Pharmac announces first round of medicine funding decisions following $191m pharmaceutical budget increase

Pharmac today announces the first round of changes to medicines funding following its $191 million pharmaceutical budget increase over the next two years.

The first changes include funding blood and breast cancer medicines, widening funded access to eight multiple sclerosis treatments, and changing funding criteria for HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), making them easier to access.

“These decisions are just the beginning,” says Lisa Williams, Pharmac’s director of operations. “This budget increase will mean many more medicines being progressed for funding over the coming 12 to 24 months.”.

“Pharmac is committed to continuing our work to fund more medicines for more people, delivering the best possible health outcomes for New Zealanders from within our fixed budget,” says Ms Williams. “With the $71 million pharmaceutical budget increase in 2022 and $120 million in 2023, we are working our way through our options for investment list, looking at what agreements we can now make with suppliers.”

All changes announced today will come into effect on 1 July 2022.

Pharmac to fund multiple cancer treatments

Pharmac are listing one new cancer treatment and widening access to two others, giving more treatment options for hundreds of New Zealanders with breast and blood cancers from next month.

“We understand how important having timely access to new cancer medicines is for patients and their families, clinicians, patient advocacy groups, and everyone else affected by cancer in our communities,” says Pharmac’s Director of Operations, Lisa Williams.

Pharmac will be funding trastuzumab emtansine for early breast cancer, gemtuzumab ozogamicin for newly diagnosed acute myeloid leukaemia and widening access to azacitidine for treatment related myelodysplastic syndrome/acute myeloid leukaemia.

Pharmac also consulted on funding widened access to obinutuzumab for people with indolent non-Hodgkin lymphoma, but a final decision on this has been delayed. “We received extensive and useful consultation feedback about the proposed funding criteria for obinutuzumab. We are looking at this feedback in detail, so that we can fully understand how the suggested changes would affect those living with non-Hodgkins lymphoma and those who support them.”    

Te Aho o Te Kahu, the Cancer Control Agency, welcomes the increased access to these cancer medicines for breast and blood cancers.

“We expect to see tangible improvements for people living with cancer across Aotearoa as a result of recent announcements,” says Chief Executive and National Director of Cancer Control, Dr Diana Sarfati. “It is really important equity remains at the centre of funding decisions, and we are encouraged the latest decisions will benefit a diverse range of Kiwis.  We will continue to work with Pharmac to ensure those living with cancer get access to the best and most effective cancer medications.”

Earlier access to multiple sclerosis treatments

Pharmac is widening access to eight medicines currently funded for relapsing remitting multiple sclerosis to enable people to get treatment sooner. From next month New Zealanders who experience one clinical episode of multiple sclerosis and meet clinical criteria will be eligible for funded treatment.

“We know that early intervention is an important step in the management of multiple sclerosis and that it will help to reduce disability,” says Pharmac’s Director of Operations, Lisa Williams. “Historically people have had to wait to have two clinical episodes before they could access funded treatment, so we’re pleased that the budget uplift has enabled us to widen funded access.”

“Pharmac received a huge amount of supportive feedback from the multiple sclerosis community in response to the consultation released in May,” says Ms Williams. “Hearing how medicines impact the lives of New Zealanders is really important in helping us understand the value of the medicines we are proposing for funding.”

Neil Woodhams, President of the Multiple Sclerosis Society of New Zealand believes this decision will have a profound effect on the long-term physical and brain health of those yet to be diagnosed with multiple sclerosis.

“It will have a huge impact on the mental health of those going through diagnosis, reducing the stress and fear of having to wait for a second event, risking unnecessary disability and disease progression,” says Woodhams.

Pharmac confirms HIV treatments will be easier to access

Pharmac are widening funded access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for preventing HIV, benefiting thousands of New Zealanders.

“Pharmac has funded PrEP since 2018 and PEP since 2009, but with quite tight funding restrictions,” says Pharmac’s Director of Operations Lisa Williams. “We are pleased to be able to confirm that the funding criteria for both treatments will be substantially widened to allow more people access to treatment.”

“For PrEP, we are removing the list of behaviours and scenarios which make a person eligible for emtricitabine with tenofovir disoproxil for PrEP. The prescriber will only need to confirm that the patient is HIV negative, and they consider the patient is at elevated risk of HIV exposure and use of PrEP is clinically appropriate,” explains Ms Williams. “We are also extending the funding approval period and removing the criteria that relate to monitoring and testing. We estimate that initially up to an additional 3,500 people per year would be able to access PrEP, increasing to 5,500 people per year in the next five years.”

“For PEP, the funding restrictions will be widened to include more scenarios where a person may be exposed to HIV. We are also widening the types of prescribers who can apply for funded access for antiretrovirals, which will remove barriers and improve access for people at risk. We estimate that 50-100 additional people per year will have access to PEP.”

“Pharmac received a huge amount of feedback and support for the changes from people living with HIV and those who support them, in response to the consultation released in May,” says Ms Williams. “We understand that access to PrEP and PEP has been difficult for some, so we’re pleased to be able to remove barriers to access that are within our control as a result of our recent budget uplift.”

Body Positive’s Executive Director Mark Fisher says, “We applaud the proposed changes to the access of PrEP. Expanding access to all people at risk of acquiring HIV is a significant step toward the elimination of HIV transmission in Aotearoa.”

“With PrEP being funded over four years ago it is a timely shift to normalise its use and remove the resulting PrEP stigma that occurs when these personal details are requested for funding eligibility.”