Proposal to fund a new type of insulin for the management of diabetes
What we’re proposing
We’re asking for feedback on a proposal to fund a new type of insulin from 1 May 2025. The medicine is a combination of insulin degludec and insulin aspart (brand name Ryzodeg).
As part of this provisional agreement with Novo Nordisk Pharmaceuticals Ltd there would also be a reduction to the confidential net price of insulin aspart (brand name NovoRapid).
Consultation closes at 5 pm, 24 March 2025 and feedback can be emailed to consult@pharmac.govt.nz
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 boost covers medicines for both cancer and non-cancer health conditions. This proposal is one of many that we’re working on to put our budget increase into action.
Questions and answers on Pharmac's budget increase
What would the effect be?
From 1 May 2025, Ryzodeg would be funded with no restrictions for people with type 1 or type 2 diabetes. We anticipate over 13,000 people would receive insulin Ryzodeg in the first full year of funding increasing to 18,000 after five years.
As this medicine is a long acting type of insulin, we expect that the majority of people who use this medicine would be people living with type 2 diabetes.
Who we think will be interested
- People with type 1 and type 2 diabetes, their whānau and caregivers
- Endocrinologists, specialist nurses, general practitioners and other health professionals involved in the care of people with diabetes.
- Groups who advocate for and support people with diabetes
- Health New Zealand | Te Whatu Ora hospitals
- Community pharmacies
- Pharmaceutical suppliers and wholesalers
About diabetes and insulin coformulations
Diabetes is a chronic health condition that affects the body’s ability to make or use insulin. Insulin is a hormone that helps the body turn sugar in the blood (glucose) into energy.
There are two main types of diabetes.
Type 1 diabetes is an autoimmune disease which stops the pancreas making insulin. This affects blood sugar control. The only treatment for type 1 diabetes is the injection of insulin guided by measured blood sugar levels.
Type 2 diabetes is a disease where the body can’t control blood sugar levels properly. This is because cells have become resistant to insulin, or because the body doesn’t produce enough insulin. Type 2 diabetes usually develops in adults, but it is becoming more common in children.
Diabetes can cause serious long-term consequences. These include microvascular complications (including kidney, nerve and eye problems) and macrovascular complications (including heart disease, stroke and peripheral vascular disease).
There are different types of insulin that can be used to manage diabetes and the serious consequences that can be associated with it. Insulin medicines have been developed to effect glucose uptake at different rates compared to natural insulin. For example, rapid-acting insulins work quickly (within minutes) to promote glucose uptake from the blood into cells, while long-acting insulins act over several hours to gradually improve glucose uptake.
Insulin coformulations
Ryzodeg is a type of medicine known as an insulin coformulation. Insulin coformulations combine two different types of insulin in a single injection.
Ryzodeg contains 70% insulin degludec, an ultralong-acting basal insulin, and 30% insulin aspart, a rapid-acting insulin. This can result in a more stable blood sugar level throughout the day and reduce the number of injections required for people with diabetes.
Ryzodeg is Medsafe approved for the treatment of both type 1 and type 2 diabetes.
Ryzodeg Medsafe datasheet | Medsafe website(external link)
Why we’re proposing this
Clinical advice
A funding application for Ryzodeg, was considered by the Diabetes Advisory Committee at its April 2023 meeting. The Diabetes Advisory Committee recommended that it be funded without restriction.
Record of April 2023 meeting of the Diabetes Advisory Committee [PDF, 682 KB]
Our advisors considered that this medicine (insulin degludec with insulin aspart) would benefit people given its extended duration of action compared with other insulins available and that it could reduce the number of insulin injections people take daily and would likely reduce the risk of hypoglycaemia compared to biphasic insulin aspart. They considered that it would be of particular benefit to people with type 2 diabetes who find multiple daily insulin injections unsuitable, those with high-carbohydrate diets, or those who practice fasting.
Changes to availability of insulin medicines
Over the past year Novo Nordisk has discontinued some of its types of insulin. This means stock of these products is no longer available or is expected to be exhausted soon. These include Mixtard 30, PenMix 30 and PenMix 50. We have let people know about this through a medicine notice on our website and contacted stakeholders directly.
Novo Nordisk has also let us know a different type of insulin, biphasic insulin aspart (branded as NovoMix 30) will be discontinued. Supply is expected to end mid-2026. Our advisors have told us Ryzodeg could provide a suitable replacement insulin for people currently using biphasic insulin aspart (branded as NovoMix30).
We will continue to update our website and share information about these discontinuations.
We welcome feedback about the changes to the availability of these medicines through this consultation.
Insulin co-formulation discontinuations: Pharmac medicine notice
Details about our proposal
From 1 May 2025, Ryzodeg would be listed in Section B and Part II of Section H of the Pharmaceutical Schedule without restriction as follows:
|
Chemical |
Formulation |
Brand |
Pack size |
Price and subsidy |
|---|---|---|---|---|
|
Insulin degludec with insulin aspart |
Inj degludec 70% with insulin aspart 30%, 100 u per ml, 3ml |
Ryzodeg Penfill |
5 |
$80.00 |
As with other insulin products, insulin degludec with insulin aspart could be dispensed monthly or 3 monthly if endorsed by the prescriber or pharmacist.
A confidential rebate would apply to Ryzodeg that would reduce the net price to Pharmac. Ryzodeg would also have protection from delisting and subsidy reduction until 30 April 2028.
As a part of the provisional agreement there would be a reduction to the net price of all currently funded presentations of insulin aspart (NovoRapid – Penfill/Flexpen).
NovoRapid would also have protection from delisting and subsidy reduction until 30 April 2028.
To provide feedback
Send us an email by 5 pm, 24 March 2025 to consult@pharmac.govt.nz
All feedback received before the closing date will be considered by Pharmac’s Board (or its delegate) prior to making a decision on this proposal.
Your feedback may be shared
When you give feedback on a consultation, your feedback becomes official information that Pharmac holds. Pharmac has legal responsibilities for how we manage this official information, under laws such as the Official Information Act and Privacy Act.
Pharmac may receive a request from people for official information, which could include your feedback. Legally, Pharmac must consider whether your feedback should be released.
We will consider your views when assessing whether the feedback has to be released. Tell us if there is anything about your feedback that you would prefer wasn’t released.
If your feedback is proposed for release, then Pharmac will contact you, unless there is a legal reason that we can't.
Note that Pharmac collects and holds your information in line with our Privacy Statement.