COVID-19: Medicines with amended access criteria
New Zealand's COVID-19 lockdown made it harder for people to see their doctor or go to hospital. In response, PHARMAC made changes to access criteria for some medicines. These changes helped people get the medicines they needed.
Changes were reversed from 1 February 2021
Following consultation in June 2020, PHARMAC signalled the return to normal for some medicines. A number of changes also became permanent.
Nine of the temporary changes are now in place permanently. All these changes will help patients access the medicines they need more easily.
Sacubitril with valsartan
On advice from the health sector, we've provided flexibility for prescribers when an echocardiogram (ECHO) is impractical. Before April 2020, patients were required to have an ECHO before a doctor could prescribe sacubitril.
During the COVID-19 lockdown, we temporarily removed the requirement for an ECHO because it was difficult for patients to get an ECHO.
Pembrolizumab and nivolumab
During the COVID-19 lockdown, we made changes to give prescribers more discretion to decide the medicine dose for their patients. We made this change permanent.
Adalimumab, etanercept, infliximab and rituximab
We have made the special authority criteria clearer that the prescriber can use their discretion when deciding how to evaluate “joint counts”. "Joint counts" are how prescribers assess whether the medicine is improving the patient’s arthritis.
We are maintaining the following changes:
- removed the need for spirometry in patients over 5 years old
- removed some specific requirements about where patients are treated
- relaxed some of the renewal requirements.
Retail Pharmacy – Specialist
The “Retail Pharmacy – Specialist” restriction required a specialist to provide a recommendation every 2 years for some funded medicines. On 1 April 2020, we temporarily removed this restriction from 24 medicines because the COVID-19 lockdown made it difficult to obtain specialist recommendations.
After consultation with the health sector, we are permanently removing the “retail pharmacy -specialist” restriction from all 24 medicines.
You can find the full definition of “Retail Pharmacy – Specialist” in Rule 2.1 of the Schedule.
We consulted on these changes in June. The feedback was broadly supportive of reversing some of the temporary changes and broadly supportive of the timeframe we proposed.
Who to contact
If you have questions about any of these changes, email firstname.lastname@example.org