate that around 30 people will benefit from ceftazidime with avibactam as a treatment option for people with CRE infections in the first year of funding, increasing to around 60 people each year after five years of funding.

Any changes to our proposal?

We received feedback from clinicians, patient support groups, suppliers, and consumers. We want to thank everyone for their feedback. Overall, the feedback was supportive.

After considering feedback and seeking further advice from our expert clinical advisors, we have amended the eligibility criteria for access to this medicine as follows:

enable clinicians to initiate treatment on the recommendation of a clinical microbiologists or infectious disease specialist, as not all hospitals will have these specialists on site
enable use in the treatment of other carbapenem resistant microorganisms (eg. Pseudomonas aeruginosa and Stenotrophomonas maltophilia)
enable use if there is reasonable likelihood of a resistant micro-organism based on the assessment of the infectious disease specialist or clinical microbiologist
enable discretion whether ceftazidime with avibactam should be administered in combination with another treatment.

A summary of the feedback and our response to this is detailed below.

Details about our decision

From 1 April 2025, ceftazidime with avibactam (Zavicefta) will be listed in Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical	Formulation	Brand	Pack size	Price
Ceftazidime with avibactam	Inj ceftazidime 2000 mg with avibactam 500 mg	Zavicefta	10	$2,250.00

Zavicefta will have protection from delisting and subsidy reduction until 30 September 2028.

Zavicefta will be listed in Part II of Section H of the Pharmaceutical Schedule subject to the following eligibility criteria:

Restricted

Initiation

Both

Prescribed by, or recommended by a clinical microbiologist or infectious disease specialist, or in accordance with a protocol or guideline that has been endorsed by the Health NZ | Te Whatu Ora Hospital; and
Either:
1. Proven infection with a carbapenem-resistant micro-organism, based on microbiology report; or
2. Probable infection with a carbapenem-resistant micro-organism, based on assessment by a clinical microbiologist or infectious disease specialist.

Our response to what you told us

Theme	Pharmac Comment
Requested that the eligibility criteria be widened to allow the use of ceftazidime with avibactam for multi-drug resistant (MDR) Pseudomonas aeruginosa and Stenotrophomonas maltophilia.	We appreciate this feedback and sought further clinical advice from the Anti-Infective Advisory Committee. Our advisors told us that ceftazidime with avibactam is an effective treatment for these MDR organisms as well. As a result of this feedback and the clinical advice we received, we have amended the proposed eligibility criteria to allow the use of ceftazidime with avibactam for these carbapenem-resistant organisms as well.
Agree that initiation should be on the advice or recommendation of an infectious disease specialist or a clinical microbiologist but consider that any clinician should be able to prescribe it based on this guidance as not all hospitals in the country have onsite specialists.	We appreciate this feedback and sought further clinical advice from the Anti-Infective Advisory Committee. As a result of this feedback and the clinical advice we received, we have amended proposed eligibility to enable initiation to be on the advice or recommendation of an infectious disease specialist or a clinical microbiologist.
Requested that ceftazidime with avibactam be able to be administered without aztreonam, noting that this should be at the discretion of an infectious disease specialist or clinical microbiologist.	We appreciate this feedback and sought further clinical advice from the Anti-Infective Advisory Committee. As a result of this feedback and the clinical advice we received, we removed the “Note” from the proposed eligibility criteria, enabling this flexibility.
Instead of “proven”, criteria should state reasonable likelihood of resistant micro-organism or carbapenem-resistant Enterobacterales based on the assessment of the infectious disease specialist or clinical microbiologist due to turnaround time on microbiology cultures.	We appreciate this feedback and sought clinical advice from the Anti-Infective Advisory Committee. As a result, we have amended proposed eligibility criteria to allow the use of ceftazidime with avibactam for both proven or probable infection with a carbapenem-resistant micro-organism, to enable treatment to be administered in a timely manner.
Include patients in private hospitals meeting the same requirements. Private hospitals are increasingly managing carbapenem-resistant Enterobacterales-colonised patients who received elective or semi urgent surgery as contracted patients from the public health system. Having funded treatment only in Health NZ \| Te Whatu Ora hospitals would make for more patient transfers and costs to public health budgets.	We understand the desire to have these treatments be available in the private setting. However, medicines listed only on the Hospital Medicines List are only funded for use in Health NZ \| Te Whatu Ora hospitals. Provision of publicly funded hospital medicines in private hospitals is a broader issue that cannot be addressed through this proposal. We will ensure this feedback is considered should there be any necessary changes to the current reimbursement model in the future.

Palbociclib brand change

What will this mean for people?

Palbociclib (Ibrance) is supplied by Pfizer and is currently funded for the treatment of advanced hormone-receptor positive (HR-positive), human epidermal growth receptor-2 negative (HER2-negative) breast cancer, subject to eligibility criteria(external link).

Currently around 550 people are receiving palbociclib. As part of this decision:

from 1 April 2025, the net price of palbociclib (Ibrance) will reduce.
from 1 July 2025, a new brand of palbociclib (Palbociclib Pfizer) will be listed
Between 1 July and 1 December 2025, anyone receiving palbociclib will need to change from Ibrance to the Palbociclib Pfizer brand
from 1 December 2025, the Ibrance brand will be delisted from the Pharmaceutical Schedule.

Palbociclib Pfizer is manufactured at the same site to the same specifications, and is packaged similarly, to Ibrance.

Brand changes like this allow us to get a better price and save money so we can fund more medicines from our set budget.

Any changes to our proposal?

We received feedback from clinicians, advocacy groups and consumers. We want to thank everyone for their feedback. Overall, feedback was supportive and provided us a valuable consumer perspective on the lead in time needed to support a brand change. Hearing from consumers helps us to better plan and implement brand changes, we highly value this feedback.

We have not made any other changes to this proposal following consultation feedback. A summary of the feedback and our response to this is detailed below.

A summary of the feedback and our response to this is detailed below.

Details about our decision

From 1 July 2025, palbociclib (Palbociclib Pfizer) will be listed in Section B and Part II of Section H of the Pharmaceutical Schedule at the following price and subsidy (ex-manufacturer, excluding GST):

Chemical	Formulation	Brand	Pack size	Price and subsidy
Palbociclib	Tab 75 mg	Palbociclib Pfizer	21	$1,200.00
Palbociclib	Tab 100 mg	Palbociclib Pfizer	21	$1,200.00
Palbociclib	Tab 125 mg	Palbociclib Pfizer	21	$1,200.00

A confidential rebate will apply to Palbociclib Pfizer, reducing its net price. Palbociclib Pfizer will have protection from delisting and subsidy reduction until 30 November 2028.

As part of this proposal, from 1 April 2025 the net price of Ibrance will reduce by confidential rebate. This would apply until its delisting at the end of the transition period.

From 1 December 2025, the Ibrance brand of palbociclib will be delisted from Section B and Part II of Section H of the Pharmaceutical Schedule.

Our response to what you told us

Theme	Pharmac Comment
Supportive of the proposed brand change, however, key stakeholder groups requested earlier notification in the future so they can prepare their community.	We appreciate the support and acknowledge the need to keep patient support and advocacy groups well informed of any potential changes. Hearing from consumers enables us to better plan and implement brand changes such as these in the future and we highly value this feedback.
Supportive of the proposed brand change and notes that this medicine remains an important option for treating metastatic breast cancer in NZ. Notes that there are emerging indications that Pharmac may receive funding applications for in the future.	We appreciate the support and acknowledge the importance of having palbociclib as a funded treatment option for metastatic breast cancer. We also note that there are other indications for CDK 4/6 inhibitors in the early breast cancer setting, for which we have received funding applications. Ribociclib – early breast cancer \| Application Tracker(external link) Abemaciclib – early breast cancer \| Application Tracker(external link) We have not received a funding application for palbociclib in the early breast cancer setting. We would welcome a funding application for palbociclib for this patient group.
Requests clarification as to when palbociclib capsules will be available for tendering.	The agreement with Pfizer does not prohibit the listing of an alternative brand of palbociclib prior to 1 December 2028. The earliest we would be able to offer Principal Supply Status as the outcome of a competitive process would be from 1 December 2028, and therefore consider that it could be included in the 2027/28 annual Invitation to Tender.

Theme

Pharmac Comment

Supportive of the proposed brand change, however, key stakeholder groups requested earlier notification in the future so they can prepare their community.

We appreciate the support and acknowledge the need to keep patient support and advocacy groups well informed of any potential changes. Hearing from consumers enables us to better plan and implement brand changes such as these in the future and we highly value this feedback.

Supportive of the proposed brand change and notes that this medicine remains an important option for treating metastatic breast cancer in NZ. Notes that there are emerging indications that Pharmac may receive funding applications for in the future.

We appreciate the support and acknowledge the importance of having palbociclib as a funded treatment option for metastatic breast cancer.

We also note that there are other indications for CDK 4/6 inhibitors in the early breast cancer setting, for which we have received funding applications.

Ribociclib – early breast cancer | Application Tracker(external link)

Abemaciclib – early breast cancer | Application Tracker(external link)

We have not received a funding application for palbociclib in the early breast cancer setting. We would welcome a funding application for palbociclib for this patient group.

Requests clarification as to when palbociclib capsules will be available for tendering.

The agreement with Pfizer does not prohibit the listing of an alternative brand of palbociclib prior to 1 December 2028.

The earliest we would be able to offer Principal Supply Status as the outcome of a competitive process would be from 1 December 2028, and therefore consider that it could be included in the 2027/28 annual Invitation to Tender.