Pharmac asking for feedback on a funding proposal to change the lives of 18,000 New Zealanders with type 1 diabetes
Update 21 May 2024
The consultation period on this proposal has closed. We received a significant amount of feedback and have identified aspects of the proposal that we need to further consider. This means that the timeframe for making CGMs available, if approved by the Pharmac Board, will be pushed back.
We are very grateful for the responses we received from people, as this offers important information and insights for us. Pharmac will host an online information session to talk about the process of developing the funding proposal and provide an update on Pharmac’s next steps.
More information about this update is available on the following pages:
Pharmac – Te Pātaka Whaioranga wants to hear what people think of a funding proposal for continuous glucose monitors (CGMs), insulin pumps, and insulin pump consumables.
“We’ve reached provisional agreements with suppliers to provide funded CGMs, insulin pumps, and insulin pump consumables for people with type 1 diabetes,” says Geraldine MacGibbon, Pharmac’s Director Pharmaceuticals.
“Today, we’ve published a consultation to find out what people think of these proposed products, and how best we roll them out to the community.”
Following the consultation and assessment of the feedback received, a proposal to fund CGMs, insulin pumps and insulin pump consumables will go to Pharmac’s Board for a decision.
If funding is approved, up to 18,000 people with type 1 diabetes would be eligible for funded access to CGMs from 1 July 2024.
MacGibbon says it’s important to note that the agreements Pharmac has reached with suppliers are provisional.
“It’ll be up to Pharmac’s Board to consider the proposal fully, including the feedback and input we’ve had from people with type 1 diabetes, consumer organisations and clinicians,” she says.
“This consultation brings us a step closer to being able to fund CGMs and the related products. We know that having these products would be life-changing for many people and we are making great progress in making them available.
“I know it’s hard to wait as we go through this final stage of the process, but we have to make sure we’re getting it right and that the equipment we fund would provide the best value and health outcomes.”
From 1 July 2024 we’re proposing:
- to fund a range of continuous glucose monitors (CGMs) for everyone with type 1 diabetes, which we expect to benefit up to 18,000 people.
- to fund one brand of insulin pump that could be paired with a funded CGM to create an automated insulin delivery system.
- to simplify the access criteria for insulin pumps.
- to increase the limit of funded packs of insulin pump consumables (including infusion sets, insulin cartridges and insulin reservoirs) to 19 packs per year (an increase from 13 currently).
From 1 October 2024 we’re proposing:
- to fund a second brand of insulin pump that could be paired with a funded CGM to create an automated insulin delivery system.
- to fund an additional CGM compatible with funded insulin pumps that can be used to create an automated insulin delivery system.
- to delist the MiniMed 770G insulin pump from the Pharmaceutical Schedule (more information below).
MacGibbon encourages people with an interest in the proposal to provide feedback by emailing consult@pharmac.govt.nz by 4pm Friday 26 April.
More information:
Possible pump change for people using insulin pumps:
For patients currently receiving funded access to the MiniMed 770G insulin pump, this proposal would require a change of insulin pump. There would be a 12-month transition period from 1 July 2024 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.
What is an automated insulin delivery system?
This proposal includes consideration of an automated insulin delivery (AID) system. AID systems have three parts: an insulin pump, a CGM, and the software that allows the insulin pump and CGM to communicate with each other.
The software 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.
More detail about this procurement process
The procurement of CGMs, alongside insulin pumps and consumables, is a very complex process, and it takes time. It has involved significant clinical and consumer input to understand what the best options are to try to fund these devices for New Zealanders.
In 2023, Pharmac signalled interest in funding CGMs, insulin pumps, and insulin pump consumables. In July 2023, Pharmac released a Request for Proposals (RFP) for the supply of CGMs, insulin pumps and insulin pump consumables. Pharmac received bids from a number of suppliers in response.
At the end of 2023 Pharmac held evaluation committee meetings with consumers, clinicians, and other health sector stakeholders, to evaluate the bids and assess the devices that suppliers put forward. Pharmac used this feedback, along with clinical advice, to help inform which suppliers would be preferred.
Pharmac has since negotiated provisional agreements with the preferred suppliers. We’re now asking people for their feedback on the funding proposal in a consultation.
Consultation:
After we have reached a provisional agreement with a supplier, we ask people what they think of the funding proposal through a consultation. We publish consultations on our website and send them directly to interested stakeholders who have subscribed to receive them.
We normally ask people what they think about our proposal to fund the product(s), the eligibility criteria, the timing, and any support required to implement the decision.
Once we have received feedback, we work with the supplier(s), the health sector, and any other relevant parties, to consider whether changes are appropriate. Funding the proposal is conditional on the feedback we receive and the Board (or its delegate) decision.
During a consultation the funding for the medicine, medical device, vaccine, or related product has not been approved.
Notification
If the funding is approved, there is always a period between notifying the public of the decision and start of funding. The health sector generally needs time to prepare, for example, they need to plan the service and set it up. And the suppliers need to make sure there is enough stock available in New Zealand to meet demand.