Pharmac to fund continuous glucose monitors for thousands of people with type 1 diabetes

29 August 2024

Media release Medicines

YouTube | Adrienne Martin talks about the decision(external link)

Audio file | Adrienne Martin talks about the decision [MP3, 4.8 MB]

Pharmac – Te Pātaka Whaioranga has decided to fund continuous glucose monitors (CGMs), insulin pumps, and insulin pump consumables for people with type 1 diabetes from 1 October 2024.

“It’s been a long wait for people with type 1 diabetes to reach this point. We thank the diabetes community for their patience as we’ve worked through the commercial process and the significant feedback we’ve received along the way,” says Adrienne Martin, Pharmac’s Manager of Pharmaceutical Funding.

“We know this decision will make a real difference to thousands of people and their whānau who face the daily challenges of managing their type 1 diabetes health care, and we are so pleased to provide funding for these life-changing products.”

About 12,000 people with type 1 diabetes are expected to receive CGMs in the first year of funding, rising to more than 18,000 after five years. There are about 4,800 people currently using insulin pumps and Pharmac expects this number to increase to nearly 10,000 over five years.

During consultation, some people asked Pharmac to add Medtronic’s brand of CGMs and insulin pumps to the funding proposal. Martin says that Pharmac will not be including the Medtronic devices in the funded options because doing so would mean restarting the commercial process.

“We have been told by our clinical advisors that the options we have chosen will give people with type 1 diabetes choice and flexibility – and that they will work for most people. After assessing the feedback and weighing up the different factors, we considered that restarting the process would have had a significant impact on people who would benefit from having these devices available now.

“So, we have made some changes to the decision to make it easier for people using the Medtronic pump to change to one of the funded options. I appreciate this will be difficult news for the people who wanted us to add the Medtronic devices and hope that the changes we have made will make a change easier for them.”

From 1 January 2025 the Medtronic MiniMed 770G insulin pump will no longer be funded for people new to insulin pumps and the funding for the consumables will stop on 1 October 2026.

The CEO of Diabetes New Zealand, Heather Verry, welcomed the decision.

“This is a monumental day for the diabetes community. Free access to CGMs and insulin pumps will not only be life changing for thousands of New Zealanders with type 1 diabetes – it will also be lifesaving. We know that for our type 1 community, this is more than just vital technology, it’s a lifeline for better health and greater freedom. Quite simply, it’s a game-changer.”

Endocrinologist and President of the New Zealand Society for the Study of Diabetes, Dr Rosemary Hall, says: “This is the biggest day for people with type 1 diabetes in Aotearoa since the arrival of insulin. Now we have the tools to help people access the highest quality of care. We’re going to see a reduction in diabetes related distress, fewer hospitalisations and medical complications, and huge improvement in our community’s mental wellbeing and quality of life.”

Chair of the National Clinical Network for Children and Young People with Diabetes, Dr Jo McClintock, says: “Our pēpi, tamariki, and rangatahi with type 1 diabetes are unlikely to see anything more important than this decision, in their lifetime. The impact of having this technology available for the parents and loved ones of young people with type 1 diabetes is going to be immeasurable – there will be lots of happy tears within whānau today.”

Karen Reed, who lives with type 1 diabetes, is thrilled to know in one month’s time she’ll be able to access a fully funded, automated insulin delivery system. “I’ve lived with type 1 diabetes for over 40 years. I’ve watched my family overseas using these devices so I’m so excited that I will have access to this life-changing technology too. Thank you to everyone who’s helped us get here.”

More information about this decision and what it means for people

Questions and answers

Q. What is Pharmac funding?

From 1 October 2024 the following CGMs will be funded for the first time:

Dexcom One+ (standalone)
Freestyle Libre 2 (standalone)
Dexcom G6 (works with both funded pumps)
Dexcom G7 (works with the Tandem pump)
Freestyle Libre 3 plus (works with the Ypso pump, and Tandem pump by July 2025)

From 1 October the following insulin pumps will be funded:

Tandem t:slim x2 (with Basal-IQ or Control-IQ automated insulin delivery system software)
mylife YpsoPump (with CamAPS FX automated insulin delivery system software)

Q. What about the Medtronic MiniMed 770G insulin pump?

From 1 January 2025 the Medtronic MiniMed 770G insulin pump will no longer be funded for people new to insulin pumps. From 1 October 2026 the range of consumables associated with the MiniMed 770G insulin pump will no longer be funded.

We originally proposed a transition period of 12 months for people to move off the MiniMed 770G insulin pump but have changed this to 24 months. This gives people more time to make a change to a different insulin pump.

Q. Who will benefit?

We estimate that in the first year of funding around 12,000 people will receive a CGM, increasing to over 18,000 after five years. Anyone with type 1 diabetes and related types of diabetes will be eligible for funding.

There are about 4,800 people currently using insulin pumps, and we expect this will increase to nearly 10,000 over 5 years. People who meet certain criteria will be eligible for funding.

The full eligibility criteria for these products are confirmed in the notification

Q. What do these devices do?

CGMs and insulin pumps are wearable medical devices.

A continuous glucose monitor measures and tracks your blood sugar levels. An insulin pump supplies insulin to support healthy blood sugar levels.

Some of these devices can work together to create an automated delivery system (AID). The AID uses the readings from a CGM to increase your insulin dose if your blood sugar levels rise too high and reduce/pause your insulin dose if blood sugar levels drop too low.

Q. What if the devices aren’t right for me?

Our clinical advisors have told us that the devices we have chosen to fund will work for most people with type 1 diabetes. They’ve also told us that there may be a small group of people that the funded CGMs and insulin pumps will not work for.

There is a pathway for those who are unable to use the funded CGM and insulin pump options. We called this the ‘alternative brand allowance’ and it allows eligible people to access other brands. This is through Pharmac’s Exceptional Circumstances Framework, with criteria informed by our clinical advisors.

To access funding for a different CGM and/or insulin pump, your prescriber would need to tell Pharmac:

the clinical reasons why the funded brands won’t work for you, or
the clinical reason you need to stay on your current brand of CGM or insulin pump.

Your prescriber would need to apply for funding using Pharmac's Exceptional Circumstances Pathway. More details will be added when they are available.

Q. What has gone into this decision, what changes have you made?

This decision followed a public consultation in March 2024. We received a huge amount of support and feedback on our proposal which has been vital to get us to this position.

The feedback we heard, both during consultation and throughout our assessment process, has helped us understand the impact of diabetes on people, their whānau and communities, and on the health and disability system.

Thanks to your feedback, and patience, we have made a number of changes to the original funding proposal. We have:

revised the eligibility criteria to make sure the intended group of people will be able to access the products.
simplified the insulin pump criteria to make sure that people who would benefit from an insulin pump would be able to get one.
increased the amount of funded insulin pump consumables to make sure people have enough supplies.
extended the time for people to move from the previously funded Medtronic MiniMed 770G insulin pump and consumables to one of the funded options, from 12 to 24 months.
streamlined the exceptional circumstances process for people who cannot use the funded CGMs and/or insulin pumps.
strengthened our implementation plan to ensure eligible people and their health care professionals have the resources and support they need.

We have also received assurance that the funding provided by other government agencies for CGMs will continue.

We’ve included the feedback we received and our response in the decision.

A timeline of this procurement process and the steps we have taken to get to this decision is available.

Q. What do people do now?

CGMs, insulin pumps and insulin pump consumables will be funded from 1 October. People can get prepared by familiarising themselves with the products and contacting their clinician.

We know that many of you will want to book appointments with your health practitioners the moment CGMs and insulin pumps are funded and available.

We know that doctors, nurses, and clinical teams will want to get these devices to you as soon as possible. But they are really stretched so you might need to wait a little for an appointment.

Find out more at the CGMs and insulin pumps webpage.