Proposal to fund continuous glucose monitors, insulin pumps, and insulin pump consumables

Medicines Consultation Closes 26 Apr

What we’re proposing

We want to hear from people about a proposal that would improve the lives of New Zealanders living with type 1 diabetes through provisional agreements with New Zealand Medical and Scientific Ltd (NZMS), Abbott Laboratories NZ Ltd (Abbott) and Pharmaco (N.Z.) Ltd (Pharmaco). Abbott products would be distributed by Mediray in New Zealand.

This proposal would result in funding a range of:

  • continuous glucose monitors (CGMs),
  • two brands of insulin pumps and automated insulin delivery (AID) system algorithms
  • the associated pump consumables

These products would be funded for people with type 1 diabetes and if approved, all people with type 1 diabetes would be eligible for funded access to CGMs.

This proposal would also result in a brand change for those people receiving the MiniMed 770G insulin pump. More about the proposed changes for MiniMed 770G users.

This consultation document contains detailed information about the proposal.

Another summary of this consultation is also available for people with type 1 diabetes, their family and whānau and other interested parties.

  • from 1 July 2024
    • the following products would be funded:
      • Freestyle Libre 2 (CGM)
      • Dexcom G6 (CGM)
      • Dexcom G7 (CGM)
      • Dexcom One Plus (CGM)
      • Tandem t:slim x2 with Basal-IQ or Control-IQ (insulin pump, algorithm, and consumables)
    • the eligibility criteria for insulin pumps and consumables would be simplified; and
    • the maximum funded quantity of insulin pump consumable packs (infusion sets, cartridges and reservoirs) would increase from 13 to 19 packs per year to accommodate those who require more frequent infusion set changes or who have higher insulin requirements.
  • from 1 October 2024 the following products would be funded:
    • an Abbott branded insulin pump compatible CGM (CGM) (Distributed by Mediray)
    • mylife YpsoPump with CamAPS FX (insulin pump, algorithm, and consumables)

For people currently receiving the MiniMed 770G pump

From 1 October 2024 the MiniMed 770G pump would no longer be funded for new patients.

From 1 July 2025, the range of consumables associated with the MiniMed 770G would no longer be funded. There would be a 12 month transition period from the proposed 1 July 2024 implementation date to ensure that there is sufficient time and resource to support this change and allow people to consider which of the funded options are right for them.

Give your feedback

We want to hear what the public think about this proposal and what implementation activities would be required if funding was approved.

Feedback on this consultation will help us to understand if any changes should be made to this proposal. Consultation closes at 4 pm on Friday 26 April. Feedback can be emailed to consult@pharmac.govt.nz.

Why we’re proposing this

There are several suppliers of insulin pumps and CGMs globally. When there are multiple suppliers who could potentially supply a product, Pharmac can use the opportunity to promote competition. 

On 11 July 2023, Pharmac released a Request for Proposals (RFP)(external link) for the supply of insulin pumps, consumables and CGMs. As a result of the RFP, Pharmac has entered into provisional agreements with Abbott, NZMS, and Pharmaco.

We estimate that approximately 18,000 New Zealanders living with type 1 diabetes could benefit from this proposal.

Clinical advice and consumer involvement in procurement process

In April 2023, we asked for advice from the Diabetes Advisory Committee about undertaking a competitive process that could potentially result in a change in funded brands of insulin pumps and consumables, and listing of CGMs on the Pharmaceutical Schedule.

The Committee supported Pharmac progressing a competitive procurement process and emphasised the unmet health need for patients who are currently managing their blood sugar via finger prick testing and multiple daily insulin doses. The Committee highlighted the benefit that continuous glucose monitors would provide all people with type 1 diabetes. The full records of the Committee considerations(external link) are available on the Pharmac website.

Throughout this process, we have collaborated with a range of stakeholders including Diabetes New Zealand, the New Zealand Society for the Study of Diabetes (NZSSD), Health New Zealand – Te Whatu Ora, the Royal New Zealand College of General Practitioners, and other healthcare professionals specialising or interested in diabetes management. This has been integral to the design and implementation of this procurement process.

In September 2023, we convened an external Evaluation Committee to evaluate all the proposals received. This Committee involved healthcare professionals, consumer representatives and educators, and representation from the broader health system to offer a wide range of perspectives. This process provided Pharmac with in-depth advice on the health and suitability benefits of the proposals received.

Funding CGMs for people with type 1 diabetes

A key theme of the advice we have received from our advisors throughout this process is the benefits that CGMs would provide for all people with type 1 diabetes. This proposal would enable Pharmac to fund CGMs for all people with type 1 diabetes.

Patient and clinician choice

A key theme that emerged from this evaluation process was that there is no single product or system that would suit the needs of all people with type 1 diabetes. Some products or systems may be more suitable for some people than others.

This proposal would provide people with type 1 diabetes the flexibility to choose which CGM, insulin pump or AID system is most appropriate for them.

  • People who want a CGM but not an insulin pump would be able to choose from a range of the Freestyle Libre or Dexcom branded CGMs.
  • People who are eligible for an insulin pump would have the choice between two insulin pumps and AID systems: the Tandem t:slim X2 with Control-IQ, or the mylife YpsoPump with CamAPS FX.

From 1 October 2024, both CGM suppliers would have at least one CGM that would be compatible with each of the funded insulin pumps providing people with the choice of which system of products best suits their needs.

What isn’t included in this proposal

This proposal does not include funded access to these products for people with type 2 diabetes.

We understand that there is emerging evidence for the use of these technologies to help people with type 2 diabetes. Māori, Indian, and Pacific people experience poorer health outcomes from type 2 diabetes than other populations. These technologies may help to reduce the inequities in type 2 diabetes. We welcome funding applications to expand the use of these products to people with type 2 diabetes.

We accept applications from anyone, including consumers, clinicians and suppliers. Any application would be considered through our usual process. Please see instructions on how to make an application

Who we think will be interested in this consultation

  • People who have type 1 diabetes and their family, whanau and caregivers
  • Groups who advocate for and support people with type 1 diabetes
  • Endocrinologists, specialist nurses, general practitioners and other health professionals involved in the care of people with type 1 diabetes.
  • Te Whatu Ora hospitals
  • Pharmaceutical and medical device suppliers
  • Wholesalers and other distributors

What would the effect be?

Insulin pumps and insulin pump consumables

Pharmac currently funds two brands of insulin pumps and associated consumables:

  • Tandem t:slim X2 with Basal-IQ supplied by NZMS
  • MiniMed 770G supplied by InterMed Medical Ltd

NZMS and Pharmaco would have dual supply status for insulin pumps and consumables until 30 June 2028. This means they would be the only suppliers whose:

  • insulin pumps would be listed from 1 October 2024
  • insulin pump consumables would be listed from 1 July 2025.

From 1 July 2024

  • the Tandem t:slim X2 insulin pump and associated consumables would continue to be funded with the addition of the VariSoft range of infusion set consumables
  • Amended eligibility criteria for insulin pumps and consumables would apply

From 1 October 2024

  • the mylife YpsoPump insulin pump and associated consumables supplied by Pharmaco would be funded
  • the currently funded MiniMed 770G insulin pump would be delisted from the Pharmaceutical Schedule
  • People using the MiniMed 770G insulin pump and associated consumables would need to change to either the Tandem or YpsoPump insulin pump by 1 July 2025

From 1 July 2025

  • the consumables associated with the MiniMed 770G insulin pump would be delisted from the Pharmaceutical Schedule. This means that there would be 12 months from 1 July 2024 for people to consider which of the funded options are right for them

30 June 2028

  • Dual Supply Status for the Tandem t:slim X2 and mylife YpsoPump insulin pumps ends.

Continuous glucose monitors (CGMs)

From 1 July 2024, Abbott and NZMS would have dual supply status for CGMs until 30 June 2028. This means they would be the only suppliers whose CGMs would be listed on the Pharmaceutical Schedule from 1 July 2024 until 30 June 2028.

From 1 July 2024

The following products would be funded:

  • Freestyle Libre 2 supplied by Abbott and distributed in New Zealand by Mediray
  • Dexcom G6, Dexcom G7 and Dexcom One Plus supplied by NZMS

From 1 October 2024

An Abbott branded insulin pump compatible CGM would also be funded. It would be distributed by Mediray.

At Pharmac’s discretion, Abbott and NZMS would be allowed to introduce newer models of CGMs during the Dual Supply Period as the technology becomes available.

Automated insulin delivery (AID) systems

The Basal-IQ, Control-IQ and CamAPS FX algorithms for use in AID systems would be funded as part of this proposal. These algorithms would be provided at no additional cost to people using the Tandem t:slim X2 and mylife YpsoPump insulin pumps respectively. Basal-IQ would continue to be available at no cost for those that require it.

Alternative Brand Allowance

Our advisors have told us that the proposed products may not be suitable for all people with type 1 diabetes. This proposal allows up to 10% of people to access a different product if their prescriber considers the listed products to be unsuitable for their needs.

We are proposing to manage the funding of alternative brands via Pharmac’s Exceptional Circumstances framework(external link). This would require an individual’s prescriber to demonstrate why the funded brands are not clinically appropriate or if a change to their brand of insulin pump would be clinically inappropriate. Applications would be different to Named Patient Pharmaceutical Applications (NPPA) and we would include more details on how to apply to our Exceptional Circumstances Framework if this proposal is approved.

Our advisors were unable to identify any particular patient groups for whom the proposed products would not be appropriate, however, we welcome any feedback on this.

About type 1 diabetes, CGMs, insulin pumps and AID systems

Type 1 diabetes

Type 1 diabetes is a chronic condition which happens when the pancreas does not produce any insulin – this affects blood sugar control. The only treatment for type 1 diabetes is the injection of insulin guided by blood sugar levels. In New Zealand, people with type 1 diabetes currently measure their blood sugar levels with finger-prick testing through a blood glucose monitor. We understand this is unsuitable and can prevent people from testing their blood sugar levels as often as guidelines recommend.  

It's important for people with type 1 diabetes to regularly check their blood sugar levels. A person with type 1 diabetes may fall into a diabetic coma if their blood sugar levels are too low (hypoglycaemia). If a person’s blood sugar levels are too high (hyperglycaemia), then they may experience a life-threatening condition called diabetic ketoacidosis.

If a person’s blood sugar levels are not controlled over an extended period of time, they are more likely to experience:

  • a heart attack or stroke;
  • damage to their nerves, eyes or kidneys

Although the prevalence of type 1 diabetes is lower in non-European New Zealanders compared to European New Zealanders, the changing demographics of children and youth in New Zealand means that there are increasing numbers of Māori, Pacific, and Asian people with type 1 diabetes. Māori and Pacific people with type 1 diabetes are more likely to experience the complications of diabetes and experience poorer health outcomes compared to non-Māori and non-Pacific people.

Insulin pumps

Insulin pumps are medical devices that continuously deliver a baseline level of insulin. They are an alternative to manually injecting insulin multiple times a day. They also allow for bolus doses of insulin to be delivered around mealtimes.

Insulin pumps consist of the pump itself, a disposable reservoir to store the insulin, and a disposable infusion set (including the tubing that connects the pump to the cannula which is inserted underneath the skin).

Continuous glucose monitors (CGMs)

CGMs consist of a sensor which sits just underneath the skin and a transmitter that regularly sends information to a compatible device (eg. smartphone, tablet or reader device). Some CGMs allow a user’s clinicians, carers, family or friends to “follow” these readings, which can help with diabetes management. In some newer CGM models, the sensor and transmitter are available as a single component.

CGMs measure interstitial sugar levels (the sugar levels in the fluid between cells), which is a good estimate for an individual’s blood sugar levels. CGMs allow people with type 1 diabetes to avoid the pain associated with regular finger-prick testing. Some CGMs can be set up with alarms to alert the user or follower when sugar levels are rising too high or dropping too low. This allows users to respond and manage rapid changes in their sugar levels.  

Some CGMs can also be paired with an insulin pump to create an automated insulin delivery system. Our advisors have told us that insulin pumps are not suitable for everyone but that CGMs would provide benefit to all people with type 1 diabetes whether used in an automated insulin delivery system or as a standalone device.  

Automated insulin delivery (AID) systems

Some insulin pumps can communicate with compatible CGMs and automatically adjust insulin doses based on glucose readings from the CGM. These systems are known as AID or hybrid closed-loop systems.

AID systems have three parts: an insulin pump, a CGM, and an algorithm (software) that allows the insulin pump and CGM to communicate with each other. The algorithm uses the readings from the CGM to increase the insulin dose if blood sugar levels rise too high and to reduce the insulin dose or temporarily pause insulin delivery if blood sugar levels drop too low.

Each AID system uses a different approach to adjusting insulin delivery in response to changing blood glucose, but generally combines pre-defined clinical inputs and machine learning (where the algorithm adapts to a user’s blood sugar profile and habits over time).

Support for people with type 1 diabetes and health care professionals

We’re interested to hear what activities would support the smooth implementation of this proposal.

We want to support equitable access and use of funded insulin pumps, CGMs, and AID systems and are particularly interested to hear feedback on the following areas:

  • what activities would be needed to support current users of the MiniMed 770G insulin pump to move to another funded brand of insulin pump?
  • what we could do to ensure Māori, Pacific peoples, and those with a disability affected by this proposal are supported?
  • what other support would health care professionals need to implement the changes in this proposal?

We will continue to collaborate with consumer groups, other agencies and organisations across the health sector to support implementation of this proposal.

Support for people with type 1 diabetes

We want everyone to have the information they need for a transition between insulin pumps, and the new listing of CGMs. Pharmac would work alongside the suppliers (Abbott (with Mediray), NZMS, and Pharmaco), consumer groups for people with type 1 diabetes, and health care professionals to support these changes.

This would include:

  • educational resources about insulin pumps, CGMs, and AID systems. We would work with suppliers and other stakeholders to develop these resources in a range of languages.
  • information on the Pharmac website, which would include the key dates for this proposal and where to find more information.

We would explore working with educational providers, like Healthify, to update their resources to include information about insulin pumps, CGMs, and AID systems to manage type 1 diabetes.

Support for healthcare professionals

We understand that healthcare professionals would need information to support people using these products. As a part of the implementation of the proposals, suppliers would provide:

  • access to consumer education resources outlined above to provide to individuals at the time of prescribing/dispensing
  • clinical data about safety and efficacy
  • product training from supplier representatives
  • online learning resources including clinical and practical information about the prescribing and use of insulin pumps, CGMs, and AID systems

In addition, Pharmac would work with clinical stakeholders to produce dedicated content on the Pharmac website, including the information above, key dates, and where to find more information.

As part of this proposal, any relevant practitioner would be able to apply for initial and renewal applications for CGMs, enabling onboarding to occur within the primary care setting. However, for initial applications for funded insulin pumps and consumables, individuals would still need to be assessed by a specialist diabetes team in secondary care.

Details about our proposal

Continuous glucose monitors

From 1 July 2024, the Freestyle Libre 2, Dexcom G6, Dexcom G7 and Dexcom One Plus CGMs would be listed in Section B of the Pharmaceutical Schedule as follows:

Chemical

Formulation

Brand (Supplier)

Pack size

Proposed price and subsidy (ex-manufacturer, excluding GST)

Continuous glucose monitor (standalone)

Combined sensor with transmitter device x 1

Freestyle Libre 2 (Abbott)

1

$ 92.83

Continuous glucose monitor (standalone)

Combined sensor with transmitter device x 1

Dexcom One Plus (NZMS)

1

$ 81.00

Continuous glucose monitor (interoperable)

9 x Continuous glucose monitor sensor kit with 1 x transmitter

Dexcom G6 (NZMS)

1

$ 990.00

Continuous glucose monitor (interoperable)

Combined sensor with transmitter device x 1

Dexcom G7 (NZMS)

1

$ 110.00

From 1 October 2024, an Abbott brand of insulin pump compatible CGM would be listed in Section B of the Pharmaceutical Schedule. Further product details would be released closer to the time.

Confidential rebates would apply to Freestyle Libre 2, Dexcom G6, Dexcom G7 and Dexcom One Plus that would reduce the net price.

From 1 July 2024 to 30 June 2028, the suppliers of the Freestyle Libre 2 (Abbott), and the Dexcom G6 and Dexcom One (NZMS) would have dual supply status. This means that Abbott and NZMS would be the two contracted suppliers of CGMs listed on the Pharmaceutical Schedule in New Zealand. Abbott and NZMS together would be guaranteed at least 90% of the funded market, with any alternative brand requiring Pharmac approval through its Exceptional Circumstances pathway. Neither supplier would be guaranteed any individual market share.

This proposal also allows Abbott and NZMS to launch newer models of CGMs throughout the dual supply period, at Pharmac’s discretion.

The Dexcom One Plus and Freestyle Libre 2 would be listed from 1 July 2024 in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Special Authority for Subsidy

Initial application (type 1 diabetes) from any relevant practitioner. Approvals valid for 1 year where the patient has type 1 or pancreatogenic* diabetes.

*This includes permanent neonatal diabetes or patients with insulin deficiency secondary to cystic fibrosis or pancreatectomy.

Renewal – (type 1 diabetes) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

Both:

  1. Patient is continuing to derive benefit according to the treatment plan agreed at induction; and
  2. There is objective evidence of maintained improvement in glycaemic control.

The Dexcom G6 and G7 CGM would be listed in Section B of the Pharmaceutical Schedule from 1 July 2024 subject to the following eligibility criteria:

Special Authority for Subsidy

Initial application (type 1 diabetes) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criterion:

Both:

*This includes permanent neonatal diabetes or patients with insulin deficiency secondary to cystic-fibrosis or pancreatectomy.

Renewal – (type 1 diabetes) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

Both:

  1. Patient is continuing to derive benefit according to the treatment plan agreed at induction; and
  2. There is objective evidence of maintained improvement in glycaemic control.

From 1 October 2024, an Abbott brand of insulin pump compatible CGM would be listed in Section B of the Pharmaceutical Schedule subject to the following eligibility criteria:

Special Authority for Subsidy

Initial application (type 1 diabetes) from any relevant practitioner. Approvals valid for 1 year for applications meeting the following criterion:

Both:

  1. Patient has type 1 or pancreatogenic* diabetes; and
  2. Has a valid Special Authority approval for insulin pump consumables for a compatible insulin pump;

*This includes permanent neonatal diabetes or patients with insulin deficiency secondary to cystic-fibrosis or pancreatectomy.

Renewal – (type 1 diabetes) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

Both:

  1. Patient is continuing to derive benefit according to the treatment plan agreed at induction; and
  2. There is objective evidence of maintained improvement in glycaemic control.

Continuous glucose monitors would be subject to the following restrictions:

a. Only on a prescription

The following maximum funded sensors per patient per year would apply:

CGM

Maximum number
of sensors per year

Freestyle Libre 2

29

Dexcom G6

45

Dexcom G7

40

Dexcom One Plus

40

Abbott and NZMS would supply standalone reader devices free of charge, to people who do not have a smartphone or smart device compatible with their respective CGMs.

Listing of insulin pumps and insulin pump consumables

Tandem t:slim X2 with Basal-IQ insulin pump and consumables

From 1 July 2024, the price of the Tandem t:slim X2 with Basal-IQ and associated consumables supplied by NZMS would be amended in Section B of the Pharmaceutical Schedule as follows.

Chemical

Formulation

Brand

Pack size

Current price and subsidy

Proposed price and subsidy

Insulin pump with algorithm

Min basal rate 0.1 U/h

Tandem t:slim X2 with Basal-IQ

1

$4,500.00

$7,653.00

Insulin pump cartridge

Cartridge 300 U t:lock x 10

Tandem Cartridge

1 OP

$50.00

$86.00

Insulin pump infusion set (teflon cannula, straight insertion with insertion device)

6 mm teflon cannula; straight insertion; insertion device; 110 cm line x 10 with 10 needles

Autosoft 90

1 OP

$140.00

$182.00

Insulin pump infusion set (teflon cannula, straight insertion with insertion device)

6 mm teflon cannula; straight insertion; 60 cm line x 10 with 10 needles

Autosoft 90

1 OP

$140.00

$182.00

Insulin pump infusion set (teflon cannula, straight insertion with insertion device)

9 mm teflon cannula; straight insertion; insertion device; 110 cm line x 10 with 10 needles

Autosoft 90

1 OP

$140.00

$182.00

Insulin pump infusion set (teflon cannula, straight insertion with insertion device)

9 mm teflon cannula; angle insertion; insertion device; 60 cm line x 10 with 10 needles

Autosoft 90

1 OP

$140.00

$182.00

Insulin pump infusion set (teflon cannula, angle insertion with insertion device)

13 mm teflon cannula; angle insertion; insertion device; 110 cm line x 10 with 10 needles

Autosoft 30

1 OP

$140.00

$182.00

Insulin pump infusion set (teflon cannula, angle insertion with insertion device)

13 mm teflon cannula; angle insertion; insertion device; 60 cm line x 10 with 10 needles

Autosoft 30

1 OP

$140.00

$182.00

Insulin pump infusion set (steel cannula, straight insertion)

6 mm steel cannula; straight insertion; 60 cm line x 10 with 10 needles

TruSteel

1 OP

$130.00

$182.00

Insulin pump infusion set (steel cannula, straight insertion)

6 mm steel cannula; straight insertion; 80 cm line x 10 with 10 needles

TruSteel

1 OP

$130.00

$182.00

Insulin pump infusion set (steel cannula, straight insertion)

8 mm steel cannula; straight insertion; 60 cm line x 10 with 10 needles

TruSteel

1 OP

$130.00

$182.00

Insulin pump infusion set (steel cannula, straight insertion)

8 mm steel cannula; straight insertion; 80 cm line x 10 with 10 needles

TruSteel

1 OP

$130.00

$182.00

From 1 July 2024, the Tandem t:slim X2 with Control-IQ insulin pump, and VariSoft infusion set supplied by NZMS would be listed in Section B of the Pharmaceutical Schedule as follows.

Chemical

Formulation

Brand

Pack size

Proposed price and subsidy

Insulin pump with algorithm

Min basal rate 0.1 U/h

Tandem t:slim X2 with Control-IQ

1

$7,653.00

Insulin pump infusion set (teflon cannula, variable insertion)

13 mm teflon cannula; variable insertion; 60 cm line x 10 with 10 needles

VariSoft

1 OP

$182.00

mylife YpsoPump with CamAPS FX insulin pump and consumables

From 1 October 2024, the mylife YpsoPump with CamAPS FX software, and associated consumables, supplied by Pharmaco, would be listed in Section B of the Pharmaceutical Schedule as follows.

Chemical

Formulation

Brand

Pack size

Proposed price and subsidy

Insulin pump with algorithm

Min basal rate 0.02 U/h

mylife YpsoPump with CamAPS FX

1

$8,970.00

Insulin pump glass reservoir

10 x 1.6 ml reservoir for YpsoPump

mylife YpsoPump Reservoir

1 OP

$50.00

Insulin pump infusion set (steel cannula, straight insertion)

5.5 mm steel cannula; straight insertion; 45 cm line x 10 with 10 needles

mylife Orbit micro

1 OP

$136.00

Insulin pump infusion set (steel cannula, straight insertion)

5.5 mm steel needle; straight insertion; 60 cm line x 10 with 10 needles

mylife Orbit micro

1 OP

$136.00

Insulin pump infusion set (steel cannula, straight insertion)

5.5 mm steel needle; straight insertion; 80 cm line x 10 with 10 needles

mylife Orbit micro

1 OP

$136.00

Insulin pump infusion set (steel cannula, straight insertion)

8.5 mm steel needle; straight insertion; 60 cm line x 10 with 10 needles

mylife Orbit micro

1 OP

$136.00

Insulin pump infusion set (steel cannula, straight insertion)

8.5 mm steel needle; straight insertion; 80 cm line x 10 with 10 needles

mylife Orbit micro

1 OP

$136.00

Insulin pump infusion set (teflon cannula, flexible insertion with insertion device)

6 mm teflon cannula; flexible insertion; insertion device; 46 cm line x 10 with 10 needles

mylife Inset soft

1 OP

$157.00

Insulin pump infusion set (teflon cannula, flexible insertion with insertion device)

6 mm teflon cannula; flexible insertion; insertion device; 60 cm line with integrated inserter x 10 with 10 needles

mylife Inset soft

1 OP

$157.00

Insulin pump infusion set (teflon cannula, flexible insertion with insertion device)

6 mm teflon cannula; flexible insertion; insertion device; 80 cm line x 10 with 10 needles

mylife Inset soft

1 OP

$157.00

Insulin pump infusion set (teflon cannula, flexible insertion with insertion device)

9 mm teflon cannula; flexible insertion; insertion device; 60 cm line x 10 with 10 needles

mylife Inset soft

1 OP

$157.00

Insulin pump infusion set (teflon cannula, flexible insertion with insertion device)

9 mm teflon cannula; flexible insertion; insertion device; 80 cm line x 10 with 10 needles

mylife Inset soft

1 OP

$157.00

Confidential rebates would apply to Tandem t:slim X2 with Basal-IQ or Control-IQ and all associated consumables, and the mylife YpsoPump that would reduce the net price.

Insulin pump with algorithm (YpsoPump with CamAPS FX, Tandem t:slim X2 with Basal-IQ, and Tandem t:slim X2 with Control-IQ) would be listed in Section B of the Pharmaceutical Schedule subject to the following restrictions:

Special Authority for Subsidy

Initial application – (type 1 diabetes) from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria:

All of the following:

*This includes permanent neonatal diabetes or patients with insulin deficiency secondary to cystic-fibrosis or pancreatectomy. 

Renewal – (type 1 diabetes) from any relevant practitioner. Approvals valid for 3 months for applications meeting the following criteria:

Both:

  1. Patient is continuing to derive benefit according to the treatment plan agreed at induction; and
  2. There is objective evidence of maintained improvement in glycaemic control.

Insulin pump with algorithm would also be subject to the following restrictions:

a. Maximum of 1 dev per prescription

b. Only on a prescription

c. Maximum of 1 insulin pump with algorithm per patient each four-year period

Note: this restriction would not apply to current users of the MiniMed 770G who would need to change to either the funded mylife YpsoPump or Tandem t:slim X2 pump.

The MiniMed 770G would remain subject to the current insulin pump criteria (SA1603(external link)), until it is delisted on 1 October 2024.

Note: While people could be started on the MiniMed 770G up until 30 September 2024, they would only be able to access funded consumables until 30 June 2025.

The Special Authority criteria for insulin pump consumables would be replaced with the following criteria from 1 July 2024:

Special Authority for Subsidy

Initial application – (type 1 diabetes) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

All of the following:

*This includes permanent neonatal diabetes or patients with insulin deficiency secondary to cystic-fibrosis or pancreatectomy. 

Renewal – (type 1 diabetes) from any relevant practitioner. Approvals valid for 2 years for applications meeting the following criteria:

Both:

  1. Patient is continuing to derive benefit according to the treatment plan agreed at induction; and
  2. There is objective evidence of maintained improvement in glycaemic control.

All insulin pump consumables would also be subject to the following restrictions (deletions in strikethrough and additions in bold):

a) Maximum of 3 5 packs per prescription

b) Only on a prescription

c) Maximum of 13 19 packs of consumables would be funded per year.

To provide feedback

Please send us an email: consult@pharmac.govt.nz by 4 pm on Friday 26 April 2024

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.

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